Holistic Nursing Care Research Articles

The relationship between psychological health and spiritual wellbeing in Iranian stoma patients

Aim: The aim of this study was to investigate the relationship between psychological problems and spiritual wellbeing in Iranian stoma patients. Methods: This descriptive-analytic study was conducted on 70 stoma patients who were enrolled through a convenience sampling method. Depression, anxiety and stress among patients were analysed using Depression, Anxiety and Stress Scale (DASS-21) questionnaire and their spiritual wellbeing was analysed using the Spiritual Wellbeing Scale (SWS). Pearson's correlation test was used to determine the relationship between depression, stress and anxiety with the total spiritual wellbeing and its dimensions. Results: The results of Pearson's correlation test showed that there was an inverse and significant correlation between stress (RR -0.728; P<0.001), anxiety (RR -0.721; P<0.001) and depression (RR -0.740; P<0.001) with the total score for spiritual wellbeing. Conclusion: These results demonstrated that there is a relationship between psychological problems and spiritual wellbeing in ostomates. That is, patients with higher spiritual wellbeing reported lower levels of psychological problems. The results of the present study can be used for holistic nursing care in these patients.

Information technology and its benefits in nursing care of the patient

Aim. The aim of this paper is to present the possibilities of application and use of modern information and communication technologies that can improve multidimensional, holistic nursing care of the patient.
 Methods. The data was collected from literature reviews.
 Results and Conclusion. Tele-diagnosis, teleconsultation and tele-nursing, i.e. services for monitoring the patient's condition and life parameters, and facilitating therapy and rehabilitation at a distance, are a response to the growing demand for modern medical services in an ageing society. This paper discuss e-services as e-consultations, which are a direct and quick possibility for health check, Internet Patient Account (IKP), e-prescriptions, e-sick leave and also the project "TeleNrsCare”, which create a network for the exchange of knowledge, technology, experience and best practices. E-health and information and communication technologies can bring benefits to the whole society by improving access to medical services and improving their quality. An ageing society and an increasing number of those who are chronically ill and stay at home result in the need for a highly qualified staff and relevant technology to quickly and efficiently provide them medical assistance.

Humanization of nursing care in the emergency service: a systematic review

Introduction: Nowadays, in spite of technological and scientific advances, there is the need for health care humanization in the Emergency Department, with a special emphasis on nurses, who are the promoter of provided care. In this way, the nursing team should be prepared to attend the other varied situations, thus, the humanization seeks another look to the assistance to the critical ill patient reflecting on the nursing care practices [1]. The aim of this review is to ascertain the importance of the humanization of the nursing care, in the critical ill patient in the emergency service. Materials and methods: This systematic literature review was conducted through scientific research, in the time space of February 2008 to February 2018 in the B-On and Ebscohost databases. Inclusion criteria: To have at least, two of the following descriptors searched in the B-on Platform: Humanization, Nursing Care, Critical Ill, Emergency Service; Full text available; in the following Languages: Portuguese, English and Spanish. The research question of this review is: What is the importance of humanization (O) in the nursing care (I) in the patient (P) in the emergency department. 35 studies were selected by exclusion and inclusion criteria. 7 studies were excluded after reading the title and the abstract and 5 were selected after reading the full text. Results: The main factors that influence the humanization of care for unstable patients are those that affect the patient’s physiological, psychological and social changes [2]. It is important to look at the unstable patient in their various aspects, seeing him as a whole, thus performing holistic nursing care [2]. There are fundamental principles, which regulate the humanized practice of nursing care, who work in the emergency field, who guarantee the basic human needs through teamwork, as well as aim at self-care, recovery and health promotion [3]. Humanized hospital care is understood as synonymous with “patient perception in its totality”, taking into account not only the physical aspects but also the social and emotional aspects [4]. Humanization is absent in the daily life of the Emergency Service [5]. Humanized care has given rise to “dehumanization”, both from the nursing professional to the patient, and from the institution to the professional [6]. However, humanization and nursing care are inseparable [6]. Discussion and conclusions: The need to provide well-being to the other should be felt as a priority to the satisfaction of the patient, experiencing humanization in all its breadth, privileging the pleasure of caring. The difficulties in the humanization of emergency departments are due to overwork and shortage of professionals, as well as inadequate structural and organizational conditions to develop health-restructuring activities. It is necessary to promote the training of health professionals, the encouragement for the creation of action strategies, giving priority to the human right to dignity and respect as a patient. Professionals should be recognized through incentives, with a good hospital structuration, as well as an adequate nurse-patient ratio in the sector to guarantee humanized nursing care.

Nurse care for the hospitalized elderly's spiritual dimension.

to analyze the nurse care for the spiritual hospitalized elderly's dimension. a qualitative study, based on Jean Watson's Theory of Human Caring. The study included 17 nurses working in a geriatric center in Salvador City, Bahia State, Brazil. The collection of testimonies occurred between January and April of 2018, through an interview. spiritual care were dialogue, encouragement and respect for religious activities, embracement, empathy. One of the obstacles to providing this care was the lack of preparation in accessing the elderly's spiritual dimension. spirituality is a dimension of human and holistic nursing care. Caring for the spirit contributes to foster transpersonal care. The difficulty may be in the lack of nurses' preparation. It is necessary that they cultivate and live their own spirituality, transmitting the understanding in each care relationship.

Development of Holistic Nursing Care Model for Mental Disorder Patients Care in Indonesia

Background: Holistic care is a comprehensive model of caring. It has been known as bio-psycho-socio-cultural approach. Objective: This study aims to develop a holistic nursing care model for mental disorder patients in Indonesia.Method: This study using explanative design with cross sectional approach. The participants are nurse in mental health hospital in one province in Indonesia. The sampe size is 120 nurses. Data were collected using questionnaire then analyzed using Partial Least Square.Results: Comprehensive modality therapy (path coefcient=0.621;t=11.75), written standard operational procedures for modality therapy (path coefcient=0.749;t=4.107), nurse competency (path coefcient=0.838;t=30.341), hospital policy (path coefcient=0.567;t=10.736), hospital facilities (path coefcient=0.861;t=23.028), community and family engangement (path coefcient=0.797;t=14.252), and cross-sector collaboration (path coefcient=0.756;t=11.326), inuenced the implementation of holistic nursing care in treating mental disorder patients. Discussion: The holistic nursing care model in treating mental disorder patientst not only bio-psycho-socio-spiritual approach but also depend on supportive healthcare facility, policy and community

Nurses’ Care Approach (NCAp): Connecting Differences to Islamic Believer Patients in the Arab World

Background: Nursing care approaches may vary from one patient to another. In the nursing profession, nurses are imbibed with the attributes of multicultural care competencies that would empower the nurses to be adaptive and mindful of how they provide and go with their carative nursing managements. This would entail that the non-Muslim nurses must be aware and be sensitive enough in their approaches and communicative exchanges with their Muslim patients. Objective: The study aims to identify the care approaches given by non-Muslim nurses working in the Arab world and how they elicit and provide a universal approach in caring Muslim patients. Methods: The study utilized a mixed methodology, specifically the explanatory sequential design, which involved a descriptive-comparative quantitative research design and eidetic qualitative research design. Results: Based on the result with the highest mean 3.63%, the respondents strongly agree that the non-Muslim nurse is aware of her own culture, 3.60% strongly agree that the non-Muslim Nurse does not discriminate the decisions of the patients regardless of gender, race, culture or belief and 3.58% still strongly agree that the non-Muslim nurse encourages patients to communicate as need arises. Here are three themes emerged from the study: understanding and respect of cultures, caring across borders, and caring calmness. In connecting the differences, non-Muslim nurses must be aware of their own culture, must not discriminate the decisions of the patients regardless of gender, race, culture or belief and must encourages patients to communicate as need arises. Conclusion: Knowing and understanding the scope of nursing practice with a high regard of respect to patients without discrimination will promote and provide holistic, safe and high-quality nursing care.

HUBUNGAN SPIRITUALITAS DENGAN STRES LANSIA DI PUSKESMAS PAKJO PALEMBANG

Elderly in aging process experienced physiological decline and loss and grieving. This can make elderly vulnerable to stress. Stress can make elderly not productive and focus on his/her losing. Stress might causes loss of interest, feelings of failure, and restless in physically and emotionally. Stress can impact to anger, anxiety, depression, pathological symptoms, and psychiatric illness. Thus, it require effective ways to manage stress which is experienced by older adults. Nursing management in handling stress can be done with holistic approach which one is spiritual care. Strong belief can make powerful positive effect to mind and body and can bring comfort. Goals : This study aim to know the relationship between spirituality with stress elderly in Palembang. Methods: Survey analytic design with cross sectional approach had done to 72 respondents by purposive. Data have been taken by Religious Commitment Inventory (RCI) and Perceived Stress Scale (PSS) then analyzed by Pearson’s correlation. Results : Results showed mean of RCI 31,03 (moderate religious) with standard deviation 7,551 and PSS mean 20,47 (moderate stress level) with standard deviation 5,642. Bivariate result showed there was negative relationship between spirituality and stress (r= –0,267; p= 0,023). Conclusion: Therefore, holistic nursing care with spiritual approach can be done by nurse in education to elderly so they can enhance their spirituality as positive and effective stress management with more intense praying, increase holy scripture learning and social interaction with other people with positive religious practice and activity.

“Enablement”—Spirituality Engagement in Pre-Registration Nurse Education and Practice: A Grounded Theory Investigation

Historically, spirituality in nursing was considered a fundamental dimension, contributing to patients’ wellbeing. Accordingly, nurses are expected to attend to the spiritual needs of patients as a part of holistic nursing care, and pre-registration nurse education (that is undergraduate nurse education) has a responsibility to equip them to fulfil this aspect of their role. However, the content of spirituality in nurse education programmes lack structure and consistency, hence further investigation into the value of such education and its transferability in clinical practice is needed. Data collection was by individual interviews with 13 pre-registration participants undertaking adult nursing between March 2012 and May 2014. Each interview was digitally recorded and transcribed verbatim. Through theoretical sampling, data collection and analysis occurred in a cyclical manner until theoretical saturation/sufficiency was reached. The participants’ main concerns were: explaining spirituality, remembering spirituality education and content, and uncertainties about facilitating patients’ spiritual needs; these combine to form ‘having sufficient spirituality education to facilitate patients’ spiritual needs’. The substantive theory of ‘Enablement’ (make possible) was constructed to explain how the participants resolved their main concern. This investigation reveals how the participants acquire and translate spirituality education to practice, so realising holistic care.

The nursing in human cytomegalovirus infection combined with infantile severe exudative polymorphous erythema

Objective To summarize the clinical nursing experience of a human cytomegalovirus infection combined with infantile polymorphic erythema. Methods Through evidence-based nursing, the family members of the children and their families were evaluated in two ways and carried out the family-centered holistic nursing care. The nursing problems of the children should be evaluated in a timely and effective manner. Results After 15 days of treatment, the patient was discharged from hospital and achieved satisfactory results. Conclusions For human cytomegalovirus infection with baby severity exudative polymorphic lupus patients, the implementation of strict protective isolation, meticulous care of skin mucous membrane, prevent eye and perineal secondary infection, close observation and prevention of severe complications in children with play a crucial role in the course of the disease and rehabilitation. Key words: Nursing care; Human cytomegalovirus; Exudative erythema multiforme

What Interventions Improve Outcomes for the Patient Who Is Depressed and in Pain?

Specific Clinical IssueThe purpose of this clinical consultation is to offer nurses evidence-based strategies to provide holistic care to their patients with comorbid depression and pain. The combination of depression and pain is common and, if not managed effectively, has negative outcomes. Treatment-resistance is one negative outcome. The worst-case scenario for unrelieved depression and/or pain is suicide. Major Practice Recommendations Based on Best EvidenceAntidepressants, particularly duloxetine, have had efficacy for pain and depression. Cognitive behavioral therapy, an evidence-based treatment for depression, has been found to decrease pain. Examples of additional interventions include exercise, relaxation techniques, mindfulness, and music. Providing holistic nursing care and working with other disciplines optimizes more effective management of these co-occurring conditions.

Comparison between nurses' and families' opinion about priorities of immediate patient's family needs

Background and objective: Acute critical illness represents a crisis not just for the individual patient however conjointly for the members of the family. Moreover, the admission of the patient represents a sudden crisis allowing no time for its preparation. The responsibilities of critical care nurses extend beyond the patients in the intensive care unit (ICU) to incorporate the members of the family of these patients. Nurses are a primary resource for members of family of ICU patients and they are in a perfect position to assist patients’ members of the family in an applicable approach. For this reason, recognition of these needs by nursing personnel is very important for applying of holistic nursing care. The aims of this study were 1) Ranking the immediate needs of members of family of critically ill patients and nurses. 2) Comparing between nurses, and families, opinion regarding priorities of immediate patient's family needs using Critical Care Family Needs Inventory (CCFNI).Methods: This descriptive study was conducted at the general ICUs of Damanhour Medical Institute which has 15 beds, Damanhour chest hospital which has 7 beds and Itay Elbaroad General Hospital which has 11 beds. The three units have a total of 100 nurses. A questionnaire was used for data collection. It consisted of part one which comprised patient's condition whose families were studied participants, biosocial knowledge related to the members of family and part two which included CCFNI tool. The adapted CCFNI was translated into colloquial Arabic. Participant members of family were individually interviewed by the researcher. Members of family were required to answer each statement with strongly agree, agree, neutral, do not agree and strongly do not agree. The interview took approximately 45 to 60 minutes to be completed, and all interviews took place within the 72 hours' time frame of each patient's admission to the critical care unit. The nurses were approached and given the questionnaires to be filled in by themselves during handover, tea or lunch break.Results: Generally, families ranked their knowledge, proximity and comfort needs higher in importance than the nurses. Also, the knowledge and assurance needs were ranked above the needs for support, comfort, and proximity by our participating nurses and members of family. Moreover, the mean scores of knowledge, proximity, support and comfort needs for members of family were significantly higher than these for nurses. Out of 35 needs of the members of family in the CCFNI, there were no significant differences between the mean scores of the nurses and those of the members of family in 10 individual needs. Results show that the nurses were correct in 10 out of 35 members of family’ individual needs. The remaining mean scores from 25 individual needs showed significant differences between the nurses and actual family needs. Results show that did not meet all the specific family needs during the care of the critically ill patients. Results show that members of family scored significantly higher than nurses on 20 statements while, the nurses scored significantly higher than members of family on only 5 of the statements.Conclusions: Families considered that knowledge then assurance was the most important needs. While nurses considered that assurance then knowledge were the most important needs which indicate that nurses underestimated the needs of the family and family need may be inaccurately evaluated by heath care team and almost unmet. Furthermore, Members of family in this study considered the needs that bring comfort and support as less in priority needs.

Spiritual Distress in Cancer Patients: A Synthesis of Qualitative Studies

Cancer affects individuals in all human dimensions. Cancer patients are more susceptible to spiritual distress. Several studies have addressed spiritual distress using quantitative designs; however, a qualitative approach to the experience of spiritual distress could provide a deeper understanding of the phenomenon. This study aims to synthesis the experience of spiritual distress as lived by cancer patients in qualitative primary studies. This is a literature review based on electronic databases search. A total of 4075 citations was identified and 23 studies were included. The most frequent qualitative research method was phenomenology (n = 15), and interviews were the main data collection method (n = 20). Two major themes have been identified related to the experience of spiritual distress: suffering and coping. Spiritual distress is an intimate, deep and suffering experience in life, which requires coping strategies and involves spiritual values and beliefs. Healthcare providers should be aware of this experience and recognize spiritual distress in cancer patients, as it is critical in providing holistic nursing care.

Applying of Neuman’s Systems Model in the course of nursing care of a patient who has Cervical Disc Herniation treatment<p>Neuman Sistemler Modelinin servikal disk herni tedavisi gören bir hastanın hemşirelik bakımı sürecinde kullanılması

Nursing is a professional health discipline and nursing models based on nursing theories form its scientific foundations. Neuman’s Systems Model is one of these models. The model focuses on the individual's well-being and is based on holistic nursing care. In the model, the individual is an open system interpreting the stressors he perceives. By defining these stressors, the nurse develops the defense mechanisms of the individual on the primary, secondary and tertiary level. The nurse is responsible for the planning, implementation and evaluation. The cervical disc hernia that affects life activities is helped cope with the stressors perceived by the individual receiving the diagnosis. Thus, the quality of life of the individual can be increased, the treatment process can be shortened and the cost can be reduced. In this study, the nursing care process of a patient who was diagnosed with cervical disc herniation was examined according to Neuman’s Systems Model. Person-specific, interpersonal and extrinsic stressors were identified in the direction of the obtained data, and nursing diagnoses suitable for the patient were established in the direction of stressors. As a result, it was found that the use of the model in this case was appropriate and it was suggested to be applied in other patient groups to evaluate the effectiveness of the model. Extended English summary is in the end of Full Text PDF (TURKISH) file.ÖzetHemşirelik profesyonel bir sağlık disiplinidir ve bilimsel bilgi kaynağını kavram,[Mh1] kuram ve modellerden almaktadır. Neuman Sistemler Modeli bu modellerden birisidir. Model bireyin iyilik haline odaklanmakta ve bütüncül hemşirelik bakımını esas almaktadır. Modelde birey, algıladığı stresörleri yorumlayan açık sistemdir. Hemşire bu stresörleri tanımlayarak bireyin savunma mekanizmalarını birincil, ikincil ve üçüncül düzeyde geliştirecek bakımın planlanması, uygulanması ve değerlendirilmesinden sorumludur. Günlük yaşam aktivitelerini olumsuz etkileyen servikal disk herni tanısı alan bireyin algıladığı stresörlerle başa çıkmasına yardım edilerek bireyin yaşam kalitesi artırılabilir, tedavi süreci kısaltılabilir ve maliyet azaltılabilir. Bu çalışmada servikal disk hernisi tanısı alan bir hastanın hemşirelik bakım süreci Neuman Sistemler modeline göre incelenmiştir. Elde edilen veriler doğrultusunda kişiye özgü, kişiler arası ve kişi dışı stresörler belirlenmiş, stresörler doğrultusunda hastaya uygun hemşirelik tanıları konulmuştur. Sonuç olarak, modelin bu olguda kullanımının uygun olduğu görülmüş, modelin etkinliğini değerlendirmek amacıyla başka hasta gruplarında da uygulanması önerilmiştir.

Caring Interaction with stroke survivors' family members—Family members' and nurses' perspectives

To examine emotional support given by nurses to family members in the acute phase after a working-aged patient's stroke based on nurses' and family members' experiences. The number of patients with stroke is increasing globally. There is a lack of knowledge about the emotional support of family members during the acute phase of working-aged stroke victims. To be able to provide high-quality nursing care during this phase, we need information about emotional support from family members' and nurses' perspective. Using a Glaserian grounded theory approach, the study was conducted using open interviews with family members and group interviews with nurses. Data were collected between 2012-2013. In this study, emotional support is identified as Caring Interaction. The changed life situation and diverse feelings aroused by the stroke are the starting point of providing emotional support to family members. It is important that the nurses notice family members' need for support at the right time, use their intuition and respond appropriately. The patient's family members are important when providing holistic nursing care for the whole family. As well as providing emotional support, high-quality nursing interventions enhance the care of family members. This study provides an explanation of the interaction process between family members and nurses. It helps family members and nurses to better understand each other. Although the data were collected 5years ago, it is assumed that the interaction between family members and nurses has not changed during these years remarkably. According to the experiences of family members and nurses who participated in this research, emotional support manifests in Caring Interaction. Being aware of body language and behaviour of family members, nurses can better interact with them.

Eight-Step Concept Analysis: Spirituality in Nursing

Spiritual care is an important part of nursing care. Spiritual care has a therapeutic effect on patients’ recovery, so it is important to know exactly what spiritual care is. It is aimed to clarify spirituality concept and to determine the scope of use in nursing literature. Antecedents of spirituality are determined as trust, hope, love, values, and need to find purpose for life. Consequences are motivation, improved life quality, and coping with difficulties. Ensuring that the meaning of this concept is handled in all dimensions will be a guide for giving holistic nursing care and can help to prevent misconceptions.

Abstract 5291: Professional nurses' awareness and practice with sexual concerns of the oncology patient

Abstract Sexuality is an important aspect of quality of life (QOL). QOL after cancer therapy is an important aspect of patient care of which sexual wellbeing forms part of the holistic nursing care although sexuality assessment is recognized as an important part of nursing care, in practice it has been observed that professional nurses may experience some difficulties to this aspect. Purpose: The purpose of this study was to gain a deeper understanding of the awareness, practice and possible barriers of professional nurses when engaging in conversation about sexuality with patients receiving cancer treatment in a private oncology care setting in Pretoria, South Africa. Objectives: The research objectives were: Ø To explore and describe the awareness and practice of professional nurses to engage in conversation about sexuality with the patient receiving cancer treatment in a private oncology setting in Pretoria. Ø To describe possible barriers that prohibit professional nurses to engage in conversation with patients receiving cancer treatment in a private oncology setting regarding sexuality Ø To make recommendations to improve nursing practice with regard to nursing care related to sexuality in the private oncology care setting. Method: An exploratory, descriptive and qualitative design was followed. A convenient purposive sample consisting of nine participants who met the inclusion criteria participated. Data were gathered through semi-structured interviews, while Creswell's method of data analysis was applied. Trustworthy measures included credibility, transferability, dependability and confirmability. This study obtained ethical clearance from all stakeholders. Results: The themes embarrassment, cultural beliefs and values emerged as barriers to engage in conversation about sexuality while, referring to a specialist in the field as suggested support to cancer treated patients arose. Limited knowledge about intensive therapy featured as the last theme. The data revealed that professional nurses themselves had restricted views on sexuality and very often would see the patient's body image and associated sexuality as not their responsibility. The concept intensive therapy was not fully understood which led to limited referral to various specialist. Conclusions: Professional nurses should be sensitized and empowered with the skills and knowledge on how patients' perception of their body image changed when been treated with cancer and the effect thereof. Reflective conversations about this sensitive topic could assist in this regard. Citation Format: Maurel C. Emeagi, Hester Rina De Swardt, Martjie De Villiers. Professional nurses' awareness and practice with sexual concerns of the oncology patient [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5291.

The Effect of Spiritual Self-care Training on the Quality of Life of Mothers of Preterm Infants: A Randomized Controlled Trial.

The present study was carried out with the aim of determining the effect of spiritual self-care training on the quality of life of mothers of preterm infants. This trial was carried out on 60 mothers with premature infants. Mothers were randomly divided into two intervention and control groups. Training for increasing awareness about the condition of the infants was carried out in both groups. In the intervention group, spiritual self-care training was also done. Data were completed in both groups before, immediately after, and two weeks after the intervention by using the standard WHO quality of life questionnaire. Data were analysed using statistical tests, including ANOVA and Repeated Measures. The results showed that the average quality of life of mothers under study was significantly different at different points of measurement in the intervention group (first, second, and third time-points) (P = 0.016). An increase was observed in the intervention group at the second time-point compared to the first time-point (84.2-88.4, P < 0.001) and in the third time-point compared to the first time-point, (87.9), which was also statistically significant (P < 0.001). According to the results of post hoc tests, there was a decrease in quality of life in the control group at the second time-point compared to the first time-point and the average score of mothers decreased from 82.9 to 75.3, which was statistically significant (P < 0.001). Spiritual self-care training can increase the quality of life and can be used as a form of holistic nursing care for mothers with premature infants in neonatal intensive care units.

Pengetahuan dan Motivasi Dengan Sikap Perawat dalam Pemenuhan Kebutuhan Spiritual Pasien di Ruang Rawat Inap RSUD Dr. H. Chasan Boesoirie Ternate

Abstract : One aspect of professional services in nursing is a matter of spiritual fulfillment, but in fact the spiritual needs of patients less attention by the nurses. This study aims to determine the related to the attitude of the nurse in meeting the spiritual needs of patients. Comparative research design using a cross sectional analytic study, samples were taken using a nonprobability sampling with purposive sampling, sample number 95 nurses working in the inpatient Medical-Surgical Hospital Dr. H. Chasan Boesoirie Ternate. Data collection using questionnaires to measure the level of knowledge, motivation and attitude of nurses in meeting the spiritual needs of patients. Data analysis using Chi-Square test to see the correlation between education, knowledge and motivation to nurse attitudes, whereas multivariate analysis is used to see the most dominant factors related to nurse attitudes. In this study, the results obtained by respondents who had a positive attitude as much as 36.8%, a negative attitude as much as 63.2%. Chi-Square test results with the attitude of educational factors (p = 0.007), knowledge (p = 0.003), motivation (p = 0.004). Multivariate analysis showed the most dominant factor is related to the attitude of education (Exp (B) = 5.704). It is concluded that there is a significant relationship between education, knowledge and motivation with the attitude of nurses in meeting the spiritual needs of patients in the inpatient Medical-Surgical Hospital Dr. H. Chasan Boesoirie Ternate. The higher the education nurses tend to be more positive attitude, while the lack of knowledge and low motivation of the nurses tend to be more negative the attitude in meeting the spiritual needs of patients. The dominant factor is related to the attitude of education. It is hoped that further enhance human resources related to quality nursing services in general and in particular in meeting the spiritual needs of patients through the application of holistic nursing care.

Distance Learning Teaching Strategies in Registered Nurse to Baccalaureate Nurse Programs: Advancing Cultural Competence of Registered Nurses in Providing End-of-Life Care

In order to prepare nurses to effectively provide holistic nursing care to an increasingly diverse patient population, nurse educators must incorporate cultural care practices into the nursing curricula. Specifically, teaching culturally competent end-of-life care is essential but can pose challenges for distance education programs. The purpose of this article is to identify multiple learning strategies utilized in an online nursing program to teach students how to provide culturally competent end-of-life care.

Curative effect analysis of the individualized holistic nursing of benign paroxysmal positional vertigo

Objective To explore the main points and matters needing attention of individualized holistic nursing of the benign paroxysmal positional vertigo (BPPV)and evaluate the effects of the outcome. Methods The clinical data of 148 patients with BPPV diagnosed and treated from September 2016 to January 2017 were enrolled, analyzed and summarized the main points and prognosis of personalized nursing. Results The 148 cases of BPPV were treated.The short-term (one week) efficacy was 90.27%, the long-term (eight week) efficacy was 97.32%.The recurrence rate was 2.70% in 4 weeks in 148 patients.University of California Los Angeles(UCLA)score and Hospital Anxirty and Depression Scale(HADS)score were compared with treatment before.The difference was statistically significant (P<0.05). Conclusions Canalith repositioning maneuvers can effectively treat BPPV.Individualized holistic nursing care should be performed before, during and after the treatment.It is very important for prognosis and patients' quality of life. Key words: Benign paroxysmal positional vertigo; Therapy; Holistic nursing care