Journal of Holistic Nursing最新文献

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.

Background: Auriculotherapy, a form of therapy that involves stimulating specific points on the ear auricle, has garnered attention for its potential in holistic stress management in adults, aligning with broader patient-centered therapeutic approaches. Objective: The aim of this study was to evaluate the effectiveness of auriculotherapy for stress relief in adults. Methods: A comprehensive search of nine databases (PubMed, Scopus, CINAHL, Web of Science, Ovid Medline, Cochrane Library, RISS, KMbase, and KISS) was performed, yielding 553 studies. Of these, 12 were selected for meta-analysis based on the inclusion criteria, which considered demographic data, types of auriculotherapy, intervention characteristics, auricular points, and stress-related outcomes. The risk of bias was also evaluated for each selected study. Results: The meta-analysis results (n = 12) indicated that auriculotherapy was significantly superior to the control group in terms of subjective stress index, blood pressure, heart rate variability, and pulse rate, as well as improving low-frequency (LF) and high-frequency (HF) heart rate components and their ratio (LF/HF) in adults. Additionally, the subgroup analysis indicated a trend where the effect size of acupressure may be larger than that of acupuncture. Conclusions: Our findings underscore auriculotherapy's efficacy in reducing stress in adults, advocating for its integration into nursing curriculums as a viable clinical intervention for stress management. Promoting its application in clinical environments could complement holistic, patient-centric care paradigms.

Purpose: To identify the effects of Reiki on stress among Japanese nurses. Design: Mixed method and intervention design. Method: A nonprobability snowball sampling was used. Twenty-one nurses were invited to receive the Reiki intervention. Physical responses were measured by pulse rate, respiration rate, blood pressure rate, and salivary α-amylase activity pre- and postintervention. Psychological responses were evaluated by the mood dimensions and Total Mood Disturbance of the Profile of Mood States 2nd Edition. To obtain qualitative data, semistructured interviews were conducted after the intervention, and a web-based questionnaire was completed the following day. Findings: Twenty-one participants completed the study, and results indicated that the Reiki intervention significantly improved psychological stress reactions. No significant differences were found in physical stress. Two categories were identified from qualitative data: "positive effects" and "negative effects". Codes including "warm," "body feeling more comfortable," and "stress awareness" emerged as the positive effects. No adverse events were indicated. Conclusion: The results are the first step toward holistic nursing care in Japan and quantitative and qualitative data confirmed that Reiki improved the psychological aspect of stress responses of Japanese nurses.

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: This study aims to delve into the process of men confronting infertility. Design: This research employed the Straussian grounded theory approach. Methods: The study encompassed interviews with 16 participants from a private fertility center in Isfahan, Iran, between March 2023 and March 2024. The interviews were semistructured. Data analysis was carried out concurrently using constant comparative methods and standard grounded theory techniques. the participants' main concerns were identified, culminating in developing a substantive theory centered around a core category. Findings: The primary category for men struggling with infertility was "forced concealment." This was exhibited through the suppression of emotions, maintaining secrecy about infertility, hiding treatment, and attributing infertility to their wives to counteract threats to their masculinity. Factors such as partners, family, societal surroundings, care providers, and beliefs influenced the adopting of the "forced concealment" strategy. Conclusions: The "forced concealment" theory offers insights into the experiences of men struggling with infertility. The study highlights the necessity of formulating culturally sensitive strategies that enable healthcare providers, nurses, and health system managers to effectively fulfill their roles and address the challenges and needs of couples confronting male infertility. This can be realized through a comprehensive approach that integrates nursing skills and competencies.