Estudio de caso con utilización del instrumento de Katharine Kolcaba teoría de rango medio del confort

Objectives:To identify patients’ general comfort levels in percutaneous coronary intervention.Methods:This descriptive research included 2 hundred cardiac patients, whom were in the Medipol Mega University Hospital, Istanbul, during the period between May 2018 and May 2019. The data were obtained by General Comfort Questionnaire and evaluated using mean, standard deviation, percentage and t-test.Results:In this study reports that patients had the mean total comfort score as 3.03±0.3. They acquired the maximum score from the psychospiritual comfort subdimension and the minimum score from the physical comfort subdimension. Patients who experienced transradial percutaneous coronaryintervention had statistically higher general, physical, psycospiritual and environmental comfort levels than those who had transfemoral intervention (p<0.05). According to both access methods, relief and ease levels were significantly different.Conclusion:Patients who experienced percutaneous coronary intervention have above medium general comfort levels. Their physical comfort scored lowest within the comfort dimensions investigated in this study. The comfort level of the patients to whom the transradial method was applied was found to be higher in comparison with the transfemoral method.

Aims/Background By addressing patients' physical, psychological, social, cultural, and environmental comfort needs holistically, Kolcaba's Comfort Theory raises the standard of care and increases patient satisfaction. This study explored the combined application of these nursing models during the perioperative period for patients undergoing nasal deformity correction surgery. Methods 92 patients undergoing nasal deformity correction at the Seventh Affiliated Hospital of Sun Yat-sen University were randomly divided into two groups: the conventional group (46 patients), which received standard perioperative nursing care, and the experimental group (46 patients), which received concept map thinking nursing combined with Kolcaba's comfort nursing intervention during the perioperative period. Clinical indicators, including the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Rhinoplasty Outcome Evaluation (ROE) and General Comfort Questionnaire (GCQ), were compared between the two groups at multiple time points. Results The experimental group demonstrated significantly shorter operation times (p < 0.001), faster recovery of nasal breathing (p = 0.002), and shorter hospital stays (p < 0.001) compared to the conventional group. Additionally, the experimental group experienced less intraoperative blood loss (p < 0.001) and a lower incidence of complications (p = 0.013). At 2 days, 1 month, and 3 months post-surgery, both groups showed decreases in SAS, SDS, and PSQI scores, with the experimental group demonstrating significantly lower scores (p < 0.05). At these same time points, the ROE and GCQ scores increased in both groups, with the experimental group achieving significantly higher scores than the conventional group (p < 0.05). Conclusion The integration of concept map thinking with Kolcaba's comfort nursing significantly improves the postoperative recovery of patients undergoing nasal deformity correction. Reduced surgical trauma, enhanced psychological health, better sleep, increased comfort, and quicker nasal function recovery are all results of this method. Clinical Trial Registration China Clinical Trial Registration Center (https://www.chictr.org.cn/showproj.html?proj=191278).

To analyse the psychometric properties and the utility of instruments used to measure patient comfort, physical, social, psychospiritual and/or environmental, during hospitalization. There are no systematic reviews nor psychometric reviews of instruments used to measure comfort, which is considered an indicator of quality in health care associated with quicker discharges, increased patient satisfaction and better cost-benefit ratios for the institution. Psychometric review. MEDLINE, CINAHL, PsycINFO, Web of Knowledge, ProQuest Thesis&Dissertations, Google. We limited our search to studies published between 1990-2015. The psychometric analysis was performed using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN), along with the Quality Criteria for Measurement Properties. The utility of the instruments was assessed according to their cost-efficiency, acceptability and educational impact. Protocol registration in PROSPERO, CRD42016036290. Instruments reviewed showed moderate methodological quality and their utility was poorly reported. Thus, we cannot recommend any questionnaire without reservations, but the Comfort Scale, the General Comfort Questionnaire and their adaptations in adults and older patients, the Psychosocial Comfort Scale and the Incomfort des Patients de Reanimation are the most recommendable instruments to measure comfort. The methodology of the studies should be more rigorous and authors should adequately report the utility of instruments. This review provides a strategy to select the most suitable instrument to assess patient comfort according to their psychometric properties and utility, which is crucial for nurses, clinicians, researchers and institutions.

To investigate the effects of positional nursing combined with positive suggestions on anxiety, procedural outcomes, and patient comfort in patients undergoing painless gastroscopy. This retrospective cohort study enrolled 153 patients undergoing sedated gastroscopy between March 2024 and August 2025. Patients were assigned to the conventional nursing group (n=73, March-October 2024) or the comprehensive nursing group (n=80, November 2024-August 2025). The comprehensive group received individualized positioning optimization and standardized positive psychological suggestions. Primary outcomes included State-Trait Anxiety Inventory-State subscale (STAI-S), examination success rate, examination duration, and General Comfort Questionnaire (GCQ). Secondary outcomes included hemodynamic stability, adverse events, recovery time, and patient satisfaction. Baseline characteristics were comparable between groups. The comprehensive nursing group demonstrated significantly lower STAI-S scores (43.23±7.68 vs 48.67±8.45, P <0.001) and shorter examination duration (6.54±1.62 min vs 7.23±1.87 min, P =0.016). GCQ scores were significantly higher in the comprehensive group (P <0.001). The comprehensive group maintained better intra-procedural hemodynamic stability with lower heart rates (P =0.002), higher oxygen saturation (P <0.001), and higher blood pressure levels (systolic BP: P =0.020; diastolic BP: P =0.008). Comprehensive group had lower overall adverse event incidence, shorter recovery time and higher modified Patient Satisfaction Questionnaire scores (modified PSQ-18) (all P <0.05). Positional nursing combined with positive suggestion may help reduce pre-procedural anxiety, improve hemodynamic stability, decrease adverse events, and enhance patient comfort and satisfaction in painless gastroscopy. This non-pharmacological intervention shows promise for integration into routine endoscopy nursing protocols.

To investigate the efficacy of lidocaine injection for the cannulation of arteriovenous fistulas in patients undergoing maintenance hemodialysis (HD). The clinical data of 91 patients who underwent arteriovenous fistula puncture and maintenance HD at our hospital from December 2023 to July 2024 were retrospectively analyzed. The patients were divided into groups based on the different pre-cannulation treatment methods. The control group (n = 43) underwent cannulation after routine disinfection, whereas the study group (n = 48) underwent cannulation following a local injection of 0.2% lidocaine. The cannulation success rate was significantly higher in the study group (97.92%) than in the control group (81.40%). After cannulation, the heart rate and the systolic blood pressure in the study group were notably lower than those in the control group. After cannulation, the scores of the study group on the Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and the Chinese version of the Perceived Stress Scale were markedly lower than those of the control group. Pain levels in the study group were also significantly lower than those in the control group. The General Comfort Questionnaire and total scores in the study group were also significantly lower than those in the control group. The complication rate in the intervention group (2.08%) was significantly lower than that in the control group (18.60%), and the satisfaction rate in the study group was 95.83% (46/48), which was significantly higher than that in the control group (79.07% (34/43)). Local injection of 0.2% lidocaine effectively alleviated pain during arteriovenous fistula cannulation, improved comfort, and reduced complications in maintenance HD patients.

to analyze the factors related to the impaired comfort of chronic kidney diseases (CKD) patients on hemodialysis. this is a cross-sectional study with 80 patients undergoing hemodialysis in a renal replacement therapy unit through interviews using two instruments, one for clinical and sociodemographic characteristics and the General Comfort Questionnaire, during the hemodialysis session. Mann-Whitney tests and the logistic regression model were used for data analysis. the study found that being younger (p=0.045); being married (p=0.05); and absence of impaired physical mobility (p=0.007) were contributing factors for greater comfort in CKD patients on hemodialysis. Thus, when establishing the odds ratio, it was possible to observe that being 55 years of age or older, being single and having impaired physical mobility represents a 45.7% chance of developing this diagnosis. sociodemographic and clinical variables contribute to the study outcome, demanding attention during the planning of nursing interventions.

BackgroundPatients' satisfaction and comfort are known as the quality indicators of nursing care. Nowadays, violence against nurses has an increasing trend. Regular nursing rounds are one of the caring programs that help improve these indicators. This study aimed to examine the effect of regular nursing rounds on patients' comfort, satisfaction, and violence against nurses. Materials and methodsThis quasi-experimental study was conducted in two groups consisting of 100 patients and 35 nurses in a surgery ward in the northwest of Iran. The satisfaction with nursing care quality questionnaire, Kolcaba's general comfort questionnaire, and work environment violence were used for data collection. In the present study, the control and intervention groups were selected using a simple sampling method. The control group received routine care only; however, the intervention group received a regular nursing round program every 2 h from the second day of their admission for three days. The satisfaction questionnaire and comfort scale were completed on the second and fifth days of admission, and the evaluation of violence against nurses was performed from the second to the fourth day. The results were analyzed using chi-square, Fisher, independent t, and paired t tests. ResultsBefore the intervention, no statistically significant difference was observed between the two groups in terms of demographic and dependent variables (p > 0/05). After the intervention, statistically significant differences were observed among the mean scores of satisfaction with nursing care (p < 0/001), comfort (p < 0.001), and violence against nurses (p = 0.041) between the two study groups, so that in the intervention group, the patients’ satisfaction and comfort increased and violence against nurses reduced during the intervention period. ConclusionsThe use of regular nursing rounds had a positive effect on the study results. Therefore, it is recommended that nurse managers design, implement, encourage, and evaluate regular nursing rounds to improve nursing care.

Objectives:To investigate the effect of Kegel pelvic floor muscle training combined with clean intermittent self-catheterization on patients with cervical cancer, and to analyze the risk factors affecting urinary retention.Methods:A total of 166 patients with cervical cancer admitted to our hospital from October 2016 to December 2019, all of whom received radical resection of cervical cancer, were divided into two groups according to the random number table method: the observation group and the control group, with 83 cases in each group. The control group underwent clean intermittent self-catheterization, while the observation group underwent Kegel pelvic floor muscle exercise combined with clean intermittent self-catheterization. The catheter replacement rate, bladder residual urine volume, self-perceived burden scale (SPB), Kolcaba general comfort questionnaire (GCQ), incidence of urinary tract infection, and urinary retention after catheter removal were compared between the two groups. Logistics regression analysis was utilized to analyze the risk factors affecting urinary retention.Results:The incidence of catheter replacement, urinary retention, dysuria and bladder residual urine volume in the observation group were significantly lower than those in the control group (P<0.05). Postoperative SPB score of the two groups decreased significantly, while the GCQ score increased significantly. Postoperative SPB score of the observation group was significantly lower than that of the control group, while the GCQ score was significantly higher than that of the control group (P<0.05). Statistically significant differences can be observed in the comparison of catheter indwelling time, urinary tract infection, surgical incision infection and surgical margin between the two groups (P<0.05). Logistic regression analysis showed that catheter indwelling time, urinary tract infection, surgical incision infection and surgical margin were independent risk factors affecting urinary retention (P<0.05).Conclusions:Catheter indwelling time, urinary tract infection, surgical incision infection and surgical margin are the risk factors for postoperative urinary retention in patients with cervical cancer. With Kegel pelvic floor muscle exercise combined with clean intermittent self-catheterization, a variety of benefits can be realized, such as improved bladder function, reduced incidence of urinary tract infections and urinary retention, as well as increased patient comfort.

Urban street comfort is a crucial measure of street environmental quality. However, traditional evaluations primarily focus on physical elements, often neglecting pedestrian perceptions. In this study, considering five core evaluation dimensions—safety, mobility, aesthetics, perceptibility, and convenience—an innovative quantitative evaluation model is proposed to assess pedestrian-perceived comfort on urban streets by integrating physical environmental factors and subjective experiences. This analysis comprises two steps: evaluation indicator extraction and weight application. Indicators are extracted from multi-source data (street-view images, real-time traffic data, points of interest, and pedestrian surveys) using a deep learning method. A comprehensive weighting method combining entropy weight and the analytic hierarchy process is used to determine the relative importance of each factor. This study focuses on Nanjing as a case study, and the results reveal significant variations across the five dimensions and their 11 secondary indicators. Street environment safety (0.143) is critical for street safety, while the degree of street traffic congestion (0.121) dominates street mobility. Street aesthetics is primarily influenced by building enclosure (0.105), and street convenience is strongly affected by the number of surrounding bus stops (0.260). Spatial analysis indicates higher comfort levels in urban centers due to well-developed infrastructure, whereas peripheral areas face challenges from inadequate facilities. Notably, areas around parks demonstrate elevated pedestrian-perceived comfort levels, highlighting the importance of green spaces. Overall, the proposed evaluation system provides new insights from the perspective of pedestrian experience and offers valuable guidance for urban planning and policy.

People are gradually requesting ever higher levels of comfort in the spaces they inhabit. These conditions of environmental, and particularly thermal, comfort have been changing during recent years, demanding more extreme temperatures than those that may be considered biologically comfortable. In temperate climates, it is important to consider the thermal adaptation of the buildings and their residents, to achieve a satisfactory balance between comfort, energy efficiency and adaptation. This paper presents a study carried out during the winter and summer periods. Climate data were recorded in the living spaces through data logger integrated-type sensors and, in parallel, the occupants completed subjective response surveys. The data obtained were evaluated through the method of Thermal Sensation Intervals Means, with the aim of determining the range of comfort assessed by the occupants in the indoor spaces monitored. A difference was found with the reference regulations, showing that in temperate climates, the dependence on artificial air conditioning is not constant. In summer, people are in a comfortable situation with reference values of almost 3°C above the limits recommended by the regulations, while in winter, the lower recommended levels are sufficient to be comfortable. Users were seen to be able to adapt to indoor temperatures, and it was concluded that, in temperate climates, dependence on artificial air conditioning is not constant. The greater the range of temperatures detected, the wider the range of tolerance of the users.

BackgroundDeltoid Muscle intramuscular (IM) injection is a standard nursing procedure that often causes discomfort and anxiety. Helfer Skin Tap (HST) and ShotBlocker have been introduced to reduce injection-related pain and improve patient experience.AimThis study compares the effects of the deltoid muscle intramuscular injection techniques Helfer Skin Tap, ShotBlocker, and Standard Technique on patients' pain, comfort, satisfaction, and fear levels.DesignThe study used a single-center, randomized, Controlled interventional study design in which three injection techniques were applied to one group.ParticipantsForty patients participated in the study.MethodsA single-center randomized controlled interventional study was conducted with patients from the Emergency Department of Atatürk University Study Hospital. Data collection tools included forms for sociodemographic characteristics, pain assessment, comfort levels, satisfaction, and fear related to injections. The interventions were applied once daily for three days, and data were analyzed using appropriate statistical methods.ResultsCompared to the Helfer Skin Tap and Standard Technique, the ShotBlocker technique caused the most minor pain and fear and the highest levels of comfort and satisfaction among patients.ConclusionThe findings suggest that the ShotBlocker technique is the most effective in reducing pain and fear while providing the highest comfort and satisfaction levels. This indicates its potential for widespread adoption in clinical practice to improve patient outcomes during deltoid muscle IM injections.Trial registrationThis research is a randomized controlled study. Therefore, a registration number was applied for at ClinicalTrials.gov. The registration number was obtained with the number “NCT05577832”. (First Posted 13/10/2022)Conclusion and implications for nursing and/or Health policyDue to its superior performance, the ShotBlocker technique should be integrated into nursing education and practice. This technique can improve the quality of patient care and enhance the patient experience during deltoid muscle IM injections.

The present case study sets out to investigate the potential and limitations of passive building design in a typical Mediterranean climate. The Maltese Islands were taken as the case study location. Assuming a fully detached, cuboid-shaped, generic multi-storey office building, one representative storey was modelled by means of the building energy simulation code WUFI®Plus. Thermal comfort was analysed based on the adaptive acceptable operative room temperature concept of EN 15251 for buildings without mechanical cooling systems. Assuming neither artificial heating nor cooling, the free-running operative room temperature was evaluated. By means of a parametric study, the robustness of the concept was analysed and the impact of orientation, window to wall area ratio, glazing, shading, thermal insulation, nighttime ventilation and thermal mass on the achievable level of thermal comfort is shown and discussed. It is concluded that in a well-designed building and by means of decent insulation (present case: Uwall = 0.54 W/(m2 · K)), double glazing, variable external shading devices and passive cooling by nighttime ventilation, a high level of thermal comfort is achievable in this climate using only very minor amounts of energy for artificial heating and cooling or possibly even none at all.

Introducción: La percepción de la comodidad en el transporte público es heterogénea debido a que sus usuarios lo son en sí, y la elección de viajar en dicho medio de transporte es un proceso que refleja diferentes actitudes de usuario, entre las que se encuentran sus características socioeconómicas. Relacionar características del usuario y su nivel de comodidad percibido puede estimarse mediante métodos estadísticos y logísticos con la finalidad de determinar la probabilidad de empleo del medio.Método: A partir de una encuesta Origen Destino aplicada en la Zona Conurbada de Querétaro y considerando que el costo generalizado del viaje en automóvil es inferior al del transporte público, la presente investigación presenta la estimación de atributos para ambos medios, por un lado, un proceso para la obtención del atributo de la comodidad en el transporte público y por el otro, un índice del costo generalizado para el automóvil.Resultados: En los modelos estimados, el atributo del medio de transporte calculado bajo el procedimiento reportado refleja una menor probabilidad de elegir el vehículo privado como medio de transporte, si se tiene un mayor nivel de comodidad en el transporte público. Además, considerando la relación intrínseca en el atributo del automóvil, entre más similar es el costo generalizado en transporte público y el del automóvil, más cercano a cero y menor utilidad plantea el automóvil, rigiendo así el atributo de la comodidad en el transporte público.Discusión o Conclusión: Se comprueba que la percepción de comodidad en el transporte público está relacionada con la elección de dicho medio. Respecto al atributo del automóvil el indicador presentado muestra que entre menor es el costo generalizado del viaje en automóvil y mayor el del autobús, lo cual genera una mayor probabilidad del uso del primer medio, lo anterior, considerado para ciudades como la del caso de estudio, en las que el costo generalizado en automóvil (considerando los parámetros expuestos) será menor que el costo generalizado en transporte público, principalmente por los tiempos totales de viaje.

Food for Thought: A Randomized Trial of Food Insecurity Screening in the Emergency Department

Towards guidelines for designing parks of the future