Michellednursing.files.wordpress.com



Comparison of Imogene King’s Theory of Goal Attainment and Katharine Kolcaba’s Theory of ComfortMichelle De WeerdAthabasca University – 3405195AbstractKing’s theory of goal attainment and Kolcaba’s theory of comfort both have had an impact on current nursing practice. Nurses can utilize the concepts of these theories in responding to nursing scenarios within their practice, such as understanding how to respond to a patient recently diagnosed with lymphoma in the emergency department. While there are several similar concepts between the theories, such as patient-centered care, therapeutic relationships, and involvement of family, that are applicable to this scenario, it is important to note that differences are present as well. Furthermore, after discussing the scenario, the theories can coincide within each other because the nurses and patient’s first goal is to achieve comfort. Comparison of Imogene King’s Theory of Goal attainment and Katharine Kolcaba’s Theory of Comfort Numerous nursing theories have been developed, analyzed, and applied to nursing practice over time. King (1997) suggests that theories help us to explain, understand, and describe experiences within our world. Nursing theories then have been established to help nurses understand and direct their practice. Imogene King developed the theory of goal attainment and Katherine Kolcaba introduced the theory of comfort to help nurses understand their actions and responses within their own practice. Utilizing these two nursing theories, this paper will address how a nurse may respond to a patient diagnosed with lymphoma. Imogene King – Goal Attainment TheoryAccording to Imogene King, nurses’ goal is to help patients maintain health, regain their health back, and reach their health goals (King, 2005). “Nursing acts are goal directed toward health and can be observed as a process of interactions with the family, the physician, and other persons and events” (King, 1999, p. 293) in determining these health goals. King’s theory consists of three systems – personal, interpersonal, and social systems. The personal system refers to the individual, the interpersonal system refers to individuals interacting with one another; for example, a nurse interacting with their patient, and the social system refers to groups of people within a community (Williams, 2001). “When transactions are made between nurses, patients, and families, one can begin to predict that goals will be attained” (King, 1997, p. 181). Furthermore, King’s theory recognizes that the nursing process involves the initial assessment, nursing diagnosis, planning, implementations, and evaluations (Petiprin, 2016) in understanding, developing, and helping patients achieve their health goals. Katharine Kolcaba – Theory of Comfort Care “Comfort has been called a distinguishing characteristic of the nursing profession” (Kolcaba, 1994, p. 1882). Katharine Kolcaba started to introduce her theory of comfort care in the 1990s, as her understanding of comfort involved patient’s needs for relief and ease when facing stressful healthcare situations (Kolcaba, 1994). The assumptions of her theory are that human beings strive to meet or have their basic comfort needs met and comfort is a desirable holistic outcome within the discipline of nursing (Kolcaba, 1994). Kolcaba’s theory of comfort can be defined within three states and four contexts. These three states include relief which refers to the experience of having a specific need met, ease which refers to a state of contentment, and transcendence which is a state when ordinary power is enhanced (Kolcaba, 1994). The four areas of context in which comfort can occur are physical, psychospiritual, social, and environmental (Kolcaba, 1994). Practice ScenarioRecently, an elderly man presented to the emergency department with a complaint of generalized abdominal pain, nausea, and decreased appetite for several days. The patient had previously made several visits to the emergency department with similar complaints. Each time he had bloodwork completed which looked okay so the patient was always sent home and instructed to return if the pain persisted. Again, this patient presented to the emergency department with diffuse abdominal pain and decreased appetite. Bloodwork was ordered which was slightly abnormal, so the patient was scheduled to go for a computed tomography (CT) scan that same night. The CT results came back showing lymphoma in the abdomen. The patient was then informed of his diagnosis by the physician. Application of Theories Both King’s and Kolcaba’s theories can be applied to the nursing scenario described above. After this patient received a diagnosis of lymphoma, the main nursing goal is to provide comfort to the patient receiving this news. Once the nurse provides comfort, both the nurse and patient can begin to develop goals for the patient’s care. SimilaritiesWithin this scenario, patient-centered care is essential. This patient just received a diagnosis of lymphoma and to understand his thoughts and feelings it is imperative to provide patient centered care. The theory of goal attainment and comfort both focus on the patient. The comfort theory focuses on nurses identifying patients’ comfort needs (Kolcaba, 2001). This patient needs relief from his pain, as well as psychospiritual comfort in understanding the meaning of this illness. The goal attainment theory also places patients at the center as; “patients have the right to participate in decisions that influence their life and their health” (King, 1991, p. 21). This patient must know his diagnosis and understand the need for a referral to the cancer center. Secondly, the relationship between the nurse and patient is crucial in both theories and within this practice scenario. The nurse needs to be able to develop a relationship with the patient and his wife in order to understand how to provide comfort. Through developing a relationship, this nurse will understand that comfort within the psychospiritual, physical, and social realms are important and includes providing pain relief for his abdominal pain and helping the patient and his wife understand the diagnosis and next treatment steps (Kolcaba, 1994). The nurse responding to this practice scenario, after having developed a therapeutic relationship, was able to spend some time talking about the referral to the cancer clinic, how the patient understood the diagnosis, and his goals for treatment. Furthermore, both theories include the patient’s family. In the practice scenario, the nurse also needs to include the patient’s wife in both the provision of comfort and goal setting. The nurse needs to address the psychospiritual context of comfort with his wife because the diagnosis also significantly impacts her. Goal attainment also looks at involving the patient’s family because the wife’s health goals for the patient, we assume, are similar to the patient’s own goals (King, 1997). Lastly, in responding to this scenario, both theories are intertwined as one. Addressing the comfort needs of the patient both in a physical and psychospiritual context is the first goal of attainment. “If enhanced comfort is achieved, patients are strengthened to engage in health-seeking behaviours” (Kolcaba, 2001, p. 90). Once a sense of comfort is achieved, the patient can come to understand the meaning of the illness and start to investigate, with the help of the nurse, his perceptions of his health goals. DifferencesThere are also some differences between these two theories in relation to this nursing scenario. Imogene King’s theory of goal attainment does not necessarily address the feelings, or comfort of the patient. Her theory suggests that nursing care’s goal is to help individuals maintain or regain health (King, 2005). Contrastingly, Katharine Kolcaba’s theory of comfort considers how the patient is feeling and making sure a sense of ease and physical comfort are met (Kolcaba, 1994). Secondly, Kolcaba’s theory is heavily dependent on the holistic nature of nursing whereas King’s theory is not. “Comfort is a desirable holistic outcome that is relevant to the discipline of nursing” (Kolcaba 2001, p. 90). Within this practice scenario, it is important to address the diagnosis of lymphoma from a holistic nature, in order to provide the care and comfort this patient and his wife need as they respond to this complex diagnosis. Lastly, Kolcaba’s theory considers the comfort and satisfaction of the nurse as well. In this nursing scenario, this nurse gains satisfaction when able to address the comfort needs of the patient and his wife (Kolcaba, 1995). ConclusionIn conclusion, one can use both theories to address the practice scenario outlined above. Imogene King’s theory and Katharine Kolcaba’s theory address different aspects of this nursing scenario. Both theories address the patient as the center of care, include family members, and focus on the nurse-patient relationship. Once the comfort of the patient is addressed and achieved, goal setting and attainment can take place. Furthermore, it is important to note there are several differences between the theories. Kolcaba’s theory is more holistic in nature whereas King’s theory of goal attainment does not necessarily address nursing in a holistic manner. Overall, both theories can play an important role in how a nurse responds to this patient who has just received a diagnosis of lymphoma. ReferencesKing,I. M. (1999). A theory of goal attainment philosophical and ethical implications. Nursing Science Quarterly, 12(4), 292-296. Retrieved from: , I. M., & Sieloff, C. L., & Frey, M., & Killeen, M. (2005). Imogene M King’s Theory of Goal Attainment. Nursing Theories and Nursing Practice (pp. 235-267). Retrieved from: , I. M. (1991). King’s theory of goal attainment. Nursing Science Quarterly, 5(1), 19-25. doi: 10.1177/089431849200500107.King, I. M. (1997). King’s theory of goal attainment in practice. Nursing Science Quarterly, 10(4). Retrieved from: Kolcaba, K. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing (1994), 19, 1178-1184. doi: 10.1111/j.1365-2648.1994.tb01202.xKolcaba, K. (2001). Evolution of the Mid Range Theory of Comfort for Outcomes Research. Nursing Outlook (2001), 49(2), 86-92. doi: 10.1067/mno.2001.110268.Kolcaba, K. Y. (1995). The art of comfort care. Journal of Nursing Scholarship, 27(4), 2987-289. Retrieved from: Petiprin, A. (2016). Imogene King – Nursing Theorist. Retrieved from: , L. A. (2001). Imogene Kings Interacting systems theory: application in emergency and rural nursing. Online Journal of Rural Nursing and Health care, (2)1, 25-30. Retrieved from: ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download