This theory involved the subjects of culture and care. Leininger discovered during her days of study as a nursing student that she was unable to provide the right extent of care to people of different cultural cities (Nelson, 2006). She decided to acquire knowledge about the cultural factors that were a missing link in her capacity as carer. She studied further and learned to provide culturally sensitive care. Caring is the essence of nursing. Universal culture care involves many culture care constructs.
Leininger (1991) adopted many steps to inculcate in herself the theme of cultural care diversity: respect and concern for the patient, anticipating difficulties, facilitating or assisting, active listening, being physically present, understanding their different cultural values and beliefs, establishing a connectedness, providing protection for women and children, touching and comfort measures (Nelson, 2006). Leininger also developed a short culturological assessment in 5 steps where she took care to recognize values and beliefs, recorded observations, identified recurring patterns, synthesized and develop a culturally feasible plan.
Being sensitive to a patient’s cultural background and doing research to further understand the differences in behaviors and remembering to apply the principles of ethics helps a nurse to practice cultural care diversity. This theory has had an immense impact on the nursing practice (Nelson, 2006). The process of acculturating people and their groups focuses on two issues that trouble them. They would prefer to maintain ethnic distinctiveness and also decide whether to retain their distinct cultural values or merge with the external world (Berry, 2003). Their interest in cultivating inter-ethnic contact is another issue which they would like to decide upon. Berry indicates four group-level acculturation strategies and four larger societal acculturation methods. Integration, assimilation, separation, and marginalization from the group-level activities. Societal acculturation involves multi-culturalism, melting pot, segregation and exclusion (Racher and Annis, 2007).
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Katherine Kolcaba propounded the comfort theory. It is indicated to be a complex construct and aims to bring comfort to the distressed patient. She describes comfort as “a multidimensional personal experience with differing degrees of intensity (Kolcaba, 1992). The construct goes much beyond the provision of mere “hope, contentment, certainty or function” (Kolcaba, 1992). Holism is the answer to comfort issues. The patient’s holistic evaluation of physical, psychological, spiritual and social behaviors enables the nurse to decide on what changes are needed to bring comfort to him.
Interventions that produce a mind-body interaction satisfying many needs at one go are now opted for. Instruments that measure holistic status must be designed. Comfort is a desirable outcome for patients (Kolcaba, 1992). Holistic assessment is not merely to collect facts; it must convey information as to what efforts would provide comfort. The efficiency of the nurse would depend on how comfortable, physically and mentally, she can make the patient. The anticipation itself of the patient for a comfortable period in hospital provides comfort (Kolcaba, 1992).
Comfort is the standard of care selected by many Heath Departments. Quality care has been defined as that care that can provide maximum physical and mental comfort to the patient. The American Nurses Association has emphasized the maintenance of life “in dignity and comfort until death” (Kolcaba, 1992). Comfort is a standard for oncology patients too. Comfort is not what everyone considers as comfort; it is that desired comfort that would satisfy the patient who is anticipating it. The definition in wellness circles goes like this: “the state in which the body is relieved of unpleasant sensory or environmental stimuli” (Kolcaba, 1992). In the comfortable state, the patient is able to plan his destiny.
Comfort in psychiatry means something a little different: “personalization, freedom of choice, space and warmth” are the factors considered (Kolcaba, 1992). If patients were to be asked for the themes in comfort, the answer would probably be the following: “disease process, self-esteem, positioning, approach and attitudes of staff and hospital life” (Kolcaba, 1992). Hospital life becomes comfortable when staff is friendly and reliable. Accessibility to care is another major comfort.
Nursing theories based on theology have been advocated by Anne Bradshaw and Kate Erikkso
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