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Although written protocols currently are directed more to pain relief than to the comfort of each child, there is increasing interest in pediatric literature about comforting strategies for children and their families. However, pediatric nurses/researchers currently utilize measures of discomfort that designate a neutral sense of comfort as in the absence of a specific discomfort. Assessing comfort as a positive, holistic outcome is important for measuring effectiveness of comforting strategies. Comfort Theory (Kolcaba, 2003), with its inherent emphasis on physical, psychospiritual, sociocultural, and environmental aspects of comfort, will contribute to a proactive and multifaceted approach to care. The framework of Comfort Theory for pediatric practice and research is easy to understand and implement. The application of the theory is strengthening and satisfying for pediatric patients/families and nurses, and benefits institutions where a culture of comfort is valued. Moreover, comfort is a transcultural and interdisciplinary concern.
According to the American Nurses Association (ANA) Standards (ANA, 1996/ 2000), pediatrie nursing is focused on the care of children and their families in a variety of health care settings. These settings include pre and post-operative arenas, ambulatory care centers, primary care offices (both physician and nurse-run), specialty clinics, community shelters, and hospitals. The type of nursing care ranges from well baby to acute and chronic care. Pediatrie nursing also includes care for grieving families as they deal with devastating diagnoses, congenital anomalies, and sudden trauma (ANA, 1996/2000).
Some of the principals that undergird pediatrie nursing are: (a) care is individualized with high respect for the goals and preferences of each child within the context of his or her family; (b) each child/family is encouraged to participate in goal setting; (c) care is holistic, encompassing physical, emotional, spiritual, mental, socioculturel, genetic, and developmental aspects of each child/family; (d) care is proactive with attention to prevention of disease and injury through family- centered education, advocacy, and effective communication; and (e) health care is interdisciplinary (ANA, 1996/2000).
Although written protocols currently are directed more to pain relief than to the comfort of each child, there is rising interest expressed in pediatrie literature about comforting strategies when assisting with or performing invasive procedures. These strategies include "positioning for comfort;" facilitating a child's special "self-comfort habits," such as thumb-sucking, blanket-holding, or rocking; and...