Journal of Holistic Nursing

Purpose: Nursing research studies investigating the relationship between spiritual wellbeing and health-related quality of life are lacking among Arab hemodialysis patients in Jordan or any other Arab country. The purpose of this study was to explore the associations between spiritual wellbeing, its religious and existential wellbeing dimensions, and health-related quality of life among Jordanian Muslim hemodialysis patients. Design: A cross sectional, quantitative correlational study. Methods: A convenience sample of 150 Jordanian hemodialysis patients completed a structured, self-administered questionnaire. Descriptive, bivariate, and multivariate regression models were used. Findings: The Jordanian hemodialysis patients had a moderate level of spiritual wellbeing and religious wellbeing, a low level of existential wellbeing, and a poor health-related quality of life. The findings revealed a significant moderate positive correlation between the spiritual wellbeing and its dimensions, and health-related quality of life. The existential wellbeing was the strongest predictor, with a large, positive, and significant effect after controlling for other spiritual, demographic and medical-related variables. Conclusion: Overall, the study suggests Jordanian hemodialysis patients use their religious and spiritual beliefs and practices as a coping mechanism, especially as sources of satisfaction, peace, comfort, strength and support, to help improve their health-related quality of life.

Aim: The aims of this sequential explanatory mixed method study were twofold 1. Firstly, to evaluate the implementation of a spiritual care subject in a nursing program. 2. Secondly, to examine undergraduate nursing students’ perceptions of providing spiritual care within their holistic care practice. Background: Studies conducted internationally indicate many nurses feel inadequately prepared to provide holistic care inclusive of spiritual care due to insufficient spiritual care education. Design: Two phase, sequential explanatory mixed method design which comprised of a quantitative study followed by a qualitative study. Methods: The setting was an Australian faith-based university. Participants comprised of undergraduate nursing students who were enrolled in a spiritual care subject. Findings: Two study findings emerged: 1. Participants’ knowledge and practice of spiritual care were transformed by the spiritual care subject, and 2. The spiritual care subject broadened perceptions of spiritual care so participants viewed themselves more equipped to provide spiritual care in their holistic care provision. Conclusion: The spiritual care subject had an affirmative influence on participants’ perceptions of providing spiritual care within holistic care practice. The findings have implications for nurse educators to consider how spiritual care content can be included within undergraduate nursing curricula.

Undiagnosed and untreated postpartum mental health disorders represent a silent health crisis. The aim of this paper was to develop a lexicon of metaphors women use to describe their postpartum mood and anxiety disorders to assist holistic nurses in recognizing as early as possible these struggling mothers. Mothers may not know the medical terminology to articulate their mental health problems and may turn to using metaphors. The metaphors included in this lexicon were obtained from the author's earlier qualitative studies of metaphors women used to describe their experiences of postpartum depression, postpartum panic disorder, and posttraumatic stress disorder due to traumatic childbirth. In this lexicon these metaphors are organized by these three mental health disorders and includes a table of definitions of each metaphor along with examples of the context of the metaphors represented by quotes from the mothers. Metaphors can be keys that open and unlock doors that stand between holistic nurses and their patients. Being attentive to metaphorical language women use to describe how they are feeling after giving birth can be an innovative approach holistic nurses can use to identify these vulnerable women and provide an opportunity to nurture and empower new mothers.

Purpose: The spiritual care of patients is often overlooked in health care as many nurses are unprepared to provide competent, holistic care that addresses patients’ spiritual needs. Since undergraduate academic instruction prepares nurses for practice, innovative strategies that train pre-licensure nurses to care for the spiritual needs of patients are essential. Design: A course needs assessment identified spiritual care as the most deficient competency for undergraduate psychiatric students. A three-phase quality improvement project designed to increase student awareness and practice of spiritual care included (a) development of a quality improvement plan, (b) implementation, and (c) outcome evaluation. Methods: Spiritual care was introduced into the Spring 2020 semester through didactic content and experiential practice. Additionally, an evidence-based spiritual assessment tool (i.e., HOPE questions) was integrated into the course to train students for use in clinical and simulation. Surveys were used to compare the 2019 and 2020 cohorts. Findings: Results showed a statistically significant increase in students’ perception of spiritual care competency after project completion. Conclusions: Future implications include the use of similar methods to improve spiritual care competency for pre-licensure nursing students. Keywords: Spiritual care, undergraduate nurse, spiritual assessment.

Background Burnout negatively affects nurses and increases nursing turnover. Many student nurses experience burnout throughout their academic program, negatively affecting student success and patient care. Objectives To explore effects of mindfulness education / self-care skills training in undergraduate nursing students on stress and self-care. Design A four-week pilot with four-week follow-up. Setting In-person mindfulness sessions were offered to first-year nursing students. Participants 67 students enrolled in a nursing skills course. Methods Four in-person mindfulness educational sessions were provided with a 4-week follow-up. Outcomes were stress and self-care, measured by the Perceived Stress Scale and Mindful Self-Care Scale at pre-, post-, and follow-up. Results 58 (86.6%) completed pilot; mean age = 22.8 (5.75), majority females (84%) and Caucasian (79%). Students practicing one or more mindfulness techniques at least 8 times outside class increased self-care 9.5% pre- to post-intervention (p = .01), although not sustained at follow-up. Stress did not change significantly in either direction (p = .94), potentially mediating the stress of starting clinical immediately following the intervention. Conclusions Mindfulness education increased self-care in first-year nursing students who practiced mindfulness outside class. Recommendations include further research and integration of mindfulness into courses to assess benefits and coping skills for future nurses.

Purpose: The purpose of the study was to examine the effects of music combined with an artistic design of a painted piano on cognitively impaired residents living in a long-term care memory facility. Design: A qualitative descriptive study design was used to elicit responses from the participants. Method: Residents of the facility were invited to attend sessions, during which familiar songs were played. Residents were invited to touch the piano. A series of five interview sessions were performed over several weeks with each resident (N = 10). Findings: Five themes were identified from data analysis: 1. Is it new? 2. A range of piano memories 3. Play it (again) kid 4. I don’t have anything to do up there 5. What is there to do now? Some residents expressed joy with the piano, and some had anxiety. However, all residents stayed for the entirety of the sessions and either participated by singing along, playing, or listening. Conclusions: Public painted piano intervention may have positive benefits for people with cognitive impairment and may be considered as part of a viable holistic care plan for this population of residents in a long-term care setting.

Background: The COVID-19 pandemic has exposed nurses to more stress and inability to practice self-care activities. These have resulted in conditions that threaten their health, well-being, and ability to work. Nurses’ lack of self-care can predispose them to chronic health conditions and staff burnout which may adversely affect patient care. The panacea for this concern is a deliberate effort to promote holistic health and wellbeing through self-care activities targeted towards physical, mental, social and spiritual aspects of nurses. The purpose of this study was to explore factors influencing self-care practices among registered nurses during COVID-19 pandemic. Methods: Convenience sampling was used to select 294 nurses from four urban hospitals in Kingston Jamaica. A questionnaire was utilized for data collection. Logistical regression analysis was conducted using Statistical Package for Social Sciences (SPSS) software version 22.0. Ethical approval was obtained. Results: The response rate was 46% (Out of 294 questionnaires distributed, only 136 were returned). Although 93% of participants engage in self-care activities during COVID-19 pandemic, only 45% practiced self-care on a daily basis. Half of the participants (50%) practiced self care activities sometimes while 5% do not engage in self care practices. Activities that promote psychological and social wellbeing were not common among participants. Most self care activities were towards the promotion of physical health and wellbeing. Majority of respondents indicated that excess workload, fatigue, lack of time and poor remuneration are factors that prevent their practice of self-care. Findings also revealed that demographic data such as age, sex, income, gender and ethnic background influences self-care practices among nurses. Conclusion: The practice of self care among nurses needs improvements. Although respondents engage in some activities to care for self, majority are not consistent with this practice.

The experience of a radical remission from a terminal diagnosis is essentially life altering. The purpose of this self-report is to provide a basis for understanding this event and to provide practitioners a guide for supporting patients during the transition process. A conceptual model is presented that outlines the structure and changes that are influenced during the transition process.

Introduction: Ubuntu is an African philosophy that reflects holistic and comprehensive care among people in the community. Holistic nursing is a philosophy of caring that focuses on holistic healing and humanism. The purpose of the study was to explore the views of the South African final-year student nurses on the ability of Ubuntu to foster holistic nursing. Methods: An exploratory descriptive qualitative method was used. Eight focus group interviews were conducted with final-year student nurses at selected universities. Colaizzi seven steps process of data analysis was utilized. Results: One of the themes that emerged was that Ubuntu can be an instrument to foster holistic nursing Ubuntu and holistic nursing share many common attributes, hence, the teaching and learning of Ubuntu could foster the type of caring embodied by holistic nursing. Discussion: Ubuntu represents an important care philosophy that can foster holistic nursing, especially when the inner driving force of the nurses is primarily to care for patients.

This study aimed to examine the effects of holistic nursing competence on work engagement, self-reflection and insight in nurses. This descriptive and cross-sectional study was conducted with 309 nurses working in Turkey. Data were collected using the “Descriptive Information Form”, “Holistic Nursing Competence Scale (HNCS)”, “Utrecht Work Engagement Scale (UWES)”, and “Self-Reflection and Insight Scale (SRIS)”. Pearson correlation analysis and multiple linear regression analysis were used to analyze the data. We found that the HNCS had a moderate positive relationship (r = 0.411, p < 0.05) with the UWES, and a weak positive relationship (r = 0.324, p < 0.05) with the SRIS. In the model established by multiple regression analysis, the effect of the HNCS, age, marital status, position, and performing the profession willingly on work engagement explained 33.7% of the variance. In another established model, the effect of the HNCS, gender, and having children on self-reflection and insight explained 11.5% of the variance. Our findings revealed the effect of holistic competence on nurses’ positive attitudes about their work engagement and self-reflection in practice. We recommended developing awareness-based programs for nurses to increase their holistic nursing competence.