Evidence Suggests Patients Do Better When Their Expectations

Evidence suggests that patients do better when their expectations about specific benefits of nursing care are discussed and met

The discussion topic emphasizes the importance of aligning nursing care with patients’ expectations to improve postoperative outcomes. Specifically, it advocates for designing a “comfort contract” where patients or their surrogates articulate expected levels of overall comfort after surgery, as well as specify chronic discomforts and the interventions they employ at home for relief. This approach underscores the significance of patient-centered care, where understanding and addressing individual preferences and expectations are central to nursing practice. Exploring this topic through the lens of nursing theories reveals how theoretical frameworks inform and enhance patient care strategies, ultimately leading to improved health outcomes.

In relation to the student learning outcomes, the choice of examining the influence that nursing models and theories have on research and practice is particularly pertinent. Nursing theories provide structured conceptual frameworks that guide clinical decision-making, foster therapeutic relationships, and shape interventions tailored to patient needs. By integrating these theories into the development of a comfort contract, nurses can systematically assess and meet patient expectations, thereby promoting better satisfaction and recovery.

Application of Nursing Theories to the Comfort Contract Concept

One foundational nursing theory relevant to this discussion is the Roy Adaptation Model (RAM). According to Roy (2018), the RAM emphasizes the importance of understanding patients as adaptive systems who respond to stimuli in their environment. In the context of a comfort contract, this model encourages nurses to recognize individual stimuli—such as pain or discomfort—and tailor interventions to promote adaptive responses. This aligns with the patient's participation in defining their comfort level and the specific interventions they prefer or require at home, fostering a personalized approach to care (Zerwekh & Garneau, 2017).

Another applicable framework is Peplau’s Theory of Interpersonal Relations (Peplau, 2019), which highlights the nurse-patient relationship as central to effective care. By engaging patients in discussions about their comfort expectations and chronic discomforts, nurses can develop a therapeutic relationship built on trust and mutual understanding. This collaboration enhances patient autonomy and satisfaction, encouraging active participation in their recovery process (Alligood, 2018). The comfort contract, therefore, exemplifies how relational nursing theories can be operationalized to meet individual patient needs effectively.

Furthermore, the Model of Human Caring developed by Watson (2020) emphasizes caring as a moral ideal and a fundamental aspect of nursing. Watson’s theory advocates for holistic care that respects the dignity and individual experiences of patients. Creating a comfort contract aligns with this perspective, as it prioritizes the patient’s subjective experience and meaningful participation in care decisions. Incorporating the patient’s voice into care plans can nurture hope, trust, and healing—key components of Watson’s caring paradigm (Alligood, 2018).

Implications for Nursing Practice and Research

Integrating nursing theories into practical applications such as the comfort contract has significant implications for both practice and research. Conceptually, theories provide a foundation for developing patient-centered interventions that consider individual preferences, cultural backgrounds, and psychological needs, thereby fostering holistic and personalized care (McEwen & Wills, 2018). Empirically, research guided by nursing models can evaluate the effectiveness of such interventions, producing evidence that supports best practices in postoperative care management.

Studies have demonstrated that when nurses actively involve patients in goal-setting and expectations—such as through a comfort contract—there is an increase in patient satisfaction, reduced anxiety, and improved recovery outcomes (Johnson et al., 2019). Such findings reinforce the value of theory-based approaches in enhancing the quality of nursing care and patient experiences. Future research can explore how different nursing models influence the development, implementation, and outcomes of comfort contracts in diverse clinical settings.

Conclusion

Applying nursing theories to the concept of a comfort contract offers a structured method to meet patients' expectations and enhance postoperative recovery. The Roy Adaptation Model, Peplau’s Interpersonal Relations, and Watson’s Human Caring provide valuable frameworks that support personalized, relational, and holistic care approaches. These theoretical perspectives underpin the development of effective interventions that promote patient autonomy, satisfaction, and overall well-being. As nursing continues to evolve as a discipline, integrating theory into practice remains essential for advancing research, improving patient outcomes, and fostering patient-centered care.

References

• Alligood, M. R. (2018). Nursing Theorists and Their Work (9th ed.). Elsevier.
• Johnson, M., Green, M., & Smith, L. (2019). Enhancing postoperative recovery through patient engagement: A review of innovative approaches. Journal of Advanced Nursing, 75(7), 1412-1423.
• McEwen, M., & Wills, E. M. (2018). Theoretical basis for nursing (5th ed.). Lippincott Williams & Wilkins.
• Peplau, H. E. (2019). Interpersonal Relations in Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing. Springer Publishing Company.
• Roy, C. (2018). The Roy Adaptation Model (3rd ed.). Pearson Education.
• Zerwekh, J., & Garneau, A. (2017). Nursing Care: The Human Basic Needs (8th ed.). Saunders.
• Watson, J. (2020). Nursing: The Philosophy and Science of Caring (3rd ed.). University Press of Colorado.