Integrative nursing in Europe - A competency profile for nursing students validated in a Delphi-study.

BACKGROUND: Integrative nursing is a framework for providing holistic care and includes complementary therapies and non-pharmacological interventions. There is no common European approach on how to educate healthcare professionals on complementary therapies and non-pharmacological interventions for symptom management. Nurses report a lack of formal education as the main barrier to applying integrative nursing. OBJECTIVES: The aim of this study is to develop and validate integrative nursing learning outcomes in a competency profile for bachelor nursing students. METHODS: A two-round Delphi study was conducted with experts on integrative nursing and/or nurse education from eight European countries. The expert panelists rated their level of agreement with learning outcomes in relation to "Knowledge, Skills, Responsibility and Autonomy" on a nine-point Likert scale (1 = strongly disagree/9 = strongly agree) and were invited to add comments in an open text field. The Rand manual's description of levels of appropriateness was used, and experts' suggestions were analyzed thematically and used for reformulating or adding learning outcomes. RESULTS: In the first round, 19 out of 23 experts participated, versus 18 in the second round. In all, thirty-five learning outcomes within the three areas Knowledge, Skills and Responsibility/Autonomy were rated. After two Delphi rounds, twenty-four included learning outcomes were classified as appropriate, with median levels of appropriateness between 7 and 9; none had been classified as inappropriate. The learning outcomes include general knowledge about selected complementary therapies and non-pharmacological interventions, safety, national rules and regulations, communication and ethical skills and competencies for self-care actions and for applying simple evidence-based complementary therapies and non-pharmacological interventions in nursing practice. CONCLUSIONS: The competency profile consist of validated competencies; the high degree of consensus from the expert panelists makes the learning outcomes relevant for structuring a teaching module for nursing students about integrative nursing.

Psychiatric care and education understood from a student perspective: Enhancing competences empowering personal and social recovery.

BACKGROUND: During the last decades, a recovery-based approach has called for a change in mental health care services. Several programmes have been presented, and the need to develop student and professional competences in education and clinical practice has been documented. AIM: The aim of this study was to explore how psychiatric care is understood seen from a student perspective (nursing students, masters nurses and a master in applied philosophy) with focus on their personal competences and the educational interventions empowering processes for users' personal and social recovery. METHOD: A qualitative design with a phenomenological-hermeneutic approach based on the French philosopher Paul Ricoeur's theory of interpretation. Data were collected through semi-structured interviews. FINDINGS: All interviewees expressed that both theoretically and clinically students did not experience a recovery-oriented approach empowering users' personal and social recovery process. On the contrary, they experienced that both education and practice were dominated by a biomedical approach providing clinical recovery. However, several students were aware of their need of developing personal and relational competences to be able to support the users' personal and social recovery journey. The students expressed that there is a need for educational processes targeting personal competences in 'becoming a professional' supporting 'presentness and awareness' and thereby the development of relational abilities and the courage to engage. The results relate to two nursing schools and two universities. CONCLUSION: A biomedical approach dominates and makes it difficult to develop students' personal competences during education in practice and theory vital to the development of personal and social recovery-oriented practices. It is recommended that educators-in practice and in school-accentuate presentness, awareness and creativity as crucial relational capabilities and incorporate this in their teaching and supervision method, supporting the education and formation of the students' (and teachers' and supervisors') personal development processes.

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.

Complementary and alternative medicine (CAM) in Danish residential homes for people with severe mental illness: Use and perceived benefits of CAM in relation to recovery.

BACKGROUND AND AIM: Mental health services in Denmark offer various rehabilitative treatment interventions to people with severe mental illness. Complementary and Alternative Medicine (CAM) such as National Acupuncture Detoxification Association (NADA) ear acupuncture are used as rehabilitative interventions. We investigated the use of CAM in four psychiatric residential homes, and whether CAM supports residents' rehabilitation and personal recovery. METHODS: Residents in four selected residential homes participated in a questionnaire study, which elicited information on the use of CAM offered in a residential home setting. The study was conducted from February to November 2017. Recovery scores were assessed using the Mental Health Recovery Measure (MHRM). RESULTS: Of 131 eligible respondents, 68 (52%) participated. CAM was used by 84% of the residents. NADA ear acupuncture (38%) and music therapy (37%) were the most commonly used types of CAM. CONCLUSIONS: CAM is a commonly used rehabilitative intervention and more than 50% receiving treatment with CAM believed that it has supported their recovery process.

The use of complementary and alternative medicine after the completion of hospital treatment for colorectal cancer: findings from a questionnaire study in Denmark.

BACKGROUND: Little is known about the use of complementary and alternative medicine (CAM) for colorectal cancer, despite the high incidence of colorectal cancer and the frequency of CAM use for cancer-related symptoms. This is the first Danish study to examine the use of CAM by individuals who completed hospital treatment for colorectal cancer. METHODS: In 2011-12, a pragmatic trial on energy healing as rehabilitation after colorectal cancer was conducted in Denmark with participants who had completed cancer-related hospital treatment within the past 18 months prior to study inclusion. As part of the trial, participants (n = 247) completed a questionnaire on the use, motivations, pathways and perceived benefits of CAM. Socio-demographic information was obtained via the Danish National Patient Registry and self-report. Descriptive statistics were generated, using SPSS, version 18, and logistic regression analysis was carried out. RESULTS: Of 247 individuals, 49.4% used some form of CAM in the past month. Nearly half of the CAM users (49.2%) used natural medicines and/or dietary supplements only; 32% consulted an alternative therapist; 18.9% used both. Those who consulted alternative therapists were most commonly women (OR: 3.36; p = .002; CI: 1.54-7.33) with high educational levels (OR: 2.77; p = 0.010; CI: 1.28-6.01); more women than men used natural medicines and/or dietary supplements (OR: 1.83; p = .047; CI: 1.01-3.30) independent of educational levels. A majority commenced CAM on their own initiative; CAM was predominantly used to achieve better physical wellbeing. Beneficial effects were reported particularly in relation to physical health; few harmful effects were reported. Of those using CAM, 51.5% did not disclose its use to their physician; 8.5% of participants reported to have been asked by their physician about CAM use. CONCLUSION: The use of CAM following completion of hospital treatment for colorectal cancer seems widespread in Denmark. The identified extensive CAM use suggests a need for more reliable and diverse information about CAM for both patients and biomedical providers, and improved communication about its use in the clinical context.