An Evolving Structure of Nature Immersion: Roots in Nightingale's Vital Power.

Background: In Florence Nightingale's view, vital power resides in both earthy materials and human nature and is an essential element of health. Vital power is defined as a health force that manifests in states of being while doing in nature to generate well-being, but little is known about the generative process of vital force. Purpose: This secondary study explored the vital power of children who experienced well-being while doing in nature. Methods: Using a framework of the Nature Immersion Model, directed content analysis of parental reflections on their children's vital power experiences sought to explore patterns of being while doing in nature observed in association with parental reports of: (a) change in their children's well-being and (b) qualities of vital power evident in parental descriptions of those changes in well-being. Conclusions: The essence of vital power encompassed feelings of a life-spark, natural energy that prompted a healing shift. Implications for Practice: Linkage between a middle-range Theory of Nature Immersion and Nightingale's perspective adds a new avenue for integrating the spiritual-physical-mental dimension of self during creative nursing praxis.

Nature Immersion in an Extreme Environment: Hiroshima Survivors' Personal Emergence Following Their Atomic Bomb Experience.

INTRODUCTION: Nature immersion is defined as multidimensional connecting with earthy materials to generate personal emergence. Personal emergence is an embodied healing force observable via synchronization of bodily rhythms. Research has revealed positive effects of green space for healing. However, little is known about healing of survivors in the space impacted with radioactive nuclear energies. PURPOSE: To use the theory of nature immersion to guide exploration of the concepts of connecting with earthy materials, personal emergence and space-time expansion in a sample of people who had experienced the catastrophic nature upheaval of the Hiroshima bombings on 6 August 1945. METHOD: A descriptive exploratory design with directed content analysis was used with existing qualitative data consisting of 29 Hiroshima atomic-bombing survivors' description of their experience. RESULTS: Self-healing empirically manifested through 23 survivors' connection with earthy materials. There was synchrony between recuperating natural space and healing of survivors. CONCLUSIONS: Synchrony, as a dimension of human connection with nature, transcended the disharmony of bombing upheaval. Although further exploration is necessary, these findings serve as evidence about the essence of healing as related to nature for those in extreme environments.

Effect of a thin-tipped short bevel needle for peripheral intravenous access on the compressive deformation and displacement of the vein: A preclinical study.

BACKGROUND: Peripheral intravenous catheter (PIVC) insertion often fails on the first attempt. Risk factors include small vein size and dehydration, causing vein deformation and displacement due to puncture resistance of the vessel. The authors developed a short, thin-tipped bevel needle and compared its puncture performance with needles of four available PIVCs using an ex vivo model. METHODS: The PIVC with the thin-tipped short bevel needle was compared to four available PIVCs using an ex vivo model which simulated the cephalic vein of the human forearm. The ex vivo model consisted of a porcine shoulder and porcine internal jugular vein, and was used for evaluation of the rate of vein deformation and vessel displacement during needle insertion. RESULTS: An ex vivo model was created with a vessel diameter of 2.7-3.7 mm and a depth of 2-5 mm. The thin-tipped short bevel PIVC needle was associated with a significantly lower compressive deformation rate and venous displacement compared to the needles of the other four PIVCs. CONCLUSION: The thin-tipped short bevel needle induced lower compressive deformation and displacement of the vein than the conventional needles. This needle has the potential to improve the first-attempt success rate of peripheral intravenous catheterization in patients with difficult venous access.

Incidence of and risk factors for self-load-related and medical device-related pressure injuries in critically ill patients: A prospective observational cohort study.

There are two types of pressure injuries: self-load-related pressure injuries (PIs) and medical device-related pressure injuries (MDRPIs), but the differences in risk factors between PIs and MDRPIs have not yet been clarified. If risk factors for PIs and MDRPIs differ, preventive interventions should take this into account. This is a prospective cohort study aimed to determine the cumulative incidence of PIs and MDRPIs in critically ill patients and to identify corresponding risk factors. The study included 1418 patients who were admitted to the critical care medical center of a single university hospital in Tokyo, Japan, between 1 December 2019 and 31 August 2020. The Kaplan-Meier method was used to calculate the cumulative incidence of PIs and MDRPIs. Furthermore, the Cox proportional hazards model was used to analyse the predictors in both the PI and MDRPI incidence and non-incidence groups. Predictors were based on data from the 0th disease day. The cumulative incidence of PIs and MDRPIs was 4.6/1000 person-days and 3.6/1000 person-days, respectively. Multivariate analysis using the Cox proportional hazards model showed that common risk factors for the occurrence of PIs and MDRPIs were possession of PI on admission, higher blood lactate, blood purification therapy, and positional restriction. The risk factors for PIs only were diabetes mellitus, septic shock, and a lower serum albumin level, while the risk factors for MDRPIs only were the D-dimer level and extracorporeal membranous oxygenation treatment. Therefore, prophylactic interventions need to consider these different risk factors.

Urban Children's Well-Being Factors and Qualities of Being and Doing in Natural Space: Nature Immersion.

Research has suggested positive effects of nature immersion-a state of being or an act of doing in natural space-for urban children who were otherwise at risk for emotional or behavioral problems. However, few studies have systematically investigated natural space qualities that predict child well-being at the clinical level. The purpose of this study was to increase the understanding of natural space qualities as factors of urban child well-being. Explanatory mixed methods were used. Quantitative data (N = 174) included a survey and two parental reports of child well-being. Interviews provided qualitative data (N = 15). Data were analyzed using generalized linear model and content analysis. Both data streams were merged into a point of meta-inference that contributed to parental assessment of enhanced child well-being: More frequent nature-child space-time immersion combined with parental valuing of nature connection (p < .001) as a soothing and safe resource. The factors of urban nature immersion affected child well-being over parental socioeconomic affluence alone. The evidence corresponds to Nightingale's tenet that an act of doing, which is considered an action of the child's own will, affects one's sense of well-being. The findings indicate that nature immersion can be applied to urban child self-care and holistic nursing modalities.