Holistic Nursing Practice最新文献

Nursing presence is an important therapeutic and diagnostic modality in patient-centered care and decision-making during end-of-life (EOL) care. Nurses cultivate presence through intentional awareness and actions to support patients, yet there is a paucity of relevant literature regarding nursing presence in EOL care. An evolutionary concept analysis employing Rodger's techniques was conducted with 20 international research studies and nine analyses of nursing presence between 1992 and 2023. The attributes, antecedents, and consequences of nursing presence in EOL care were described, a theoretical definition was proffered, and suggestions for its clinical application and future research directions were offered. As evidenced by this concept analysis, nursing presence in EOL care is an intentional, temporal, spatial, and intrapersonal relationship. More research and analysis of this concept are needed, especially in long-term care settings given continued growth in the long-term care patient population and the prevalence of nurses leading EOL care in that setting.

Diabetes is a chronic, complex condition, which requires intensive daily management for adequate glycemic control. The burden of daily tasks necessary for diabetes self-management can negatively impact psychosocial outcomes. The practice of gratitude in patients with chronic conditions has demonstrated improvement in poor psychosocial outcomes. The purpose of this review is to examine the effect of gratitude interventions on glycemic and psychosocial outcomes in individuals with diabetes. We searched 5 databases in September 2024 to identify research articles that met inclusion criteria. Six studies met inclusion criteria. Interventions included gratitude journaling, gratitude therapy, writing a gratitude letter, and gratitude reflection. Results indicate gratitude is a feasible intervention and may improve anxiety and depressive symptoms, quality of life, and coping with diabetes. There was heterogeneity in intervention delivery and results. Further research is required to ascertain the extent of correlation between gratitude, and glycemic and psychosocial outcomes.

This parallel-group randomized controlled trial aimed to investigate the effect of progressive relaxation exercises on dyspnea and comfort level in individuals with chronic obstructive pulmonary disease. The study utilized a stratified and block randomization methodology, with 42 patients completing the trial. Patients in the intervention group received 30-min progressive relaxation exercises for 6 weeks. The mean dyspnea level scores of the patients in the intervention group at week 6 were found to be lower than those of the control group, with a statistically significant difference between the two groups ( P < .05). Furthermore, a statistically significant decrease in patients' mean comfort level scores in the intervention group was observed over the follow-up periods ( P < .05). The study results demonstrate that progressive relaxation exercises constitute an effective nursing intervention for managing dyspnea in patients with chronic obstructive pulmonary disease.

This study was carried out to develop a spiritual care model for clinical nurses. This study has used a 3-step strategy proposed by L. O. Walker and K. C. Avant (2019) for theory synthesis. In the second phase of this study, an integrative review was conducted to retrieve and select relevant articles. A total of 227 documents were included for theory construction. After identifying and defining the basic assumptions of the model, the concept of spiritual care was defined as a paradigmatic concept with a holistic approach. Then the metaparadigmatic concepts (ie, human being, environment, nursing, and health) were defined according to the holistic approach. After defining the model care goals, clinical strategies and interventions were defined according to the goals and the concept of health as an outcome of spiritual care. Nurses' clinical roles were conceptualized within the conceptual framework that includes 3 main steps of nursing process: (1) assessment and identification of the client to explore the spiritual perspective; (2) planning and implementing spiritual care; (3) documenting and evaluating spiritual care. This model can tell clinicians what to do in caring for patients, especially chronic and end-stage patients. Therefore, this model could help provide better care for all clients.

Although there is limited information on efficacy and safety of complementary and alternative medicine (CAM), they are increasingly used by patients with cancer. We aimed to determine the prevalence and predictors of CAM use among a sample of Iranian cancer patients. In this cross-sectional study, conducted in an outpatient cancer clinic, patients with solid tumors or hematologic malignancies in different stages were asked to complete a questionnaire to measure CAM usage. A total of 131 patients with a median age of 58 years (18-86 years) participated in this study. CAM use was reported by 51.9% (n = 68) of the patients. Female gender and higher education level were significantly associated with the use of CAM (OR = 2.47, P value = .01 and OR = 2.55, P value = .02, respectively). Vitamins and minerals were the most frequently used CAM (n = 37, 54.4%). The main reasons for CAM use were to improve immune system and fight cancer (n = 48, 70.6%) followed by relieve side-effects from conventional cancer treatments (n = 26, 38.2%). Although three (4.4%) patients reported side-effects, most patients (n = 53, 77.9%) were satisfied with their CAM use. Among CAM users, 55 (80.9%) patients had reported their CAM use to physician. The CAM use is highly prevalent among adult cancer patients. Health care providers need to raise their awareness on probable disadvantages or benefits of CAMs and discuss these issues with patients.

During pregnancy, a woman's body undergoes physiological and metabolic changes to nourish the developing fetus. Every woman experiences pregnancy-related stress differently, with symptoms and difficulties ranging from mild to severe. However, various therapies are available to help reduce stress levels. The purpose of this study is to assess the impact of integrated yoga, which includes asanas and pranayama, on stress levels and physiological markers in pregnant women. The study is a prospective, randomized, controlled, single-blind trial with 2 parallel groups. The intervention group was provided with integrated yoga therapy, while the control group was given routine standard care from 18 to 22 weeks to 33-35 weeks of gestation. To measure the stress level, a standardized perceived stress scale was used, which has 10 items with stress scores ranging from 0 to 4, with a maximum score of 40. The average stress score was significantly lower in the intervention group ( P < .001) as well as normal physiological parameters when compared to the control group. Findings suggest that practicing yoga during pregnancy is safe and effective in reducing stress and preventing complications. Women who began yoga therapy during their second trimester reported a significant decrease in physiological parameters from baseline to post-intervention. However, further randomized controlled trials are necessary to determine the validity and usefulness of yoga therapy during pregnancy.

End-of life-experiences, including profoundly meaningful dreams, visions, and sensations, may be experienced by caregivers at the time of a patient's death, yet few caregivers feel comfortable discussing these experiences with colleagues or other members of the care unit. This article presents findings from a descriptive qualitative study of end-of-life experiences reported by caregivers and frames these experiences within Watson's Theory of Transpersonal Caring, which is a holistic approach to health care that emphasizes the transpersonal caring relationship. Watson's Theory is particularly useful for framing end-of-life experiences in a caregiving context as it avoids debates about the nature of these experiences and emphasizes their therapeutic value in human caring. This article also argues that it is time for open discussions about end-of-life experiences reported by caregivers and what they might teach us about death and dying.