Journal of Holistic Nursing最新文献

Purpose: Specialty nursing certifications serve as a validation of nursing knowledge in specific areas. Holistic nursing emphasizes comprehensive patient care and incorporates complementary alternative modalities (CAM) into daily care. Despite its significance, limited research has evaluated the perceived value of holistic nursing certification among nurses. Study Design: Descriptive survey design. Methods: The Likert-scale survey Perceived Value of Certification (PVCT)-12 Tool was given to holistic certified and non-certified nurses at a large, academic Magnet hospital in the northeast United States from 10/2022 to 2/2023. Additionally, non-certified nurses were asked to select the top three barriers to certification from a list of nine. The responses between certified and non-certified nurses were compared using the Chi-square test, Fisher's exact test, or Student's t-test as appropriate. Findings: A total of 59 nurses (25 certified, 34 non-certified) met inclusion criteria. Ninety-six percent of certified nurses versus 64.7% of non-certified nurses agreed that certification demonstrates a commitment to the nursing profession, p = 0.004, but, otherwise, responses to the PVCT-12 Tool were similar. Both groups felt certification was more strongly associated with intrinsic factors (e.g., sense of accomplishment) than extrinsic factors (e.g., salary). Conclusion: Nurses were consistent in their perceived value of holistic certification, regardless of their certification status.

Purpose of Study: Nurses' caring behaviors are essential for improving patient outcomes. This study aimed to investigate the associations between spiritual well-being, job satisfaction, and specific dimensions of caring behaviors among Iranian nurses. Design of Study: A descriptive cross-sectional design was used. Methods Used: A total of 200 nurses were recruited through convenience sampling from four government hospitals in northern Iran during 2023. Data were collected using a demographic form, the Caring Behaviors Inventory, the Spiritual Well-being Scale, and the Job Satisfaction Survey. Statistical analyses were conducted using two-level logistic regression models with the Restricted Maximum Likelihood (REML) method in STATA Version 17. Findings: Spiritual well-being was significantly associated with overall caring behaviors and subdimensions such as respectful communication and ensuring human presence (p < 0.001). Internal job satisfaction was significantly related to ensuring human presence (p < 0.05), while external satisfaction and existential well-being showed no significant associations (p > 0.05). Unit-level clustering accounted for less than 3% of variance in caring behaviors. Conclusion: Spiritual well-being and internal job satisfaction play key roles in promoting nurses' caring behaviors. Interventions to enhance spiritual well-being hand strengthen internal aspects of job satisfaction may contribute to better patient care outcomes.

Purpose: Black communities experience higher rates of preventable health inequities, such as uncontrolled blood pressure (BP), pain, and overall health challenges. The Nurses 4 Black Well-being (N4BW) project explores these inequities through a health promotion lens. Spirituality has been shown to be a positive culturally relevant health factor that is central to holistic nursing efforts. Therefore, this study explored relationships between self-rated spirituality and health outcomes (BP, pain, and overall health) among marginalized Black community adults. Design: A cross-sectional quantitative study was conducted. Methods: Surveys were administered to a convenience sample of N = 203 Black adults across local community sites in marginalized areas in the Midwest United States, with support from key community partners. Theistic and non-theistic spiritual experiences, systolic BP, pain, and self-rated health were assessed using standardized assessments. Findings: Regression analyses found no significant health effects for theistic or non-theistic spirituality across outcomes of systolic BP, pain, and self-rated health. Conclusion: While spirituality remains a central concept in holistic nursing, these findings suggest that its relationship with health may be more nuanced than previously understood.Additional holistic nursing research exploring spirituality's role in the health and holistic well-being of marginalized Black community adults is needed.

Purpose: The goal of this quality improvement project was to increase staff nurses' knowledge of and comfort level with administration of aromatherapy, reduce barriers in the administration of aromatherapy, and increase use of aromatherapy as a holistic nursing intervention on an acute care surgical unit. Prior to the project, aromatherapy use was explored on this 28-bed unit and revealed there were less than three aromatherapy administrations per month. Design: The project followed guidelines for quality improvement outlined by the Plan-Do-Study-Act (PDSA) model and was further informed by the holistic theoretical framework of aromatherapy. Methods: The project implemented a new aromatherapy station and provided access to quick reference materials. Quantitative data surrounding aromatherapy administration were gathered through chart review. Qualitative data were gathered through observation of staff and interviews with key stakeholders. Findings: Data surrounding aromatherapy administration revealed an increase in use on this surgical unit with the project implementation. Conclusions: Benefits from this project informed an increased comfort level with aromatherapy and ease of administration by nurses. Patients may then experience subsequent benefits related to being offered aromatherapy as part of a holistic approach to their treatment plan.

Purpose of Study: This project explored the feasibility and perceived benefits of integrating mindfulness training, grounded in holistic nursing philosophy, into undergraduate and post-licensure BSN nursing curricula to support student well-being and resilience. Design of Study: Nursing faculty implemented an educational intervention using a pre-post design across two university nursing programs. Methods Used: Faculty embedded a semester-long mindfulness curriculum into existing nursing courses. Students received lectures, accessed curated mindfulness resources, and completed a reflective journal assignment. Pre- and post-intervention surveys assessed changes in students' knowledge, attitudes, and practices related to mindfulness. Findings: Among 103 students who completed both surveys, knowledge of mindfulness increased from 42% to 91%, and regular practice rose from 41% to 73%. Students reported improved stress and anxiety management, emotional awareness, and resilience. Nearly all participants (96%) indicated plans to continue mindfulness practices. Journal reflections revealed themes of improved mood, self-care prioritization, and enhanced coping strategies. Conclusions: Faculty successfully implemented mindfulness training, and students responded positively. The intervention supported stress reduction and resilience, aligning with national nursing education competencies and reflecting holistic nursing's emphasis on whole-person care. Findings suggest mindfulness integration may be a valuable, low-cost strategy to enhance nursing education and promote student well-being.

Purpose: This evidence-based practice quality improvement project aimed to holistically address chronic pain-impacting over 100 million Americans-by exploring the potential of vitamin D supplementation as a non-opioid, integrative treatment. Theoretical Framework: Guided by the Johns Hopkins Nursing Evidence-Based Practice Model (JHEBP), the project aligns with holistic nursing by emphasizing whole person and evidence-informed, non-pharmacologic interventions. Method: The project was implemented at a free clinic in Central Appalachia, involving 30 vitamin D-naïve patients with chronic pain who received a weekly oral dose of 50,000 IUs of vitamin D for 12 weeks. Participants completed pre- and post-surveys, clinical evaluations, and serum level testing to assess outcomes. Findings: After 12 weeks, patients showed statistically significant reductions in pain intensity (p = 0.007) and pain interference (p = 0.020), with serum vitamin D levels rising from 24 to 36 ng/mL (p < 0.001) and a large effect size (Cohen's d = 1.28); 91% reported subjective benefit. Implications: This project supports incorporating vitamin D as part of a holistic, equitable, and evidence-based approach to chronic pain management, reducing reliance on opioids and advancing integrative nursing practice.

Purpose: This paper grounds the DREAM model, a practice-based framework developed from research on caring presence, aimed at enhancing holistic nursing care through being fully present and engaged with the patient, within Watson's Transpersonal Theory of Human Caring and the Unitary Caring Science worldview. The DREAM model was subsequently operationalized as a framework for providing care to adolescents with mental health conditions using the Nursing Interventions Classification (NIC). Design/Methods: The key concepts in the DREAM: Dedication; Respect through relationship; Environment; Art of nursing; and Motivation were linked to and conceptualized within concepts in Watson's Transpersonal Theory of Human Caring to demonstrate how the DREAM model can be philosophically grounded and practically operationalized within a caring science perspective. The model was then operationalized by linking the key concepts to five priority NIC interventions. Findings: The findings underscore how evidence-based nursing actions can enhance caring presence and relational engagement in healthcare, particularly in adolescent mental health care, creating a synthesis of caring theory with NIC. Conclusion: Through the grounding of the DREAM model in Watson's theory and its operationalization using the NIC, the authors invite a new discourse on advancing adolescent mental health care.

Purpose: This study explored how family members of terminally ill patients in an intensive care unit (ICU) experience anticipatory grief as a holistic, multidimensional phenomenon. Design: A qualitative phenomenological approach guided by Jean Watson's Theory of Human Caring was used to capture participants' lived experiences. Methods: In-depth semi-structured interviews were conducted with seven family members of terminally ill patients in the ICU of a public hospital in West Java, Indonesia. Participants were recruited using purposive sampling. Data were analyzed using Colaizzi's method and reported according to the COREQ checklist. Findings: Five interrelated themes emerged: (a) emotional storm in the face of uncertainty; (b) faith as a spiritual anchor; (c) searching for meaning through reflection; (d) the need for connection and compassion; and (e) preparing the heart through ritual, hope, and letting go. Families experienced grief as a spiritually rooted, emotionally intense, and relationally significant journey, shaped by cultural practices and their interactions with nurses. Conclusions: Anticipatory grief in the ICU is a holistic crisis that calls for intentional, compassionate, and spiritually sensitive nursing presence. Findings support the integration of holistic caring principles and culturally congruent support into ICU practice.

Aim: Nurses are well-qualified to deliver integrative complementary therapy interventions, a holistic approach to assist individuals experiencing anxiety and stress. Self-regulated, controlled breathing exercises (a clinical approach) are reported to decrease anxiety and increase stress tolerance. The aim of this systematic review was to evaluate the effectiveness of breathing exercise interventions on the psychological and physiologic outcomes of anxiety and stress among adults and assess the state of the science in the post-COVID-19 population. Methods: A systematic review was conducted, and four scientific databases were searched: PubMed, CINAHL, EMBASE, and Web of Science. Inclusion criteria included: (1) peer-reviewed studies, (2) adults over 18, (3) breathing exercise interventions, and (4) anxiety or stress as outcomes. Results: Out of 309 studies identified, 19 were included. Twelve reported significant improvements in anxiety and nine reported significant improvements in stress following varying breathing exercise interventions (p < .05). No adverse events were reported. Conclusions: Breathing exercises were found to be effective in reducing anxiety and stress in adults, however, there continues to be limited evidence that includes large randomized controlled trials. Breathing exercises are a holistic care approach that can be safely implemented by nurses to decrease symptomatology among adults, including the post-COVID population.