As mentioned earlier, the desired outcome of nursing care is comfort and there are many articles in which the researchers have talked about the needs of the patients and the things that alter the comfort of the patients. Kolcaba suggested that the cancer patients who are terminally ill can benefit from comfort care as it pays attention to the perspective and needs of the patients. Through such kind of care, the patient is not only provided with pain relief, but the depression of the patient is also addressed adequately. As she said that patients who are not in pain but are depressed seek comfort in the transcendental sense as well as in the psycho-spiritual sense (Kolcaba, 1992 p 4). In some of her works, she has explained the use of the instruments and their application by the nurses. Kolcaba reckons that the instruments presented by her to evaluate the comfort are significant indicators that are given by the patients, are altered by the kind of nursing care being given to the patient and are associated with the health care system and its integrity. For example, this theory is particularly very significant for application by nurses that interact with the patients before they are being taken to the OR, or when they are in the OR. This is important to reduce the anxiety level, which can hinder the smoothness of any procedure that is being performed. Application in Research

It has been around a decade since this theory has come up to the surface and during this time it has been subjected to empirical testing. Studies have shown that when the caretaker or the nurse starts giving the patient a comfort measure in the form of any intervention, so as to meet the holistic comfort of the patient, the comfort level of the patient is elevated over a former baseline value. At the moment, Kolcaba is devising ways to test the last part of the theory so that she can establish a relationship, if it exists, between the community or institutional setting and patient comfort. She also seeks to demonstrate the extent of the patient satisfaction with the application of this theory in the healthcare system. She wished to do so by making the patients fill out a survey after they are discharged from the hospital.

Application in Education

It should be noted here that Kolcaba's (1992) theory is of middle range nature and therefore it might not be appropriate for the curricular development as it expands on a few but not all the aspects of nursing care. However, it is also noteworthy that this theory has to offer some very important content for the students of nursing to those of masters, at both the graduate and undergraduate levels. According to the articles that have explained the application of this theory in nursing practice, this theory can prove to be useful for educating students. For instance, Cox (1998) believed that Kolcaba's theory was helpful when it came to teaching nursing students how to take care of older adults and the students found it very easy to apply this theory while addressing the holistic comfort demands of the elders in a setting that would cater their acute needs. This theory has also been suggested to be beneficial to reduce the stress in students in educational settings.

In another article, Kolcaba (1994) has explained her theory in depth and in a way that might suit the students. According to this article, comfort is defined as the characteristic that distinguishes the nursing professions from others. The aforementioned statement makes the application of this theory useful in education. A theoretical work has been presented in this article in which an intra-actional perspective has been used to develop a theory that indicates comfort as being a positive result of nursing. In this article, it was described how an elevation in comfort was an indication of reduction of negative tensions and engagement of positive tensions. It should be remembered here that the facilitator of the results of comfort is the nurse. This is because, according to theory, it has a relationship with external/internal health-seeing attitudes of a peaceful death.

Application of Theory to My Practice

I have made use of this theory in many cases, although I was not aware of the fact that this theory actually existed. There are a number of management protocols that involve a hand massage. I would like to add here that I have performed hand massage...

Moreover, in some patients, to decrease the stress level and to increase comfort, I have also performed foot massage on these patients. Such practices are enjoyed by the female patients to a great extent and great degree of relaxation is seen in them when they are being massaged. The reason why I have been hesitant to hand to foot massage the male patients is that in many cultural settings, such actions are considered a taboo. Even though, it is an extremely simple intervention, it can cause significant change in the behavior and comfort level of the patient.
This theory is mostly used in the surgery setting, since this is one of the settings in which the stress level of the patients is the highest. From the start of the perioperative stage of the surgery, the main concern of the doctors, nurses and healthcare givers should be the mental status of the patient and how the patient is going to react to the surgical procedure. As a nurse, it is my duty to make sure that the patient is not anxious and feeling comfortable with the care that I am giving. As a result, I have to do anything that is in my hands to make sure that the patients as well as the attendants have sought all the answers to any queries that they might have in mind that could increase the anxiety and stress level. When taking the patient to the OR, it is my duty to make the patient comfortable while he or she is being anesthetized and being positioned for the procedure. To do this, I always stand beside the patient and keep analyzing his or her expressions or listen to the noises that are being made by the patient in the operative setting. Once the patient has been through the surgical procedure, I have to make sure that the patient is feeling comfortable and safe pertaining to the kind of care that he or she is being given. Kolcaba's theory is nothing but basic nursing. Nonetheless, it has to be the ultimate goal of any nurse of healthcare provider to be with a patient who is feeling comfortable so that the process of healing could set in and stress could be reduced.

As with any other theory, this theory also has some weaknesses. The main weakness of this theory is that since the expectations of every patient are different, the same generalized rules do not work on every patient. Some patients have been going through the disease for such a long time that interventions like hand and foot massage do not work on them. Moreover, these patients might also react differently to the application of this theory. Apart from this, the measurement of comfort at times becomes a difficult task since it can only be assessed and not measured quantitatively. Patients who come with a psychiatric problem are less likely to benefit from this theory as most of them are not in the mental state to understand and feel the kind of care that is being given to them.

Evaluation

Personally, I believe that if this theory is applied in its true spirit then it can cause a great deal of comfort in the patients. If the nurses understand this theory fully and understand its significance then the patients are to benefit a lot from it. As it has been a very old and popular notion that apart from treatment, will power is also very important for the recovery of the patients. Through the application of this theory, the will power of the patients can be strengthened and therefore they can recover earlier than they normally would.

There are no difficult statements in this theory and that is what makes it user friendly. It quite simple and many nurses would agree that they had been applying it without knowing that it exists. The theory contains some very typical things which need to be followed closely.

The only difficulty that I have faced so far in the application of this theory is the difference in reactions of different patients.

One of the ways through which this theory can be made more usable and applicable is its inclusion in the curriculum of nursing. This will make this theory a part of the subconscious of the nurses and therefore they will never forget to apply it.

Bibliography:

Kolcaba K. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19(10): 1178-1184.

Kolkaba, K. (1992). Holistic comfort: Operationalizing the construct as a nurse-sensitive outcome..Advances in Nursing Science, 15…