Comfort and nurses' moral choices.
ABSTRACT Caring has been advocated as integral to nursing ethics, and much theorizing has suggested that it may be a partial or the entire foundation for nursing's ethic. Yet few research studies have examined the practical expression of caring in the clinical setting. The author describes the concept of comfort as an aspect of care experienced by long-term care nurses in their daily practice related to moral choices. The design of the study was descriptive and qualitative. The sample consisted of 15 registered nurses who were participants in the author's previous study of moral certainty and uncertainty. Their responses to interview questions during the previous study suggested the topic for the present study. A semi-structured interview consisting of eight neutral open-ended questions was conducted with each participant. The findings suggest that long-term-care nurses function in the roles of mediator and communicator. In these roles, they try to meet a mental ideal of "good nursing practice'. They use multiple criteria on which to base their moral choices including comfort, their own and their residents. The author examines the providing and feeling of comfort as related to the nurses' moral choices.
- [show abstract] [hide abstract]
ABSTRACT: Based on data gathered from registered nurses at two hospitals, this research examined the extent to which empathy variables contributed to nursing stress and occupational commitment. The empathy variables examined were emotional contagion (i.e. sharing the emotions of patients), empathic concern (i.e. being concerned for patients) and communicative effectiveness (i.e. effectively communicating with patients and their families). Nursing stress was explored through the variables of depersonalization, reduced personal accomplishment and emotional exhaustion. Multiple regression analyses revealed that the combination of the three emotional communication variables explained significant proportions of the variance in all three of the stress variables, as well as occupational commitment. The analyses further revealed that a lack of empathic concern and poor communicative responsiveness accounted for significant proportions of the variance in depersonalization. Lack of empathic concern, poor communicative responsiveness and high emotional contagion significantly contributed to reduced personal accomplishment. Emotional contagion explained a significant proportion of the variance in emotional exhaustion. Emotional contagion also significantly reduced occupational commitment. The findings are discussed in terms of nursing education and administration.Journal of Advanced Nursing 07/1999; 29(6):1351-9. · 1.53 Impact Factor
Article: Comfort on a ward for older people.[show abstract] [hide abstract]
ABSTRACT: Comfort is often considered to be a central part of nursing, although the value placed on it may have diminished over time. Many views of comfort are expressed in the literature but it still remains a diffuse concept that requires further clarification. Research evidence about older people and comfort is limited, and further work is needed to find out how staff and patients view comfort and how it is achieved in practice. This paper reports a study to investigate what comfort means both to older people in hospital and their health care workers. Ethnography was the methodology chosen, and data were collected using in-depth interviews with 19 older people and 27 staff members, and 130 hours of participant observation, complemented by additional weekly visits to the study ward. Three themes were identified: the nature of comfort/discomfort; key determinants of comfort/discomfort; and the underlying factors that influence the achievement of comfort/discomfort. In this hospital setting, the focus of nursing on relief of discomfort suggested a tendency to react to problems, rather than proactively to create an environment that facilitated comfort. Staff were aware of ideals of practice but found these difficult to achieve in reality. In this study comfort was not consistently provided, and some ways of working actively promoted discomfort. As comfort is central to nursing and nursing is central to the care of hospitalized older people, it is crucial that practitioners are enabled to fulfil their potential in this area.Journal of Advanced Nursing 06/2004; 46(4):380-9. · 1.53 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: (i) Explore the meaning of comfort care for hospice nurses. (ii) Provide an understanding of how this work is pursued in the hospice setting. (iii) Examine the means by which hospice nurses provide comfort to hospice patients. The concepts of 'comfort' and 'comfort care' have long been a subject for examination by nurse researchers. The paper provides an overview of selected, relevant literature in this area. The methods used by nurse researchers have almost always been qualitative, and have focused on the meaning of nursing care for dying patients, from both nurses' and patients' perspectives. The paper reports a hermeneutic phenomenological study of the work of 15 hospice nurses based in one hospice in the north of England. Sampling was purposive, and data were collected by means of semi-structured interviews. A reflective diary was also kept. The interpretation of data was guided by phenomenological and hermeneutic methodology. The nurses interviewed spoke openly about their experiences of working with hospice patients. They saw the relief of suffering through 'comfort care' as an important element of their work. The findings are presented under three thematic headings: 'Comfort and relief', 'Peace and ease' and 'Spirituality and meaning'. Hermeneutic phenomenology is an important method for uncovering the complex realities of nursing work. The nurses' perspectives on 'comfort care' they offer to patients were revealed by the data presented here, which were interpreted to offer a unique perspective on this type of nursing work. These findings offer insights to nurses in both hospice and other settings; they give a number of perspectives on the nature of 'comfort care' and the meanings attached to it by experienced hospice nurses'.Journal of Clinical Nursing 04/2007; 16(4):742-51. · 1.32 Impact Factor