Application of comfort care theory

a. Comfort and Anxiety Levels of Women with Early-Stage Breast Cancer Who Receive

Radiotherapy

Nurses explain the need for the comfort of persons in a stressful healthcare setting, according to

Kolcaba's Comfort Theory. Kolcaba's Comfort Theory and RTCQ have the features of a guide in guiding

care and measuring nursing care efficiency. The research found that in addition to offering patient

comfort prior to radiation, eliminating or reducing worry and tension had a favourable impact on

radiotherapy application (Kolcaba and Fox, 1999). However, it is noted that the comfort and anxiety

levels of each patient must be assessed prior to developing and implementing patient-specific comfort-

improving nursing treatments. The RTCQ, which was developed by Kolcaba, has been determined, and

reliability and validity studies have been conducted in the country; it examines the relationship between

health-promoting behaviours and comfort in nursing care, and it also determines that comfort improves

the individual's health-promoting behaviours. The RTCQ is a 26-item senary (1-6) Likert type paper-pen

questionnaire with responses ranging from "definitely agree" to "certainly disagree" that is used to

assess comfort in women with breast cancer who are getting radiation. The higher the questionnaire's

score, the more at ease you are (min 1 and max 6). The RTCQ Cronbach alpha coefficient was 0.61 for

application and 0.63 for retest application, according to Karadag et al. (2019). The questionnaire's

Cronbach alpha coefficient was determined to be 0.71 in this research.

Patients and their families want to be comfortable; thus, it's an essential objective of nursing

care. Kolcaba defined comfort as "an immediate state of being strengthened by having the

human needs for relief, ease, and transcendence addressed in four contexts of experience

(physical, psychospiritual, sociocultural, and environmental)" and quantified comfort through

the development of comfort questionnaires. The juxtaposition of the three states of comfort
 with the four settings of comfort experience yields the taxonomic structure, a 12-cell grid that

has been employed in study and practice. Nurses may aim their treatment in goal-directed and

quantifiable ways by assessing comfort as a positive, holistic result (Karadag et al., 2019). While

the women with breast cancer getting radiation reported moderate levels of comfort, they also

reported modest levels of worry. The women's trait anxiety, on the other hand, was shown to

be greater than their state anxiety. The state might be regarded as nervousness caused by the

unfamiliarity of the equipment and treatment setting, which subsides when therapy is followed.

Other studies that look at the anxiety levels of breast cancer patients have shown that their

anxiety levels are moderate, which is comparable to our findings (Zhang et al., 2018) Zhang et

al., 2018, identified during RT, with the RTCQ mean score of the experiment group being

4.620.76 and the RTCQ mean score of the control group being 4.310.67.

Comfort and quality of life in patients with breast cancer undergoing radiation therapy

The Radiation Therapy Comfort Questionnaire (RTCQ, 1999) was developed by Kolcaba and

adapted from the General Comfort Questionnaire (GCQ) to assess nursing care for early-stage breast

cancer patients receiving radiation therapy. Karabacak adapted the research to Turkish culture after

determining the study's reliability and validity. The scale has been prepared as a six-point Likert scale

ranging from "I definitely agree-6" to "I definitely disagree -1" in this case. For a total of 26 items, the

scale includes positive (11 things) and negative (15 items) emotions. The negative numbers were

computed in the other direction, and the comfort score was derived by dividing the total score by the

number of questions. The scale has a range of scores ranging from 1-6, with higher scores indicating

more comfort. Relaxing interventions (directional dreaming, massage, therapeutic touch, etc.) are

known to increase the patient's comfort, according to Kolcaba's comfort theory. Patients with increased

comfort exhibit changes such as relaxation, positive thinking, feeling well and being happy, according to
the study. These patients are more successful in seeking health behaviours and applications, resulting in

a higher treatment success rate. Comfort and mental state, fatigue, psychological stress, radiation

therapy and cognitive coping, and muscle strain have all been linked in early-stage breast cancer

patients undergoing radiation therapy. It has also been discovered that patient comfort levels and

quality of life scores are linked.

The research assesses the changes in the condition of the patients and their health after

determining their comfort level, after discovering a link between their comfort and quality of life ratings.

In this situation, nurses identify both the physical, psychospiritual, sociocultural, and environmental

comfort requirements of the patients to whom they provide holistic care. To address these demands, a

variety of treatments are used, and each patient's comfort level should be assessed before and after the

therapies. It should not be forgotten that elements outside the nurse's control (such as the patient's

financial situation, social support level, prognosis, and so on) have a substantial impact on the efficacy of

the comfort treatments. People receiving radiation treatment are asked to move out of the position of the

patient in a different manner than patients receiving chemotherapy. As a result, the patient's recovery and

return to everyday activities should be encouraged. To facilitate a speedier return to normal activities

following adjuvant radiation treatment, supportive and protective interventions should be used.
 References

Karadag, E., Uğur, Ö., & Çetinayak, O. (2019). The effect of music listening intervention

applied during radiation therapy on the anxiety and comfort level in women with

early-stage breast cancer: A randomized controlled trial. European Journal of

Integrative Medicine, 27, 39–44. https://doi.org/10.1016/j.eujim.2019.02.003

Zhang, J.-J., Shu, H., Hu, S.-S., Yu, Y., Sun, Y., & Lv, Y. (2018). Relationship between

time elapsed since completion of radiotherapy and quality of life of patients with

breast cancer. BMC Cancer, 18(1). https://doi.org/10.1186/s12885-018-4207-y