Journal of Holistic Nursing

International labor migration has increased the day-to-day encounters of persons from different cultural groups. The concept of ethnicity, its historical development, its ambiguity, and its role in the interactions between persons of different cultural groups are explored. The arena of health care for migrants brings to the fore issues of providing culturally competent care. In an ideal world, all nursing care of migrants would be delivered by skilled transcultural nurses; but in the real world, this is not yet the case. A case study of a Mexican migrant woman and a non-Hispanic Midwestern nurse is used as a background for examining the role of ethnicity in determining care needs and expectations and for providing nurses with a perspective that can improve nurse-client collaboration.

A hermeneutic phenomenological study was conducted to explore how eight professionally competent nurses experienced and evaluated the relation between their childhood adaptation to dysfunctional families and their nursing careers. From the participants' discussion of this topic, the following themes emerged: escaping difficulties by becoming a nurse, coping roles guide nursing career, sensitivity to the untold, transforming dysfunctional responses, and wounded healers. The study did not support the view that children of alcoholics seek careers in nursing to meet their codependent needs for self-esteem, control, or belonging. Instead, its findings indicate that some children of alcoholics become competent nurses by finding positive application for the coping skills they learn in their families. This indicates that, when working with individuals from dysfunctional families, nurses could support them to create new avenues for their coping skills instead of trying to "exterminate" them because of their "codependent" nature.

Oncology, parish, and hospice nurses in the Midwest were surveyed to explore what nursing interventions they implement to enhance the spirituality of clients and how they learned about these interventions. Some 95 spiritual nursing interventions were identified and ranked according to frequency of implementation. The most frequently identified nursing interventions were referral, prayer, active listening, facilitation and validation of clients' feelings and thoughts, conveying acceptance, and instilling hope. The most frequently ranked implemented interventions were communication and religious nursing interventions. Only 15% of the participants indicated that they learned the most about spirituality and spiritual nursing interventions from basic and advanced nursing education combined. Findings support the need for increased emphasis of theoretical and clinical spiritual knowledge in nursing education and the development of a typology of spiritual nursing interventions to direct nurses in enhancing the spirituality of clients and implementing holistic nursing care.

Literature about the significance of health promotion for the elderly and identification of various determinants of health-promoting activities contains numerous inconsistencies. From a review of nursing and health-related literature over the past decade, it is possible to draw only limited conclusions about the commitment of the elderly to health-promoting behaviors. Despite this, the importance of the roles of social support and spirituality for the empowerment of older adults to practice health-promoting activities is a consistent research finding in this population. Parish nurse programs expand home health and public health provider roles and use the faith community as a cooperative means for sociocultural implementation of successful health promotion. Significance for nursing education, practice, and research is discussed.

The purpose of this descriptive study was to better understand elders' beliefs regarding chronic pain. The research questions were (a) What are the pain beliefs of elders experiencing nonmalignant chronic pain (NMP) and chronic pain associated with malignancy with the hope for recovery (MHR)? (b) Are there differences in pain beliefs between the NMP group and the MHR group? and (c) Do elders have similar or different pain beliefs? Sixty adults age 65 or older, all cognitively intact, completed the Pain Beliefs Questionnaire; 30 had arthritis and 30 had cancer. Of the total, 60% responded that pain is the result of damage to the body—either often, almost always, or always. Another 13% believed that pain was rarely or never the result of such damage, and 15% rarely or never saw pain as a sign of illness. In all, 68% responded that depression makes pain seem worse.

The purpose of this study was to examine the effect of three Therapeutic Touch treatments on the well-being of 20 persons with terminal cancer in palliative care. Participants in the experimental group (n = 10) received three noncontact Therapeutic Touch treatments, the duration of which varied between 15 to 20 minutes. Participants in the control group (n = 10) participated in three rest periods. Well-being was measured at preintervention time and immediately postintervention time using the Well-Being Scale, a visual analogue scale measuring pain, nausea, depression, anxiety, shortness of breath, activity, appetite, relaxation, and inner peace. The results of the study support the hypothesis that three noncontact Therapeutic Touch treatments increase sensation of well-being in persons with terminal cancer.

Chronic sorrow often affects not only an individual who has a chronic illness or disability but the family members as well. This is the story of how chronic sorrow affected the life of a man diagnosed with prostate cancer and the family members who lived through it with him. It is told in the first person by his daughter not only as a tribute to her father, but also as a prospective learning experience for anyone involved with an individual moving through a chronic or terminal illness or disability. It integrates theory, research, and personal experience in an effort to understand this common human response to a chronic or terminal illness.