Journal of Holistic Nursing

Purpose: Explore what spiritual care means to nurses who work in emergency care units. Design and Method: Nine nursing professionals from an emergency care unit at a private health institution affiliated with the Universidad de La Sabana participated in this descriptive qualitative study. Nonparticipant observation, field notes, and in-depth interviews with a question guide were used to collect the data, which were analyzed by means of content analysis. Results: Three themes and their corresponding subthemes were identified with respect to the significance of spiritual care: (1) interpretation of spiritual care, (2) the patient and the family in spiritual care, and (3) the role of the nurse in spiritual care. Conclusions: These findings provide a deeper understanding of spiritual care in terms of its significance. They also acknowledge its importance to nursing practice in emergency care units. The significance of spiritual care is based on theoretical, scientific, and humanistic points of reference (the discipline of nursing) that strengthen the therapeutic relationship between the patient/family–nurse dyad. The study also offers evidence for holistic nursing practice that requires theoretical-academic, administrative, and assistance support.

Purpose: This study had two aims: (1) to test the feasibility, safety, and efficacy of using a wireless pedometer in a cohort of nurses; and (2) to understand if wireless pedometer use increased number of steps walked, number of flights of stairs climbed, daily activity level, and improved personal perception of health. Design: This study used a nonexperimental exploratory design to test the feasibility and efficacy of using a wireless pedometer in a cohort of nurses. Pre- and posttest measures captured the number of steps walked, flights of stairs climbed, activity level, and perception of health. Results: Sample characteristics: 27 females, 3 males; 90% non-Hispanic Caucasian, 3% Hispanic; 47% between the ages of 55 and 65 years. Eighty percent of the participants reported that they were caregivers of other people. There was a significant increase from baseline to the end of the study in the following measures: self-perception of steps walked (p < .001), flights of stairs climbed (p < .005), self-perception of daily activity (p < .001), and although there was an improvement in self-perception of health, the change was not significant. Conclusions: The wireless pedometer was a feasible, safe, and efficacious device to use. This study may have implications for interventions aimed at improving caregiver health.

Purpose: This study examined whether practicing Tai Chi (TC) along with music can maximize the effects of TC on compliance and fall-related risk factors (Dynamic Gait Index and fear of falling). Design: A convenient sample was recruited in a community senior center. Eighteen women aged 50 to 84 years (9 White, 9 Black) were block randomly assigned to a TC in silence (TC + S; n = 6) or a TC with music (TC + M; n = 12) class. Method: Thirteen participants (4 in TC + S group, 9 in TC + M group) with completed pre- and posttests were included in the final analysis. Paired t tests were conducted to examine changes within groups over time and analysis of covariance was used to assess group differences. Findings: After 15 weeks of intervention, balance increased in both groups with significantly higher benefits in the TC + M group (p < .05). Fear of falling scores improved in TC + M group and compliance rate was higher in this group. Conclusions: Practicing TC + M may help increase adherence in White and Black middle-aged and older women, and maximize the effects of TC on fall-related risk factors. Studies with more rigorous study design, including musical considerations, are warranted.

Choices in care during the end stages of life are limited by the lack of resources and access for rural people. Nursing advocacy based on the holistic understanding of people and their rural communities may increase the opportunity for choice and improve the quality of care for people living and dying at home. Pragmatism and nurse agency theory were used for a practical exploration of how district nurses successfully advocate for rural Australian end-of-life goals to begin the development of a practice model. In two stages of data collection, rural district nurse informants (N = 7) were given the opportunity to reflect on successful advocacy and to write about their experiences before undertaking further in-depth exploration in interviews. They defined successful advocacy as “caring” that empowers people in the “big and small” personal goals important for quality of life. The concepts described that enable successful advocacy were organized into a network with three main themes of “willing” investment in holistic person-centered care, “knowing” people and resources, and feeling “supported.” The thematic network description provides deep insight into the emotional skill and moral agency involved in successful end-of-life nurse advocacy and can be used as a sound basis for modeling and testing in future research.

Purpose: Presence is the essence of professional nursing in the nurse–patient connection. Nursing students have little exposure to strategies fostering presence. This pilot study explored students’ perceptions of strategies to encourage presence in the classroom. Design: A three-question survey was distributed to students in the last week of classes. Faculty not teaching that course administered the survey. Method: Four faculty used strategies aimed at encouraging presence. These strategies included starting class with a mindfulness minute, mindful movement, singing bowl, peace and power check in, and a discussion of a current event. Each class used only one strategy consistently through the semester. Participants were undergraduate and graduate students enrolled in one of seven classes taught by these faculty. Findings: Overall the students found strategies to be beneficial. In reflecting on the experience with the strategies, four themes emerged: calming/relaxing; focusing/centering; setting aside distractions; and feeling community and connection. Conclusion: These brief strategies were acceptable to most students and were helpful to the students in preparing for class. The response to mindfulness minute was most positive. Further research is needed on the introduction of strategies that help students in the classroom and may also increase presence at the bedside.

Aim: To evaluate the psychometric properties of an Arabic version of the Spiritual Care-Giving Scale (SCGS) in a sample of Saudi nursing students. Method: A convenience sample of 202 Saudi nursing students was included in this descriptive cross-sectional study. The 35-item Arabic version of the SCGS (SCGS-A) was tested for internal consistency, stability reliability, content validity, and construct validity. Findings: The SCGS-A manifested acceptable internal consistency and stability reliability with computed Cronbach’s alpha ranges from .84 to .94, and an intraclass correlation coefficient of .97. The item-level content validity index ranged from .83 to 1, and the scale-level content validity index (average) was .98. The principal component analysis revealed five dominant components with eigenvalues greater than 1, and a cumulative contribution rate of 62.0%. The five factors were moderately to strongly correlated (r = .29-.56; p < .001) with each other and with the overall SCGS-A score (r = .57-.77; p < .001). Conclusion: The SCGS-A manifested an acceptable reliability and validity in Saudi nursing students, which supports its sound psychometric properties. With the establishment of this valid and reliable tool, timely and accurate assessment of student nurses’ perceptions about spirituality and spiritual care can be facilitated.

Purpose: The purpose of this qualitative study was exploring what the roles and challenges of health care providers working within Northern Canadian Aboriginal communities are and what resources can help support or impede their efforts in working toward addressing health inequities within these communities. Design: The qualitative research conducted was influenced by a postcolonial epistemology. The works of theorists Fanon on colonization and racial construction, Kristeva on semiotics and abjection, and Foucault on power/knowledge, governmentality, and biopower were used in providing a theoretical framework. Methods: Critical discourse analysis of 25 semistructured interviews with health care providers was used to gain a better understanding of their roles and challenges while working within Northern Canadian Aboriginal communities. Findings: Within this research study, three significant findings emerged from the data. First, the Aboriginal person’s identity was constructed in relation to the health care provider’s role of delivering essential health services. Second, health care providers were not treating the “ill” patient, but rather treating the patient for being “ill.” Third, health care providers were treating the Aboriginal person for being “Aboriginal” by separating the patient from his or her identity. The treatment involved reforming the Aboriginal patient from the condition of being “Aboriginal.”

Aim: To evaluate the psychometric properties of the Spiritual Coping Strategies scale Arabic version (SCS-A) in a sample of nursing students in Saudi Arabia. Method: This study had a cross-sectional design with a convenience sample of 100 nursing students in Saudi Arabia. Using the SCS-A and the Muslim Religiosity Scale for data collection, data were analyzed to establish the reliability and validity of the SCS-A. Findings: Good internal consistency reliability (Cronbach’s α > .70) and stability reliability (intraclass correlation coefficient > .80) were observed. Two dominant factors were extracted from the scale items, the nonreligious coping strategies and religious coping strategies, which accounted for 35.5% and 32.7% of the variance, respectively. The religious coping subscale exhibited a strong positive correlation with the religious practices subscale of the Muslim Religious Involvement Scale (r = .45, p < .001) and total religiosity score (r = .48, p < .001) as well as a weak positive correlation with the intrinsic religious beliefs subscale (r = .25, p < .05). No significant relationship was found between nonreligious coping subscale and the Muslim Religious Involvement Scale. Conclusion: The SCS-A exhibited an acceptable validity and reliability, supporting its sound psychometric properties with respect to the responses from Saudi nursing students.