Linking the Unitary Paradigm to Policy through a Synthesis of Caring Science and Integrative Nursing

The body's dignity in integrative understanding of health in IBD - A hermeneutic approach to holistic care

BACKGROUND AND PURPOSE

This article will convey a new understanding of health and disease as a coherent dimension where the whole body interacts with its natural environment. This understanding is linked to a theoretical framework and illustrated by reference to research with patient experiences with inflammatory bowel disease (IBD), with the disorders Crohn's disease and ulcerative colitis. Creating ecological sustainability towards a greener health service where the body has a higher intrinsic value is a growing concern.

MATERIAL AND METHODS

The methodological approach is hermeneutic, whereby the results of one's own research are interpreted and reconceived through reflection towards a new understanding. Themes from patients' experiences are interpreted in light of the theoretical frame of reference of this article in order to achieve a new understanding.

RESULTS

The further interpretation of the state-of-the-art article and empirical articles resulted in the following themes: 1. The lived body is understood as a coherent whole and a place of inner freedom. 2. The body in a lowered state of stress helps the patient to experience dignity and vitality. 3. An integrative understanding of health in terms of IBD brings dignity and wholeness to the body.

CONCLUSION

This article sheds light on the connections between body knowledge, nutrition, dignity, and integrative understanding of health in acute and chronic IBD. In clinical practice, the connections may happen when giving the patient the opportunity for recovery by learning to listen to the body. Dignity is linked to both coping and expert help from clinically competent health professionals.

The safety and efficacy of using moxibustion and or acupuncture for cancer-related insomnia: a systematic review and meta-analysis of randomised controlled trials

Introduction:

This study aimed to synthesise the best available evidence on the safety and efficacy of using moxibustion and/or acupuncture to manage cancer-related insomnia (CRI).

Methods:

The PRISMA framework guided the review. Nine databases were searched from its inception to July 2020, published in English or Chinese. Randomised clinical trials (RCTs) of moxibustion and or acupuncture for the treatment of CRI were selected for inclusion. Methodological quality was assessed using the method suggested by the Cochrane collaboration. The Cochrane Review Manager was used to conduct a meta-analysis.

Results:

Fourteen RCTs met the eligibility criteria. Twelve RCTs used the Pittsburgh Sleep Quality Index (PSQI) score as continuous data and a meta-analysis showed positive effects of moxibustion and or acupuncture (n = 997, mean difference (MD) = −1.84, 95% confidence interval (CI) = −2.75 to −0.94, p < 0.01). Five RCTs using continuous data and a meta-analysis in these studies also showed significant difference between two groups (n = 358, risk ratio (RR) = 0.45, 95% CI = 0.26–0.80, I² = 39%).

Conclusion:

The meta-analyses demonstrated that moxibustion and or acupuncture showed a positive effect in managing CRI. Such modalities could be considered an add-on option in the current CRI management regimen.

Patients' experiences of the caring encounter in health promotion practice: a qualitative study in Swedish primary health care

BACKGROUND

Previous studies have reported that organizational structures and cultures in primary health care are obstacles to district nurses doing successful work in health promotion practice (HPP). Because organizational structures are not easily changed, Jean Watson's Attending Nurse Caring Model (ANCM) was introduced and piloted at a primary health care center in Sweden, aiming to transform HPP so as to empower district nurses and increase their work satisfaction.

AIM

To investigate patients' experiences of the caring encounter in HPP after introduction of the ANCM in Swedish primary health care, the aim being to explore the essential components of the caring encounter between patients and district nurses.

METHODS

A descriptive and qualitative research design was used. Data collection was performed using individual face-to-face interviews with twelve patients at risk for developing CVD. Data analysis consisted of both deductive content analysis, using a categorization matrix based on the ANCM and, subsequently, inductive latent content analysis.

RESULTS

The findings were abstracted into three themes: 1.'Feeling the deepest essence of being cared for': to be respected and being put at the center of the encounter; 2. 'Feeling acceptance and worth': being treated with openness and permissive attitudes, 3. 'Being in a supportive atmosphere that promotes hope': to feel trust and being trusted in the encounter, and being empowered by hope. The unifying main theme of the caring encounter was abstracted as 'Experiencing human dignity'.

CONCLUSION

The present study revealed that the essence of the caring encounter between patients and district nurses in HPP is to be unconditionally accepted in an environment that inspires hope and encouragement. The ANCM seems to be a promising model to use for strengthening the caring encounter and supporting CVD patients in making healthy lifestyle choices. However, further studies of qualitative and quantitative designs are needed to investigate what the ANCM can contribute to HPP in Swedish primary health care.

Expert Consensus on Nurses' Human Caring for COVID-19 Patients in Different Sites

This study aims to develop the expert consensus on nurse’s human caring for Corona Virus Disease 2019 (COVID-19) patients in different sites, and thus provide a guideline on providing whole process and systematic caring for COVID-19 patients. Based on the frontline experiences of human caring for COVID-19 patients and the review of literature, the initial draft of consensus was made and finalized after online meeting and revisions. The experts reached consensus on the following parts: terms and definitions, principles of human caring for COVID-19 patients, and human caring measures for COVID-19 patients in different sites. The expert consensus is practical, concise, and reasonable for guiding the nurses providing human caring for COVID-19 patients, as well as other similar infectious diseases.

What’s in a Definition?Holistic Nursing, Integrative Health Care, andIntegrative Nursing: Report of an Integrated Literature Review

Background: Nurses and others have used various terms to describe our caring/healing approach to practice. Because terms used can influence our image of ourselves and the image others have of us, we sought to clarify their meanings. Questions: How are the terms holistic nursing, integrative health care, and integrative nursing defined or described? Do we identify with these definitions/descriptions? Are the various terms the same or are they distinct? Method: We conducted an integrated review of peer-reviewed literature following the process described by Whittemore and Knafl. Using standard search methods, we reviewed full texts of 94 published papers and extracted data from 58 articles. Findings: Holistic describes “whole person care” often acknowledging body–mind–spirit. Holistic nursing defines a disciplinary practice specialty. The term integrative refers to practice that includes two or more disciplines or distinct approaches to care. Both terms, integrative and holistic, are associated with alternative/complementary modalities and have similar philosophical and/or theoretical underpinnings. Conclusions: There is considerable overlap between holistic nursing and integrative nursing. The relationship of integrative nursing to integrative health care is unclear based solely on definitions. Consideration of terms used provides opportunities for reflection, collaboration, and growth.

Implementing Integrative Nursing in a Pediatric Setting

Pediatric blood and marrow transplantation (BMT) is one of the most challenging allopathic treatments a patient and family can be faced with. A large Midwest academic health center, and leader in pediatric BMT, made the decision in 2013 to incorporate integrative nursing as the care delivery model. Nurses trained in advanced nursing practice and specialized in integrative health and healing performed a deep-dive needs assessment, national benchmarking, a comprehensive review of the literature, and ultimately designed a comprehensive integrative program for pediatric patients and their families undergoing BMT. Four years after implementation, this paper discusses lessons learned, strengths, challenges and next phases of the program, including a research agenda. The authors conclude that it is feasible, acceptable and sustainable to implement a nurse-led integrative program within an academic health center-based pediatric BMT program.

What Is It Like to Experience Improved Care Coordination Through a Community Outreach Program? A Qualitative, Descriptive Study

Community-based programs deploying community health workers (CHWs) who collaborate with other entities are beginning to emerge as the US health system evolves. Although these programs have used various evaluation criteria to determine program success, little research has been completed to examine the experiences of program participants as they receive these services. The purpose of this qualitative descriptive study was to describe what it was like to experience the benefit of improved care coordination through a community-based program featuring CHWs, in collaboration with community-based interprofessional providers. Knowing the help I needed emerged as the overarching theme.