Total pain and comfort theory: implications in the care to patients in oncology palliative care

ABSTRACT Objective: To reflect on the possible connections between Katharine Kolcaba's Theory of Comfort and Cicely Saunders’s concept of Total Pain and the implications to the care of the oncology palliative care patient. Method: Theoretical reflection based on a literature review carried out in May 2020, in the PubMed and LILACS databases, which sought to answer the question: “Are there any theoretical-conceptual connections between Kolcaba's Theory of Comfort and the concept of Total Pain by Saunders?” Results: The knowledge of the concepts presented allows redirecting the focus of care towards individualized actions to strengthen the patient and his participation in the choices of comfort interventions. Conclusion: Understanding the connections between the concept and theory presented provides the patient in oncology palliative care with individualized and qualified care, focused on the person and not on the disease and can contribute to a greater effectiveness of nursing interventions aimed at the relief of suffering.

ANALISIS KASUS KANKER LIDAH DALAM KONTEKS ASUHAN KEPERAWATAN DENGAN PENDEKATAN COMFORT THEORY MODEL

Prevalensi pasien dengan kanker setiap tahun terus mengalami peningkatan. Kanker lidah merupakan keganasan jenis karsinoma yang mengenai lidah dan hampir 95% berupa karsinoma sel skuamosa. Kanker lidah merupakan kanker dengan progresifitas yang tinggi dengan prognosis jelek sehingga angka kematiannya akibat kanker lidah sangat tinggi serta menimbulkan ketidaknyaman. Kenyamanan merupakan titik pangkal dari berbagai kesembuhan yang akan dicapai oleh klien. Perbaikan kondisi klien tidak akan dicapai jika kebutuhan akan rasa nyaman tidak terpenuhi. Dalam pemberian asuhan keperawatan masalah yang muncul pada kanker lidah adalah nyeri kronis, ketidakseimbangan nutrisi kurang dari kebutuhan tubuh dan ketidakefektifan pola napas. Analisis proses praktik residensi menunjukkan bahwa comfort theory dapat diterapkan pada pasien dengan kasus keganasan dalam pemberian asuhan keperawatan, karena mampu mengidentifikasi ketidaknyaman pasien secara holistik dari aspek fisik, psikospiritual, sosiokultural dan lingkungan

An Art Intervention to Promote Comfort with Veterans in Long Term Care: From Not Significant (Ns) To Significance

Objectives: The study objective was to promote hospitalized veterans’ comfort through an art intervention (AI). Kolcaba’s comfort theory guided the study. Sample and setting: Researchers recruited residents from a Community Living Center (CLC) at Miami Veterans Administration Healthcare System (MVAHS). Nurse researchers and recreational therapists collaborated to deliver the AI. Methods and variables: A quasi-experimental pre-post-test design tested the AI on veteran comfort, depression, and social connectedness. Results: Over six-months, staff identified 81 residents as appropriate to recruit for the study. Fifty-one males and 10 females (ages 26-95) agreed (75% response rate). Due to data collection challenges, residents’ cognition, time constraints, disabilities, and respondent burden, only 18 sets of usable pre-post data were available for analysis (ns results). Implications for nursing: The AI was “significant” to many other participants (n = 160) who were unable or unwilling to complete the research instruments. The most popular AI activity, the monoprint, has been “adopted” by recreational therapists and suggested to enhance communication with oncology patients. Kolcaba’s comfort theory will continue to be promoted during art activities on CLC I and II with extension of art activities to the bedside of CLC III Hospice residents. Keywords: Veterans, Art, Intervention, Comfort, Long Term Care