Nursing Care of a Patient with Hypertension and Chronic Kidney Disease Followed by Comfort Theory and NANDA Diagnoses with NIC-NOC Classification: A Case Report/ Hipertansiyon ve Kronik Böbrek Hastalığı ile Takip Edilen Hastaya Konfor Kuramı ve NIC-NOC Sınıflamasıyla NANDA Tanıları ile Yapılan Hemşirelik Bakımı: Bir Olgu Sunumu

Öz

Hypertension is one of the most common chronic diseases in the world and in our country. It is also seen in a large portion of the elderly population and leads to chronic kidney disease and heart disease. The complications it causes increase the cost of care, placing a significant burden on the healthcare system. Therefore, nursing care plays a crucial role in the management of hypertension. In this case, a patient's medical history was taken in accordance with Kolcaba's comfort theory, and deficiencies in the comfort zone were identified according to the taxonomy. Furthermore, an evidence-based nursing process was implemented using the NANDA-I Taxonomy II, NOC, and NIC classification systems. Taxonomic classification determines individuals' comfort levels and reveals deficiencies in the comfort zone. Accordingly, when the care provided was evaluated, the targeted values in the second NOC outcome criteria were achieved in most areas. The combined NANDA-I Taxonomy II, NOC, and NIC nursing classification systems, along with Kolcaba's comfort theory, were found to be successful in providing effective care.

Anahtar Kelimeler

• Nursing Care Process
• Hypertension
• Comfort Theory
• Chronic Kidney Disease
• NOC-NIC

Hipertansiyon ve Kronik Böbrek Hastalığı ile Takip Edilen Hastaya Konfor Kuramı ve NIC-NOC Sınıflamasıyla NANDA Tanıları ile Yapılan Hemşirelik Bakımı: Bir Olgu Sunumu/ Nursing Care of a Patient with Hypertension and Chronic Kidney Disease Followed by Comfort Theory and NANDA Diagnoses with NIC-NOC Classification: A Case Report

Öz

Hipertansiyon hastalığı dünyada ve ülkemizde en çok görülen kronik hastalıklardan birisidir. Hastalık yaşlı nüfusun büyük bir bölümünde görülmekte ayrıca kronik böbrek hastalığı ve kalp hastalıklarına yol açmaktadır. Meydana getirdiği komplikasyonlar bakım maliyetini arttırarak sağlık sistemine büyük yük getirmektedir. Bu nedenle hemşirelik bakımının etkisi  hipertansiyon hastalığının yönetiminde oldukça önemli rol olmaktadır. Bu olguda Kolcaba’nın konfor teorisi doğrultusunda hastadan anamnez alınmış taksonomiye göre konfor alanındaki eksiklikler saptanmıştır. Ayrıca, NANDA-I Taksonomi II, NOC ve NIC sınıflandırma sistemleri kullanılarak kanıt temelli hemşirelik bakım süreci uygulanmıştır. Taksonomik sınıflandırma bireylerin konfor düzeylerini belirlemekte ve konfor alanındaki eksiklikleri ortaya koymaktadır. Buna göre verilen bakım değerlendirildiğinde ikinci NOC sonuç kriterlerinde hedeflenen değere çoğu alanda ulaşıldığı NANDA-I Taksonomi II, NOC ve NIC bir arada sunulan hemşirelik sınıflama sistemlerinin ve Kolcaba’nın konfor kuramının etkili bakım vermede başarılı olduğu görülmektedir.

Anahtar Kelimeler

• Hemşirelik Bakım Süreci
• Hipertansiyon
• Konfor Kuramı
• Kronik Böbrek Hastalığı
• NOC- NIC

Kaynakça

1. 1. Feo R, Conroy T, Jangland E, Muntlin Athlin Å, Brovall M, Parr J, et al. Towards a standardised definition for fundamental care. A modified Delphi study. J Clin Nurs. 2018;27(11-12):2285-99. https://doi.org/10.1111/jocn.14247.
2. 2. Mudd A, Feo R, Conroy T, Kitson A. Where and how does fundamental care fit within seminal nursing theories: a narrative review and synthesis of key nursing concepts. J Clin Nurs. 2020;29(19-20):3652-66. https://doi.org/10.1111/jocn.15420.
3. 3. Nasiri M, Jafari Z, Rakhshan M, Yarahmadi F, Zonoori S, Akbari F, et al. Application of Orem's theory‐based caring programs among chronically ill adults: a systematic review and dose–response meta‐analysis. Int Nurs Rev. 2023;(1):59-77. https://doi.org/10.1111/jocn.14247.
4. 4. Akbaş D, Özer S, Yıldırım Y. Lydia hall model-based care in a patient with gastrointestinal bleeding after cardiac arrest. Turk J Card Nur. 2022;13(30):50-3. https://doi.org/10.5543/khd.2022.211724.
5. 5. Potter AP, Perry AG, Stockert AP, Hall AM, Ostendorf R W. Fundamentals of nursing. 11. Baskı. St. Louis: Elsevier; 2021. s. 2517-601.
6. 6. Balkan E, Oskay Ü. Nursing care of a patient with cervical cancer according to Kolcaba’s comfort theory. Ordu University J Nurs Stud. 2023;6(1):166-73. https://doi.org/10.38108/ouhcd.1069543.
7. 7. Konlan K D, Shin, J. Determinants of self-care and home-based management of hypertension: an integrative review. Global Heart. 2023;18(1):16. https://doi.org/10.5334/gh.1190.
8. 8. Aydoğdu S, Güler K, Bayram F, Altun B, Derici Ü, Abacı A, et al. Türk hipertansiyon uzlaşı raporu. Turk Kardiyol Dern Ars. 2019;47(6):535-46. https://doi.org/10.5334/gh.1190.

9. 9. Lin Y, Zhou Y, Chen C. Interventions and practices using comfort theory of Kolcaba to promote adults’ comfort: an evidence and gap map protocol of international effectiveness studies. Systematic Reviews. 2023;12(1):1-10. https://doi.org/10.1186/s13643-023-02202-8.
10. 10. Wensley C, Botti M, McKillop A, Merry AF. Maximising comfort: how do patients describe the care that matters? a two-stage qualitative descriptive study to develop a quality improvement framework for comfort-related care in inpatient settings. BMJ Open. 2020;10(5):e033336. https://doi.org/10.1136/bmjopen-2019-033336.
11. 11. Kolcaba K, Crawford CL. Comfort. Peterson SJ, Bredow TS, eds. In: Middle Range Theories: Applicatoin to nursing research and practice. London: Wolters Kluwer; 2020. p.189-209.
12. 12. Bice A, Kolcaba K. Katharine Kolcaba’s Comfort Theory. 5. Baskı. FA Davis; 2020.
13. 13. Terzi H, Yeşilyurt E. Planning the homecare of a laryngeal cancer patient receiving external radiotherapy according to Kolcaba's comfort theory: a case-report. Gazi Sağlık Bilimleri Dergisi. 2023;8(2):1-15. https://doi.org/10.52881/gsbdergi.1188693
14. 14. Lin Y, Zhou Y, Chen C, Yan C, Gu J. Application of Kolcaba’s Comfort Theory in healthcare promoting adults’ comfort: a scoping review. BMJ Open. 2024;14(10):e077810. https://doi.org/10.1136/bmjopen-2023-077810.
15. 15. Kolcaba KY. A taxonomic structure for the concept comfort. Image J Nurs Sch. 1991;23:237-40. https://doi.org/10.1111/j.1547-5069.1991.tb00678.x.
16. 16. Kolcaba K, Tilton C, Drouin C. Comfort theory: A unifying framework to enhance the practice environment. JONA: the Journal of Nursing Administration. 2006;36(11):538-44. https://doi.org/10.1097/00005110-200611000-00010
17. 17. Yücel Ş Ç, Arslan G G, Bagcı H. Effects of hand massage and therapeutic touch on comfort and anxiety living in a nursing home in Turkey: a randomized controlled trial. J Relig Health. 2020; 59.1:351-64. https://doi.org/10.1007/s10943-019-00813-x
18. 18. Balkan E, Oskay Ü. Nursing care of a patient with cervical cancer according to Kolcaba’s Comfort theory. Ordu University J Nurs Stud. 2023;6(1):166-73. https://doi.org/10.38108/ouhcd.1069543
19. 19. Bulechek G, Butcher H K, Dochterman J M, Wagner C. Hemşirelik girişimleri sınıflaması (NIC), Erdemir F, Kav S, Yılmaz A, çeviri eds. 6. Baskı. İstanbul: Nobel Tıp Kitabevleri; 2017. p. 63-390.
20. 20. Wilkison J M, Barcus L. Pearson Hemşirelik tanıları el kitabı. Kapucu S, Akyar İ, Korkmaz F, çeviri editörleri. NANDA-I tanılar, NIC girişimleri, NOC çıktıları. 11. Baskı. Ankara: Pelikan Yayınevi; 2018.
21. 21. Moorhead S, Johnson M, L Mass M, Swanson E. Nursing outcomes classification (NOC) measurement of health outcomes. 6. Baskı Louis MO: Elsevier; 2013.
22. 22. Gülpak M, Oktay A A. Kronik böbrek hastalığı olan hastada NANDA tanıları ve NIC girişimleri ile hemşirelik bakımı: olgu sunumu. KSU Medical Journal. 2020; 15(2):67-79. https://doi.org/10.17517/ksutfd.685567
23. 23. De La Cruz MBR, Pacheco EEJ, Molocho LAF. Nursing care process for patients with pneumonia and arterial hypertension in the emergency department of a hospital in Lima. AG Salud. 2023;1:14. https://doi.org/10.62486/agsalud202314
24. 24. Bal C, Koç Z. Nursing diagnoses according to NANDA-I, NIC-nursing ınterventions and NOC outcomes of ındividuals who suffered ıschemic stroke. Turk Klin J Nurs Sci. 2020;12(3):443-56. https://doi.org/10.5336/nurses.2019-70124
25. 25. Baykara ZG, Çalışkan N, Öztürk D, Karadağ A. The use of nursing theories and models: a qualitative study. Cukurova Med J. 2019;44:281-9. https://doi.org/10.17826/cumj.562393
26. 26. Emrullahoğlu A, Dilek F, Altunan B. Post-stroke care: structuring the nursing process in line with the nursing model based on life activities. Balkan Sağlık Bilimleri Dergisi. 2025;4(1):6-17. https://doi.org/10.61830/balkansbd.1677595
27. 27. Duman HT, Yıldırım Y, Fadıloğlu Ç, Aykar FŞ. A case of atrial fibrillation according to Kolcaba's comfort theory. Turk J Cardiovasc Nurs. 2020;11(24):37-42. https://doi.org/10.5543/khd.2020.98598
28. 28. Koçak İ, Baga Y, Tekin S. B, İpekçoban G. Nursing care given to the patient diagnosed with pulmonary embolism with rare pneumonia and pulmonary embolism together with NANDA, NOC and NIC classification system in line with the life model: case report. Hemşirelik Bilimi Dergisi. 2025;8(2):291-301. https://doi.org/10.54189/hbd.1596707
29. 29. Ribeiro S, Oliveira Aguilera AC, Silveira Domingues M, Mangini Bocchi, SC, da Silva Domingos. Nursing process applied to an elderly with hypertension and chronic kidney disease: a case study. Saúde Coletiva [Internet]. 2021[cited 2025 Jul 18];11(71). Available from: https://openurl.ebsco.com/EPDB%3Agcd%3A11%3A24713531/detailv2?sid=ebsco%3Aplink%3Ascholar&id=ebsco%3Agcd%3A154230957&crl=