Holistic Nursing Practice Research Articles

Faith Community Nursing Practice and Holistic Nursing Practice: A Comprehensive and Inclusive Comparison of Both Specialties

Faith community nursing and holistic nursing are recognized by the American Nurses Association as nursing specialties. Both nursing specialties practice with the understanding that holistically caring for an individual as a unique whole in his or her totality including respecting and attending to a human being's spiritual and/or faith-based needs across the life span is integral in promoting health and healing. The purpose of this article is to present the evolution of faith community nursing and holistic nursing practice and to compare their similarities and differences based on each specialty's current Scope and Standards of Practice. Utilizing each specialty's Scope and Standards of Practice allowed the authors a fair, practical, and extensive means for presenting a comprehensive and inclusive comparison. Continued and partnered research should be conducted by both specialties to advance their scope and standards of practice, to support comprehensive evidence-based and outcome-based care that promotes health, healing, compassion and caring, and to educate others regarding each nursing specialty's role, value, and significant contributions to the art and science of nursing.

Remembrance and Renewal: Health Care Staff Spiritual Self-Care.

Relationship-based care (RBC), a holistic framework of caring, models partnerships in caring to permeate at levels of patient, provider-self, provider-teams, and community. Remembrance and Renewal (R&R) is a RBC practice addressing spiritual self-care. At a dedicated time and space, R&R is offered monthly, rotating through six different buildings at an academic, medical center. To date, close to 2,000 visits have occurred. Those engaging in the practice express appreciation for the space to grieve and space to renew their spirit. R&R is a RBC practice in alignment with the scope and standards of holistic nursing practice and addresses the Quadruple Aim of improving health care staff's work-life balance.

Spiritual Care Perceptions of Baccalaureate Nursing Students.

Purpose: The purpose of this study was to examine baccalaureate nursing (BSN) students' perception of spirituality and spiritual care as a component of holistic nursing practice. Aim: The specific aim of this study was to determine the perception levels of spiritual care, religiosity, and spirituality in first- and last-semester BSN students. Method: This descriptive cross-sectional study used a convenience sample of BSN students. Participants (n = 150) completed demographics with self-reflected levels of religiosity and spirituality, the Spiritual Care-Giving Scale (SCGS), and the Spirituality and Spiritual Care Rating Scale (SSCRS). Findings: First-semester and last-semester BSN students were predominately single, female, Caucasian, and Christian. First-semester BSN students completed the SCGS and SSCRS upon entrance and exit in the first semester of the nursing program with no significant differences found. However, the last-semester BSN students scored significantly higher than the first-semester BSN students on the SCGS and the SSCRS. Conclusion: Over the course of the nursing program, the last-semester BSN students gained insight into spiritual care placing a higher emphasis on spirituality and less on religiosity. This supports the threading of spiritual nursing care throughout the nursing curriculum. Further study validation is needed.

Dysbiosis of the Gut Microbiome: A Concept Analysis.

Background:Gut microbes influence the development several chronic conditions marking them as targets for holistic care, prevention strategies, and potential treatments. Microbiome studies are relatively new to health research and present unfamiliar terms to clinicians and researchers. "Dysbiosis" often refers to an alteration in the gut microbiome, but conceptual clarification is rarely provided. Purpose: The purpose of this study is to refine a conceptual definition of dysbiosis based on a review of nursing literature. Method: A Rodgerian approach to concept analysis was used. CINAHL, PubMed, and Web of Science were queried using "dysbiosis" through December 2018. Each article was analyzed with regard to the antecedents, attributes, and consequences of dysbiosis. Essential elements were tabulated and compared across studies to determine recurring themes and notable outliers. Findings: Analysis revealed several important antecedences, attributes, and consequences of dysbiosis. The findings also elucidated notable gaps and highlighted the co-evolving nature of the proposed definition with advances in microbiome research. Conclusion: This article adds a proposed definition of dysbiosis, offering a contribution of conceptual clarity upon which to enhance dialogue and build research. The definition emphasizes risk factors and consequences of dysbiosis as implications for holistic nursing practice.

The Effects of Mompyeogi Movement Exercise on Body Skin Temperature

Background: Spine stretching and flexibility exercise is introduced by the group of Mompyeogi movement exercise ('mom' as body and 'pyeogi as stretching) that is growing in the Republic of Korea. Although it does not move as fast as an aerobic exercise, the benefit of body organ stretching movement position on this movement exercise can be perceived by Mompyeogi participants.Purpose: This study aimed to investigate the effects of Mompyeogi movement exercise on the alteration of body skin temperature.Methods: A pre-post experimental study was carried out to 20 participants who were divided into two groups: male and female. Each group was assigned to do either normal breathing (chest respiration) or deep breathing (abdominal respiration) when performing Mompyeogi movement exercise. Body skin temperatures were measured a couple of times before, during, and after the exercise using thermal infrared cameras. The collected data were analyzed descriptively in frequency and percentage.Results: Results showed that Mompyeogi movement exercise combined with deep abdominal breathing methods increased body skin temperature. Participants who were in low group temperature (t<33°C), underweight, and had normal body mass index showed an increased body skin temperature after the exercise. On the other hand, participants who were in the group age of 60-74 years old performing normal chest respiration showed a stable body skin temperature after the exercise.Conclusion: Stretching organ as a part of basic Mompyeogi movement exercise combined with deep abdominal breathing increased the body skin temperature. Future research of Mompyeogi movement exercise needs to explore a self-healing effort as a preventing and promoting programs contributed to holistic nursing practice.

Incorporating holism in nursing education through the Integrative Student Growth Model (ISGM)

The concept of holism is threaded throughout nursing. Holistic nursing practice has emerged as a prevalent concept in the provision of quality nursing care, calling nurses to focus on the whole person. Holistic self-care has been said to prevent burn-out, decrease compassion fatigue, and promote workplace civility. However, strategies for teaching holism in nursing education are lacking. The Integrative Student Growth Model (ISGM) offers an innovative, systems-based model for nurse educators to teach abstract values integral to professional nursing practice such as caring, holism, inclusiveness, integrity and excellence. This article discusses one aspect of the Integrative Student Growth Model, holism, which can be integrated at three defined levels present in all nursing programs. The authors propose a conceptual definition of holistic nursing education and suggest strategies for creating a holistic academic environment at each of the three levels. Finally, recommendations for future inquiry are explored as a means to test the model and the potential impact on student learning outcomes, and subsequently, patient outcomes.

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.

Effect of psychological intervention on post-traumatic stress symptoms and pregnancy outcomes among women with previous recurrent abortion

Background: Recurrent abortion is both physically and psychologically a traumatic experience. Some women also experience anxiety, anger, posttraumatic stress, and guilt about future childbearing. Supportive psychotherapy aims to minimize deterioration and maximize competence within the limitations imposed by the illness. The purpose of the study was to study the effect of psychological intervention on post-traumatic stress symptoms and pregnancy outcomes among pregnant women with previous recurrent abortion.Methods: Research design: a quasi-experimental research design (with pre-post measurements) was used in this study. Subjects: A purposive sample of 40 pregnant women was recruited. Tools: Two tools were used for data collection: interviewing questionnaire and posttraumatic stress disorder checklist.Results: There was a statistically significant difference between pre and post intervention results regarding stress symptoms severity after the intervention. Psychological intervention was associated with positive pregnancy outcomes.Conclusions and recommendations: The first research hypothesis was accepted as it was found that the psychological intervention decreased post traumatic stress symptoms among studied women. The second hypothesis was also accepted as the psychological intervention was associated with positive pregnancy outcomes. Manage women with recurrent abortion within the purview of holistic nursing practice which address the bio-psychosocial responses of abortion.

Five Pillars of Islam in Relation to Physical Health, Spiritual Health and Nursing Implications

This study aimed to examine five pillars of Islam and their relationship with physical and spiritual health. The five pillars of Islam are the foundation of Muslim life, considered mandatory by believers, and Muslims are required to observe them with utmost dedication. They are summarized as Shahadah, Salah, Zakat Saum, and Hajj. he first pillar of Islam, declaration of faith (Shahadah) includes the most important concept, which is the complete submission to the will of Allah (SWT) by obeying and believing in Him. Spirituality in general is defined as “religious belief or the spiritual quality of something”, “a search for the sacred”, “personal growth, or an encounter with one's own inner dimension”. The World Health Organization (WHO) mentions spiritual health as one of four dimensions to well-being; physical, mental, social, and spiritual”. Moreover, holistic nursing practice includes treating people as a whole and attending to a client’s physiological, psychological, and spiritual needs. Thus, this study intends to further explore the unitary aspect of Islam that infuse each of the pillars, and their effects on physical, spiritual well-being and nursing implications associated with it. Five pillars of Islam are discussed from the Quran, Alhadith, and Sunnah (the sayings and traditions of the Prophet) as baselines, and further additions from the knowledge of the Islamic scholars. And it is noted that our practices based on the five pillars of Islam have not only positive effects on physical but also spiritual health. This paper pointed out that while performing obligatory duties as stipulated by Islam, one could achieve spiritual enhancement as well as physical strength and well being.

Mindfulness-based stress reduction training yields improvements in well-being and rates of perceived nursing errors among hospital nurses.

This pilot study aims to further document mindfulness-based stress reduction (MBSR)'s effect on well-being while exploring its impact on errors among hospital nurses. The concept of mindfulness has been found to be highly relevant to holistic nursing practices but remains understudied and underused. Preliminary evidence suggests that MBSR can reduce stress among nurses. As stress and mental processes such as inattention are potential sources of error, MBSR may also help to improve patient safety. Reducing errors is of significant relevance in healthcare settings. A randomized controlled trial with a matched pair design was conducted. Seventy Registered Nurses and licensed practical nurses were randomized to MBSR (N=37) or a waitlist control condition (N=33). Intention-to-treat ANCOVAs revealed that MBSR produced significant improvements in distress. High levels of treatment satisfaction were reported by a majority of participants. Of the nurses who reported that errors had been a problem for them (28.6%), a perceived improvement was noticed by over a third (37.5%) at 3months post-treatment. These initial findings suggest that the benefits of MBSR may extend to nursing errors.

Living With Diabetes in Appalachia: A Focus Group Study.

This article presents an innovative holistic practice application based on evidence from a focus group study on managing diabetes. The purpose of this study addressed the research question: How do persons with type 2 diabetes describe ways of managing the challenge of living with diabetes? A second purpose was to link the findings on ways to manage diabetes to holistic nursing practice through story theory. Nine adults with type 2 diabetes living in rural West Virginia participated in 3 focus groups. Using content analysis, the study findings integrated themes with core qualities, and are as follows: living life as an evolving process is awakening to the present and doing it your way, being on guard is a vigilant ongoing responsibility, attending to bodily experience is awareness of body and facing life stress, and knowing the consequences is awareness of potential problems and taking charge. Merging the study findings with the concepts of story theory led to the development of an innovative practice application for managing diabetes. Managing diabetes in this practice application goes beyond problem-centeredness to a patient-centered approach, offering attention to individual preferences. Since managing diabetes is a major problem in Appalachia, there a need for innovative approaches. This study adds to the body of knowledge on how persons from Appalachia manage diabetes. In addition, it offers a story practice approach for managing diabetes-replacing a problem focus to a more holistic approach to practice leading to more meaningful and fulfilling outcomes.

Connecting Holistic Nursing Practice With Relationship-based Care: A Community Hospital's Journey

Creating supportive, caring environments for both staff and patients is a basic principle of holistic nursing practice and an increasingly important aspect of today's health care delivery system. The core of workforce engagement is the relationship of joy and meaning in the delivery of care of health care providers: joy in having a sense of accomplishment and significance in the work through processes leading to successful outcomes. Meaning refers to the sense of importance and impact in the daily work routines. Joy results with attainment and fulfilment from the meaning of the work. 1 Sikka R Morath JM Leape L The quadruple aim: care, health, cost and meaning in work. BMJ Qual Saf. 2015; 24: 608-610 Crossref PubMed Scopus (311) Google Scholar At Broward Health Imperial Point (BHIP), we live this philosophy. Creating supportive, caring environments for both staff and patients is a basic principle of holistic nursing practice and an increasingly important aspect of today's health care delivery system. The core of workforce engagement is the relationship of joy and meaning in the delivery of care of health care providers: joy in having a sense of accomplishment and significance in the work through processes leading to successful outcomes. Meaning refers to the sense of importance and impact in the daily work routines. Joy results with attainment and fulfilment from the meaning of the work. 1 Sikka R Morath JM Leape L The quadruple aim: care, health, cost and meaning in work. BMJ Qual Saf. 2015; 24: 608-610 Crossref PubMed Scopus (311) Google Scholar At Broward Health Imperial Point (BHIP), we live this philosophy.

Taboo in the Workplace: A Qualitative Study of Taiwanese Nurses' "Not-Eating Pineapple" in Clinical Practice.

There has been an increased emphasis on nurses' mental health and well-being in the workplace. Psychologists have established a correlative link between individual's beliefs on luck and mental health. The pineapple taboo has been observed among Taiwanese hospital nurses as a prevalent superstitious belief for bringing luck or warding off increased clinical workloads, but how and why the ritual persists in the hospital workplace remains unknown. This article aims to explore the latent meaning of observance of the taboo and how it is related to nurses' clinical practice and possibly affects their mental health at work. A qualitative research was designed in line with the hermeneutic phenomenological method. Through purposive sampling, 18 nurse participants were recruited for in-depth semistructured interviews. Resulting from the ensuing analysis, 3 modalities were identified as constituting the spectrum of observance of the taboo: (a) "strictly not eating pineapple"; (b) "not eating pineapple at work"; and (c) "eating pineapple without admitting to doing so." Each reflects the position of nurses revealed in relation to the pineapple taboo in clinical settings. Based on the subjective narratives of nurses, it may be understood as an active moral attempt at "being right" rather than a passive avoidance of bad luck in the taboo observation. The findings facilitate an appropriate understanding of the embedded meaning of nurses' workplace-related belief and its seminal function of empowerment for nurses in holistic nursing practice.

A Practice-Based Theory of Healing Through Therapeutic Touch: Advancing Holistic Nursing Practice.

For nearly 50 years, Therapeutic Touch (TT) has contributed to advancing holistic nursing practice and has been recognized as a uniquely human approach to healing. This narrative explores the development of a practice-based theory of healing through TT, which occurred between 2010 and 2016. Through the in-depth self-inquiry of participatory reflective dialogue in concert with constant narrative analysis, TT practitioners revealed the meaning of healing within the context of their TT practice. As the community of TT experts participated in an iterative process of small group and community dialogues with analysis and synthesis of emerging themes, the assumptions and concepts central to a theory of healing emerged, were clarified and verified. Exemplars of practice illustrate the concepts. A model of the theory of healing illuminates the movement and relationship among concepts and evolved over time. Feedback from nursing and inter-professional practitioners indicate that the theory of healing, while situated within the context of TT, may be useful in advancing holistic nursing practice, informing healing and caring approaches, stimulating research and education, and contributing to future transformations in health care.

Advanced Holistic Nursing Practice Narratives: A View of Caring Praxis.

Advanced holistic nurses (AHNs), emerging as leaders in health care transformation, are described as caregivers, but caring and caring-within-practice are often difficult for AHNs to explicate. Nursing research that describes caring in advanced practice is limited. Only one study has been reported that focused on describing practice for advanced practice nurses. This article presents a secondary analysis of narratives from a larger qualitative study of holistic pediatric nursing practice. From that study, narratives provided by six holistic advanced practice nurse participants, working in a variety of settings, were extracted and analyzed to illuminate caring-within-practice. Participants were asked to write a reflective narrative on a patient exemplar of caring and use John's model for structured reflection to provide a deeper reflection on their narrative of caring. Researchers analyzed the extracted narratives to identify common themes of caring-within-practice. Seven themes emerged depicting AHNs caring-within-practice: normalizing the environment, creating sacred space, being rooted in compassion, the art of being present, establishing trust-caring, coaching the family as caregiver, and inspiration for the future. This article provides excerpts from the narratives that support the themes, discusses the findings, and presents implications of the study.

Implementing the SCCM Family-Centered Care Guidelines in Critical Care Nursing Practice.

Family-centered care is an important component of holistic nursing practice, particularly in critical care, where the impact on families of admitted patients can be physiologically and psychologically burdensome. Family-centered care guidelines, developed by an international group of nursing, medical, and academic experts for the American College of Critical Care Medicine/Society of Critical Care Medicine, explore the evidence base in 5 key areas of family-centered care. Evidence in each of the guideline areas is outlined and recommendations are made about how critical care nurses can use this information in family-centered care practice.

Art Images in Holistic Nursing Education

Background: Nursing research has concentrated on empirical knowing with little focus on aesthetic knowing. Evidence from the literature suggests that using visual art in nursing education enhances both clinical observation skills and interpersonal skills. The purpose of this review was to explore how visual art has been used in baccalaureate nursing education. Methods: Of 712 records, 13 studies met the criteria of art, nursing and education among baccalaureate nursing students published in English. Results: Three quantitative studies demonstrated statistical significance between nursing students who participated in arts-based learning compared to nursing students who received traditional learning. Findings included improved recall, increased critical thinking and enhanced emotional investment. Themes identified in 10 qualitative studies included spirituality as role enhancement, empathy, and creativity. Conclusion: Visual arts-based learning in pre-licensure curriculum complements traditional content. It supports spirituality as role enhancement in nurse training. Visual art has been successfully used to enhance both critical thinking and interpersonal relations. Nursing students may experience a greater intra-connectedness that results in better inter-connectedness with patients and colleagues. Incorporating visual arts into pre-licensure curriculums is necessary to nurture holistic nursing practice.

Assessing the Readiness of Nursing Sectors in Low- and Middle-Income Countries to Adopt Holistic Practice: Rwanda as Exemplar.

Over the past several years, holistic nursing education has become more readily available to nurses working in high-income nations, and holistic practice has become better defined and promoted through countless organizational and governmental initiatives. However, global nursing community members, particularly those serving in low- and middle-income countries (LMICs) within resource-constrained health care systems, may not find holistic nursing easily accessible or applicable to practice. The purpose of this article is to assess the readiness of nursing sectors within these resource-constrained settings to access, understand, and apply holistic nursing principles and practices within the context of cultural norms, diverse definitions of the nursing role, and the current status of health care in these countries. The history, current status, and projected national goals of professional nursing in Rwanda is used as an exemplar to forward the discussion regarding the readiness of nurses to adopt holistic education into practice in LMICs. A background of holistic nursing practice in the United States is provided to illustrate the multifaceted aspects of support necessary in order that such a specialty continues to evolve and thrive within health care arenas and the communities it cares for.

Meanings Given to Professional Care: Focus Group Results

Background: Many studies have focused on exploring the concept of care from patient and nurse perspectives, but knowledge is limited regarding student perceptions. Objective: To explore the meanings given to the concept of professional care from the perspective of graduate students in nursing and pastoral care. Research design: A qualitative study was employed with the formation of six focus groups. Data were analyzed via a thematic content analysis of the discussions. Participants and research context: Thirty-one students attending a University College in Oslo participated. Findings: Seven main themes and forty-four subthemes were identified. Major themes included reverence and respect for the dignity and value of human life, bonding, sensitive to self and other, communication, competence, willfulness and deep caring. Discussion: Different levels of intentionality, professional comportment and caring consciousness were revealed in the discussions. Findings also lend support to major beliefs and values in Watson’s Human Caring Theory. Conclusion: The focus groups generated valuable detail of complex experiences behind student’s perceptions, attitudes, beliefs and actions. Focus group methodology can enhance holistic nursing practice by providing opportunities to explore and clarify holistic care values, create opportunities for self-awareness and transformative learning in education, clinical practice, administration and research.

Healing and Transcendence

Healing and transcendence are concepts of considerable interest to nurses who engage in holistic nursing practice. The two concepts are often used within the context of adaptation to describe the processes experienced by individuals who experience suffering and distress from various life events. Despite their intuitive significance to the human experience, the similarities and differences between the two concepts remains unclear. The purpose of this paper is to present the results of a Roy adaptation model-guided comparison of the two concepts that addresses their shared and distinct characteristics.