Journal of Holistic Nursing

This nursing research study was designed to reveal the life stories of nurse practitioners in rural Appalachia using storytelling and ballad elements of the culture. The researcher was born in a rural Appalachian community in Virginia and was summoned to return to the place of her birth, feeling an invisible kinship to land, blood ties to family, and a longing to honor rural nursing. Seven nurse practitioners from the same community shared their life stories. Using the heuristic phenomenological research method of Moustakas, the researcher became storyteller. The metaphor of bloodroot emerged as the unity of meaning for the life stories. The theme essences were revealed as interconnection: intricate patterns of rural Appalachian culture, intertwining relationships, interrelationships, and inner journey. “Brand New Home,” an Appalachian bluegrass ballad, along with pictures of Appalachia, underpins and culminates this study as a creative synthesis. Implications for nursing practice, education, and research are included.

Purpose: This ethnographic study describes the health-related perceptions of immigrant Latino adolescents from Mexico. Method: Fourteen adolescents, purposively recruited from two non-health-based community settings, participated. Each was interviewed twice and completed a visual narrative project using disposable cameras. Audiotaped transcripts and photographs were inductively analyzed. Findings: Being healthy is holistically perceived by these adolescents and includes physical, mental, spiritual, social, and environmental factors. Pictures portrayed healthy and unhealthy influences and behaviors, including eating habits, exercise, self-care, relationships, garbage, and pollution. Personal responsibility was important in being healthy and in promoting one's health. Family was identified as an important source of health-related information. Implications: Nurses recognizing the holistic, comprehensive health-related perceptions of immigrant Latino adolescents can promote their health and design culturally and developmentally appropriate educational strategies and health interventions aimed at eliminating health disparities.

Functional status decline places an enormous burden on health care services and strategies to identify at risk subgroups are needed. The purpose of this study was to examine the relationship between sense of coherence (SOC) and functional status to determine if SOC can be used to identify at-risk subgroups. In a convenience sample (N = 65) of nursing home residents measures of functional status and SOC were compared at 2 times. The mean functional status score of the weak SOC group (n = 28) at Time 1 was 16.14 and 17.32 at Time 2 indicating functional status decline. The mean functional status score of the strong SOC group (n = 37) at Time 1 was 12.38 and 11.76 at Time 2 indicating improved functional status. Although these changes were not statistically significant the trends suggest that a weak SOC may indicate increased risk for functional status decline.

Attitudes and sociocultural perceptions provide the context within which women experience menopause. Cultural influences greatly affect how women perceive and manage their menopausal symptoms. Cultures may be categorized based on way of life, including traditional, immigrant, and modern. Varying perceptions and symptom experiences are described, including modifiable and nonmodifiable factors that affect the level of distress women feel with menopause. Helping women actively participate in management of menopausal symptoms including self-care strategies will contribute to feelings of control of menopausal symptoms and overall health. By using the highest levels of evidence regarding management of menopause, becoming familiar with the cultural and psychosocial influences of menopause and then empowering women to make decisions regarding management, health care providers can improve their care of perimenopausal and menopausal women.

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.

Improvisation has long been considered a function of music, dance, and the theatre arts. An exploration of the definitions and characteristics of this concept in relation to the art and practice of nursing provide an opportunity to illuminate related qualities within the field of nursing. Nursing has always demonstrated improvisation because it is often required to meet the needs of patients in a rapidly changing environment. However, little has been done to identify improvisation in the practice of nursing or to teach improvisation as a nursing knowledge-based skill. This article strives to explore the concept of improvisation in nursing, to describe the characteristics of improvisation as applied to nursing, and to utilize case studies to illustrate various manifestations of improvisation in nursing practice.