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” Integrating Holistic Care and Comfort: A Comparative Analysis of Jean Watson’s Theory of Human Caring and Katharine Kolcaba’s Theory of Comfort in Enhancing Nursing Practice ”
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School
NURS 510
4/7/2024
” Integrating Holistic Care and Comfort: A Comparative Analysis of Jean Watson’s Theory of Human Caring and Katharine Kolcaba’s Theory of Comfort in Enhancing Nursing Practice ”
1. Introduction
Theories of nursing serve as the basic or floor guides that are relied on to direct the practice, education, and research in the nursing profession. Such theories build the logical framework for nursing theorizing that enables us to define, explore, and understand different nursing phenomena and good strategies to achieve desirable results. This information is essential because it is meant to define the nursing discipline, affect the quality of healthcare, and provide effective patient care by giving specific opinions and directions. Nursing theories are often classified into two types: grand theory and middle-range theory. The latter is a complex and ambitious theory that enables the nurse to develop a comprehensive perspective on healthcare at a macro level, and the former is a narrow and straight theory with greater practical value in specific regions of nursing practice.
In this comparison, the selected grand nursing theory is Jean Watson’s Theory of Human Caring, as it primarily encompasses a humanistic approach to nursing together with scientific thought. It is well known that it is more concerned with caring than curing the best way, which, for instance, can make a patient better than a simple medical cure. This theory brings to the forefront one of the facets of the nurse-patient relationship, which is the caregiving, beliefs, and ethics of the nurse, thereby helping through the journey.
A selected middle-range theory is Katharine Kolcaba’s Comfort Theory, which is more relevant in clinical practice. This theory finds roots in the concept that nurses are supposed to spot the direct demands of patients to be at ease. Once the need is seen and satisfied, the health-seeking behavior of patients is boosted. Thereby, the patients tend to enjoy wellbeing and an improved health state.
The goal of this essay is to identify and illuminate the core ideas of the two theories, as well as discuss their use in nursing practice. This discussion is aimed at stressing how each framework makes its subject-matter contribution to the body of knowledge and practice of nursing, thereby closing the gap and emphasizing their importance and significance in clinical practice. This paper intends to define the fundamentals surrounding the grand theory and middle-range theory examined in that process so as to improve the role of nursing theories in enhancing patient care and also advance nursing as a profession.
2. Background of the Theories
The Grand Nursing Theory, “The Theory of Human Caring,” which is a derivative of Jean Watson’s late 1970s. Humanized sentence: The theory was developed specifically in reaction to her observation that the clinical focus of nursing as well as its technical aspects overwhelmed the care of humankind. She stressed that caring is the sense that nursing is about, placing attention on the relationship between the provider and the patient, leading to an improved health state. The introduction of existential and phenomenological philosophy has amended Watson’s theory, adding depth and balancing the role of the nurse-patient relationship. Its development sees the two pillars of the theory—preventive and curative interventions—as a source of strength to achieve a complete package that can create space for unexpected authentic caring moments (McEwan, M., and Wills, E. M. 2021). Watson’s Theory of Human Caring as the main foundation of nursing education, practice, and research provides a holistic view, placing value on the dignity and worthwhile character of living beings.
From the other point of view, Katarina Kolcaba’s Theory of Comfort, a middle-range theory half a decade old, appeared in the 1990s. What the author can do is draw from the knowledge gained from clinical experience and related discomfort nursing literature. In her proposal, she argues that the function of nursing is to address the comfort needs of patients physically and psych spiritually, environmentally and culturally, so that overall health is improved and contentment and efficiency increase. Kolcaba’s Theory of Comfort is only one of the concepts in the Comfort Ology Theory. Nevertheless, it has probably been implemented in theoretically guided interventions that aim to improve the comfort of the patients and the patients’ well-being in many clinical settings. The theory, however, is a subject of empirical testing and refinement, improving its applicability and utility in achieving the required improvement in patient care outcomes. An interesting fact is that its development mirrors a growing realization that comfort is an indispensable part of healing and a nursing role that, similarly, is never static in doing its assigned tasks.
3. Philosophical Underpinnings
Jean Watson’s Theory of Human Caring starts off its supposition with existential and phenomenological philosophies, focusing on the way humans feel for another human and how one deeply and freely chooses to have existential experiences such as birth, sickness, wellness, and mortality. Watson’s theory prioritizes caring as a nursing professional’s moral choice. This connection goes beyond ordinary actions like caring for each other physically. It is about getting along and becoming one (Sharma, M. C., and Kalia, R. 2021). This fundamental ethos directs the way of thinking in nursing, as it wants to emphasize nurture, compassion, and holistic concern for an individual in their totality of needs. The importance of offering individualized care that respects the patient’s dignity and fully acknowledges the person as an individual is argued by the principle. Therefore, healing in all spheres of a patient’s life is promoted by this principle. This idea of humanistic values emphasizes the centrality of the subjective sensation of being ill or being healthy. The honesty and awareness of the action of caring create a unique and individual approach that is based on understanding the peculiarities of every patient.
Katharine Kolcaba’s Theory of Comfort Advocates views comfort as a prerequisite for all patients and a key measure of quality in healthcare. Drawing from nursing, psychology, and environmental theories, Kolcaba conceptualizes comfort as existing in three forms: sound, wings, light, and jubilation, transcending the limits of their physical, psych spiritual, ecological, and cultural environment’s perimeter. This overall concept of comfort demonstrates that the patient is a multidimensional being who requires not only a diversion of pain but also clinical intervention. Kolcaba’s theory with a philosophical basis is profoundly significant in nursing theory because it shifts the focus towards individuals’ comfort needs and suggests distinctive interventions that are tailored to their comfort needs. Therefore, the success of this theory relies mainly on the comfort of patients, up to satisfaction and health outcomes, which indicates that the role of the nurse as a facilitator of comfort can be highlighted even more. On the one hand, the bedroom seemed clean and dry, while on the other hand, the kitchen was soaked in flood water.
4. Major Assumptions, Concepts, and Relationships
Jean Watson’s Theory of Human Caring is built on several key assumptions: that paying attention to the situation means delivering care only between two people; that caring is a combination of curative factors aimed at meeting all human needs; and that true care leads to positive consequences, namely, health improvement or individual or family growth. Besides the Caring Processes, which are the three main ones, the Transpersonal Care Relationship and the Caring Moment/Care Occasion also play a role. This interrelationship emphasizes nursing as a caring science, or curatives factors, that act as their guide to the growth and development of a bond of understanding and empathy with the patient (Lin, Y., et al., 2023). Despite the loss of connections prior to the emotional encounter, the caregiver remains a powerful instrument of faith for the patient. Within these guidelines, caring is regarded as a force that provokes ethical behavior among nurses, going well beyond patient’s physical health to place their general well-being at the center. It points to how the care of human beings is, in fact, holistic, and therefore, any nurse-patient relationship becomes a sort of spiritual, existential text that has the potential to bring healing to the other elements of life involved.
In Katharine Kolcaba’s Theory of Comfort, comfort is a short-term goal of nursing care, whereas it involves the desirability of care that is essential for the maintenance and enhancement of health-seeking behaviors. The fundamental principles consist of health wants, health measures, healthy strategies, and proper dieting. Comfort needs are identified in three types—relief, ease, and transcendence—and across four contexts: mental and psychological, as well as ethnical, ethereal (spiritual), and environmental factors (physical environment). The respite (interventions) are created frontline for these needs, and because of it, patients leave the comfort (transcendent) of discomfort or transcend it. Furthermore, patients actively indulge in health promotion behaviors, which are actions taken by the patient to ensure proper functioning of their body for a long time. These concepts build on each other to show that particular comfort needs recognition and satisfaction, which prove to be key contributors towards healthy well-being. Kolcaba’s theory is based on a proactive patient-centered approach to nursing in which the nurse plays a pivotal role in evaluating the patient`s comfort. The patient is at the center of this comfort model, from which the entire health care process follows, and is therefore a solid basis for wellness and healthcare satisfaction.
5. Clinical Applications, Usefulness, and Value of Extending Nursing Science Testability
Jean Watson’s Theory of Human Caring is one of the theories that have been helpful to nursing science in that it gives a framework that is based on the metrics of human care, which include the holistic and relational elements. Instruction and practice in this area make nurses understand the significance of their actions and behaviors. It results in the establishment of respectful relationships between patients and nurses that can be assessed by looking at the satisfaction, level of engagement, and psychological health of the patients. The theory’s testability relates to the introduction of interventions designed to enhance caring practices, with the results measured either by quantitative and qualitative methods or through direct interactions with the patients (allowing for the validation of the theory).
The theory in Katharine Kolcaba’s Theory of Comfort represents the practical means of evaluating and ensuring comfort position, which is the company element of quality care. However, the effectiveness of the system can be addressed in clinical settlements where the entire care service can be specified in the hierarchy of need groups and corresponding interventions generated. This qualitative research is based on the existence of a comfort questionnaire and other tools that allow measurement of comfort before and after the nursing intervention. Through this mechanism, the theory’s testability is made possible, allowing researchers to determine the efficiency of comfort measures and support some nursing practices in a scientific way, which in turn promotes nursing science.
6. The study compares the application of both theories in nursing practice.
In the real world, Jean Watson’s Theory of Human Caring and Katharine Coleba’s Theory of Comfort aid practical nursing, and although they have different applications and implications, they are both very valuable. Watson’s approach, which basically prioritizes holistic nursing care, accentuates the qualities of nursing tasks (Bagheri, S., et al., 2023). This process promotes an empathetic and compassionate perspective, which allows providers to enhance their care of sick patients holistically. Its merit is in supporting an on-board angle rather than a mechanical attention to details, but it may not be adequate because it has a broad and philosophical essence.
To a different degree, Kolcaba’s comfort theory is both a transparent and practical instrument for comfort to be addressed and measured—anything that can be useful across a wide range of clinical cases. It’s emphasis on comfort as a basic patient requirement brings to the fore simple but effective solutions that can be immediately put into action to redefine the patient care scenario and rejoice. The theory’s ability to be implemented in real-life situations and through observation is a major advantage since it allows myriad treatment options, including evidence-based practice. The type of problem specific to an individual might instead narrow the domain less than the other aspects of patient care, which are broader and more complex, as in the nurse-patient relationship espoused by Watson’s theory.
Both theories contribute uniquely to nursing practice: Watson’s premise is regarding person-centered care, and Kolcaba’s is aimed at practical strategies for adding comfort to patients. As shown by these nursing theories, nursing theories can take many different forms, some of which are subjective and others more factual.
7. Specific Examples of Application in a Clinical Setting
In the hospital setting, Watson’s Theory of Human Care can be realized through the ongoing development and nurturing of the caring environment that turns out to be essential in the healing process. For example, the nurse can show patient-centered care by using Watson’s Curative Factors by way of active listening, proving supportive touch, and establishing a healing environment where patients’ privacy and dignity are respected. With this approach, in particular, the target can be the cases of palliative care that involve more aspects than physical pain: comfort, dignity, and emotional support. By establishing a true and deep connection with the often terminally ill patients and their families, the quality of their lives is improved, which makes both the spiritual and emotional needs of these people satisfied.
It is particularly important that the theories of Katherine Kolcaba (1983), which are centered on care, comfort, and pain management, be used in the post-operative unit. Through identifying the patients’ requirements on a physical, psychological, environmental, and sociocultural level, nurses can shape treatments addressing the exact discomforts. Several examples signify this, like offering appropriate pain management, creating a quiet and calming environment in the in the room and among caregiving staff, providing reassurance to reduce anxiety, providing information to reduce anxiety, and simultaneously respecting cultural values in care routines. Such targeted comfort measures are so critical; they can really improve patients’ overall comfort and speed up the recovery, as well as their happiness and their positive attitude towards the care received, and thus demonstrate the theory’s practical application in improving patient outcomes.
8. Parsimony
Katharine Kolcaba’s Theory of Comfort, including the criterion-focused comfort concept in an explicitly differentiated way, is certainly a distinctive approach that is the exact opposite of Watson’s extensive nurse’s theory of human caring. The Theory of Comfort provides easy-to-follow and applicable strategies for addressing the needs of patients, and thanks to that, it can be used anywhere, making it applicable not only for the most common types of pain but also for others such as nausea and anxiety. This is antithetical to the approach of Watson, who, while his theory is complex and multifaceted, focuses on the moral and philosophical foundations of care. Therefore, this approach is not as simple as Watson’s, as its metrics and operations are more obscure, making it less parsimonious. However, it is universal for nursing, as it provides a deeper conceptual framework for nursing practice.
9. Conclusion
Such a comparison is unique in that it brings out the aspects of accompaniment in Jean Watson’s Theory of Human Caring and Katharine Kolcaba’s Comfort Theory, which should be emphasized in nursing practice (Almukhaini, S. J., et al. 2020). What Watson’s theory does is bring a humanistic approach to the nurse-patient relationship through its focus on experience-oriented, empathetic care on the one hand, and Kolcaba’s theory presents a concrete and measurable framework to facilitate patient comfort on the other. On the one hand, Watson’s method generates a deep-flowing moral connection with patients, but on the other hand, Kolcaba’s approach contributes towards making it more specific and concise, hence more parsimonious and easily applied in a multidisciplinary realm. The integration of these models is likely to greatly enhance patient care by solving problems concerning both the humane and the practical sides of nursing. Correspondingly, the impact of these disclosures on clinical nursing practice is mind-blowing, and it is desirable to achieve a balance between empathetic care and empirically-based comfort strategies to be the beacon under which future nursing research will shed light upon the revelation of how the combination of these approaches would be the best ways to manage patient outcomes in different healthcare environments.
References
McEwan, M., & Wills, E. M. (2021). Theoretical basis for nursing. Lippincott Williams & Wilkins.
Sharma, M. C., & Kalia, R. (2021). Testing the Katharine Kolcaba theory of comfort: effectiveness of integrative comfort care interventions on discomfort experienced by children (aged 5–10) during the postoperative period. Journal of Pediatric Surgical Nursing, 10(4), 168–175.
Lin, Y., Zhou, Y., & Chen, C. (2023). Interventions and practices using the Comfort Theory of Kolcaba to promote adults’ comfort: an evidence and gap map protocol of international effectiveness studies. Systematic Reviews, 12(1), 33.
Bagheri, S., Zarshenas, L., Rakhshan, M., Sharif, F., Sarani, E. M., Shirazi, Z. H., & Sitzman, K. (2023). Impact of Watson’s human-care-based health promotion program on caregivers of individuals with schizophrenia. BMC health services research, 23(1), 711.
Almukhaini, S. J., Goldberg, L., & Watson, J. (2020). Embodying caring science as an Islamic philosophy of care: Implications for nursing practice. Advances in Nursing Science, 43(1), 62–74.
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