Analysis of the Theory of Integrative Nurse Coaching.

The Theory of Integrative Nurse Coaching (TINC) has been analyzed according to the method of Walker and Avant. We have found that TINC is a well-constructed mid-range theory in the discipline of nursing. Within the domain of holistic nursing, it is focused on the goal of healing the whole person, synthesizing a large amount of theoretical material related to the concept of healing and placing it within the context of nursing as a discipline. With underpinnings in holistic nursing, it aligns with numerous grand nursing theories via the metaparadigm, healing, and patterns of knowing. It is easily translated into holistic nursing practice, actualized in the role of the nurse coach. It describes a method of holistic nursing practice that is suitable for use in numerous settings, including lifestyle, chronic disease, and end of life, among others. Although there is little published research using the theory, there is potential for application in holistic nursing practice, education, research, policy, and administration. We have identified numerous potential research questions that would test the theory. In this time of global nursing shortage and burnout, it is notable that this mid-range theory explicitly describes how self-care of the nurse enhances client care.

Integrative Health and Wellness Assessment Tool.

The need for self-care in critical care nurses is recognized on a national level. Stress, unhealthy lifestyles, and chronic disease in the general population is mirrored in nursing, affecting burnout, retention, quality outcomes, and well-being. Integrative approaches to promote well-being are supported by nursing theories and tools such as the Integrative Health and Wellness Assessment (IHWA). Through coaching techniques and the IHWA, nurses can support their self-development via self-assessment, self-reflection, self-evaluation, and self-care. This article discusses the role of the IHWA and a coaching process to aid critical care nurses in implementing sustainable self-care strategies.

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.

Instrument Development of Integrative Health and Wellness Assessment™.

The nurse coach role was developed to address the needs of our nation and the world for health and wellbeing. The Theory of Integrative Nurse Coaching provides a foundation for coaching interventions supporting health promotion, and a framework for the development of the Integrative Health and Wellness Assessment (IHWA) short form. This 36-question Likert-type scale self-reporting tool assists participants in assessing healthy behaviors through a self-reflection process, provides information for the coaching relationship, and may be an outcome measurement. This article describes the history of the IHWA tool and the development and pilot testing of the IHWA short form using guidelines provided by DeVellis. Results of the Kaiser-Meyer-Olkin test yielded a value of .520, and the Bartlett's test of sphericity was significant. Cronbach's alpha overall scale internal consistency was .88 ( n = 36). Pilot study results indicate that the scale could be improved through additional revision, and an ongoing study is in progress.

A pilot feasibility study of the effects of touch therapy on nurses.

The White House Commission on Complementary Alternative Medicine (CAM) has recommended that safe and effective CAM practices be evaluated to determine their role in maintaining wellness and promoting health. There is little research on individual bodywork/energy therapies and their effects on wellness. The purpose of this pilot study was to assess the effect of AMMA treatments on relaxation and anxiety in staff nurses, and to examine themes describing the nurses' experiences. It was hypothesized that nurses receiving AMMA treatments would demonstrate reduced anxiety, as measured by a Visual Analog Scale (VAS) and increased relaxation, measured by physiologic parameters. The study was designed as a prospective, randomized, blinded clinical trial, with convenience sampling of 24 nurses working 12-hour shifts. While both groups demonstrated decreased anxiety after intervention, the experimental group consistently showed greater differences between pre- and post-treatment anxiety scores. The mean change in physiologic parameters between groups was not significant. Themes derived from a final interview included: importance of touch in nursing care, stress reduction, increased self-awareness, the need for self-care and a new understanding of the mind-body connection. Outcomes suggest the need for further research with a larger population to assess this intervention's impact on anxiety, stress, self-care and caring relationships.

Healing: the journey from concept to nursing practice.

PURPOSE: To build on current knowledge and definitions of healing to further analyze and clarify the concepts as it relates to nursing practice and care of the conscious adult patient. METHODS: Literature surrounding previous concept analyses and definitions of healing were reviewed. Using the process outlined by Walker and Avant, model, borderline, related, and contrary patient case examples with brief rationale are presented. FINDINGS: Theoretical definition: Healing is as a positive, subjective, unpredictable process involving transformation to new sense of wholeness, spiritual transcendence, and reinterpretation of life. Operational Definition: Healing is the personal experience of transcending suffering and transforming to wholeness. CONCLUSIONS: Nurses, through transpersonal caring, and patients, through beliefs and their innate healing abilities/nature/God, may mediate the healing process. As nurses focus on the International Year of the Nurse and global health, it is paramount that healing, a major tenet of nursing, be explored and analyzed to increase understanding for both nurses and patients.

The effect of a holistic program on health-promoting behaviors in hospital registered nurses.

PURPOSE: The purpose of the study was to examine the effect of a holistic program, the Collaborative Care Model (CCM) Program, and the development of a self-care plan on health-promoting behaviors in hospital nurses. DESIGN: A quasi-experimental, pretest, posttest, repeated measure, comparison-group design was used. METHOD: The study was conducted in a large, academic medical center in the northeast. The experimental group included registered nurses (RNs) from units in one institution introduced to the CCM and development of a self-care plan in an 8-hour program. The control group received no intervention. Data were collected using the Health Promoting Lifestyle Profile II instrument (HPLP II); a 52-question Likert-type scale with six subscales examining health-promoting behaviors. FINDINGS: Using repeated measures analysis of variance there was a significant increase (p = .02) in the overall HPLP II mean, spirituality ( p = .04), interpersonal relations (p = .04), and nutrition scores (p = .04) of the experimental group as compared over time with the control group. CONCLUSIONS: The CCM plus the development of a self-care plan significantly increased overall health promoting behaviors, and spirituality, interpersonal relations, and nutrition scores in these RNs.