Nurses' Attitudes Towards Death and Their Effects on Spirituality and Spiritual Care.

This study aimed to determine the effect of nurses' attitudes towards death on spirituality and spiritual care. This is a descriptive and correlational study. There was a moderate correlation between the total score on the Spirituality and Spiritual Care Rating Scale and the total and subdimension scores on the Attitude Towards Death Scale. It was found that the scores on the subdimensions of objective acceptance, escaping/acceptance and fear of death explained 41.7% of nurses' perceptions of spirituality and spiritual care. For holistic nursing care, it is very important that nurses are aware of their patients' spiritual needs and are capable of providing supportive spiritual service without regard for their own attitudes towards or spiritual thoughts about death.

The Experience of Holistic Nurse Coaching for Patients With Chronic Conditions.

Purpose: The purpose of this study was to explore and describe the lived experience of adults with chronic conditions receiving holistic nurse coaching. Method: A qualitative phenomenological research design was used for this study. A purposive sample of 15 patients with varied chronic conditions participated. Institutional review board approval was obtained from the participating university prior to data collection. The patients' stories of their experiences with holistic nurse coaching were analyzed using Colaizzi's method of phenomenological analysis. Findings: Eight theme clusters emerged when the formulated meanings were organized into the following categories: (1) Seeking Guidance to Navigate Life's Challenges, (2) Entering a Safe Sacred Place, (3) Feeling Empowered and Accountable, (4) Developing Strategies to Access Different Ways of Knowing, (5) Finding the Answers Within, (6) Making Healthy Behavioral Changes, (7) Forming a New Caring Relationship with Self, and (8) Transforming to a Brand-New Approach to Life. Conclusions: Findings from this study provide insight into experiences of holistic nurse coaching for patients with chronic conditions. Further research is needed to examine the influence of holistic nurse coaching on health outcomes related to chronic conditions such as quality of life, patient empowerment, and targeted metrics related to specific chronic conditions.

Effectiveness of Nurse's Intentional Presence as a Holistic Modality on Depression, Anxiety, and Stress of Cardiac Surgery Patients.

One of the important aspects of recovering after bypass surgery is mental disorders of patients. Despite the importance of intentional presence in interpersonal interactive space in holistic nursing, a few experimental and clinical trial studies are conducted on this subject. This study determines the effect of intentional presence of a holistic nurse on anxiety, stress, and depression in patients undergoing coronary artery bypass graft surgery. The study used a randomized clinical trial conducted on 80 patients referred to heart surgery department from March 2016 to June 2017, who were allocated to the control and intervention groups randomly. DASS 21 (Depression, Anxiety, Stress scale) questionnaire and a checklist to determine stressor resources were used to measure the variables. Four 30- to 45-minute sessions of nursing intentional presence were conducted for each patient individually in the intervention group. The results showed homogeneity between 2 groups in demographic variables (P > .05). But there was heterogeneity between 2 groups (P < .05) for some stressors. By using analysis of covariance and excluding the effect of stressors and the first scores before the intervention, statistics represented a significant decrease in stress, anxiety, and depression scores in the intervention group compared with the control group (P < .0001). The results of this study indicated that the intentional presence of a nurse as an effective nursing procedure can reduce the depression, stress, and anxiety of the patients undergoing coronary artery bypass surgery.

Development of a measure to assess healthcare providers' implementation of patient-centered care.

BACKGROUND: Patient-centered care (PCC) is a vaguely defined element of high-quality care, which precludes its consistent and precise operationalization. A conceptualization of PCC was derived from the literature and guided the development of an instrument to assess implementation of PCC by healthcare providers. The items of the instrument capture specific activities that reflect three components of PCC: holistic, collaborative, and responsive care. This paper reports on the measure's content and construct validity and reliability. METHODS: Content validity was evaluated in a sample of 11 nurse practitioners who rated the relevance of each items' content in reflecting the respective component of PCC. The content validity index (CVI) was estimated. Construct validity and internal consistency reliability were examined in a survey of 149 nurse practitioners employed in acute care institutions, using factor analysis and the KR-20 coefficient, respectively. RESULTS: The CVIs were 100% for the three subscales assessing the holistic, collaborative, and responsive care components of PCC. The items in each subscale loaded on one factor. The KR-20 coefficients were .66, .70, and .42, respectively. Overall, the majority (>70%) of respondents indicated performance of the activities comprising the three components of PCC. LINKING EVIDENCE TO ACTION: The PCC measure demonstrated acceptable psychometric properties. The low variance in responses, which is anticipated for instruments assessing fidelity of intervention implementation, accounts for the low reliability coefficients. Additional testing of the measure's psychometric properties in different groups of healthcare providers is warranted. The measure can be used to monitor healthcare providers' implementation of PCC in their usual practice.

Outcomes of newly practicing nurses who applied principles of holistic comfort theory during the transition from school to practice: a qualitative study.

The aim of this qualitative study was to explore if newly practicing nurses benefited from learning holistic comfort theory during their baccalaureate education, and to provide a conceptual framework to support the transition from school to practice. The study was conducted among graduates of an accelerated baccalaureate nursing program where holistic comfort theory was embedded as a learner-centered philosophy across the curriculum. A phenomenological process using van Manen's qualitative methodology in education involving semi-structured interviews and thematic analysis was used. The nurses recalled what holistic comfort meant to them in school, and described the lived experience of assimilating holistic comfort into their attitudes and behaviors in practice. Themes were established and a conceptual framework was developed to better understand the nurses' lived experiences. Results showed that holistic comfort was experienced as a constructive approach to transcend unavoidable difficulties during the transition from school to practice. Participants described meaningful learning and acquisition of self-strengthening behaviors using holistic comfort theory. Holistic comfort principles were credited for easing nurses into the realities of work and advocating for best patient outcomes. Patient safety and pride in patient care were incidental positive outcomes. The study offers new insights about applying holistic comfort to prepare nurses for the realities of practice.

The use of complementary and alternative medicine by nurses.

BACKGROUND: Complementary and alternative medicine (CAM) use is common among patients attending the department of the authors of this article. With expanding roles of nurses in various clinics, the nurses are often asked for their advice on CAM use by their patients. CAM education is not part of the nursing curriculum in various parts of the world. The aim of this study was to establish the use of CAM by nurses along with their knowledge base and attitudes towards it. METHODS: A questionnaire-based study based on the published literature was used among qualified nurses. The data were collected and analysed using SPSS for Windows. RESULTS: The response rate was 86% (531/621; females were 91% and the mean age was 32 years (range 20-63). Eighty percent of the responders admitted to use of CAM and 41% were using CAM at the time. The most commonly mentioned CAM were massage, cod liver oil and cranberry juice. CAM was mostly used for relaxation, joint pain and urinary tract infection. Only five nurses believed CAM was not effective and 74% would recommend CAM use to others. Ninety-three percent of nurses did not have any formal education on CAM. Most nurses would consider some education on CAM to enable them to counsel their patients. CONCLUSIONS: The use of CAM is high among nurses. As patients are increasingly relying on nurses for advice on its use, it is important for nurses to be educated about CAM in order to guide their patients.

Development of the Holistic Nursing Competence Scale.

This study developed a scale to measure the nursing competence of Japanese registered nurses and to test its psychometric properties. Following the derivation of scale items and pilot testing, the final version of the scale was administered to 331 nurses to establish its internal consistency, as well as its construct and criterion-related validity. Using an exploratory and a confirmatory factor analysis, 36 items with a five-factor structure were retained to form the Holistic Nursing Competence Scale. These factors illustrate nurses' general aptitude and their competencies in staff education and management, ethical practice, the provision of nursing care, and professional development. The Scale has a positive correlation with the length of clinical experience. A Cronbach's alpha coefficient was 0.967. The Scale is a reliable and valid measure, helping both nurses and organizations to correctly evaluate nurses' competence and identify their needs for professional development.

Health promotion in nurses: is there a healthy nurse in the house?

The purpose of this pilot study was to examine the health-promoting lifestyle behaviors of acute-care nurses using the Health Promotion Model. Statistical analysis of 149 returned Health-Promoting Lifestyle Profile II surveys indicates areas of weakness in stress management and physical activity. No significant difference is found between unit, demographic factors, and subscale scores at the p < .01 level, but medical-surgical nurses consistently scored better than the critical-care nurses in health promotion. Findings support the need for the development of holistic nursing interventions to promote self-care in the identified areas. Strategies include educational/experiential classes in holistic nursing; individualized unit-based activities fostering stress management, such as massage, reflexology, and imagery; and development of an employee wellness program.

As práticas integrativas na Estratégia Saúde da Família: visão dos agentes comunitários de saúde / Las prácticas integrativas en la Estrategia Salud de la Familia: visión de los agentes comunitarios de salud / Integrative practices in Family Health Strategy: vision of community health agents

O estudo objetiva identificar as práticas integrativas utilizadas pela população na Estratégia Saúde da Família do Distrito Leste de Goiânia, segundo os Agentes Comunitários de Saúde e verificar suas crenças frente às práticas adotadas pela clientela. A amostra foi de 35 profissionais, que responderam a um questionário nos meses de fevereiro e março de 2008. Pela análise quantiqualitativa dos dados, destacou-se o uso da homeopatia, fitoterapia, acupuntura, chás medicinais, massoterapia, yoga e shantala, sendo relacionado tanto à promoção quanto à recuperação da saúde. Houve concordância no uso dessas práticas na Estratégia Saúde da Família pelo baixo custo, ausência de efeitos colaterais, satisfação e crença da população. Recomenda-se o planejamento de ações para a capacitação dos Agentes Comunitários de Saúde e aplicação da Política Nacional de Práticas Integrativas/Complementares, no intuito de ampliar as alternativas do cuidar e possibilitar ao usuário a escolha do tratamento que julgar melhor para promoção da sua saúde.

The study aims at identifying the integrative practices used by the population in Family Health Strategy in the Eastern District of Goiania, GO, Brazil, according to Community Health Agents and at verifying their beliefs in face of integrative practices adopted by the clientele. The sample was composed of 35 professionals, who answered a questionnaire structured in February and March, 2008. The quantiqualitative analysis of the data highlighted the use of homeopathy, phytotherapy, acupuncture, medicinal teas, masotherapy, yoga, and shantala. Their use was related both to promotion and recovery of health. There was agreement on the use of such practices in the Family Health Strategy on the basis of their low cost, lack of side effects, satisfaction, and trust on the part of the population. Planning of actions is advisable for the empowerment of Community Health Agents and application of National Politics of Integrative/Complementary Practices, in order to enlarge care alternatives and to give users a choice of treatment they deem best for promoting their health.

El estudio tiene por objeto identificar las prácticas integradoras utilizadas por la población en la Estrategia Salud de la Familia del Distrito Este de Goiania-GO-Brasil, según los Agentes Comunitarios de Salud y verificar su creencias frente a las prácticas de integración adoptadas por la clientela. La muestra fue de 35 profesionales que respondieron a un cuestionario en los meses de febrero y marzo de 2008. Para el análisis cuanticualitativo de los datos, se destacó el uso de la homeopatía, fitoterapia, acupuntura, tés medicinales, masoterapia, yoga y shantala, siendo su uso relacionado tanto a promover cuanto a la recuperación de la salud. Hubo acuerdo en el uso de esas prácticas en la Estrategia Salud de la Familia por el bajo costo, la falta de efectos colaterales, satisfacción y creencia de la población. Se recomienda la planificación de acciones para la capacitación de los Agentes Comunitarios de Salud y la aplicación de Políticas Nacionales de Integradoras/Complementarias, con el fin de ampliar las alternativas del cuidar y ofrecer al usuario la opción de tratamiento que considere mejor para la promoción de su salud.

Documenting health promotion services in community-based nursing centers.

A data-collection tool developed to document health promotion services and describe program participants was used by 7 community-based nursing centers for 12 months. Data analysis results found that a wide range of services were offered to target populations across the life span, with adults aged 60 and older being the largest group of program users.

Holism in community leg ulcer management: a comparison of nurses in Sweden and the UK.

Collaboration between Kronoberg County Council and Växjö University, Sweden, and Hull and East Riding Community NHS Trust and the University of Hull, UK, enabled an international comparison of care of patients with chronic leg ulcers in the two countries. An aim of the survey study was to compare what "holistic care" meant to nurses working in primary health care (PHC) and nursing home settings in Kronoberg County (KC) and the East Riding of Yorkshire and Hull (ER). A questionnaire, which obtained quantitative and qualitative data, was returned by 311 (222 completed) nurses in KC and 124 in ER (response rates of 54 and 50% respectively). Assessment and planning of wound management focused on the wound. Swedish nurses paid more attention to patients' experience of the wound, lifestyle factors and environment than UK nurses, but in both countries holistic care appeared to be lacking. Issues for nurse education concerning holistic care were identified. Revision of guidelines and consensus documents to facilitate holistic care is also suggested.

The integration of holistic nursing practices and complementary and alternative modalities into curricula of schools of nursing.

CONTEXT: Schools of nursing in the United States have responded to the increasing consumer use of complementary and alternative modalities and consumer demand for health professionals knowledgeable in complementary and alternative modalities by incorporating holistic nursing practices and complementary and alternative modalities into their curricula. OBJECTIVE: To determine the extent to which US schools of nursing have incorporated holistic nursing practices and complementary and alternative modalities into their curricula. DESIGN: Electronic web-based survey. SETTING: Surveys were sent to 585 US schools of nursing. PARTICIPANTS: Sample (n = 125) of deans and directors (or their designees) of Baccalaureate and higher degree US nursing programs at schools holding membership in the American Association of Colleges of Nursing (AACN). MAIN OUTCOME MEASURES: Demographics of US schools of nursing, percentages of schools who utilized the American Holistic Nurses' Association (AHNA) definition of holistic nursing practice and the Holistic Core Curriculum Guidelines, and percentage of complementary and alternative modalities incorporated into the curricula. RESULTS: Almost 60% (n = 74) of the responding schools used the definition of holistic nursing practice in their curricula and were familiar with the Holistic Nursing Core Curriculum. The majority (84.8%, n = 106) included complementary and alternative modalities in their curricula. CONCLUSIONS: The study provides preliminary evidence that US. schools of nursing are incorporating holistic nursing practices and complementary and alternative modalities into their curricula reflecting a response to increased consumer use of complementary and alternative modalities and consumer demand for health professionals who are knowledgeable about complementary and alternative modalities.

Complementary, alternative, integrative: have nurses kept pace with their clients?

While medical literature reflects an interest in the use of complementary therapies, there is a paucity of studies in the nursing literature addressing the use of therapies by nurses, either on themselves or on their clients. While the utilization rate of complementary therapies by the general population has been estimated to be as high as 45%, and nurses are interacting with clients who use these therapies on a daily basis, little is known about nurses' attitudes, knowledge, or perceived efficacy of the therapies.

The integration of complementary therapies in North and South Thames Regional Health Authorities' critical care units.

Subsequent to the rising interest in complementary therapies, a survey was conducted to determine the extent of integration of complementary therapies in critical care units in the North and South Thames Regional Health Authorities in the Greater London area. In total, 45 critical care units were surveyed at random. The results of the survey indicated Neonatal Intensive Care Units showed the greatest interest and provision (75%) of complementary therapies. This was primarily in the application of baby massage. In contrast, only 10% of Coronary Care Units surveyed provided complementary therapies. Results further indicated that of 51.1% of critical care units which claimed to provide complementary therapies, only 7% provided interventions on a routine, systematic basis.