Integrative Nursing Interventions for Cancer-Related Symptoms in Oncology Inpatients: Results of a Descriptive Pilot Study.

BACKGROUND: Integrative nursing (IN) is an essential component of integrative medicine and integrative oncology. IN includes a range of external naturopathic, integrative nursing interventions, such as compresses, embrocation, and foot/hand baths, aimed at alleviating symptoms and side effects of conventional treatment. The project IMPLEMENT-UKU ("Implementation of IN at the University Hospital Ulm") was accompanied by a descriptive pilot study on the use of IN interventions on cancer-related symptoms in oncology inpatients, the characterization of these patients and the evaluation of the impact. METHODS: A single-arm study was conducted using a paper-based questionnaire administered before the IN interventions (t0) and 24 hours after the IN interventions (t1). Topics included sociodemographic data, symptoms, quality of life, health status, psychological burden, attitudes, and experience and satisfaction with the IN interventions. Analyses were descriptive using absolute and relative frequencies. RESULTS: During the 6-month study period out of 66 patients recommended for IN consultation by medical and nursing staff on 2 wards, 62 (93.9%) accepted the offer. Of those patients who received IN, 21 patients (33.9%) participated in the study. The number of IN interventions received per patient ranged from 1 to 3 during the 24-hour survey period. And a total of 36 IN interventions were performed: The most treated body region was the feet/legs (50.0%), followed by the back (25.0%), using oils such as solum oil (41.7%) and lavender oil (13.9%). Embrocation (77.8%) was the predominant type of IN intervention. For patients, the mean FACIT-F score was 29.2 ± 12.5. The mean PHQ-4 score was 3.0 ± 1.9. Regarding sleep quality in the last 4 weeks, 13 participants (61.9%) described it as rather or very poor. Satisfaction with the IN was high, with a large proportion of participants evaluating the IN interventions very positively. CONCLUSION: The study's findings suggest that there is a great need for IN among oncology inpatients. These patients are open to and interested in IN interventions and evaluate them positively. IN provides a promising opportunity to provide non-pharmacological support to inpatients. The integration of IN in conventional oncology care settings may enhance patient-centered care and contribute to improved patient wellbeing.

A Journey of Joy: Dr. Barbara M. Dossey's Evolution in Nursing.

Dr. Barbara M. Dossey is an internationally recognized pioneer in the holistic nursing and nurse coaching movements. She is a Florence Nightingale scholar, nurse theorist, and national and international speaker and teacher on the role of holistic, integral, and integrative nursing and nurse coaching in the integrative healthcare paradigm. Her theory of integral nursing presents the science and art of nursing. Her coauthored theory of integrative nurse coaching, a middle-range theory, is a framework to guide integrative nurse coaches in nurse coaching practice, education, research, and healthcare policy. In this column, Dr. Dossey shares her scholarly journey of joy.

Integrative Nursing: A Framework for Whole-Person Mental Health Care.

The incidence of mental illness continues to increase since the start of the COVID-19 pandemic (Mental Health America, 2022). Demand for mental health services has grown, and providers report being "unable to meet the demand" or having an increase in wait times for access to care (American Psychological Association, 2022, para. 1). Due to this increase in demand, more patients are seeking mental health care from their primary care providers. Over the past decade, integrative models of care have been expanding into mental health care (Lake, 2017). Integrative Nursing is a strategy for improving the quality of care provided to patients seeking care for mental health diagnoses, as well as those with a goal of increasing mental health and wellbeing. This article proposes that Integrative Nursing can serve as a framework for providing whole-person mental health care.

Evidence for Choosing Qigong as an Integrated Intervention in Cancer Care: An Umbrella Review.

Cancer is the second leading cause of noncommunicable disease death, with an increasing incidence. Qigong practice can moderate non-intrinsic, modifiable risk factors that act on the stress response using physical movements, breathing, and focused attention. The purpose of this umbrella review is to provide a concise summary to facilitate an evidence-based decision to integrate Qigong into cancer patients' care. Relevant systematic reviews and meta-analyses were identified and retrieved from the JBI database, Cochrane Library, PubMed, Embase, and CINAHL. Of all of the studies assessed, none found evidence of a risk to cancer patients, indicating that Qigong is a safe practice that can be used even by frail patients. The overall quality of life, cancer-related fatigue, and cognitive impairment were improved by Qigong. Different Qigong programs have different impacts on sleep quality and gastrointestinal problems, suggesting that longer practice sessions are required to achieve improvements. To maintain Qigong's effectiveness, an ordinary practice is essential, or such effectiveness will wear off. The use of biological markers in efficacy assessments needs to be more systematically studied. However, positive WBC, RBC, and CRP trends in Qigong practitioners are evident. Higher-quality clinical studies are necessary to measure variables more closely related to Qigong functioning and consider cancer's multifactorial nature.

Integrative Nursing and the ANA Scope and Standards of Practice: Expanding the Reach of Nursing for Families and Society.

The American Nurses Association's (ANA) recently published 4th edition of the Scope and Standards of Practice provides authoritative guidance on actions and behaviors that all registered nurses are expected to perform competently, regardless of role, population, specialty, or setting. The newly defined scope emphasizes the art and science of caring, compassionate presence, and the expectation that nurses be advocates for all, recognizing the connections of all humanity. It also makes frequent reference to whole-person care and highlights the importance of mindfulness by inviting nurses to reflect on how they can incorporate mindfulness and other integrative therapies into their self-care and professional practice. A new standard explicitly states that advanced practice registered nurses should have the competency to prescribe evidence-based traditional and integrative treatments, therapies, and procedures that are compatible with the consumer's cultural preferences, norms, and abilities. Integrative Nursing is aligned with the ANA Scope and Standards of Practice and provides a useful framework for practice that expands the reach of nursing across clinical and community settings and patient populations. In this article, exemplars highlight how Integrative Nursing is being implemented in clinical settings and nursing education programs.

Educational courses on non-pharmacologic complementary interventions for nurses across Europe: The INES mapping pilot study.

BACKGROUND: Pharmacological interventions still form the mainstay of the management of pain, anxiety, sleep problems and discomfort. In Europe, an estimated 100 million people use complementary non-pharmacological interventions (NPIs) for these conditions. In their pre-registration education, nurses do not generally learn about the various types of NPIs and how patients and health care professionals can include NPIs complementary to their standard care. Some nursing schools in Europe offer elective courses on NPIs, often relying on individual initiatives. Little is publicly available about the content of these programmes and how they relate to the current nursing curriculum for EU countries. OBJECTIVES: This pilot study aims to explore and map the field of nursing education with regard to complementary NPIs for nurses in Europe. DESIGN: A web-based open-access questionnaire administered through the online survey tool LimeSurvey® was designed by the authors. PARTICIPANTS: The questionnaire was sent to a purposive sample of 49 experts on nurse education and complementary NPIs from 16 European countries. All levels of education were eligible for inclusion. METHODS: The questionnaire consisted of 35 items regarding course content, teaching material, teaching methods and methods of assessment. In addition, respondents were invited to perform a strengths, weaknesses, opportunities and threats (SWOT) analysis in relation to their education programme. Qualitative data was analyzed using a directive content analysis approach. RESULTS: Between January and May 2020, thirty-one completed questionnaires from ten different countries were returned (response rate 63.3%). Massage, meditation, mindfulness and relaxation are the most taught interventions. Anxiety, stress, chronic pain, depression and sleep problems are the most common symptoms addressed. CONCLUSIONS: Currently, a consistent and European approach to education for nurses on complementary NPIs and integrative nursing is lacking. Although taught at regular nursing educational institutes, the courses discussed here are not yet embedded in mainstream education for nurses.

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.

What's in a Definition? Holistic Nursing, Integrative Health Care, and Integrative Nursing: Report of an Integrated Literature Review.

Background: Nurses and others have used various terms to describe our caring/healing approach to practice. Because terms used can influence our image of ourselves and the image others have of us, we sought to clarify their meanings. Questions: How are the terms holistic nursing, integrative health care, and integrative nursing defined or described? Do we identify with these definitions/descriptions? Are the various terms the same or are they distinct? Method: We conducted an integrated review of peer-reviewed literature following the process described by Whittemore and Knafl. Using standard search methods, we reviewed full texts of 94 published papers and extracted data from 58 articles. Findings: Holistic describes "whole person care" often acknowledging body-mind-spirit. Holistic nursing defines a disciplinary practice specialty. The term integrative refers to practice that includes two or more disciplines or distinct approaches to care. Both terms, integrative and holistic, are associated with alternative/complementary modalities and have similar philosophical and/or theoretical underpinnings. Conclusions: There is considerable overlap between holistic nursing and integrative nursing. The relationship of integrative nursing to integrative health care is unclear based solely on definitions. Consideration of terms used provides opportunities for reflection, collaboration, and growth.

Advancing Well-Being and Health of Elderly with Integrative Nursing Principles.

There is a need for holistic care for the survival of the elderly, to increase their independence in their daily life activities, to improve their health and their well-being in order to ensure a healthy aging. Integrative nursing principles are a field of application of holistic philosophy and may be a guide to health professionals in improving the health of individuals, families and communities. These principles were first announced in 2014, and have been described as a health approach that takes the individual, family and society as a whole together with their environment and relationships and adopts the principle of using all the healing methods in health care. Integrative nursing principles can be used as a guide to holistic assessment and improvement of the health of the elderly. Interventions who take care of them with the environment they live in (home visits), support their existing healing process (focusing to patient during nursing care), benefit from the healing effect of the nature (spending time in nature), strengthen the relationship (mobilization of the social environment) and use all evidence-based healing methods (yoga, tai chi) should be included in the care of elderly individuals. Health professionals should learn integrative nursing principles and care for these principles in order to improve the health and well-being of the elderly. Giving care according to integrative nursing principles can increase the quality of life of the elderly and reduce health spending.

Implementing Integrative Nursing in a Pediatric Setting.

Pediatric blood and marrow transplantation (BMT) is one of the most challenging allopathic treatments a patient and family can be faced with. A large Midwest academic health center, and leader in pediatric BMT, made the decision in 2013 to incorporate integrative nursing as the care delivery model. Nurses trained in advanced nursing practice and specialized in integrative health and healing performed a deep-dive needs assessment, national benchmarking, a comprehensive review of the literature, and ultimately designed a comprehensive integrative program for pediatric patients and their families undergoing BMT. Four years after implementation, this paper discusses lessons learned, strengths, challenges and next phases of the program, including a research agenda. The authors conclude that it is feasible, acceptable and sustainable to implement a nurse-led integrative program within an academic health center-based pediatric BMT program.

Linking the Unitary Paradigm to Policy through a Synthesis of Caring Science and Integrative Nursing.

The principles of integrative nursing and caring science align with the unitary paradigm in a way that can inform and shape nursing knowledge, patient care delivery across populations and settings, and new healthcare policy. The proposed policies may transform the healthcare system in a way that supports nursing praxis and honors the discipline's unitary paradigm. This call to action provides a distinct and hopeful vision of a healthcare system that is accessible, equitable, safe, patient-centered, and affordable. In these challenging times, it is the unitary paradigm and nursing wisdom that offer a clear path forward.

Introducing Essential Oils into Pediatric and Other Practices at an Academic Medical Center.

Aromatherapy is an integrative intervention that uses essential oils to address symptom management, potentially as a first-line intervention or as a complement to other medical treatments. Aromatherapy is gaining widespread acceptance and increased scientific evidence of efficacy. Integrative and holistic nursing care uses integrative therapies such as aromatherapy and the principle of moving from a less invasive intervention to a more invasive intervention according to patient needs, symptoms, and preferences. Aromatherapy is often provided as a minimally invasive, independent, and integrative nursing intervention. This article describes the process used to introduce essential oils into practices at a large Midwestern academic medical center.

Complementary Therapy for Cancer Survivors: Integrative Nursing Care.

OBJECTIVE: The number of cancer patients who survive more than 5 years after the completion of their initial treatment is increasing. Oncology nurses must consider the needs of long-term cancer survivors in addition to those of cancer patients undergoing treatment because cancer survivors experience anxiety over several issues, including the risk of recurrence and progression of cancer status and symptom management. METHODS: We tried to examine the effect of complementary therapy (CT) to reduce anxiety. The experimental study compared an intervention group (5 males and 68 females) that underwent four CTs and a control group (5 males and 56 females) that received no intervention. The intervention group practiced the CTs in their home for 20 min/day, 2 days/week, for 8 weeks, for a total of 16 times, whereas the control group performed their usual routines. Stress response scale-18 (SRS-18) scores consisting of three subscales (depression-anxiety, temper-anger, and lethargy) were compared between the groups and across time within each group. RESULTS: The intervention group reduced depression and anxiety significantly than the control group. Furthermore, the intervention group expressed the following positive feedback: "being able to relax," "being distracted from their worries and anxieties," "being able to sleep," "feeling more in-touch with reality," and "wanting to continue the practice." CONCLUSIONS: The study might accurately reflect the perspectives of women with cancer because the majority of the patients were women. Meanwhile, the result suggests that CTs might be useful for long-term cancer survivors who experience anxiety that influence their quality of life.

Living in health, harmony, and beauty: the diné (navajo) hózhó wellness philosophy.

Hózhó is the complex wellness philosophy and belief system of the Diné (Navajo) people, comprised of principles that guide one's thoughts, actions, behaviors, and speech. The alignment of integrative nursing principles and the Hózhó Wellness Philosophy illustrates the power that integrative nursing offers as a meta-theoretical perspective that can transform our healthcare system so that it is inclusive and responsive to the needs of our varied populations. Integrative nursing offers the opportunity to re-introduce cultural wellness wisdom, such as Hózhó, as a means to improve whole-person/whole-systems wellbeing and resilience. Integrative nursing, through the acceptance and validation of indigenous health-sustaining wisdom, contributes to the delivery of effective, authentic, culturally tailored, whole-person/whole-system, patient-centered, relationship-based healthcare. Highlighting the Diné Hózhó philosophy re-introduces this philosophy to the Diné, other American Indian/Alaska Native nations, global indigenous cultures, and even nonindigenous people of the world as a means to promote and sustain global health and wellbeing.

Hózhó es el complejo sistema de creencias y la filosofía del bienestar de los Diné (Navajos) que abarca los principios que guían los pensamientos, acciones, comportamientos y el habla de una persona. La convergencia de los principios de la atención integral con la filosofía Hózhó del bienestar ilustra el poder que la atención integral ofrece como perspectiva metateórica que puede transformar nuestro sistema sanitario, de forma que sea inclusivo y dé respuesta a las necesidades de nuestra variada población. La atención integral ofrece la oportunidad de volver a introducir el bagaje cultural relativo al bienestar, como el Hózhó, como un medio para mejorar el bienestar y la recuperación tanto en las personas como en los sistemas. La atención integral, a través de la aceptación y validación de la sabiduría indígena relacionada con la salud, contribuye a proporcionar una asistencia sanitaria efectiva, auténtica, adaptada culturalmente, individual, integral, centrada en el paciente y basada en los vínculos. Destacar la filosofía Hózhó de los Diné hace que esta filosofía vuelva a introducir a los Diné, a otras naciones nativas de indios americanos y de Alaska, a las culturas indígenas globales e incluso a las personas no indígenas del mundo como un medio para promover y mantener la salud y el bienestar global.

Effect of Integrative Nursing Intervention on Chronic Heart Failure of Elderly Patients / 中国康复理论与实践

@#ObjectiveTo investigate the effect of integrative nursing intervention on chronic heart failure of elderly patients. Methods80 elderly patients with chronic heart failure were divided into integrative nursing intervention group (n=40) and the control group (n=40). All the patients were treated with routine treatment and nursing. The patients of integrative nursing intervention group were given prescient nursing, mental nursing and exercise rehabilitation. ResultsThe total effective incidence of integrative nursing intervention group was more than that of the control group (P<0.05), and the 6 minutes walk test was longer (P<0.05).ConclusionIntegrative nursing intervention is benefit to the recovery of the elderly patients with chronic heart failure.