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Promoting comfort and sleep
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Comfort care involves actions to promote comfort; for some people, total comfort may not be possible, due to the effects of illness or surgery, so the aim is then to promote comfort as far as possible using different approaches. Kolkaba (1995, 2003) has developed theories of comfort and applied these to care in different settings. She asserts that when comfort care is successful, people feel well cared for and comforted because the care was efficient, individualised and holistically targeted to the whole person. Kolkaba (2003) gives examples of comfort existing in three forms: relief, ease and transcendence, for example, (1) the relief of postoperative pain by administering prescribed analgesia, (2) addressing the anxiety of an individual by comforting them to feel content and at ease and (3) supporting an individual to transcend or rise above their challenges, e.g. an individual who is involved in physical therapy or a rehabilitation programme.
Dignity at the end of life
Published in Milika Ruth Matiti, Lesley Baillie, Paula McGee, Dignity in Healthcare, 2020
Kolcaba’s work on the theory of comfort in nursing also provides some insight (Kolcaba, 2009). She suggests that there are three levels of comfort outcomes: to relieve discomfort, to ease discomfort or to transcend discomfort. These goals work well with the concept of suffering at the end of life in that it may be possible to relieve completely some forms of suffering and to ease to some degree other forms of suffering. However, sometimes it is necessary to assist patients and families in transcending, rising above, the suffering and supporting them to find some level of comfort in very discomforting situations. In Kolcaba’s theory, discomfort can be experienced in three domains: physical, psychospiritual and environmental. These are not dissimilar domains to those of Ruijs et al’s (2009) work on suffering or Chochinov et al’s (2002) work on dignity, and confirm the hypothesis that suffering and comfort, and therefore dignity, are all multidimensional, whole-person experiences. Furthermore, these three theoretical views highlight that the relationship between suffering and dignity can be balanced by comfort. Taking these three related concepts together, one can see how comfort measures counteract the effects of suffering and promote dignity.
Four-Handed Method Improves Neonates’ Comfort During Suctioning
Published in Teuku Tahlil, Hajjul Kamil, Asniar, Marthoenis, Challenges in Nursing Education and Research, 2020
This “four-handed” technique for mucus suctioning aims to create comfort, reduce stress, and improve the baby’s self-regulation behaviour and facilitate the work of nurses in suctioning mucus. Comfort is one of the basic needs that must be met to improve health and productivity. This technique was introduced by Cone, Pickler, Grap, Mcgrath, and Wiley (2013) through a Cone dissertation (2011). Four-handed or four-handed technique is the implementation of mucus suctioning carried out by two people, namely the operator and assistant. The operator will focus on the mucus suctioning done, while the assistant will assist the implementation of mucus suctioning such as maintaining the position of the endotracheal tube (ET) tube to stay in position, as well as creating comfort for the baby such as positioning the arms and legs flexing if needed.
COVID-19 vaccination delivery in long-term-care using the CARD (Comfort Ask Relax Distract) system: Mixed methods study of implementation drivers
Published in Canadian Journal of Pain, 2022
Anna Taddio, Katherine S. McGilton, Nancy Zheng, Lydia Yeung, Benoit Lafleur, Jollee S.T. Fung, Noni E. MacDonald, Melissa K. Andrew, Chris P. Verschoor
In 2015, we created a clinical practice guideline2 about reducing immunization stress-related responses (ISRRs) in vaccine recipients, including pain, fear, and fainting.3 Then in 2019, we developed a framework called the CARD (comfort, ask, relax, distract) system that converted the guideline recommendations into actionable steps for health care providers and vaccine clients.4 Within each letter category of the word CARD, there is a group of evidence-based activities that health care providers and individuals can use (or “play”) to minimize ISRR and improve the vaccination experience. Comfort strategies include interventions that encourage serenity and physical ease, such as welcoming clinic settings with comfortable seating. The ask category invites individuals to ask questions about issues that concern them so that they can feel informed and prepared. Relax strategies include interventions that help keep people calm. Finally, distract strategies take an individual’s mind off the procedure. Importantly, vaccine clients are invited to participate in the vaccination process and to select their preferred coping strategies.
A hybrid educational approach to service learning: impact on student attitudes and readiness in working with medically underserved communities
Published in Medical Education Online, 2022
Arvind Suresh, Nakia M. Wighton, Tanya E. Sorensen, Thomas C. Palladino, Roshini C. Pinto-Powell
While student participants reported improved confidence in directing underserved individuals to community resources, there was no corresponding improvement in student comfort discussing SDoH with patients. It is plausible that students entering the curriculum may have already had a high level of comfort in this area based on their prior experiences working with the underserved. Alternatively, students may have also felt that the virtual group discussion setting, especially with the lack of structured one-to-one conversations with community members, was not sufficient to fully prepare them for future patient encounters. Interestingly, our cohort showed a decrease in participant comfort discussing race/ethnicity and cultural background with patients despite showing increased comfort with other SDoH. We hypothesize this may be due to less racial and ethnic diversity in the hybrid cohort, and reflective of increased student awareness of their own knowledge gaps and biases without sufficient experience in addressing these topics with patients. This represents an opportunity for improvement in our curriculum to include additional experiential learning such as simulated patient encounters.
Exploring the comfort of head personal protective equipment for Chinese firefighters: an interview study
Published in International Journal of Occupational Safety and Ergonomics, 2022
Xuanzhi Wang, Jianwu Chen, Ruifeng Yu
Comfort is the comprehensively physical and psychological feeling that individuals produce when interacting with the environment [14]. Direct observations and questionnaire surveys have been conducted on workers related to PPE in automobile packaging plants. The results show that over half of the workers surveyed did not feel comfortable with their protective equipment [2]. Researchers have summarized the comfort dimensions of ordinary clothes as follows: thermophysiological, sensory/tactile, sports and psychological comfort [15]. A study on protective clothing for pregnant women has focused on thermal, sensory and sports comfort [16]. Another study on the comfort of medical staff’s PPE during the COVID-19 pandemic has indicated that comfort issues include visual, communication, hearing and movement difficulties [17]. An effective comfort rating scale (CRS) based on the NASA task load index (NASA-TLX) is used [18], in particular, to evaluate wearable equipment. The comfort of wearable devices in the CRS includes six dimensions: emotion, attachment, harm, perceived change, movement and anxiety. However, no specific research has been conducted on the comfort of firefighters’ HPPE.