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Purpose: Research supports holistic expansion of the construct of resourcefulness by adding spiritual practices to the existing personal and social dimensions. This study describes the development and testing of items to measure spiritual resourcefulness. Methods/Design: Study phases were: (1) focus group development of item stems and responses; (2) expert testing; (3) scale construction; (4) field testing in 234 family caregivers; and (5) psychometric analysis to identify items for inclusion in a final scale. Findings: A focus group developed 40 item stems with potential responses reflecting three conceptual components of spiritual practices (rational, ritualistic, and relational). Content experts selected the best response for each item. A six-point Likert scale consistent with the Resourcefulness Scale © was constructed. Data from field testing were factor analyzed. The best solution revealed two factors containing 12 items. Ritualistic and relational items loaded together (44.7% variance explained). Rational items loaded separately (19.5% variance explained). Higher-order factor analysis indicated the two subscales reflected a single construct (71.93% variance explained; r  = .44, p  < .001). Conclusion: Availability of a psychometrically sound measure of spiritual resourcefulness is critical to expand resourcefulness training interventions to be more holistic. Clinical interventions can be enriched by including strategies to enhance personal, social, and spiritual resourcefulness skills.

Although caregiver identity theory asserts there is no single generic caregiver identity, comparisons on demographic characteristics and burden of care have not been made among caregivers of persons with various health conditions. Using social media to access study participants, this cross-sectional study of 234 family caregivers of persons with various health conditions examined their demographic characteristics (age, gender, and race/ethnicity) and burden of care (daily care hours and caregiving years) using online data collection. Nine groups of caregivers were formed by the care recipient's health condition. Caregiver groups were similar in gender (95% women) and race/ethnicity (88% white), and differed on age (F=4.74; p<.001) daily care hours, and caregiving years (F's=2.76 and 2.84; p<.01). The findings suggest that caution is needed when recruiting caregivers through social media as the sample may not represent all caregivers. However, differences by care recipient condition on age and burden of care warrant further consideration.

Peripartum women are exposed to a variety of stressors that have adverse health consequences for the maternal-child dyad (e.g., impaired bonding). To combat these adverse health consequences, heart rate variability biofeedback (HRVBF) may be implemented by holistic nurses to aid peripartum women experiencing a high level of stress. A systematic review was completed using the guidelines established in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. To be included in the review, studies had to meet the following criteria: (a) published scientific articles, (b) studies published in English, (c) experimental, quasi-experimental, or case reports, (d) use of HRVBF as the main treatment, (e) use of psychological stress as a dependent variable, and (f) studies published until December 2017. The major findings of this review can be described as follows: (a) HRVBF and psychological stress in peripartum women are related concepts, (b) peripartum women who completed HRVBF report a reduction in stress compared with participants who did not receive HRVBF, and (c) there is currently no information on the effectiveness of HRVBF on psychological stress in the first and early second trimester of pregnancy. Overall, this systematic review of the literature provides objective evidence that HRVBF may be a potential beneficial adjuvant treatment for stress management in peripartum women.

This study examined relationships among personal and social resourcefulness and spiritual practices and their associations with perceived stress, depressive symptoms, and self-assessed health in 138 women caregivers of elders with dementia. Caregivers who rated high on personal and social resourcefulness and spiritual practices (by median splits) had the lowest perceived stress, fewest depressive symptoms, and best self-assessed health, followed in sequence by women rating high on two of the three, high on one of the three, and low on all three. Hierarchical regression analyses that introduced spiritual practices after resourcefulness showed significant increases in the R-square change by 3% and 5% for perceived stress and depressive symptoms, respectively, but no significant change for self-assessed health. Strong associations among personal and social resourcefulness and spiritual practices, and similar relationships with two health outcomes, suggest that spiritual practices may be a third dimension of resourcefulness.