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This study aimed to explore women with breast cancer (WBC) lived experiences on the use of Complementary and Alternative Medicine (CAM) for breast cancer management. van Manen's phenomenology of practice was used as the methodology and method in this study. In-depth interviews guided by semi-structured questions were conducted with 21 WBC recruited using convenience sampling. The thematic analysis generated four main themes: Access, affordability and support for medical treatment, beliefs in CAM treatment, feeling the potential benefits of CAM, and Acknowledging the negative aspects of CAM. The outcomes from using CAM based on the lived experiences of WBC indicated that some CAM treatments could improve quality of life. However, some fraudulent CAM obtained from unprofessional CAM providers could cause harmful effects, delay medical cancer treatment, and increase breast cancer treatment costs. Therefore, there is an urgent need to enhance the awareness of appropriate treatment, including evidence-based CAM, for WBC. Improved understanding in the use of CAM as a part of quality breast cancer care services could contribute to increasing the quality of life and survival rates of women with breast cancer.

Background: Artwork can be used to practice the development of holistic care for nursing students. This activity was designed for senior nursing students to develop their holistic nursing skills through a series of in-class activities while viewing Frida Kahlo's The Broken Column . Aim: This study's aim was to design an educational experience to develop a more holistic approach to caring for patients for nursing students. Method: Students submitted their initial impressions of the painting via an anonymous quiz. After a guided Visual Thinking Strategies (VTS) session, students submitted impressions of the artwork. A VTS facilitator read a history of an accident which revealed the cause of Kahlo's medical and emotional pain. Students then wrote about their perceptions of the painting's meaning and how they might use VTS in caring for their patients. Answers were analyzed using Braun and Clark's thematic analysis. Results: The themes identified were emotions and feelings, metaphor, life/story, and listening to inform perspective. Most found that VTS changed their impressions and enhanced their ability to question patients and inform their care. Conclusion: Students found that VTS expanded their view of patient care and helped them see the patient more holistically, aligning with the development of clinical judgment.

Purpose: The purpose of the study was aimed to explore the trajectory of thoughts and feelings related to religiosity and spirituality using a holistic approach following attendance at group-Quran Recitation (QR) sessions among annual flood victims. Design: This is a qualitative study with an in-depth retrospective interview conducted data in 2019. Methods: The purposive sampling was applied to conduct face-to-face individual video-recorded semistructured interviews. Seventeen participants followed six QR chanting sessions in Bandung, Indonesia. Data were transcribed verbatim and analyzed using inductive analysis. Findings: After extracting evidence expressions of participants, the research team generated the central theme of "Holism of Religiosity and Spirituality," using three influential sub-themes, including obedience to God's will, growing a positive mindset through spirituality and life started to be delighting from nine categories. Conclusion: The relationship of body-mind concepts of holism through QR among flood sufferers was explored. The effect of QR chanting is beneficial to change awareness about the wisdom of spirituality. The holistic approach of religiosity and spirituality in nursing care is recommended to promote all service settings, especially community and disaster nursing in the Indonesian context. Future research is needed to develop QR chanting activities among multiethnic and socio-cultural groups as alternative therapy quantitatively.

Purpose: This concept analysis aims to address the gap in knowledge regarding the concept of successful refugee cohabitation with host families. It seeks to develop a conceptual model that integrates holistic nursing and healthcare practices into refugee cohabitation settings to enhance refugee well-being. Methods: A comprehensive literature search was conducted using Walker and Avant's methodology for concept analysis. Findings: Successful refugee cohabitation with host families concept characterized by peaceful coexistence, power dynamics, hospitality, and cultural tolerance. Antecedents include refugee shelter needs, societal acceptance, humanitarian solidarity, and legal support. Consequences include refugee inclusion and integration, societal cohesion, psychological well-being, and refugee-host acceptance. Conclusions: Successful refugee cohabitation is defined as a private hosting arrangement that embodies shared living spaces and peaceful coexistence amid conflict or crises, fostering resilience and support for displaced individuals by local citizens. It combines hospitality, balanced power, and cultural tolerance, driven by refugee needs for shelter and a commitment to successful refugee settlement and integration. This hosting arrangement promotes societal development and cohesion, economic growth, psychological well-being, and foster inclusion and intergroup tolerance. The integration of holistic nursing principles into refugee cohabitation practices can foster more inclusive and healthy communities.

Purpose: To evaluate the impact of an abbreviated (4-week) and asynchronous, mindfulness-based intervention (MBI) on nurses' perceived stress and mindful attention and awareness. Design: An evidence-based quality improvement pilot program. Methods: The participants ( n = 15 nurses) attended a 4-week, asynchronous MBI. The participants attended a 90-minute webinar on mindfulness as a prerequisite, followed by 4 weeks of guided meditation and informal mindfulness practice materials. The MBI was offered remotely with self-modulated practice. Participants also provided the number of days per week they participated in formal meditation practice. Project participants completed pre- and post-intervention questionnaires. Project instruments included the Mindful Attention Awareness Scale (MAAS) and the 10-item Perceived Stress Scale (PSS). Findings: 12 complete pre-and post-intervention surveys were analyzed. Significant improvements were noted in participant mean MAAS scores post-intervention ( p = .004). Cumulative PSS scores also decreased post-intervention ( p = .009). Conclusion: The 4-week MBI demonstrated a statistically significant impact on nurses' perceived stress and mindful attention and awareness. Additionally, this Doctor of Nursing Practice (DNP) student led program was offered in an asynchronous and remote format, which was received well by program participants and may be a practical option for future MBIs.

Background: Alzheimer's disease (AD) is a crippling epidemic that is predicted to affect over 15 million people worldwide by the year 2050. Symptoms such as refusal to cooperate, impaired communication and cognition, and agitation and anxiety can play a large part in the difficulties that surround caring for an AD patient. There are medications that are marketed to treat AD symptoms, but many have harmful side effects. Holistic methods, such as music therapy, are gaining attention for their ease of implementation and limited side effects. Aim: The purpose of this project was to implement a music therapy intervention for people with AD in hospice and evaluate the levels of agitation experienced by the patient. Method: The study was conducted over a period of eight weeks. Music therapy was administered nightly for 20 minutes by caregivers and the Pittsburgh Agitation Scale was completed at the beginning of the study, at four weeks into the study, and at the completion of the study. Results: The intervention was found to be significant in reducing aberrant vocalization, motor agitation, aggressiveness, and resisting care. Conclusion: Based on the findings, music therapy may be useful as a holistic intervention for decreasing agitation in individuals with AD.

Aim: Holistic nursing competence is very important for increasing job satisfaction and reducing turnover intention. The aim of this study is to explain the relationship between nurses' holistic nursing competence, job satisfaction and turnover intention, and the mediating effect of job satisfaction between holistic nursing competence and turnover intention. Design: The cross-sectional design was adopted and explained with a hypothetical model. Methods: The study was conducted between March, 8 and May, 5 2021 in a training and research hospital in Turkey. The research was conducted on 342 voluntary nurses. Percentage, frequency distribution, descriptive statistics (mean, standard deviation) and Pearson correlation analysis were benefitted to evaluate the data. Path analysis was used for model testing. p < 0.05 was accepted for significance. Results: The mean scores of the nurses in all scales were moderate. Holistic nursing competence was positively correlated to job satisfaction, but it is detected as negatively and less correlated to turnover intention (p < .05). Job satisfaction played a mediating role between nurses' holistic nursing competence and their turnover intention (p < .05). Conclusions: It is important to understand nurses' holistic nursing competencies and job satisfaction and to reduce their intention to leave. These concepts should be taken into account in order to retain professional nurses with holistic nursing competence.

Purpose: The purpose of this study was to investigate student nurses' perceptions of how creative art activities might support spiritual self-exploration, foster understanding of holistic care and promote spiritual growth in relation to Mercy and Jesuit values emphasized in their nursing program. Design: A qualitative design was used with data collected through surveys and students' reflections. Methods: Students enrolled in an introductory nursing course with a service-learning component participated in the study. Students were initially asked to create drawings depicting Mercy/Jesuit charisms, spirituality, and holistic nursing then complete written reflections. At the term's end, students created group art projects connecting service learning, holistic nursing care, and spiritual growth. Students responded to survey questions regarding spirituality, Mercy/Jesuit charisms, nursing practice, and their art experiences. Findings: Surveys were completed by 122 of the 137 students who participated in the art projects. After initial difficulty with artistic expression, most students reported the projects provided an opportunity for introspection related to personal spirituality, nursing, and the impact of service-learning experiences on future nursing practice. Conclusion: Arts-based learning can help students explore and express spirituality related to nursing and support their understanding and integration of values essential to the delivery of holistic nursing care.

Background: Health disparities between Native Americans and white Americans persist due to a variety of factors, including colonization, poverty, and racism. Racist interpersonal interactions between nurses and other healthcare providers and tribal members may also contribute to reluctance among Native Americans to engage with Western healthcare systems. Purpose: The purpose of this study was to better understand the healthcare experiences of members of a state-recognized Gulf Coast tribe. Methods: In partnership with a community advisory board, 31 semistructured interviews were conducted, transcribed, and analyzed utilizing a qualitative description approach. Results: All participants mentioned their preferences, views about, or experiences of using natural or traditional medicine approaches (referenced 65 times). Emergent themes include (a) preference for and use of traditional medicine; (b) resistance to western healthcare systems; (c) preference for holistic approaches to health; and (d) negative provider interpersonal interactions contributing to reluctance in seeking care. Conclusion: These findings suggest that integrating a holistic conceptualization of health and traditional medicine practices into Western healthcare settings would benefit Native Americans.

Background: Native American/American Indian (NA/AI) people have higher rates of chronic disease, including substance use and mental health disorders, compared to White Americans. Though pharmaceuticals can be helpful in addressing many chronic healthcare conditions, many people do not take medications as prescribed. NA/AI identity has been found to be associated with lower rates of medication adherence compared to White Americans. Purpose: The purpose of this study is to better understand NA/AI women's perceptions, beliefs, and experiences related to medication. Methods: Thirty-one semi-structured interviews were conducted with NA/AI women from a state-recognized tribe located in the Gulf South. Interviews were transcribed and analyzed using a qualitative description approach. Results: Eighteen women discussed their experiences using medications when asked about their healthcare experiences. Participants identified the following themes in their discussion of medication: (a) Cost of Medication as a Barrier; (b) Negative Side Effects of Western Medication; (c) Fear of Resistance and Dependence; (d) Preference for Traditional Medicine or None; and (e) Lack of Communication around Medications from Providers. Conclusion: Our findings support the growing call for cultural safety within medical settings and integrating NA/AI conceptualizations of health and well-being and traditional practices into western healthcare settings to better support NA/AI people.

This paper presents a middle-range theory of storytelling in nursing education. Both explanatory and predictive, the theory further develops the existing conceptual work on the topic of storytelling. It places storytelling as a pedagogical technique within the realm of holistic nursing theory and philosophy. Storytelling is seen as a manifestation of the process of integral interconnectedness. The theory suggests a mechanism by which storytelling, as mediated by narrative transportation and neuroplasticity, can be effective in promoting desirable outcomes for holistic nursing students, including the achievement of affective and cognitive educational objectives. The theory describes the relationship of storytelling to narrative transportation and neuroplasticity. Within the concept of storytelling, the Temporal Bidirectionality of Story and Experience and the Story Creation-Interpretation-Recreation Cycle of telling and listening are explained. This theory was developed using deductive reasoning combining existing nursing and non-nursing theories. Recommendations for research and application are included.

This study aimed to examine the effects of holistic nursing competence on work engagement, self-reflection and insight in nurses. This descriptive and cross-sectional study was conducted with 309 nurses working in Turkey. Data were collected using the "Descriptive Information Form", "Holistic Nursing Competence Scale (HNCS)", "Utrecht Work Engagement Scale (UWES)", and "Self-Reflection and Insight Scale (SRIS)". Pearson correlation analysis and multiple linear regression analysis were used to analyze the data. We found that the HNCS had a moderate positive relationship (r = 0.411, p < 0.05) with the UWES, and a weak positive relationship (r = 0.324, p < 0.05) with the SRIS. In the model established by multiple regression analysis, the effect of the HNCS, age, marital status, position, and performing the profession willingly on work engagement explained 33.7% of the variance. In another established model, the effect of the HNCS, gender, and having children on self-reflection and insight explained 11.5% of the variance. Our findings revealed the effect of holistic competence on nurses' positive attitudes about their work engagement and self-reflection in practice. We recommended developing awareness-based programs for nurses to increase their holistic nursing competence.

Introduction: Ubuntu is an African philosophy that reflects holistic and comprehensive care among people in the community. Holistic nursing is a philosophy of caring that focuses on holistic healing and humanism. The purpose of the study was to explore the views of the South African final-year student nurses on the ability of Ubuntu to foster holistic nursing. Methods: An exploratory descriptive qualitative method was used. Eight focus group interviews were conducted with final-year student nurses at selected universities. Colaizzi seven steps process of data analysis was utilized. Results: One of the themes that emerged was that Ubuntu can be an instrument to foster holistic nursing Ubuntu and holistic nursing share many common attributes, hence, the teaching and learning of Ubuntu could foster the type of caring embodied by holistic nursing. Discussion: Ubuntu represents an important care philosophy that can foster holistic nursing, especially when the inner driving force of the nurses is primarily to care for patients.

Purpose: The purpose of this study was to explore emergency care nurses' experiences of an intervention to increase compassion and empathy and reduce stress through individual mindfulness training delivered via workshops and a smartphone application. We also explored how the nurses felt about the practical and technical aspects of the intervention. Design: Qualitative interview study. Method: Individual interviews were conducted with eight of the 56 participants in the intervention study and used phenomenological analysis to illuminate how they made sense of their lived experiences of mindfulness training. Findings: Three themes illuminated the nurses' experiences: becoming aware, changing through mindfulness, and gaining the tools for mindfulness through workshops and the mobile application. The first two themes expressed personal experiences, whereas the third expressed experiences of the practical and technical aspects of the intervention. Most nurses found the mobile application easy to use and effective. Conclusions: Emergency care nurses can feel that the awareness and changes that come with mindfulness training benefit them, their colleagues, and the patients for whom they care. The findings also provide insights into the challenges of practicing mindfulness in a busy emergency care setting and into the practical aspects of using a smartphone application to train mindfulness.

The collapse of the Champlain Towers South (CTS), a condominium in Miami, Florida, left a diverse group of survivors and healthcare clinicians tasked with finding ways of coping with the disaster. Within seconds, the CTS collapse became a global tragedy due to the coastal neighborhood's rich international mix of residents. Although this tragedy impacted communities across globe, a large population of Hispanic victims lived in CTS that were deeply affected. Culturally adaptive interventions and holistic healthcare for Hispanic individuals are highly relevant because Hispanic Americans represent one of the fastest growing demographic groups in the United States. To reach, engage, and address the needs of Hispanic victims, this article provides an overview of psychosocial factors that influence Hispanic victims with trauma and discusses holistic psychotherapeutic approaches in nursing care that can be applied to improve victims' well-being. Culture is an important consideration in health; therefore, this article highlights and operationalizes culturally tailored holistic nursing care that draws from the physical, mental, emotional, and spiritual dimensions of health and well-being that can be used in clinical settings with Hispanic clients who have experienced trauma.

Objective: To understand the process of building culturally competent compassion in nurses who care for vulnerable populations. Method: This is a qualitative study of a "single case study" type, developed with 18 nurses who worked in an emergency care unit in the city of Belo Horizonte, Brazil, between October 2020 and January 2021. Data collection was performed through individual online or one-to-one interviews, following a semi-structured script. Data were treated following thematic content analysis, proposed by Bardin. All ethical precepts were taken into account. Results: After data analysis, the following categories were created: a) Looking within: the recognition of cultural identity; b) Paths to be taken: from the gap to cultural knowledge; c) Attentive listening as essential nursing care; d) Culturally competent compassion as an infinite opportunity for growth. Final considerations: Culturally competent compassion is a subjective, complex, and essential construct in holistic nursing care. When implemented successfully, we gain a significant improvement in the quality of healthcare provided to patients and their families as well as a decrease in social inequality, and the protection of human rights.

The purpose of this quantitative, descriptive, exploratory study was to gauge the degree to which nurse practitioners (NPs) incorporate holistic nursing values in their care, with a special focus on shared decision-making (SDM), using the Nurse Practitioner Holistic Caring Instrument (NPHCI), an investigator-developed scale. A single open-ended question inviting free-text comment was also included, soliciting participants' views on the holistic attributes of their care. A convenience sample of NPs ( n  = 573) was recruited from a southeastern U.S. state Board of Nursing's (BON) publicly available list of licensed NPs. Results suggest that NPs do indeed perceive their care to be holistic, and that they routinely incorporate elements of SDM in their care. Highest scores were accorded to listening, taking time to talk to patients, knowledge of physical condition, soliciting patient input in care decisions, considering how other areas of a patient's life may affect their medical condition, and attention to "what matters most" to the patient. Age, gender, level of education, practice specialty, and location were also associated with inclusion of holistic care. Free-text responses revealed that NPs value holistic care and desire to practice holistically, but identify "lack of time" to incorporate or practice holistic care as a barrier.

Nursing care historically has not been separated from institutional care costs. Organizations seek to quantify nursing care with no assignation of the value or uniqueness of the individual patient-nurse encounter. New models point to measuring care at this level. Nursing care encompasses tangible evidence that can be easy to quantify but, in the paradigm of healing and caring, and more specifically within the knowledge pool of holistic nursing, significant contributions are intangible and thus hard to measure. Anthroposophic nursing's 12 nursing gestures offer an integration by making intangible nursing practice tangible. They incorporate addressing the whole person and more clearly show the caring and healing aspects of nursing care. Making such intangibles of care tangible contribute to the discussion of nursing value and how it is measured in healthcare organizations. More research is needed, however, to refine and value nursing care to more accurately reflect the connection between caring, healing, and patient outcomes.

Human trafficking, also known as modern-day slavery, is a public health crisis and a growing worldwide crime exploiting approximately 40.3 million victims. A decade ago approximately 79% of human trafficking crimes were related to sexual exploitation and 18% were related to forced labor, but more recent reports show approximately 50% and 38%, respectively. Although sexual exploitation continues to make up the majority of human trafficking crimes, forced labor continues to grow at an alarming rate. The purpose of this paper is 2-fold. First, to empower healthcare providers and community volunteers serving potential victims of human trafficking in traditional and nontraditional settings with human trafficking identification training. This education should include the use of a validated human trafficking screening tool and the timely provision of resources. Second, to guide professional nurses in the holistic approach to caring for potential victims of human trafficking. The core values of holistic nursing practice and Watson's Theory of Human Caring are the pillars guiding mindful and authentic nursing care. Merging evidence-based practice with holistic care will boost victim identification and rescue.

Purpose: To describe women's initial experiences and up to a year in retrospect of their life situation with a confirmed Takotsubo syndrome (TS) diagnosis. Method: A single case study literature review based on nine articles published by nurses was analyzed deductively using a nursing life dimension model. Results: All but one case was conducted on the North American continent and TS had largely affected women with previous cardiac history and had been triggered by one or two stressful life events. The biophysical life dimension manifested in distinct and troublesome inconvenience and in retrospect in fretting and grievous ailments. The emotional dimension manifested in pronounced ways and attitude-related sensations, feelings or moods while the intellectual dimension manifested in an unmanageable world of thought. The spiritual-existential dimension manifested in a life-denying view of life and the socio-cultural dimension manifested in an asocial life. Conclusions: With TS best practice in mind and a person-centered care and holistic approach, comprehensive descriptions are needed of how women identify, interpret, and use knowledge to manage their life situation. Cardiac nurses need further comprehensive descriptions to implement actions. Prior to implementation of such programs, this knowledge needs to be disseminated among cardiac nurses and evaluated in international randomized controlled trials.

Older adults diagnosed with schizophrenia (OADWS) often enter long-term care facilities with unique challenges related to trauma and stress experienced throughout their life course. Health care workers often report that when they work with this population, they feel unprepared due to limited training. In this article, life course theory is presented as a lens for holistic nursing research and as a way for nurses to adapt interventions already used with cognitively impaired older adults (e.g., those diagnosed with Alzheimer's disease) for OADWS in long-term care. It is hoped that these ideas will facilitate discussion of ways to inform training for holistic long-term care of OADWS. Holistic principles of nursing addressed with life course theory as a lens include the following: (a) accounting for strengths and challenges; (b) honoring experiences, values, and health beliefs; (c) viewing interrelationships with the environment; and (d) nurturing of peace, wholeness, and healing.

Aim: To explore and develop understanding of nursing home staff's emotional experiences of being in a close relationship with a resident in long-term care who later died. Design: Ethnographic fieldwork. Methods: As part of fieldwork, narrative interviews were conducted with nursing home staff ( n  = 6) in two nursing homes in Norway and analyzed using interpretative phenomenological analysis. Findings: Through data analysis, we identified three superordinate themes: (1) wanting to be something good for the resident and their families, (2) striving to make sense of the resident's death, and (3) struggling to balance being personal and professional. Implications for holistic nursing and conclusion: Nursing home staff experience tensions between ideals of distanced professionalism and the emotional experience of proximity, evidenced by personal commitment and mutual recognition in relationships with "special residents" in long-term care. To support holistic practice, awareness is needed of the emotional impact of relationships on health professionals. Suppressing feelings puts staff at risk of moral distress, compassion fatigue, and burnout, as well as higher turnover and absenteeism. Managers should facilitate discussions on professionals' ideals of relationship-based practice, including processing of, and reflection on, emotional experiences in long-term care. Rituals to mark a resident's death can provide further emotional containment.

This article describes a holistic revisioning of symptom theory for nursing practice. The Holistic Theory of Unpleasant Symptoms (HTOUS), informed by the Science of Unitary Human Beings, describes the complexity of symptom experience and how nursing actions can be associated with its transformation. Existing theories of unpleasant symptoms which broadly describe the antecedents, characteristics, and consequences of symptoms, have been reconceptualized from holistic and integral perspectives. Applying integral concepts such as human energy field and pattern manifestation expands understanding of both symptom experience and the nurse's response to it. Spirituality is an addition to symptom theory, being seen as a characteristic of Human Energy Field pattern manifestations. The theory's major concepts are symptom experience manifestations and wellbecoming manifestations. Concepts of the sustaining presence of the nurse and voluntary mutual patterning are explored. Pain, nausea, dyspnea, anxiety, despair, and other symptoms are discussed. Because HTOUS is acausal and nonlinear, it is widely applicable to creative, theory-directed nursing practice and research. Recommendations are made for practice, research, and further theory development.

Objective: to understand the meanings and practices related to spirituality experienced by Nursing teams in the daily care provided in Oncology., Methods: qualitative research, guided by the theory of Holistic Nursing by Myra Levine, conducted with members of the Nursing team at an Oncology hospital in Brazil. Data collection was carried out in 2018, through an interview guided by a semi-structured script. Data analysis was performed using Lawrence Bardin's Content Analysis technique., Results: two categories emerged: the first brought to light the meanings attributed to spirituality by the Nursing team and the second category presented the practices of spiritual care by Nursing personnel in their daily routine in Oncology, highlighting that professionals address spirituality with patients in different ways., Conclusion: the approach to spirituality in Oncology care and in the professional training of Nursing personnel is essential, as a way of providing holistic and humanized care, thus strengthening the psycho-spiritual dimension in daily care.

Among all the groups and occupations that have been affected by the global pandemic, nursing professionals stand out as having been particularly hard-pressed due to the dramatic increase in the need for their services. Given the rising tide of coronavirus disease 2019 patients who require specialized medical treatment as well as the millions of others that are lining up for vaccinations, it can be assumed that many nursing professionals have had to endure such things as longer working hours, tighter schedules, and the intensity of a work environment in which failure of care and multiple deaths are the daily fare. This article proposes that nurses can avoid such severe consequences by taking up a regime of enhanced self-care management that enables them to achieve psychophysical balance and wellness. Three practices are highlighted in this regard: prayer, meditative walking, and the mindfulness practice of body scanning. Our suggestion is that these coping strategies will be both beneficial and healthful for nursing professionals in terms of enhancing their spiritual/existential resilience and meeting their own need for consolation as they navigate in an extremely difficult and demanding work environment.

Purpose: This study investigated the relationship between nursing students' profile variables and their state of mental well-being and resilience during the coronavirus disease-19 (COVID-19) pandemic and how this impacts their understanding of holistic nursing care provision. Design: This study used a cross-sectional design and total enumeration sample ( n  = 439) from all enrolled nursing students in the College of Nursing of a state-run university. Method: The 10-item Connor-Davidson Resilience Scale (CD-RISC) and 14-item Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) were used to collect data from the participants. A correlational analysis was employed to determine the relationship between the responses of the participants to their profile variables. Findings: There were no significant differences in age, gender, and year level in the 10-item CD-RISC and WEMWBS. Regarding the WEMWBS, the mean total score of those with 61-100% of the allowed units was significantly higher than those with 31-60%. Finally, the CD-RISC scores revealed that participants with a general point average (GPA) of A were significantly higher than those with a GPA of B+ or B. Conclusion: Academically performing students (those with a GPA of B and above) are more resilient. In addition, there is an existing linear relationship between high mental well-being and the ability to pursue higher academic loads.

Aim: To investigate how migrant nursing home staff relate to religion in their care for patients who are approaching death., Method and Theory: Individual in-depth interviews were conducted with 16 migrant health care workers from five nursing homes in Norway. The overall analytic approach was hermeneutical. The parts and the whole were interpreted in light of each other to gain a "thick description" of the data material in order to show the ways in which experiential meaning-making draws on cultural webs of sign ificance., Findings: Religion held various meanings for the migrant health care workers interviewed. Religious and cultural competence and knowledge of migrant nursing home staff was neither asked for by the management nor discussed in the staff group. The way our participants related to religion at work was therefore based on individual preferences and internalized practices., Conclusion and Implication for Practice: Organized reflection groups among staff are needed in order to integrate and develop religious literacy in the multicultural nursing home setting. Such reflection groups can help the individual staff member to perform holistic nursing, that is, to be attentive of the interconnectedness of biological, social, psychosocial, and spiritual aspects in a human being.

This article is a philosophical review of school nursing and its constructs framed by Barbara Dossey's holistic nursing theory. The author describes the application of holistic nursing theory within the school nurse's area of activity. The review suggests that holistic nursing theory can be applied in several areas of school nursing. School nurses have a multifaceted occupation that includes meetings with students, parents, and school staff. Barbara Dossey's holistic nursing theory offers the school nurse tools to deal with people's varied experiences, feelings, and needs.

Purpose: To test an interdisciplinary art-based educational program for beginning baccalaureate traditional and accelerated nursing students., Design: Longitudinal study (Pretest-Posttest) of nursing students' metacognitive awareness., Method: As part of a first-semester foundations nursing course, all students participated in the Art of Nursing program consisting of three 90-minute sessions led by graduate Art Education students in a local fine arts museum. Before and after the program, subcomponents of critical thinking were assessed using the Metacognitive Awareness Inventory (MAI)., Findings: A total of 218 students (56 traditional, 162 accelerated) participated. Statistically significant improvement was observed on seven components of the MAI. Although significant increases were observed for Declarative ( p < .0001), Planning ( p < .0001), and Comprehension Monitoring ( p < .0001), the differences pre to post were of different magnitudes between the student groups, characterizing a large change in the traditional versus accelerated group., Conclusions: Our results suggest that (1) nursing students' metacognitive awareness benefits from the museum-based experience despite demographic and educational differences and (2) overall the accelerated student group has exhibited higher metacognitive awareness at baseline as compared with the traditional student group; however, both groups demonstrate significant growth in this area after experiencing an art-based program.

Research has suggested positive effects of nature immersion-a state of being or an act of doing in natural space-for urban children who were otherwise at risk for emotional or behavioral problems. However, few studies have systematically investigated natural space qualities that predict child well-being at the clinical level. The purpose of this study was to increase the understanding of natural space qualities as factors of urban child well-being. Explanatory mixed methods were used. Quantitative data ( N = 174) included a survey and two parental reports of child well-being. Interviews provided qualitative data ( N = 15). Data were analyzed using generalized linear model and content analysis. Both data streams were merged into a point of meta-inference that contributed to parental assessment of enhanced child well-being: More frequent nature-child space-time immersion combined with parental valuing of nature connection ( p < .001) as a soothing and safe resource. The factors of urban nature immersion affected child well-being over parental socioeconomic affluence alone. The evidence corresponds to Nightingale's tenet that an act of doing, which is considered an action of the child's own will, affects one's sense of well-being. The findings indicate that nature immersion can be applied to urban child self-care and holistic nursing modalities.

Purpose: Effects of a mindfulness-based (MB) yoga practice on stress, burnout, and indicators of well-being among nurses and health care professionals (HCPs)., Design: A randomized controlled trial, 80 HCPs assigned to either MB yoga intervention or control group., Method: The MB yoga intervention group ( n  = 41) attended weekly yoga classes and practiced yoga independently. The control group ( n  = 39) did not receive the yoga intervention. Study participants completed pre- and postintervention questionnaires, instruments included (a) Perceived Stress Scale; (b) Maslach Burnout Inventory; (c) Vitality subscale of the Medical Outcomes Study Short Form-36; (d) Global Sleep Quality item, (e) Mindfulness Awareness Survey, and (f) subscale of the Brief Serenity Scale. Diurnal salivary cortisol and blood pressure were assessed pre and postintervention., Results: Significant improvements ( p  < .01) noted in MB yoga compared with control for self-reported factors, including stress (Perceived Stress Scale), burnout (Maslach Burnout Inventory), vitality (Medical Outcomes Study Short Form-36), sleep (GSQ), serenity/inner haven (IH), and mindfulness (Mindfulness Awareness Survey). Diurnal cortisol slopes and blood pressure were not significantly improved., Conclusion: The MB yoga intervention had a statistically significant effect on the health and well-being of nurses and HCPs, most specifically for measures of stress; perceived stress, burnout, vitality, sleep quality, serenity, and mindfulness.

Aim: To investigate the association between nurse-patient interaction and sense of coherence among cognitively intact nursing home residents. Method: In a cross-sectional design, data were collected in 2017 and 2018 using the Nurse-Patient Interaction Scale (NPIS) and the 13-item Sense of Coherence Scale (SOC-13). Of the 204 cognitively intact nursing home residents who met the inclusion criteria, 188 (92%) participated, representing 27 nursing homes. Multiple regression in a general linear model estimated the possible effects of the 14 NPIS items on SOC-13 sum score, the possible effects of the NPIS (sum score) on SOC-13 (sum score) as well as on the subdimensions of SOC-13, comprehensibility, meaningfulness, and manageability (both without and with adjusting for sex and age). Results: Four of the 14 NPIS items revealed highly significant correlations with SOC-13 (sum score; unadjusted and adjusted for age and gender). Furthermore, the analysis adjusted for age and gender showed significant associations for NPIS (sum score) with SOC-13 (sum score), manageability, and comprehensibility. The correlation between NPIS and meaningfulness was not statistically significant. Conclusion: Nurse-patient interaction is significantly associated with SOC-13 and its subdimensions of comprehensibility and manageability but not meaningfulness. Nurse-patient interaction might be an important resource in relation to residents' sense of coherence and its subdimensions.

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.

Purpose: Traditional Chinese medicine (TCM) proposes the world as a holistic unity of energy. With a long history of use, TCM is generally accepted in the Chinese health care system. Despite growing global interest and use, TCM has received a mixed response from Western health care systems. This study aimed to describe the underpinnings of TCM, compare TCM and Western medicine, and suggest how key modalities might be applied to strengthen holistic nursing care in the United States. Design: A qualitative, descriptive exploratory investigation employing a constructivist grounded theory. Method: Interview of TCM healers in Hong Kong ( n = 5). Transcripts were reviewed to identify common themes and categories. Findings: Five themes were identified: improvement in energy flow and health, TCM as "a way of knowing," curing source versus symptoms of disease, declining TCM practice in Hong Kong, and need for interprofessional education. Conclusions: TCM is considered useful in chronic illnesses, whereas those with acute illnesses often seek Western medicine. Failing to address the holistic care needs and preferences of individuals results in less than optimal health outcomes. Nurses need explicit TCM content and would benefit from a restructuring of curricula and clinical experiences to foster integration into caring practices.

The critical review of the literature describes the definition clarity of spirituality, religion, and faith. These three terms are interchangeably used in the literature. However, each of these terms has its own definitions. For example, the term spirituality has more than 13 conceptual components. It is abstract and subjective and is different from religion and faith. Spirituality can be a connection to God, nature, others, and surrounding. Spirituality is associated with quality and meaning in life. Conversely, religion is attributed to traditional values and practices related to a certain group of people or faith. Religion is guided by tradition, rules, and culture. Religion is defined as a personal set or institutionalized system of religious attitudes, beliefs, and practices. Religion is the service or worship of God or the supernatural. Faith is often associated with religion and spirituality. Faith is more personal, subjective, and deeper than organized religion and relates to the relationship with God. The concept of spirituality lacks a professional understanding. It is imperative that the holistic view of nursing must strive to understand the definition of spirituality.

This article reports on an experiment in 28 pediatric hospitals across 14 African and Asian cities. The aim was to examine the effect of a customized spiritually sensitive intervention (SSI) on mitigating depressive symptoms among hospitalized children with congenital heart diseases (CHD). Results showed that post-SSI, 1,139 treatment group children were less depressed vis-à-vis the control group. The SSI was more effective for children from African cities, boys, middle class, Christians and Buddhists, those undergoing medical care for ventricular septal defects, children who stayed in the hospital for 2 to 3 weeks and who regularly self-practiced the lessons after hospital discharge. The SSI could be effectively used for holistic pediatric nursing and health care across contexts with CHD affected children, with some culture-specific variations for greater impact.

Holistic nursing is founded on the values of integrality and the awareness of whole-people and whole-system interconnectedness. These concepts are foundational to the broader global health agendas and initiatives of our time, which seek to improve human, animal, and planetary health. The United Nations 2030 Agenda for Sustainable Development represents the most remarkable transnational initiative in history: a 15-year plan (2015-2030) rallying the efforts of all countries, governments, and concerned citizens worldwide to foster human-planet thriving and survival. The purpose herein is to substantiate the United Nations 2030 Agenda as a holistic nursing priority and theory-practice opportunity for current and future professional maturation. This article provides a background of the 17 Sustainable Development Goals (SDGs), a discussion regarding their relevance to holistic nursing, and an explanation of the essential nature of partnerships in attaining each of these "Global Goals." We link the discussion of the SDGs directly to the American Holistic Nurses Association's Core Values and identify implications for practice, education, research, and policy. Holistic nursing is ideally situated throughout the health care system and in the broader global context to advocate and advance the SDGs.

Older adults diagnosed with schizophrenia (OADWS) have unique needs for care and live longer today than their forebears who were diagnosed with schizophrenia. As a result, nurses need to be prepared for the specific care of individuals who live with schizophrenia as they age. Together, Life Course Theory and holistic nursing suggest a good fit in the quest for successful solutions and/or outcomes for the unique problems that OADWS face. Holistic nursing views the patient as a whole person, considering all aspects of the patient's experiences within life's broader environment. The life course paradigm offers an effective way for nurses to understand issues that patients face throughout their lives, thus enhancing holistic nursing with a historical perspective. This is especially important for the care of OADWS, who face unique disparities as well as physical and psychological comorbidities over their life course. This article is intended to initiate a discussion of OADWS, focused with Life Course Theory as a holistic lens. Literature pertinent to the life course of OADWS is reviewed, followed by an analysis of the life course paradigm in relation to OADWS' unique experiences. Conclusions support the holistic use of Life Course Theory in research and interventions for OADWS.

Background: Nurses and others have used various terms to describe our caring/healing approach to practice. Because terms used can influence our image of ourselves and the image others have of us, we sought to clarify their meanings. Questions: How are the terms holistic nursing, integrative health care , and integrative nursing defined or described? Do we identify with these definitions/descriptions? Are the various terms the same or are they distinct? Method: We conducted an integrated review of peer-reviewed literature following the process described by Whittemore and Knafl. Using standard search methods, we reviewed full texts of 94 published papers and extracted data from 58 articles. Findings: Holistic describes "whole person care" often acknowledging body-mind-spirit. Holistic nursing defines a disciplinary practice specialty. The term integrative refers to practice that includes two or more disciplines or distinct approaches to care. Both terms, integrative and holistic , are associated with alternative/complementary modalities and have similar philosophical and/or theoretical underpinnings. Conclusions: There is considerable overlap between holistic nursing and integrative nursing. The relationship of integrative nursing to integrative health care is unclear based solely on definitions. Consideration of terms used provides opportunities for reflection, collaboration, and growth.

Purpose: To explore the personal experiences, challenges, and practices of parish nurses in their communities., Method/design: The overall study used a mixed methods concurrent embedded design to describe parish nurses' experiences with diabetes education and preconception counseling in their practice. Also included were descriptions of generalized practices. Therefore, this current report will focus on these broader experiences. Focus group data were collected using face-to-face, teleconference, and video conferencing formats with 48 nurses who consider themselves to be parish nurses and analyzed with content analysis., Findings: Four qualitative themes were identified in the data: (1) Gaining Entry Through Trust, (2) Enhanced Focus on Spiritual Caring, (3) Accomplishing Much Despite Challenges, and (4) Practice Making a Difference. Parish nurses are uniquely situated to provide holistic care for the mind, body, and spirit of their patients. Despite the many positive aspects, parish nurses experience unique challenges, such as funding their practice and working independently., Conclusions: The parish nurses can play a vital role in providing holistic care to patients in a faith-based community. Future work is needed to address the challenges of parish nurses such as access to continuing education programs related to health topics of concern to their community members.

Purpose: Pain is a problem for individuals undergoing hemodialysis. Renal disease, comorbidities, concurrent symptoms, and dialysis procedures pose barriers to adequate pain management. The purpose of this study was to evaluate feasibility, examine construct validity of The Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive testing (CAT) instruments, and explore pain benefits of Reiki sessions conducted during hemodialysis., Design: A one group, repeated-measures design was used., Method: Fifteen participants received Reiki for 20 minutes, twice a week for 4 weeks. Pain, fatigue, and depression were evaluated using established symptom scales and PROMIS CAT instruments., Findings: Participants reported general relaxation feelings with Reiki and acceptability of using a touch-screen device to respond to web-based measures. Although staff were initially reluctant to engage patients for Reiki, they reported Reiki did not interfere with workflow and thought Reiki could be integrated into the practice setting. Significant, strong correlations with established symptom scales support construct validity of PROMIS CAT instruments. There was a significant decrease in mean symptom scores after four weeks of Reiki. Effect size values suggest a range of practical significance., Conclusions: Findings suggest Reiki provides symptom relief for individuals receiving hemodialysis, and randomized clinical trials to establish Reiki's pain benefits in this population are warranted.

This article describes the outcomes of nursing students taking a course in complementary and alternative therapies focusing on energetic modalities that were used as a means of self-care. Students kept journal logs and did a formal presentation for the class. Nursing students reported decreased stress and improved concentration, academic performance, productivity, and problem-solving while experiencing a greater appreciation of their clinical experiences. Using Therapeutic Touch and other subtle energy interactions, the students also cited improved interpersonal relationships, increased feelings of calmness, a higher degree of self-awareness and self-care, reduced physical pain, increased energy, and greater appreciation of the world around them. The theoretical framework was Margret Neuman's theory of health as expanding consciousness. While this is an elective nursing course, the nursing students were primarily juniors and seniors already taking clinical courses. A research study with a wide sample of student participants, especially freshmen, and using quantitative as well as qualitative measures would be beneficial to determine if such a course should be part of the standard nursing curriculum to not only expand nurses' understanding of complementary and alternative therapies but also to help students with their own self-care and influence their practice as clinicians.

Purpose: To examine the relationships and differences in the use of intuition among three categories of practicing nurses from various clinical units at a medical center in the Midwest., Design: Descriptive, correlational, cross-sectional, prospective design., Method: Three categories of nurses were based on the clinical unit: medical/surgical nurses ( n = 42), step-down/progressive care nurses ( n = 32), and critical care nurses ( n = 24). Participants were e-mailed the Rew Intuitive Judgment Scale (RIJS) via their employee e-mail to measure intuition in clinical practice. Participants were also asked to rate themselves according to Benner's (novice to expert) proficiency levels., Findings: Nurses practicing at higher self-reported proficiency levels, as defined by Benner, scored higher on the RIJS. More years of clinical experience were associated with higher self-reported levels of nursing proficiency and higher scores on the RIJS. There were no differences in intuition scores among the three categories of nurses., Conclusion: Nurses have many options, such as the nursing process, evidence-based clinical decision-making pathways, protocols, and intuition to aid them in the clinical decision-making process. Nurse educators and development professionals have a responsibility to recognize and embrace the multiple thought processes used by the nurse to better the nursing profession and positively affect patient outcomes.

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.

Background: Although pain is one of the most prevalent symptoms among cancer patients, medications do not always result in sufficient pain relief. Furthermore, these medications only address the physical component of pain. Art making, a holistic approach, may distract the user's attention from pain and allow expression of the nonphysical (e.g., psychological, spiritual) components of pain. The purpose of this systematic review was to evaluate evidence for the efficacy of art-making interventions in reducing pain and improving health-related quality of life (QoL) among cancer patients., Method: PubMed, Academic Search Premier, ProQuest, and CINAHL were searched from database inception to September 2016 using the following search terms: neoplasm, cancer, tumor, pain, pain management, quality of life (QoL), well-being, art therapy, painting, and drawing., Results: Fourteen articles reporting 13 studies were reviewed. Some studies reported beneficial effects of art making on pain and QoL, but the evidence was weakened by poor study quality ratings, heterogeneity in art-making interventions and outcome measures, interventions including non-art-making components, and few randomized controlled studies., Conclusion: More rigorous research is needed to demonstrate the efficacy of art making in relieving cancer-related pain and improving QoL.

Purpose: The spiritual dimension of a patient's life is an important factor that may mediate detrimental impacts on mental health. The lack of research investigating spiritual well-being, religiosity, and mental health among Jordanian hemodialysis patients encouraged this research. This study explored levels of spiritual well-being and its associations with depression, anxiety, and stress., Design: A quantitative, cross-sectional correlational study., Method: A sample of 218 Jordanian Muslim hemodialysis patients completed a structured, self-administered questionnaire. The data were analyzed using descriptive statistics and linear multivariate regression models., Findings: The hemodialysis patients had, on average, relatively low levels of spiritual well-being, moderate depression, severe anxiety, and mild to moderate stress. The results of the regression models indicated that aspects of spiritual well-being were negatively associated with depression, anxiety, and stress, but only existential well-being consistently retained significant associations after controlling for religious well-being, religiosity, and sociodemographic variables., Conclusions: Greater spiritual and existential well-being of Jordanian hemodialysis patients were significantly associated with less depression, anxiety, and stress. It appears that these patients use religious and spiritual beliefs and practices as coping mechanisms to overcome their depression, anxiety, and stress. The implications for holistic clinical practice are explored.