Holistic Nurse Practitioner Care Including Promotion of Shared Decision-Making.

The purpose of this quantitative, descriptive, exploratory study was to gauge the degree to which nurse practitioners (NPs) incorporate holistic nursing values in their care, with a special focus on shared decision-making (SDM), using the Nurse Practitioner Holistic Caring Instrument (NPHCI), an investigator-developed scale. A single open-ended question inviting free-text comment was also included, soliciting participants' views on the holistic attributes of their care. A convenience sample of NPs (n = 573) was recruited from a southeastern U.S. state Board of Nursing's (BON) publicly available list of licensed NPs. Results suggest that NPs do indeed perceive their care to be holistic, and that they routinely incorporate elements of SDM in their care. Highest scores were accorded to listening, taking time to talk to patients, knowledge of physical condition, soliciting patient input in care decisions, considering how other areas of a patient's life may affect their medical condition, and attention to "what matters most" to the patient. Age, gender, level of education, practice specialty, and location were also associated with inclusion of holistic care. Free-text responses revealed that NPs value holistic care and desire to practice holistically, but identify "lack of time" to incorporate or practice holistic care as a barrier.

The Effects of Mindfulness Meditation on Stress and Burnout in Nurses.

Background: Occupational burnout related to stress in the workplace is experienced by nurses who are regularly confronted with trauma, suffering, and high workloads. Burnout can negatively impact patient care and have detrimental effects on nurses' physical and mental health. Mindfulness-based stress reduction programs have been researched as a potential holistic intervention for reducing stress and burnout in nurses through cultivating present awareness, emotional regulation, and positive thinking. Purpose: This critical review of the literature explores current knowledge on the effectiveness of mindfulness meditation on stress and burnout in nurses, examines gaps in the current literature, and provides recommendations for future research on this topic. Methods: Search terms included mindfulness, meditation, mindfulness-based stress reduction , occupational stress, stress, burnout, and nurs*. Peer-reviewed research directly related to the impact of mindfulness-based stress reduction on nurses experiencing stress and/or burnout was reviewed. Findings: Findings reveal evidence that mindfulness meditation is effective in decreasing stress and burnout in nurses. Mindfulness-based interventions have been shown to significantly decrease stress, improve all aspects of burnout, and increase self-compassion and compassion satisfaction in practicing nurses. Conclusions: Mindfulness meditation has the potential to decrease stress and burnout in nurses by decreasing self-judgment and overidentification with experience, and by increasing resiliency, compassion, and emotional regulation.

Yoga and perceived stress, self-compassion, and quality of life in undergraduate nursing students.

BACKGROUND: Student nurses' experience of stress while enrolled in educational programs is well-documented; however, complementary and alternative therapies to alleviate or prevent nursing program-related stressors are not. The purpose of this study was to explore the effect of a yoga intervention on stress, self-compassion, and quality of life in undergraduate nursing students. METHODS: Seventy-three undergraduate nursing students participated in this two-group, quasi-experimental, repeated-measures, study. Students self-selected participation in a one-hour yoga class, offered each week for 12 weeks, and completed Stress, Self-Compassion, and QOL scales at baseline, week 6, and week 12. Information on intervention participation and yoga practice outside the intervention was also solicited. Descriptive statistics and mixed-model analysis of variance were used to analyze the data. RESULTS: There were no statistically significant differences between groups over time on perceived stress or QOL. There were statistically significant differences between groups on self-kindness (F3, 69 = 3.86, P = 0.013). CONCLUSIONS: Further research on the effects of yoga for stress reduction in nursing students using randomized controlled trials is recommended.

Holistic Nursing Values in Nurse Practitioner Education.

Much has been written about the inclusion of holistic nursing values and practices in undergraduate nursing education, but their inclusion and influence in advanced practice nursing education has not been fully explored. Nurse practitioners (NPs) are nurses, so it is assumed that the nursing perspective provides a framework for NP education and practice, and that NP education represents the blending of a holistic nursing approach with medical diagnosis and treatment. Nurse practitioners are taking increasing responsibility for filling the gap in primary healthcare availability in the U.S., and in the current political and economic healthcare climate, NPs are in a position to promote primary care models that honor comprehensive, patient-centered, and relationship-based care. As a result, it becomes essential to quantify the inclusion of these values in NP educational programs and coursework, as instilling core values for practice begins in educational environments. This quantitative, descriptive study explored the inclusion of holistic nursing values by NP faculty, using the Nurse Practitioner Holistic Caring Instrument (NPHCI). The NPHCI exhibited quite high reliability and validity in the sample, including confirmation of its three subscales. Survey results suggest that NP faculty actively incorporate holistic nursing values in educational coursework, and that age, length of time teaching in NP programs, highest educational degree, and academics as the primary area of practice were important indicators of the inclusion of holistic nursing values in NP program curricula. Findings add to knowledge of NP education, but further study is warranted.

Nursing Students' Attitudes and Use of Holistic Therapies for Stress Relief.

PURPOSE: The purpose of this study was to explore student nurses' openness to using or recommending holistic therapies, the strategies they use to manage stress from school or work, and their perceptions of the impact of holistic therapies on personal health. STUDY DESIGN: Qualitative component of a quasi-experimental, mixed-methods study. METHODS: A convenience sample of undergraduate nursing students in a southeastern U.S. university completed baseline surveys, including demographics and three open-ended questions regarding attitudes toward holistic therapies and strategies used for stress management. Qualitative thematic analysis was undertaken to identify recurring themes in textual data. FINDINGS: Students are open to using or recommending holistic therapies but identify lack of knowledge and lack of time as barriers to their practice. Among strategies used by student nurses to manage stress from school or work were physical activity, prayer and meditation, time management, distraction, socialization, artistic pursuits, animal interactions, and other activities. Themes describing holistic therapies' impact on personal health were wholeness, self-empowerment, relaxation/restoration, and alternative/complement to traditional medicine. CONCLUSIONS: Findings indicate receptiveness by student nurses to the use of holistic therapies but point to the need for the inclusion of informational as well as experiential education on holistic therapies within nursing curricula.

Development and testing of an instrument to measure holistic nursing values in nurse practitioner care.

As primary care delivery evolves in the United States with nurse practitioners (NPs) as key providers, exploring the patient's perception of the nature and quality of NPs' care is of critical importance to healthcare consumers, providers, educators, policy makers, and underwriters. The aim of this study was to describe the development and testing of the Nurse Practitioner Holistic Caring Instrument, a new, investigator-developed measure of the preservation of holistic nursing values in NP care. Results suggest that NPs provide patient-centered, comprehensive, and clinically competent care, rendering them ideally suited to leading primary health care delivery. However, further testing in more diverse populations and settings is needed to strengthen preliminary findings.

Development of a Quantitative Measure of Holistic Nursing Care.

Holistic care has long been a defining attribute of nursing practice. From the earliest years of its formal history, nursing has favored a holistic approach in the care of patients, and such an approach has become more important over time. The expansion of nursing's responsibility in delivering comprehensive primary care, the recognition of the importance of relationship-centered care, and the need for evidence-based legitimation of holistic nursing care and practices to insurance companies, policy-makers, health care providers, and patients highlight the need to examine the holistic properties of nursing care. The Holistic Caring Inventory is a theoretically sound, valid, and reliable tool; however, it does not comprehensively address attributes that have come to define holistic nursing care, necessitating the development of a more current instrument to measure the elements of a holistic perspective in nursing care. The development of a current and more comprehensive measure of holistic nursing care may be critical in demonstrating the importance of a holistic approach to patient care that reflects the principles of relationship-based care, shared decision-making, authentic presence, and pattern recognition.

The covered wagon journey: student chronicles in advanced holistic nursing.

This article recounts the experiences of a first cohort of graduate students in a newly implemented advanced holistic nursing (AHN) track, one of only a handful in the nation, and the first in Florida. The increasing popularity of complementary and alternative healing processes represents the insufficiency of a health system of fragmented care and a desire for holistic healing that is beyond mainstream allopathic care. Graduate holistic nurse education equips nurses to explore the commitment needed to advance the evolution of health care. The covered wagon journey is a metaphor for this meaningful participation. Students journaled their experiences as cotravelers in a lone wagon: embarking on a courageous journey, forging a path of discovery, and reaching their destination as pioneers. This cohort experience embodied the central tenets of holistic nursing, thus creating conscious change and unity within a learning community. The future of AHN is addressed in the context of the contemporary health care environment.