This paper endeavors to critique Katherine Kolcaba's comfort theory using the criterion-based (C-BaC) model. According to Parker and Smith (2010), the theory explains comfort in three dissimilar forms that include transcendence, relief, and ease. The theorist describes holistic comfort as the instant experience of strengthening through having the needs for transcendence, relief and ease fulfilled in four perspectives. These perspectives include physical, environmental, socio-cultural and psycho-spiritual.
Critiquing the Kolcaba's Comfort Theory Using the Criterion-Based (C-Bac) Model
According to Johnson and Webber (2010), a criterion-based critique model denotes an illustration of a cluster of standards that may be utilized in examining selected elements of nursing theory. A criterion-based model holds definitive standards which direct judgment formation. In this perspective, C-BaC limits the elements to the eight components shown below.
The theorys meaning should be clear and comprehensible.
Boundaries are compatible with nursing practice.
Language is explicable and consists of minimum jargon.
Key concepts must be identified, as well as defined.
Concepts prompt the development of propositions.
Assumptions and variables facilitate the understanding and interpretation of propositions.
Theoretical understanding facilitates in explaining and predicting phenomena.
Theory has an influence on nursing practice.
In order to understand the meaning of the comfort theory as it concerns nursing, it is imperative to split and describe it in three parts. According to March and McCormack (2009), the first part of the theory states that nurses ought to appraise the holistic comfort requirements of patients in every setting. The second part states that improved comfort fortifies patients to knowingly or sub-consciously embark on actions that move them in the direction of a situation of well-being. The actions are referred to as health-seeking actions and present rationale for executing comfort interventions. The third part of the comfort theory entails institutional integrity. health-seeking actions in institutional integrity may be is described as the status or quality of health care organizations in regard to being comprehensive, sound, decent, ethical, as well as professional health care providers.
It is essential to note that the universal understanding of nursing fits within the definition of this theory. According to Kolcaba and Steiner (2000), in the nursing practice, comfort is considered to be a positive outcome which is related to a rise in health seeking actions, as well as positive institutional results. Nurses are continuously employing the three forms of comfort mechanisms, in addition to trying to assist patients move to the transcendence stage without essentially knowing it. The comfort theory befits patients, as well as families in diverse settings. In applying the comfort theory, nurses efficiently consider, as well as minister in a compassionate manner to the distinctiveness and intricacy of every patient within the perspective of the family structure. This includes infants, children, adolescents, adults, aged, as well as the dying. Consequently, the theory presents an effective way to mold care, as well as communicate to interdisciplinary teams the interventions that are effective. As a result, the boundaries in the comfort theory are consistent with the contemporary and upcoming nursing practice.
The language used in Kolcaba's comfort theory is understandable and comprises of minimum jargon. The clear language used in this theory makes the theorys subject matter understandable, and unproblematic to interpret.
In exploring the key concepts used in the theory, it is imperative to note that the Kolcabas comfort theory was inspired by her opinion that holism is anchored in a persons wholeness. This includes a persons body, mind, as well as spirit interrelating in intricate ways with compound ecologies. According to Kolcaba and Steiner (2000), holistic comfort merges the concepts of comfort and holism. In this theory, the notion of holism is anchored in the principle of considering the whole, for instance a community or an individual and as a result cannot be lessened to the summation of its parts. Consequently, this means that holistic comfort ought to be considered as being situational and consequently construed as a whole. Informal and formal definitions of comfort and holism address the intricacies of holistic comfort, mainly when its implication is examined with regard to nursing students as well as recently practicing nurses. In regard to the concepts of relief, transcendence and ease, these concepts may be understood as relief and ease attributable to freedom from coercion and apprehension. Such freedom eventually cultivates transcendence.
The concepts introduced in the Kolcabas comfort theory prompt the development of the theorys propositions. One proposition is that holistic comfort exceeds the summation of its parts which are ease, relief and transcendence. According to March and McCormack (2009), comfort is not at all times unambiguous, but is, rather, embedded in the foundation of the framework under consideration. In order for a nursing practitioner to offer authentic comfort, it is imperative for the nurse to know the significance of comfort for a specific person, culture, or group. To be capable of applying the concept of comfort into practice, the nurse first requires learning about it within the perspective of a nursing theory.
Comprehensible assumptions and variables are essential in facilitating the understanding and interpretation of propositions. In this context, the intervening variables entail those aspects that are not expected to vary and over which the nurse hold little control. March and McCormack (2009) assert that, the proposition that holistic comfort exceeds the summation of its parts which are ease, relief and transcendence is attainable when nurses execute a diversity of interventions towards meeting the patients needs and determining or appraising the comfort levels of patients, prior to, and subsequent to, those interventions. It is important to note that this also includes negative and positive intervening patient variables where the nurse has modest control, but have substantial effect on the accomplishment of comfort interventions. These variables may include the patients cognitive condition, financial state, level of social support, as well as prognosis.
While theoretical understanding facilitates in explaining and predicting phenomena, a nurse may find it complex to put into practice the holistic comfort concept as a result of its abstract disposition. Kolcaba (2003) argues that, this corresponds to the complexity in determining holistic comfort in nursing instruction. Consequently, it is important to develop quantifying tools that would facilitate in measurement, planning, as well as evaluation of the efficacy of holistic comfort. A taxonomic structure that was developed by Kolcaba for appraisal, of patient comfort proves useful in this regard.
In determining the influence of the Kolcabas comfort theory on nursing practice, it is imperative to note that the theory presents a framework for nursing practice guidelines. According to March and McCormack (2009) the guidelines stipulate that in order to provide holistic care that is oriented towards comfort, it is necessary that the provision be unambiguous and well- documented. In addition, the framework encourages administrators to ensure that the requisite institutional commitment, as well as support is nurtured in order that an environment of comfort in health care institutions can be achieved.
The theoretical structure of the comfort theory holds valid potential towards guiding the work, as well as thinking of healthcare providers. This theory can be utilized in nursing instruction or comforting learners in an educational setting. The Kolcabas comfort theory does not essentially have to entail only health care settings. The theory is implementable in diverse fields by a healthcare team.
Johnson, B.M, & Webber, P.B. (2010). An Introduction to Theory and Reasoning in Nursing (3rd ed.). New York, NY: Lippincott Williams & Wilkins.
Kolcaba, K., & Steiner, R. (2000). Empirical Evidence for the Nature of Holistic Comfort. Journal of Holistic Nursing, 18, 46-62.
Kolcaba, K. (2003). Comfort Theory and Practice: A Vision for Holistic Health Care and Research. New York, Springer Publishing Co.
March. A. & McCormack. D. (2009). Nursing Theory-Directed Healthcare: Modifying Kolcaba's Comfort Theory as an Institution-Wide Approach. Holistic Nursing Practice, 23, 75-80.
Parker, M.E., & Smith, M.C. (2010). Nursing Theories and Nursing Practice. Philadelphia: F. A. Davis Company.
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