In this issue:  Research Profile: Elizabeth Kinchen, Research at AHNA Conference and much more...
American Holistic Nurses Association
Connections in Holistic Nursing Research
April 2016, Vol. 8 No. 2
In This Issue
Advancing Clinical Excellence through Holistic Nursing Research
Farewell from Sue Robertson
New Chair of the AHNA Research Committee
Research Profile: Elizabeth Kinchen
Research Term: Theory of Integral Nursing
AHNA Researchers in Action
Student Corner
A Call to Action for Research
A Call for Beginnings Articles
AHNA 2016 Conferenc
Nurses Week
Opportunities for Nurses
Consultation Service
Quick Links
Advancing Clinical Excellence through Holistic Nursing Research
Margo Halm
Margo Halm
Guest Editorial:  Margo A. Halm, PhD, RN, ACNS-BC, NEA-BC

Margo A. Halm serves as the Director of Nursing Research, Professional Practice and Magnet at Salem Health, an OHSU Partner in Salem, Oregon.  Halm was the recent co-guest editor of a series on Holistic and Integrative Nursing in the American Journal of Nursing that launched with the October 2015 issue.  She can be reached at margo.halm@salemhealth.org
 
We are what we repeatedly do.
 Excellence, then, is not an act,
but a habit.   - Aristotle
 
Holistic nursing focuses on bringing conventional, complementary and integrative philosophies and approaches together to improve the physical, emotional, social and spiritual outcomes of our patients/families and colleagues, as well as our own outcomes.  As holistic nurses, how can we continuously improve whole-person centered care?  
 
Hospitals on the Magnet journey embed clinical excellence standards (see the ANCC's Magnet Model below) into the fabric of their organizations.  While all of these standards are interlocking, I'd like to reflect on the "New Knowledge, Innovations and Improvements" standards as they relate to holistic nursing practice.

ANCC___s Magnet Model
ANCC's Magnet Model
Evidence-based practice (EBP) has become the gold standard for setting and updating standards for clinical care (see diagram below). 
Evidence Based Practice
As holistic nurses we demonstrate clinical excellence embodied in the Magnet® Recognition Program when we commit to updating our existing practices using the best available evidence from the literature or our professional organization's standards like those of the American Holistic Nurses Association.  Another way we can demonstrate excellence is by using evidence to make the case for a new patient care practice or for staff self-care.  
 
For example you might want to add an essential oil to an established patient care protocol based on new evidence in a certain patient population, or you may want to initiate a new program such as Reiki on your oncology unit due to new science showing its impact on specific outcomes.  By offering patients/families options and choices in their healing and recovery, we bring the patient values/preferences component of EBP alive in our daily practice. 
 
When evidence for an important problem doesn't exist, the Magnet model encourages nurses to generate new evidence for practice through research.  One holistic research project in particular comes to mind as an example.  In my role as a nurse scientist I had the privilege of mentoring clinical nurses who were interested in bringing complementary therapies to their patients in the preoperative unit to reduce anxiety.  Through a partnership with our certified clinical aromatherapist we designed a three-arm clinical trial that investigated the effects of Lavandin (a hybrid of Lavender) compared to a placebo (jojoba oil) or standard care (i.e., family presence, medications).  Findings demonstrated that Lavandin significantly reduced preoperative anxiety, providing high level evidence for this simple, low-cost intervention that holistic nurses can integrate into their practice to bring comfort to patients.  Becky and Sue, the clinical nurse investigators went on to present these findings at their national conference, the American Society of PeriAnesthesia Nurses, and we published our findings in the Journal of PeriAnesthesia Nursing.1  Research dissemination like this is a trademark of being a Magnet nurse.
 
In summary, other hallmarks of clinical excellence related to 'new knowledge' include fostering innovations and using technology to improve nursing practice and/or the patient experience.  Many hospitals have transformed their patient care units and public areas by using the science related to light, color, connection to nature, and reduction of environmental stressors like sound, to promote optimal healing environments.  These improvements may also benefit staff.  For example at my Magnet facility, we have developed respite rooms to promote self-care of all employees.  The rooms include a full body massage chair, as well as a sound machine and a few other resources to help staff create an environment where they can de-stress and recharge, even if only for a few moments, so they can be present with their patients   Clinically, nurses can also integrate new technologies like music therapy into the patient care arena to improve whole-person centric outcomes and ultimately, the patient experience.
                                                                             
References
  1. Braden B, Reichow S, Halm M.(December 2009.) The use of the essential oil Lavandin to reduce preoperative anxiety in surgical patientsJournal Perianesthesia Nursing. 2009; 24(6):348-355.
Thank You and Farewell Message: 
Sue Robertson, RN, PhD, CNE, Chair, Research Committee 
Sue Robertson, RN, PhD, CNE
Sue Robertson
I have had the privilege of chairing the Research Committee (RC) for the last four years.  In recent weeks, I reflected on how much we accomplished during this time.  We gained renewed energy and more varied holistic research interests from new members that enriched the committee.  Happily, many of the members who "built" the committee continued to provide wisdom and guidance. 
 
We implemented important programs and resources.  The Research/QI Program is a terrific resource for novice researchers and those completing DNP or QI projects.  Journal Clubs and webinars introduced novel research as well as providing mentoring on aspects of conducting good holistic nursing research.  Revising and updating the White Paper and policies ensured currency of process. 
 
Research e-News continues to help us "meet" each other and learn more about our research backgrounds and interests.  The editors have kept us abreast of important trends and issues in research and shared research results.  Publications is an easy way to learn about current holistic nursing research we might not be aware of.  The addition of A Call to Action for Research provides a place to both identify topics that need holistic research and a source of potential collaboration.  The Student Corner highlights student research, an important addition to the newsletter. 
 
In addition, we met, talked, laughed, shared concerns, and formed new relationships both in meetings and at the conference.  I will never forget how invigorated I felt at the RC meeting last summer, listening to members describe their current research projects.  Inspiring!
 
I want to thank the Co-Chairs, Michalene King and Cindy Barrere, and Connections in Holistic Nursing Research co-editors, Pamela Crary and Sue Roe, for their work and support, and especially Colleen Delaney.  She has been the champion of research on the Board of Directors for the last four years.  Not only did she bring research to the forefront of discussions, but she gave so much wisdom and support to the committee activities and meetings.  We would not be where we are without her work.  I also remember that I built on what previous chairs established. 
 
Most of all, I want to thank the members of the RC for their commitment and support.  It has been a joy to see you at conference, hear about your research, share stories, and work with you in our varied endeavors.  I know that the incoming chair and vice-chairs will continue to "grow" and expand the committee in new directions.
Margaret "Marty" Downey, PhD, RN, AHN-BC, CHTP, CNE to Assume Chair of the AHNA Research Committee
Marty Downey
Marty Downey
Dr. Marty Downey is currently an Associate Professor at Boise State University School of Nursing and will assume the Chairperson role of the AHNA Research Committee this summer. 
 Her teaching specialties are critical care nursing, medical-surgical nursing, health assessment, holistic nursing & health practices, stress management, and humor in health. Marty's BSN is fromMarycrest College and her MSN is from Idaho State University with a focus on Nursing Education. She received her PhD from the University of Idaho in Adult and Organizational Learning. Marty worked in critical care and was nationally certified in critical care nursing for over 20 years, and now holds Alumnus CCRN status. She has been certified as an Advanced Holistic Nurse (AHN-BC) for over 16 years, and is a mentor for the BirchTree Center for Healthcare Transformation. Marty completed her Certified Healing Touch Practitioner (CHTP) in 2013 and is also a Certified Nurse Educator (CNE).  She will soon be in the role of Emeritus Faculty at Boise State University beginning in May 2016, and beginning June 1st will lead the AHNA Research Committee.  Congratulations Marty.
Research Profile:  Elizabeth Kinchen PhD, RN, AHN-BC
Elizabeth Kinchen
Elizabeth Kinchen
Elizabeth Kinchen PhD, RN, AHN-BC is an Assistant Professor at the University of Central Florida College of Nursing in Orlando, FL.
 
What is your current area of research?
I am currently exploring holistic attributes of Nurse Practitioner (NP) practice from the patient's perspective, how NPs see their practice as holistic, and how holistic nursing values are incorporated in educational programs. I am especially interested in quantifying the advantages of comprehensive, whole-person, and patient-and relationship-centered care by NPs, with a view to influencing policy, reimbursement, and collaborative agreements. I am also currently involved in studying the effects of yoga on stress in university Nursing faculty, staff, and students.
 
Tell us how you got started in research and how it has evolved over the years.
As a research assistant in my graduate program, I was involved in a study of Nurse Practitioner graduates, and I began to be interested in that model of care, as a blend of Nursing and Medicine, and in its potential for enhancing and transforming healthcare delivery. That really started me on the path that would become my dissertation research, and is my current area of interest.
 
What are some of your biggest challenges, surprises, and joys in conducting holistic nursing research?
I am continually surprised at how much public interest there is in a holistic approach to health, and how supportive people are of nurses leading the way in seeking out and sharing information about the physical, emotional, mental, social, and environmental influences on heath. I think that one of the biggest challenges in holistic nursing research is in continuing to document and produce rigorous, credible evidence demonstrating the value of holistic therapies as viable adjuncts (and, in some cases, alternatives) to traditional treatment strategies to policy-makers, payers and 'mainstream' health providers. We are also producing new knowledge every day about ancient traditions and practices, and being a part of that process of re-discovery is immensely satisfying.
 
What advice would you give new holistic nurse researchers?
I think the most important thing is to value your own ideas. Every study is another 'piece of the puzzle' in our understanding of health and wellness, and we all have something important to contribute. My greatest joy as a new researcher has been the realization that I am contributing to the body of knowledge in Nursing, and that what I am doing means something.
 
What excites you about the future of holistic nursing research?
Nursing has always been grounded in holistic principles, but I think we are just now coming to a realization about our own potential for remodeling care. It is an exciting time to be a nurse and a researcher, to be involved in exploring new paths, and to assist people in finding their own way to health.
Research Term:  Theory of Integral Nursing
By Tamisha Gatewood-Henderson, MSN, MHA, RN
 
Roman Milert
The Theory of Integral Nursing (TIN) is a grand theory developed by Barbara Dossey, who expanded Ken Wilber's Theory of Integral Health.  A grand theory is one that focuses on broad and general areas and concepts that can be used in a variety of settings and populations. The TIN is descriptive providing definitions of concepts and suggesting a new way of looking at the world of integration.  The four-quadrant model of Ken Wilber describes the reality of experience. This further helps with "understanding the dimensions of how we perceive the world, coupled with Carper's theory of how we come to know what we know" (Frisch and Potter, 2015). The TIN includes five components:
  • (a)  healing, at the center
  • (b)  the metaparadigm of nursing which includes nurse, health, person, and environment or society, touching or healing
  • (c)  six patterns of knowing (includes personal, empirics, socio-political, ethics, aesthetics, and not knowing)
  • (d)  four quadrants (Interior/Individual, Exterior/Individual, Interior/Collective, and Exterior/Collective) adapted from Wilber's integral theory, and
  • (e)  AQAL (all quadrants, all levels, all lines, and states, and all types) The concepts of AQAL (all quadrants, all levels) use the I, We, It, and Its which are elements of awareness.
Florence Nightingale was considered the first integralist - or "health diplomat". This person focuses on the individual and the collective, the inner and outer, and human and nonhuman concerns (Dossey, 2008).  Not only was Nightingale concerned with the basic needs of humans, but she was also concerned with all aspects of the environment, including a connection with the Divine as an awareness.

This TIN has importance in holistic nursing because it is meant to address broad areas of nursing and expand our notions of who and what we are.
 
References:
Dossey, B. (January/March 2008). Theory of integral nursing. Advances in nursing science. 31(1) E52-E73.

Frisch, N. & Potter, P. (2016). Nursing theory in holistic nursing practice. In B. M. Dossey, L. Keegan, C. Barrere, M.A. Blasko Helming, D. Shields, & K. Avino (Eds.), Holistic Nursing - A Handbook for Practice(pp 111-120).  Burlington, MA: Jones and Bartlett Learning 

View AHNA's growing research glossary. To contribute a definition or suggest a term, please contact research@ahna.org.
AHNA Researchers in Action
Publications
W. Richard Cowling. (March 2016). Introducing new purpose, aims, and scope. Journal of Holistic Nursing, 34(1), 4-5.
Full text available to AHNA members. Learn how.

Fanny Airosa, Torkel Falkenberg, Gunnar Öhlén,and Maria Arman. (March 2016). Tactile massage as part of the caring act: A qualitative study in short-term emergency wards. Journal of Holistic Nursing, 34(1), 13-23.
Full text available to AHNA members. Learn how.

Helen Lorraine Erickson, Margaret Elizabeth Erickson, Mary Elaine Southard, Mary E. Brekke, M. Kay Sandor, and Mary Natschke. (March 2016). A proactive innovation for health care transformation: Health and wellness nurse coaching. Journal of Holistic Nursing, 34(1), 44-55.
Full text available to AHNA members. Learn how.

Perpetua Markwell, Katrina Morris, Carol Ryan, Barbara J. Polivka, and Annetra Taylor. (March 2016). Snack and Relax®: A strategy to address nurses' professional quality of life. Journal of Holistic Nursing, 34(1), 80-90.
Full text available to AHNA members. Learn how.

AHNA members names in bold. We would love to hear about your research. Have you started your dissertation, had a paper published, presented, etc. Send your "Researcher in Action" to research@ahna.org. For publications, click on the article title for link to abstract (if available).
Student Corner 
Masters and Doctoral students are invited and encouraged to send abstracts of their thesis/ dissertations/quality improvement projects and submit to Connections in Holistic Nursing Research for possible publication in the Student Corner. This gives students an opportunity to publish and allow others to gain interest in their work. If you are a mentor or advisor for a graduate student, please encourage them to share with us. Please send your submissions to Dr. Michalene A. King at kingm@rmu.edu or michalene1@comcast.net  We look forward to reading about your scholarly work.
A Call to Action for Research
Call to Action
Do you have a topic that you believe needs to be researched? Would you like to discover that other holistic nurses are also interested in your topic and would like to collaborate? Submit your ideas to Michalene King at kingm@rmu.edu or michalene1@comcast.net for possible inclusion in a future e-newsletter.
~Michalene King
Call for 2016 Beginnings Articles
Beginnings Magazine AHNA is requesting articles for Beginnings magazine on 
  • Self-Care: Finding Time and Balance for the August issue, articles due May 15th;
  • Holistic Nurse Entrepreneur for the October issue, due July 15th; and
  • Holistic Mental Health Nursing for the December issue, due on September 15th.
Please email article submissions to Becky Lara at editor@ahna.org. Submission guidelines can be downloaded at www.ahna.org/submitarticles
AHNA 2016 Conference - Interconnectedness: the Soul of Holistic Nursing
May 31 - June 5, 2016 | Bonita Springs, FL
2016 AHNA Conference Research Posters
Thursday, June 2 8:45 AM - 9:45 AM
Friday, June 3 10:00 AM - 11:00 AM
 
  1. Aromatherapy, Creating a Caring Moment
    Christine Coughlin, RN & Margaret Reid, RN
  2. Art Images in Holistic Nursing Education
    Cheryl V Elhammoumi, MSN, BA, RN, CCRN
  3. Effect of Integrative Medicine Therapies in the Acute Care Setting
    Carole Reifsnyder BSN, RN, HNB-BC
  4. Exploring the Interconnectedness of Nurse Knowledge, Clinical Confidence and Self-Care Practices Of Nursing Working in Hospice and Palliative Care
    Monica Wooldridge, NP-C, FNP-BC, ACHPN
  5. Facilitators and Barriers of Tai Chi Practice in Older Adults: A Mixed Method Approach
    Yan Du, RN, BSN
  6. Impact of the Electronic Health Record on Patients' Perception of Feeling Known by Their Nurse
    Lisa A Preston, MSN, RN
  7. Maintaining Optimal Caregiving in a Healthy Environment through Assessment of Risk for Strain and Frequency of Physical Health Symptoms of Caregivers of Persons with Parkinson's Disease
    Maryann Abendroth, PhD, RN
  8. Music Therapy and Pain Management: The Evidence
    Saliha Erenay, MSN, RN
  9. Peer to Peer - Recognizing the Need for Self-Care in the Workplace
    Elizabeth Dailey, BSN, RN, OCN, HN-BC
  10. The Effects of Healing Touch on the Vital Signs of Critical Care Patients: Implications for Holistic Nursing Practice
    Mary Ann Friesen, PhD, RN, CPHQ
  11. Examination of the Use of Healing Touch by Registered Nurses in the Acute Care Setting: Implications for Holistic Nursing Practice
    Mary Ann Friesen, PhD, RN, CPHQ
  12. The Lived Experience of Folklore Practice as a Health Patterning Modality
    Mary A Joseph, RN, PhD, AHN-BC, APP
  13. Utilizing Music and Nature Sounds for Hospice Cancer Patients
    Lenny Chiang-Hanisko, PhD
  14. Why Men Won't Take Meds: How Unspoken Gender Stereotypes Create Isolation and Limit Potential for Healing
    Lee Ann Hawkins, PhD, RN, FNP-BC
  15. ZAFÈ NEG SE MISTÈ:  The Process of Making Decisions About End-of-Life Healthcare for an Adult Family Member Among Haitian and Haitian Americans in South Florida
    Susan Charlotte Ladd, PhD, MSN, RN
Nurses Week: May 6-12, 2016
Florence Nightingale Commemorative Moment
Florence Nightingale The Florence Nightingale Commemorative Moment started in 2000 as a celebration of nursing's most known contributor and ended up launching a worldwide movement. The Nightingale Moment occurs May 12 at noon (your local time). At that moment, every nurse around the world is invited to pause, take a moment of silence or create a healing ceremony or ritual in celebration and dedication of holistic nursing. We will create a wave of healing consciousness as nurses world-wide observe this moment.

Our collective goal is to reach every nurse in the world with this message. Please take the time to distribute this message by letter, phone, fax, e-mail, meetings, networks, and one-on-one sharing.  Visit our website for suggestions on how you can celebrate the Nightingale Moment. www.ahna.org/Home/Events-Calendar/Nightingale-Moment

May 6th starts this year's National Nurses Week, are you prepared to celebrate this nation's extraordinary caregivers?  Download the National Nurses Week Resource Toolkit , which is full of ways to spread awareness about the week. Inside are various logos, banner ads and other resources that can be readily displayed on any website or even mailed.
Opportunities for Nurses
International Congress of Nurses is pleased to release its Call for Abstracts and launch the website for its 2017 Congress: www.icncongress.com. Headlined with the theme Nurses at the forefront transforming care, the Congress will take place in Barcelona, Spain from 27 May-1 June, 2017. Online submission of abstracts opens on May 16, 2016 and will close on October 10, 2016.

The 2017 ANA Annual Conference will be held in Tampa, FL, March 8-10, 2017. The Conference call for abstracts is open until May 2, 2016 11:59 p.m. PDT. The primary contact for each abstract submitted will be notified by electronic communication of their acceptance status by July 2016.  Submit conference abstracts online here.

Promoting Research and Quality Improvement in Holistic Nursing through
Consultation Service

AHNA Research Consultation Service

The AHNA Research Committee is now offering a program for those nurses who want to conduct research or are working on a quality improvement project, but need some guidance. If you are a new researcher who would like some assistance, the AHNA Research Consultation Program is for you.

For AHNA members, this service is provided for $20 for one research consultation and $50 for three, and can be purchased online at www.ahna.org/shop. Consultations are expected to be less than one hour, and will be most productive when the Consultation Request Form is thoughtfully completed. For example, providing your area of research interest and other descriptors will enable the program manager to better match you with a consultant. After purchasing your consultation service, you will receive an email receipt that guides you in the process for your consultation. This program is managed by Cindy Barrere, who can be contacted at cynthia.barrere@quinnipiac.edu.

The AHNA Research Committee is very excited to make this service available to the members, continuing their focus to promote and support future researchers in holistic nursing.

  American Holistic Nurses Association
 Feel free to share the content in this eNewsletter with your e-mail contacts, list-serves, or favorite discussion boards/ blogs. Please just be sure to mention that Connections is a benefit of AHNA membership.
 
Connections in Holistic Nursing Research   
Editor-in-Chief: 
Michalene A. King PhD, RN, CNE 
Co-Editors:
Pamela Crary PhD, RN, AHN-BC
Sue Roe DPA, MS, BSN, RN
AHNA Board of Directors Coordinator for Research:
Colleen Delaney PhD, RN, AHN-BC
Chair of the Research Committee of AHNA:
Sue Robertson RN, PhD, CNE  
 
Although the AHNA supports the concepts of holism, it refrains from endorsing specific practitioners, organizations, products, services or modalities. Opinions expressed in this eNewsletter may not reflect the position of the AHNA.

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