An Interdisciplinary Framework for Palliative and Hospice Education and Practice.

Leading highly functional health care teams in all practice settings is sustained through the identification of a conceptual framework to guide education and practice. This article presents an interdisciplinary framework for palliative and hospice education and practice. The framework builds on theoretical caring to convey elements of relational, holistic and compassion; articulates interprofessional tenets for guiding values; and aligns with constructs for palliative and hospice best practices. The framework invites those at the bedside and in leadership to be intentional in attending to education and the necessary activities that address the day-to-day operations of palliative and hospice care, as well as, honoring all interdisciplinary collaboration that supports quality outcomes and inspires actions that transform.

Structured Coaching Programs to Develop Staff.

Health care environments are complex and chaotic, therein challenging patients and professionals to attain satisfaction, well-being, and exceptional outcomes. These chaotic environments increase the stress and burnout of professionals and reduce the likelihood of optimizing success in many dimensions. Coaching is evolving as a professional skill that may influence the optimization of the health care environment. This article reflects on three coaching programs: Gallup Strengths-Based Coaching, Dartmouth Microsystem Coaching, and Health and Wellness Nurse Coaching. Each approach is presented, processes and outcomes are considered, and implications for educators are offered. Continuing education departments may recognize various coaching approaches as opportunities to support staff professionals achieve not only the triple aim, but also the quadruple aim. J Contin Educ Nurs. 2017;48(8):373-378.

Treatments for Inflammatory Arthritis: Potential But Unproven Role of Topical Copaiba.

Traditional medicines for inflammatory arthritis (IA) include nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 inhibitors (COXIBs), which have variable clinical benefits and serious side effects. In large-scale randomized, controlled trials (RCTs) in IA, they have demonstrated significant decreases in pain and inflammation but also significant increases in gastrointestinal symptoms, serious bleeding, and cardiovascular events. Copaiba, an essential oil used topically, has potential but unproven benefits, with few to no side effects. Basic research supports its mechanisms of benefit, but human data are sparse and include 1 case series and 1 small RCT examining its benefits for another inflammatory condition, not IA. Providing effective and safe pain relief for patients with IA presents clinical, public health, and research challenges. The clinical challenge is to maximize the benefits of treatment and minimize its risks. Sales of copaiba are increasing and may continue to do so even in the absence of reliable evidence from RCTs, providing a public health challenge. Thus, the research challenge is to test topical copaiba versus a placebo for IA patients against a background of usual care in RCTs of sufficient size, dose, and duration. If such trials show positive results, a logical next step might be head-to-head comparisons against NSAIDs and COXIBs. Evidence from RCTs may support more widespread use or, to paraphrase Huxley, conclude that copaiba is yet another beautiful hypothesis slain by ugly facts.

Caring Across the Continuum: A Call to Nurse Leaders to Manifest Values Through Action With Community Outreach.

As health reform continues to advance, there is a need for nurse leaders to broaden their perspective related to possible nursing practice models and potential community partners in order to successfully address caring, accomplish the triple aim mandate, and achieve suitable metrics for maximum reimbursement. Intentional efforts must be made by nurse leaders to maximize caring and ensure that professional nurses are responding to the key drivers shifting health care delivery in the 21st century. Academic-practice collaboration (APC) and community-based participatory action research (CBPAR) align well. Together, they provide an ideal mechanism to pursue endeavors that extend evidence for caring services across the health care continuum. One APC/CBPAR model for community outreach that can maximize individual and population health outcomes is highlighted in this article. Furthermore, useful action steps are offered that could be taken by a nurse leader to develop and maintain any form of APC/CBPAR in order to manifest values through caring action across the health care continuum.

Exploration and Description of Faith-Based Health Resources: Findings Inform Advancing Holistic Health Care.

It is important to use all holistic resource opportunities in communities, such as integrative healing centers, and mind-body-spirit approaches to health. These holistic approaches may be realized through nontraditional avenues, such as faith-based resources. This article reports on an exploratory study that describes faith-based resources supporting holistic health in a southeastern region of the United States. A working definition for "faith-based health resources" was "ecumenical and interfaith community-based, open-access health resources that include in mission for service a reference to faith." Excluded from the definition were institutional services from hospitals, focused social services from area agencies, and federally funded services.

Hearing the voice of nurses in caring theory-based practice.

The authors in this paper describe the process and findings of a participatory action research project between a college of nursing and a for-profit acute healthcare organization as practice environment transformation occurred, grounded in caring theory. The participatory action research process and findings emphasize the importance of the intention to know what matters and the required time, courage, and commitment necessary to actualize practice environments that support nursing. Implications show efforts to develop and sustain theory-based practice environments that enable the full expression of nursing and a way of being that honors and celebrates the uniqueness of nurses.

Sustaining health in faith community nursing practice: emerging processes that support the development of a middle-range theory.

This article reveals processes that support theoretical development for holistic nursing in the context of a faith community. The emerging processes enhance the articulation of the holistically focused practice, add clarity to faith community nursing activities and outcomes, and contribute to theoretical clarification and development. Theoretical clarity is essential to guide faith community nursing practice, research, and education because there is tremendous potential for the specialty practice to contribute to the health of a community across the continuum of caring and because to date there has been no unifying model for this practice proposed. A lack of a theoretical basis can result in disparate and disconnected approaches to studying, testing, and promoting the practice.

A methodological review of faith-based health promotion literature: advancing the science to expand delivery of diabetes education to Black Americans.

Non-traditional avenues, such as faith-based organizations (FBOs), must be explored to expand delivery of diabetes self-management education (DSME) to benefit Black Americans with type 2 diabetes (T2D). The purpose of this study was to methodologically review the faith-based health promotion literature relevant to Blacks with T2D. A total of 14 intervention studies were identified for inclusion in the review. These studies detailed features of methods employed to affect health outcomes that DSME similarly targets. Analysis of the faith-based studies' methodological features indicated most studies used (1) collaborative research approaches, (2) pre-experimental designs, (3) similar recruitment and retention strategies, and (4) culturally sensitive, behaviorally oriented interventions with incorporation of social support to achieve positive health outcomes in Black Americans. Findings indicate FBOs may be a promising avenue for delivering DSME to Black Americans. Informed by the findings, a focused discussion on advancing the science of faith-based interventions to expand delivery of DSME to Black Americans with diabetes is provided.

Faith: a concept analysis.

AIM: This paper reports a concept analysis of faith. BACKGROUND: There are numerous scholars who consider spirituality and religiosity as they relate to health and nursing. Faith is often implied as linked to these concepts but deserves distinct exploration. In addition, as nursing practice conducted within communities of faith continues to emerge, concept clarification of faith is warranted. METHOD: Qualitative analysis deliberately considered the concept of faith within the lens of Margaret Newman's health as expanding consciousness. Data sources used included a secondary analysis of stories collected within a study conducted in 2008, two specific reconstructed stories, the identification of attributes noted within these various stories and selected philosophical literature from 1950 to 2009. FINDINGS: A definition was identified from the analysis; faith is an evolving pattern of believing, that grounds and guides authentic living and gives meaning in the present moment of inter-relating. Four key attributes of faith were also identified as focusing on beliefs, foundational meaning for life, living authentically in accordance with beliefs, and interrelating with self, others and/or Divine. CONCLUSION: Although a seemingly universal concept, faith was defined individually. Faith appeared to be broader than spiritual practices and religious ritual and became the very foundation that enabled human beings to make sense of their world and circumstances. More work is needed to understand how faith community nursing can expand the traditional understanding of denominationally defined faith community practices and how nurses can support faith for individuals with whom they encounter within all nursing practice.