Holistic Nursing - A Return to Healing

Holistic nursing practice is an ever-evolving transformative process with core values that require continued growth, professional leadership, and advocacy. Holistic nurses are required to stay current with all new required competencies, such as the Core Competencies in Genetics for Health Professional, and, as such, be adept at translating scientific evidence relating to genetics/genomics in the clinical setting. Knowledge of genetics/genomics in relation to nursing practice, policy, utilization, and research influence nurses' responsibilities. In addition to holistic nursing competencies, the holistic nurse must have basic knowledge and skills to integrate genetics/genomics aspects. It is important for holistic nurses to enhance their overall knowledge foundation, skills, and attitudes about genetics to prepare for the transformation in health care that is already underway. Holistic nurses can provide an important perspective to the application of genetics and genomics, focusing on health promotion, caring, and understanding the relationship between caring and families, community, and society. Yet there may be a lack of genetic and genomic knowledge to fully participate in the current genomic era. This article will explore the required core competencies for all health care professionals, share linkage of holistic nurses in practice with genetic/genomic conditions, and provide resources to further one's knowledge base.

Holistic Nursing as a Specialty: Holistic Nursing—Scope and Standards of Practice

Phenomenology contributes to holistic nursing by interpreting the first-person encounter with the lived world. Holistic nursing care integrates biopsychosociological knowledge with the practical care that is the legacy of generations of practicing nurses. A practice, when interpreted phenomenologically, is a historically developed way of fostering human well-being. Nursing is the practice of caring. Because nursing care concerns helping persons to live better in their world, it includes the moral, esthetic, and interpersonal aspects of care. These spiritual aspects are integrally enmeshed in holistic nursing. The spiritual in holistic nursing also designates the value dimension of meaning that gives life its worth and patients and nurses the courage to be. Interpreted phenomenologically, holistic nursing integrally relates scientific meaning with the meanings of nursing practice, the lived world of patients, and the meaning that gives patients and nurses the courage to seek well-being in a world altered by illness and debilitation.

The provision of spiritual care is referred to in professional practice guidelines and mandated in nurses' ethical codes. Still, a gap exists regarding essential training in spiritual conversation and assessment, leaving some health care providers feeling uncomfortable when assessing spiritual support needs. The purpose of this study was to assess hospice and palliative nurses' and holistic nurses' perceptions of spirituality and spiritual care. It was assumed that the standards of care for hospice and palliative nurses and holistic nurses stipulate that spiritualty is addressed within the framework of their specialties and provide education for spiritual care, thus making these nurses proficient in providing spiritual care. This exploratory, descriptive study utilized a web-based survey to measure perception of spirituality and spiritual care giving using a modified Spirituality and Spiritual Care Rating Scale. A convenience sample was recruited from members of the Hospice and Palliative Nurses Association and the American Holistic Nurses Association (n = 250). Descriptive statistics summarized data as well as qualitative analysis of written narratives. Content analysis of open-ended survey questions was used to identify themes until saturation. This study found that given adequate resources and education, nurses can be positioned to address the spiritual needs of patients and provide appropriate care. This study adds to an emerging body of evidence suggesting that training in spiritual care should be an important component of the foundational nursing curriculum.

Background: Holistic nursing, grounded in the philosophy of treating the entire person, encompasses physical, emotional, psychological, and spiritual care to enhance the overall well-being of both the patient and the nurse. Holistic nursing approaches, such as mindfulness, aromatherapy, and therapeutic touch, have been increasingly implemented in nursing to respond to the problems of stress, pain, and emotional and psychological distress and are part of a worldwide trend toward more integrative approaches to care. Aim: To review and synthesize the current evidence for efficacy, mechanisms, application, and limitations regarding mindfulness, aromatherapy, and therapeutic touch in nursing. Methods: A narrative review was conducted using PubMed, CINAHL, PsycINFO, and Scopus, with keywords that included "holistic nursing" and "mindfulness efficacy." The quality of each study and all types of evidence was appraised with Joanna Briggs Institute tools with an emphasis on systematic reviews, meta-analyses, and RCTs. Results: Mindfulness was found to have positive and significant effects on reducing anxiety and stress and decreasing burnout (g=0.57). Aromatherapy has positive effects on sleep and pain management. Therapeutic touch has a moderate effect on pain management; however, there is limited direct mechanistic evidence. The majority of limitations include the non-standardized interventions and scepticism. Conclusion: This review provided evidence-based support that these approaches support better outcomes for patients and resiliency for nurses. A larger-scale integration of these approaches in practice requires pre-determined and coordinated protocols, and further systematic review methodology will determine their effectiveness in daily healthcare practice. Keywords: Holistic Nursing, Mindfulness, Aromatherapy, Therapeutic Touch, Integrative Care.

Objective To analyze the effect of holistic nursing intervention on patients with pulmonary tuberculosis complicated with heart failure. Methods Ninety-eight patients with pulmonary tuberculosis and heart failure admitted to the Fifth People's Hospital of Wuxi from July of 2016 to January of 2018 were selected as the study subjects. They were randomly divided into control group and observation group, 49 cases in each group. The control group received routine nursing, while the observation group received holistic nursing. The length of hospitalization, the score of nursing satisfaction and the effect of treatment were compared between the two groups. Results The length of hospitalization in the control group was (18.08±3.63) d, and the nursing satisfaction score was (85.17±3.48) scores. The length of hospitalization in the observation group was (9.52±2.41) d, and the nursing satisfaction score was (98.36±0.19) scores. The treatment time of the observation group was longer than that of the control group, and the nursing satisfaction score was higher than that of the control group, and the differences were statistically significant (P<0.05). The total effective rate in the control group was 79.59% (39/49), and the total effective rate in the observation group was 97.96% (48/49). The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05). Conclusion In the treatment of patients with pulmonary tuberculosis complicated with heart failure, holistic nursing can help to improve the clinical therapeutic effect and the satisfaction of nursing, and promote the recovery of patients'condition, which is worthy of popularization and application. Key words: pulmonary tuberculosis; heart failure; holistic nursing

The journey to holism is the result of a grounded theory study of 18 members of the American Holistic Nurses' Association. Participants were prompted to "Tell me about holistic nursing" and replies revealed a seven-step process to becoming a holistic nurse. The process is an expansion of Van Gennep's three-stage theory of rites of passage, which involves separation, marginality/liminality, and reintegration. The expanded process begins with separation from mainstream nursing and concludes with reintegration into nursing as a holistic nurse. The marginality/liminality step shows five active steps: gathering information to quell the distress of the separation, applying that information to others, changing focus to self-care, applying the information to self, and increasing self-knowledge. This article describes the process and presents data to support the conclusion that the growth of a holistic nurse follows a recognizable course.

Objective To explore the effects of holistic nursing without family caregivers on alleviating pain, promoting wound healing and reducing complication for patients undergoing the surgery for deep perianal space abscess. Methods 28 patients who suffered from deep perianal space abscess admitted to Anorectal Department of the Affiliated Hospital of Jining Medical College from Jan 2007 to Jan 2008 were selected as control group, while 33 patients from Feb 2008 to Feb 2009 as intervention group. The former group was given the traditional nursing, while the latter group holistic nursing without family caregivers. Both groups were administered with the same operative procedure and medicine. Incidence rate of uroschesis and constipation,pain grades during bowels flushing and changing wound dressing, and wound healing duration after the intervention were compared. Results There was significant difference between both groups on the above indicators (P ＜ 0. 05). Conclusions Holistic nursing without family caregivers could help to relieve pain,reduce postoperative complication rate and promote wound healing for patients undergoing the surgery for deep perianal space abscess; therefore it is worthy of being broadly applied in clinic. Key words: Perianal abscess; Holistic nursing; Nursing without family caregivers

Teaching nursing students a holistic approach to patient care and integrating treatment modalities is a crucial component of traditional holistic nursing education. This study aims to investigate the educational competency of student nurses in holistic nursing by employing a descriptive comparative design among the 209 student nurses from the University of Hail, Kingdom of Saudi Arabia. Results showed that the student nurses perceived that they have been skillful in the following; professional, legal, and ethical nursing (3.22±.455), management (3.27±.492), leadership (3.29±.493), and professionalism (3.32±.505). On gender and professional, legal, and ethical nursing, there found significant gender differences (t=.822; p=.012). Also, management was found to have significant differences with gender (t=.281; p=.009). Leadership (t=-.694; p&gt;488) and professionalism (t=.885; p&gt;.377) were found to have no significant difference with gender. Moreover, the professional, legal, and ethical nursing (t=.822; p&lt;.001) and management (t=.910; p&lt;.001) were found to have significant differences with the age of the student nurses, while leadership (t=.231; p&gt;.794), and professionalism (t=.270; p&gt;.764) were found no significant difference with age. On civil status, there found a significant difference in professional, legal, and ethical nursing (t=1.337; p&lt;0.001). Meanwhile, management (t=.992; p&gt;.397), leadership (t=.142p&gt;.935), and professionalism (t=1.122; p&gt;.341) were found to have no significant difference with civil status. Incorporating holistic nursing into nursing courses and research programs would help educate student nurses for multicultural practice contexts as healthcare settings become more diverse.

In Spring 2010, an innovative Master of Science in Holistic Nursing track was launched in as the realization of a vision for graduate holistic nursing held by the faculty of the Christine E. Lynn College of Nursing in Palm Beach County. As 1 of 6 such tracks in the nation and the only holistic master's program in Florida, there were few guideposts to lead the way. The development of holistic nurse education that answered to student, community, and faculty needs within an unpredictable health care environment involved courage, commitment, and risk taking. The purpose of this article is to describe the philosophical foundations, professional framework, and development process that gave form and shape to the advanced holistic nursing track.

In the development and administration of a certification examination in holistic nursing, an important issue is to ensure adequate content validity. Thus, the American Holistic Nurses' Association (AHNA) and the American Holistic Nurses' Certification Corporation (AHNCC), with the assistance of the National League for Nursing, conducted a practice analysis study to generate empirical data on the professional activities and knowledge required to practice holistic nursing on a day-to-day basis.

Objective To explore the cognitive training and nursing intervention for patients with mild to moderate Alzheimer's disease. Methods Fifty patients with mild to moderate Alzheimer's disease who were treated in our hospital from January 2015 to March 2017 were divided into two groups with the random number table. The observation group was given holistic nursing and cognitive training, while the control group was given conventional nursing. The score of mental state (MMSE) was recorded in the two groups before and after the nursing. Results MMSE score in the observation group before and after the nursing were (17.93±3.45) and (25.17±4.60), those in the control group were (18.05±3.26) and (21.43±3.09), the improvement degree of mental state of the observation group was better than that of the control group, with statistically significant difference (P<0.05). Conclusion Holistic nursing and cognitive training has significant effect in patients with mild to moderate Alzheimer's disease, which can improve the mental state and quality of life of patients, worthy to be widely used clinically. Key words: Alzheimer's disease; Cognitive training; Holistic nursing

A study of an undergraduate course in holistic nursing was conducted to determine its impact on personal and professional health care practices. A mixed method design was used to examine responses on a sample of 200 participants. Results indicated a positive personal impact with continued application of concepts into professional health practices. Personal and professional nursing practices were influenced from 1 to 7 years after completing the holistic nursing course. After introduction of the concepts of self-care and holistic approaches to health, students and graduates experienced a shift in values and beliefs related to their own health practices. Continued exposure to holistic practices creates a pattern of awareness toward health that affects future personal and professional nursing practice, creating a paradigm shift for emerging nursing students and graduates from the course. This affects the manner in which nurses meet the needs of their clients in a variety of settings.

The transformation from traditional nursing practice to holistic nursing is one that requires recognition of multiple ways of knowing. Transformative learning theory reflects a strong bias toward cognitive epistemology and propositional knowing. This epistemology, labeled here as truncated, rests on an understanding of experience derived from pragmatism. This article describes an extended epistemology derived from the work of John Heron that better reflects the full range of knowing utilized by holistic nurses. This epistemology provides a foundation for innovative approaches for the development of holistic awareness in the training and continuing professional development of nurses. One such approach, collaborative inquiry, is described.

Holistic nursing is guided by modern nursing concept and framed by nursing procedures, providing high quality nursing according to patients’ psychological, physiological, social and cultural needs. To develop holistic nursing in pediatrics is to develop nursing services for the purpose of satisfying the various clinical needs and psychological nursing of children. It is of great significance to establish holistic nursing concept, provide high quality nursing service for hospitalized children, and take targeted psychological intervention to alleviate their adverse psychological stress, which can improve treatment compliance and clinical efficacy, and shorten the length of hospital stay. In this paper, scientific and effective psychological nursing stress intervention means are used to improve the psychological anti-stress level of hospitalized children, and nursing intervention means are put forward, contribute to the maintenance of children’s mental health and the development of children’s mental health work and also to provide a theoretical basis for the intervention and treatment of children with psychological stress.