The Effects of Guided Imagery on Comfort in Palliative Care.

Guided imagery (GI) is a nonpharmacological intervention that is increasingly implemented in different clinical contexts. However, there have been no studies on the effect of GI on the comfort of inpatients of palliative care (PC) units. Therefore, the aim of this study was to evaluate the effects of GI on the comfort of patients in PC. A 1-group, pretest-posttest, pre-experimental design was used to measure differences in heart rate, respiratory rate, pain, and comfort in patients (n = 26) before and after a 2-session GI program. The intervention featuring GI increased comfort, measured by an Abbreviated Holistic Comfort Scale and the visual analog comfort scale (P < .001), and decreased heart rate (P < .001), respiratory rate (P < .001), and pain, as measured by the (numerical) visual analog pain scale (P < .001). This study demonstrates that the use of an intervention featuring GI increases the comfort of oncology patients admitted to a PC unit. The use of GI by nurses is inexpensive, straightforward to implement, and readily available and may result in the provision of comfort care.

Comfort and Fluid Retention in Adult Patients Receiving Hemodialysis.

Successful hemodialysis treatments for patients with renal failure depend on patient adherence to prescribed treatment regimens. Lack of adherence may contribute to patient discomfort between hemodialysis treatments. This article reports a descriptive, correlational feasibility study that utilized Kolcaba's Comfort Theory as a framework. The purpose of the study was to determine a potential relationship between comfort and fluid retention (a proxy for adherence) in adults with end stage renal disease receiving hemodialysis. A convenience sample of 51 patients receiving hemodialysis was studied. Comparisons of patient weight gain between hemodialysis treatment sessions measured fluid retention by proxy. Results indicated no significant relationship between the variables of comfort and adherence to fluid restrictions. However, this finding has potential to support clinical practice to minimize weight gain to sustain comfort. Awareness of comfort as a consideration for adherence to prescribed treatment regimens may help nurses coach individuals to improve treatment adherence.

An Evaluation of Patient Comfort During Acute Psychiatric Hospitalization.

PURPOSE: To assess the difference in the level of comfort between psychiatric inpatients who received a warmed blanket and psychiatric inpatients who did not receive a warmed blanket. DESIGN AND METHODS: A descriptive pilot study from a convenience sample of 37 psychiatric patients aged 18-59. Subject's level of comfort was measured with Kolcaba's verbal rating scale (VRS). FINDINGS: Independent t-tests showed that the VRS mean score was lower in the control group (6.81) than the experimental group (7.29). PRACTICE IMPLICATIONS: Comfort is central to nursing and there has been little research regarding the effects of warm topical applications in the psychiatric hospital setting. Warmed blankets are not routinely offered to patients in the psychiatric setting. The use of warmed blankets may increase patient comfort.

Cultural adaptation and validation of the Portuguese End of Life Spiritual Comfort Questionnaire in Palliative Care patients.

BACKGROUND: Holistic comfort is an important outcome in palliative care and an important goal for patients, relatives and healthcare workers. Holistic comfort considers one's acceptance of life circumstances, support from loved ones and health care professionals, and peaceful resolution of relationships during stressful situations. However, this type of comfort is still difficult to measure, particularly in palliative care patients, as there is a lack of instruments available, especially in the Portuguese language. This study aims to provide an accurate and sensitive instrument to assess the spiritual comfort of Portuguese palliative care patients. OBJECTIVE: To perform the cultural adaptation and validation of a Portuguese version of the End of Life Comfort Planning Questionnaire in Palliative Care patients. METHODS: Methodological research, with analytical approach. The translation, synthesis, back translation, review, pretest, semantic evaluation and analysis of the psychometric properties were performed. A total of 141 palliative care patients from acute medical-surgical settings at a central hospital in the north of Portugal were recruited. The Ethics Committee approved the research. RESULTS: The internal consistency analysis of the adapted instrument resulted in a global alpha value of 0.84 and the factor analysis presented a solution with five factors with rational meaning. The Portuguese version comprised 20 items. CONCLUSIONS: The instrument has good psychometric properties. It was reliable, valid and sensitive to the existence of the spiritual comfort of palliative care patients, and appropriate for further research.

Comfort Theory: Unraveling the Complexities of Veterans' Health Care Needs.

The health care needs of veterans, especially those who have served in combat zones and their families are complicated, challenging, and interrelated. Physical limitations impact mental health, and mental health problems affect every aspect of adjustment to civilian life. Comfort theory offers a simple and holistic pattern for identifying needs, creating interventions to meet those needs, and evaluating the effects of those interventions. The aim of this article is to demonstrate how comfort theory has been applied throughout 1 Veterans Administration System to fulfill the goal of providing quality veteran-centric care. The application of comfort theory to daily patient and family care, discharge planning, and follow-up in various settings, as well as ways to enhance institutional integrity and branding are discussed.

Validation of the Holistic Comfort Questionnaire-caregiver in Portuguese-Brazil in a cohort of informal caregivers of palliative care cancer patients.

PURPOSE: The aims of this study were to perform a cross-cultural adaptation and to assess the psychometric properties of the Portuguese (Brazil) version of the Holistic Comfort Questionnaire-caregiver (HCQ-caregiver) in a sample of family caregivers (FCs) of palliative care (PC) cancer patients. METHODS: The HCQ-caregiver was applied by a trained interviewer to a sample of 150 FCs of PC patients with advanced cancer; 50 participants were subjected to a retest 2 to 7 days after the initial test. The mean score, ceiling and floor effects, and skewness of each HCQ-caregiver item were measured. The instrument's internal consistency was assessed by means of Cronbach's alpha, and the test-retest reliability was assessed using the intraclass correlation coefficient (ICC). The convergent validity was assessed through the correlation between HCQ-caregiver and quality of life scores. Scores on the HCQ-caregiver were compared (discriminant validity) as a function of treatment setting and FC's self-perception of emotional health. RESULTS: A ceiling effect was found in 19 items, four of which exhibited maximum response rates above 90 % and inadequate results regarding skewness. Cronbach's alpha was 0.858, and the ICC was 0.961. The scores on the HCQ-caregiver exhibited moderate-to-strong correlations with the scores of quality of life. The FCs' perceptions of comfort did not differ as a function of the treatment setting but were greater when the FCs had a better self-perception of their emotional health. CONCLUSIONS: The present study demonstrates the validity and reliability of the Brazilian version of the HCQ-caregiver.

Cancer patients caregivers comfort.

Cross-sectional study, carried out at the outpatient clinic of an oncology hospital. Data were collected from 88 caregivers of cancer patients using the Caregiver General Comfort Questionnaire (GCQ) to assess the caregivers' comfort. The caregivers' GCQ score mean was 203.9; better comfort scores was associated with age, care time and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients' physical and environmental comfort and to caregivers' spirituality. 203.9; better comfort scores were associated with age of the caregiver and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients' physical and environmental comfort and to caregivers' spirituality. Caregivers, who didn't have a paid job or leisure's activities showed a worse GCQ. The GCQ scale can help to identify factors that interfere in caregivers' comfort, as well as needs that can be modified through health professionals' interventions.

Comfort and hope in the preanesthesia stage in patients undergoing surgery.

PURPOSE: Comfort and hope have been identified as important components in the care of perianesthesia patients. The purpose of this study was to explore the relationship between comfort and hope in the preanesthesia stage in patients undergoing surgery. DESIGN: A descriptive cross-sectional survey was conducted with 191 surgical patients. METHODS: Data were collected using the Perianesthesia Comfort Questionnaire and Herth Hope Index. FINDINGS: Direct and significant relationships were observed between comfort and hope (P≤.001, r=0.65). Also, significant relationships were observed between educational level and marital status with comfort (P≤.01). The relationship between educational level and hope was significant (P≤.001). Significant relationships were also observed between gender and marital status with hope (P≤.01). CONCLUSIONS: Overall, this study showed that a significant relationship exists between comfort and hope. Additionally, some demographic characteristics influenced comfort and hope in these patients. Health care providers should arrange the environment in a way that allows the surgical patients to experience comfort and hope and recognize the impact of personal characteristics when caring for surgical patients, particularly in the preanesthesia stage.

Cancer Patients Caregivers Comfort / Conforto De Cuidadores De Pacientes Com Câncer / La Comodidad De Los Cuidadores De Pacientes Con Cáncer

Cross-sectional study, carried out at the outpatient clinic of an oncology hospital. Data were collected from 88 caregivers of cancer patients using the Caregiver General Comfort Questionnaire (GCQ) to assess the caregivers’ comfort. The caregivers’ GCQ score mean was 203.9; better comfort scores was associated with age, care time and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients’ physical and environmental comfort and to caregivers’ spirituality. 203.9; better comfort scores were associated with age of the caregiver and current occupation; positive aspects of comfort were related to the fact that caregivers felt loved, to patients’ physical and environmental comfort and to caregivers’ spirituality. Caregivers, who didn’t have a paid job or leisure’s activities showed a worse GCQ. The GCQ scale can help to identify factors that interfere in caregivers’ comfort, as well as needs that can be modified through health professionals’ interventions.
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Estudo transversal cujo objetivo foi avaliar o conforto de cuidadores de pacientes com câncer. Envolveu 88 cuidadores de pacientes em atendimento ambulatorial de um hospital especializado em oncologia. Utilizou-se o General Comfort Questionnaire (GCQ) validado para o português. Verificou-se que o escore médio do GCQ dos cuidadores foi de 203,9. Os melhores escores de conforto estiveram relacionados à idade e ocupação do cuidador; os aspectos positivos do conforto envolveram sentir-se amado, o conforto ambiental e físico do paciente e a espiritualidade do cuidador. Cuidadores que não exerciam atividade remunerada ou lazer apresentaram piores escores de GCQ. Concluiu-se que escala de GCQ pode ajudar a identificar fatores que interferem no conforto dos cuidadores de pacientes com câncer, assim como necessidades que permitam a intervenção dos profissionais de saúde.

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Estudio transversal que tuvo como objetivo evaluar la comodidad de los cuidadores de pacientes con cáncer. Participaron 88 cuidadores de pacientes en atención ambulatoria de un hospital oncológico. Para la recolección de los datos, se utilizó el General Comfort Questionnaire (GCQ) validado para el portugués. La puntuación media del GCQ de los cuidadores fue de 203,9. Las mejores puntuaciones de comodidad estaban relacionadas con la edad y la ocupación del cuidador; los aspectos positivos fueron sentirse amado, comodidad física del paciente y de su ambiente y la espiritualidad del cuidador. Las peores puntuaciones fueron observadas en los cuidadores que no tienen trabajo remunerado o descanso. Se concluye que la escala GCQ puede ayudar a identificar factores que interfieren en la comodidad de los cuidadores de pacientes con cáncer, así como identificar las necesidades que permitan la intervención de los profesionales de la salud.
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The effect of a nursing labor management partnership on nurse turnover and satisfaction.

OBJECTIVE: The effects of a nursing labor management partnership (NLMP) on nurse turnover and nurse satisfaction were examined. BACKGROUND: Job satisfaction and retention are among the factors related to the nursing shortage. The NLMP was a specific intervention where nursing leaders, both nonbargaining and bargaining, worked collaboratively to improve patient care and outcomes. METHODS: The study was conducted in a large, Magnet-designated urban academic medical center in the Northeastern United States. The hospital has more than 1,000 inpatient beds and more than 2,200 registered nurses, 2,107 of whom are members of a nursing union. Nurse turnover and satisfaction were studied before (2005) and after (2008) the implementation of the NLMP model. RESULTS: There was a significant decrease in nurse turnover and a significant increase in nurse satisfaction (from moderate to high) post-NLMP. CONCLUSIONS: This study establishes a basis for further nursing research on the implementation of an NLMP in union environments.

The effects of guided imagery on comfort, depression, anxiety, and stress of psychiatric inpatients with depressive disorders.

This article describes the efficacy of a guided imagery intervention for decreasing depression, anxiety, and stress and increasing comfort in psychiatric inpatients with depressive disorders. A quasi-experimental design sampled 60 short-term hospitalized depressive patients selected consecutively. The experimental group listened to a guided imagery compact disk once a day for 10 days. The Psychiatric Inpatients Comfort Scale and the Depression, Anxiety, and Stress Scales (DASS-21) were self-administered at two time points: prior to the intervention (T1) and 10 days later (T2). Comfort and DASS-21 were also assessed in the usual care group at T1 and T2. Repeated measures revealed that the treatment group had significantly improved comfort and decreased depression, anxiety, and stress over time.

Development and psychometric evaluation of the Psychiatric In-patients Comfort Scale (PICS).

OBJECTIVE: To develop and evaluate the psychometric characteristics of the Psychiatric In-patients Comfort Scale (PICS) in hospitalized psychiatric patients. METHOD: The items of the PICS were drawn from a literature review, existing comfort instruments, suggestions made by experts, and interviews on perceived comfort with 18 hospitalized patients. A pilot study was performed with the first version of the scale, containing 98 items, in a sample of 49 patients. This process resulted in a 51-item version. Internal consistency, construct validity, and concurrent validity were measured in a second sample of 273 patients. RESULTS: Data analysis, factor analysis, and reliability analysis resulted in a 38-item version. The factor analysis indicated a 3-factor structure: relief, ease, and transcendence, which explained 38.64% of the total variance. The comfort dimensions correlated positively with well-being and with positive experiences of suffering and negatively with the remaining dimensions of suffering, supporting concurrent validity. Cronbach's alpha coefficient of the total PICS-38 was 0.89, and the subscales ranged from 0.75 to 0.90. CONCLUSION: Based on psychometric properties, the PICS is a valid and reliable tool that can be used by nurses to assess comfort in hospitalized psychiatric patients. The items are conceptually grouped in 3 factors corresponding to the states of relief, ease, and transcendence of the comfort structure proposed by Kolcaba.

Comparison of a healing touch, coaching, and a combined intervention on comfort and stress in younger college students.

Three nursing interventions to increase total comfort and reduce stress-related events in young college students experiencing stress were compared. Healing Touch, coaching, and a combination of both, were compared to a waitlist. On comfort and stress, Healing Touch had better immediate results, while coaching had better carryover effects.

Desarrollo y evaluación psicométrica de la escala de evaluación de la comodidad en pacientes psiquiátricos hospitalizados (PICS) / Development and psychometric evaluation of the Psychiatric In-patients Comfort Scale (PICS)

Objetivo. Desarrollar y evaluar las características psicométricas de la escala de evaluación de la comodidad en pacientes psiquiátricos hospitalizados (PICS). Método. Se elaboraron los ítems de la escala a partir de una revisión de la bibliografía, de los instrumentos de comodidad existentes, de las sugerencias dadas por los expertos y de las entrevistas hechas a 18 pacientes hospitalizados acerca de la comodidad percibida. Se realizó un estudio piloto con la primera versión de 98 ítems en una muestra de 49 pacientes. Este proceso produjo una versión de 51 ítems en la que se evaluaron la coherencia interna, la validez estructural y la validez concurrente con otra muestra de 273 pacientes. Resultados. Como resultado del análisis de los datos, del análisis factorial y de la fiabilidad, se obtuvo una versión de 38 ítems. El análisis factorial indicó una estructura de 3 factores: alivio, tranquilidad y trascendencia, que explicaron el 38,64% de la variación total. Las dimensiones de comodidad se correlacionan positivamente con el bienestar y con las experiencias positivas de sufrimiento y negativamente con las dimensiones restantes del sufrimiento, apoyando la validez concurrente. El coeficiente * de Cronbach del PICS-38 total fue 0,89 y de las subescalas varió de 0,75 a 0,90. Conclusión. Basado en las propiedades psicométricas, el PICS es una herramienta válida y fiable para ser usado por enfermeras en la valoración de la comodidad en los pacientes psiquiátricos hospitalizados. Los 3 factores en que se agrupan los ítems conceptualmente corresponden a los estados del alivio, tranquilidad y trascendencia de la estructura de comodidad propuestos por Kolcaba

Objective. To develop and evaluate the psychometric characteristics of the Psychiatric In-patients Comfort Scale (PICS) in hospitalized psychiatric patients. Method. The items of the PICS were drawn from a literature review, existing comfort instruments, suggestions made by experts, and interviews on perceived comfort with 18 hospitalized patients. A pilot study was performed with the first version of the scale, containing 98 items, in a sample of 49 patients. This process resulted in a 51-item version. Internal consistency, construct validity, and concurrent validity were measured in a second sample of 273 patients. Results. Data analysis, factor analysis, and reliability analysis resulted in a 38-item version. The factor analysis indicated a 3-factor structure: relief, ease, and transcendence, which explained 38.64% of the total variance. The comfort dimensions correlated positively with well-being and with positive experiences of suffering and negatively with the remaining dimensions of suffering, supporting concurrent validity. Cronbach's * coefficient of the total PICS-38 was 0.89, and the subscales ranged from 0.75 to 0.90. Conclusion. Based on psychometric properties, the PICS is a valid and reliable tool that can be used by nurses to assess comfort in hospitalized psychiatric patients. The items are conceptually grouped in 3 factors corresponding to the states of relief, ease, and transcendence of the comfort structure proposed by Kolcaba

Comfort Theory: a unifying framework to enhance the practice environment.

The application of theory to practice is multifaceted. It requires a nursing theory that is compatible with an institution's values and mission and that is easily understood and simple enough to guide practice. Comfort Theory was chosen because of its universality. The authors describe how Kolcaba's Comfort Theory was used by a not-for-profit New England hospital to provide a coherent and consistent pattern for enhancing care and promoting professional practice, as well as to serve as a unifying framework for applying for Magnet Recognition Status.

Effects of comfort warming on preoperative patients.

THERMAL COMFORT IS ONE DIMENSION of overall patient comfort, and it usually is addressed by covering the patient with warmed cotton blankets. WARMING HELPS A PATIENT maintain normothermia and appears to decrease patient anxiety. AN STUDY WAS CONDUCTED in a preoperative setting to compare the effects of preoperative warming with warmed cotton blankets versus patient-controlled warming gowns on patients' perceptions of thermal comfort and anxiety. BOTH WARMING INTERVENTIONS had a positive effect on patients' thermal comfort and sense of well-being. Patients who used the patient-controlled warming gown also experienced a significant reduction in preoperative anxiety.

Development of the healing touch comfort questionnaire.

This study provided preliminary evidence for internal consistency reliability (Cronbach alpha = .94) of the newly developed Healing Touch Comfort Questionnaire. Fifty-six Healing Touch (HT) recipients (51 women and 5 men with a mean age of 51) completed the questionnaire. Participants with more than 4 HT treatments had higher comfort levels than those with fewer than 4.

Effects of hand massage on comfort of nursing home residents.

Patient comfort is a goal of therapeutic nursing practice and a primary nursing function. Residents in nursing homes have many comfort needs including physical, psychospiritual, sociocultural, and environmental. These comfort needs are addressed by various caregivers including nurses, nursing assistants, and family members. Hand massage is a simple comfort intervention that can be incorporated readily into routine nursing care activities and conveys caring through touch, individual attention, and presence. As an intervention, hand massage promotes comfort and facilitates communication between care recipients and caregivers. The purpose of this study was to test the effectiveness of hand massage as an intervention that affects nursing home residents' comfort and satisfaction. Results are presented for 35 participants who received hand massage and 25 participants in a comparison group. Findings showed no significant differences in comfort levels or satisfaction with care over time. Significant group differences, however, were found for comfort and satisfaction when measured at specific time periods. The discussion highlights these mixed findings and presents implications for further development of hand massage as part of nursing home residents' care.

Comfort Theory and its application to pediatric nursing.

Although written protocols currently are directed more to pain relief than to the comfort of each child, there is increasing interest in pediatric literature about comforting strategies for children and their families. However, pediatric nurses/researchers currently utilize measures of discomfort that designate a neutral sense of comfort as in the absence of a specific discomfort. Assessing comfort as a positive, holistic outcome is important for measuring effectiveness of comforting strategies. Comfort Theory (Kolcaba, 2003), with its inherent emphasis on physical, psychospiritual, sociocultural, and environmental aspects of comfort, will contribute to a proactive and multifaceted approach to care. The framework of Comfort Theory for pediatric practice and research is easy to understand and implement. The application of the theory is strengthening and satisfying for pediatric patients/families and nurses, and benefits institutions where a culture of comfort is valued. Moreover, comfort is a transcultural and interdisciplinary concern.