Identifying Holistic Nursing Research Priorities for 2023-2026.

The primary goal of holistic nursing research is to develop and expand the knowledge base of holism and healing for nursing praxis. This article provides an overview of the process used to identify the research priorities for holistic nursing research over the next 3 to 5 years. A mixed method design using Appreciative Inquiry and surveys revealed five research priorities and the holistic philosophical foundation for these priorities. Additionally, new challenges in the environment, person, health, and nursing will undoubtedly emerge, requiring nurses to discern the research needs beyond 2026. This work seeks to inspire holistic nurses to consider research related to the American Holistic Nurses Association's five key research priorities.

A Systematic Review of Women's Experiences of Interpersonal Violence During the COVID-19 Pandemic.

OBJECTIVE: To explore and synthesize women's experiences of interpersonal violence during the COVID-19 pandemic. DATA SOURCES: The MEDLINE, Ovid, Embase, Cochrane, Web of Science, and CINAHL databases were searched to identify articles published between December 2019 and November 2022. STUDY SELECTION: Seventeen peer-reviewed studies were included, for a total of 2,046 women. DATA EXTRACTION: Data were extracted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. DATA SYNTHESIS: COVID-19 brought many challenges for women experiencing interpersonal violence. Women reported worsening of abuse during the pandemic. The pandemic led to severe economic challenges, which eventually precipitated more abuse. Additionally, women experienced mental health distress from social isolation and increased surveillance and control from their abusive partners. Several factors affected their ability to access health care and support services; these included limited availability of services, fear of contracting the virus, and an abusive partner who restricted their movement outside the home. CONCLUSION: The pandemic presented multiple challenges and additional stressors for women who experienced interpersonal violence during pandemic-related restrictions on services, gatherings, and work and school outside of the home. The findings from this review signify the need to raise public awareness about violence against women and to plan for coordinated efforts to decrease violence against women and address victims' needs in the event of future pandemics or other public health emergencies.

Energy Healers' Distance Healing Experience.

The purpose of this study was to describe the experience of energy healing practitioners (specifically, Healing Touch) use of distance healing to provide insight into the methods, practice, and experience from the providers' perspective. One hundred and fifty-three energy workers participated in the open-ended survey. Overall, the experience of using distance healing during the pandemic was positive for practitioners in both giving and receiving. Practitioners also reported primarily positive feedback from their patients. A few respondents reported feeling hesitant about using distance healing and preferred hands-on work. However, distance healing was generally seen as providing flexibility to the practitioners' work, connection, and enhanced understanding of the human energy field.

The associations between physical activity, health-related quality of life, regimen adherence, and glycemic control in adolescents with type 1 diabetes: A cross-sectional study.

BACKGROUND: Adolescents with Type 1 Diabetes (T1D) display a greater than two-fold higher risk of developing diabetes-related complications compared with their healthy peers and the risk increases markedly as glycated hemoglobin (HbA1c) increases. The majority of the known factors associated with improved glycemic control in adolescents with T1D are geared toward Western populations. Therefore, this study examined the associations between Physical Activity (PA), Health-Related Quality of Life (HRQoL), and regimen adherence on glycemic control in a Middle Eastern population of adolescents with T1D METHODS: The study utilized a cross-sectional design of Jordanian adolescents (aged 12-18) with T1D (n = 74). Self-reported measures used were the Pediatric Quality of Life-Diabetes Module, the International Physical Activity Questionnaire, and the Summary of Diabetes Self-Care Activities. HbA1c values were obtained from the medical records. Correlation analyses were conducted using Pearson's and Spearman's correlation tests. Multiple regression analyses were conducted to determine if HRQoL, PA, and regimen adherence predict glycemic control. RESULTS: Only 14.8 % of the participants demonstrated good glycemic control (HbA1c ≤ 7.5 %). Participants with poor control had a statistically significant lower mean PA of MET-minutes/week (3531.9 ± 1356.75 vs. 1619.81 ± 1481.95, p < .001) compared to those with good control. The total sample was found to demonstrate low HRQoL (47.70 ± 10.32). Participants were within the acceptable range of PA (1885.38 ± 1601.13) MET-minutes/week. HbA1c significantly inversely correlated with PA (r = -0.328, p = .010) and regimen adherence (r = -0.299, p = .018). The regression analysis revealed that PA significantly predicted glycemic control (ß = -0.367, p < .01) as adherence (ß = -0.409, p < .01) and disease duration did (ß = 0.444, p < .01). CONCLUSION: Better glycemic control was significantly associated with higher PA and regimen adherence levels. The correlation between PA and glycemic control depends highly on the level of regimen adherence or arguably, adherence acts as a buffer in the correlation between PA and glycemic control. There was no significant association between glycemic control and HRQoL.

Psychosexual responses to BRCA gene mutations in women of childbearing age.

BACKGROUND: Diagnosis of a BRCA gene mutation presents a dilemma because life-changing medical decisions must be made to prevent breast and ovarian cancer. There is minimal evidence regarding how psychosexual functioning, psychological well-being with regard to body image and sexuality, affects the decision to have prophylactic treatment in women of childbearing age (WCBA; 18-49 years) with a BRCA gene mutation. PURPOSE: To explore, describe, and interpret the experience of women with a BRCA mutation during the treatment and decision-making process. METHODOLOGY: A qualitative descriptive design was used to recruit participants online through social media postings and from national and local BRCA support groups. Participants participated in semistructured interviews exploring their experience after BRCA diagnosis. Interpretive descriptive analysis was used to identify themes. RESULTS: The purposive sample comprised 18 women aged 21-49 years. Four major themes, such as body image, sexuality, femininity, and childbearing/childrearing, were identified that influenced decisions related to the diagnosis and management of a BRCA mutation. All participants voiced that concerns regarding body image and sexuality caused hesitancy in their decision to have prophylactic surgery. Women who had undergone bilateral prophylactic mastectomy were concerned about the impact of the surgery, scarring, breast disfigurement, and the lack of sensation resulting from surgical intervention. CONCLUSIONS: Psychosexual concerns arise from internal and external influences that significantly affect the decision to undergo prophylactic measures. Therefore, body image, sexuality, and sexual orientation should all be addressed during the decision-making process. IMPLICATIONS: Provider communication and preparation for realistic surgical outcomes can be improved to assist WCBA throughout the decision-making process and enhance psychosexual functioning.

Healing Touch: A Strategy for Acute Care Nurses' Stress Reduction.

The purpose of the study is to determine whether administering healing touch (HT) is more effective than deep breathing (DB) for reducing acute care nurses' stress during a shift. A randomized cluster trial assessed 150 nurses' vital signs and Visual Analog Scale for Stress (VASS) levels pre, post, and at follow-up to achieve a power of .7 and medium affect size. Open-ended questions following the intervention enriched quantitative findings describing the experience, facilitators, and barriers to potential use in nursing. The generalized estimating equation 1 (GEE1) comparisons of mean change over time, found that nurses in the HT intervention, had significantly lower VASS stress scores at posttreatment (-0.95, p = .0002) and at follow-up (-0.73, p = .0144) than the DB group, and the respiratory rate (RR) rate differences were nearly significant at post-intervention and significant at follow-up, respectively (1.36, p = .0568 and -2.28, p = .0011), indicating lower RR after HT. These findings support the use of HT as an effective stress reduction strategy as a relevant strategy to sustain a viable nurse work force post-COVID-19.

Experience in Radical Remission: A Self Study and Framework.

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.

Nurse-Driven Interventions for Improving ELBW Neurodevelopmental Outcomes.

Survival rates for extremely low-birth-weight (ELBW) infants are improving as neurodevelopmental impairment (NDI) rates stay stable, thereby increasing the overall number of infants with NDI. Although there are many determinants of NDI in this population, nutritional factors are of interest because they are readily modifiable in the clinical setting. Nurses can influence nutritional factors such as improving access to human milk feeding, using growth monitoring, establishing feeding policies, implementing oral care with colostrum, facilitating kangaroo care, and providing lactation education for the mother. All of these measures assist in leading to a decrease in NDI rates among ELBW infants.

Relationship Between Maternal COVID-19 Infection and In-Hospital Exclusive Breastfeeding for Term Newborns.

OBJECTIVE: To evaluate the relationship between maternal COVID-19 infection and the odds of in-hospital exclusive breastfeeding for term newborns. DESIGN: Retrospective descriptive quantitative. SETTING: A large, urban hospital with more than 6,000 births annually. SAMPLE: Term newborns born between March 1, 2020, and March 31, 2021 (N = 6,151). METHODS: We retrospectively extracted data from electronic health records to evaluate the relationship of maternal COVID-19 infection with the odds of in-hospital exclusive breastfeeding using univariate analysis and logistic regression models. The covariates included insurance type, race/ethnicity, glucose gel administration, length of stay, newborn gestational age, newborn birth weight, and maternal COVID-19 infection. RESULTS: Maternal COVID-19 infection was not significantly related to the odds of in-hospital exclusive breastfeeding (p = .138) after adjustment for covariates in the logistic regression model. However, when newborns who received pasteurized donor human milk supplementation were excluded from the logistic regression model, maternal COVID-19 infection significantly decreased the odds of in-hospital exclusive breastfeeding (p = .043). CONCLUSION: Maternal COVID-19 infection was not significantly related to the odds of in-hospital exclusive breastfeeding when newborns received donor human milk supplementation. Access to donor human milk for supplementation for term newborns may protect the odds of in-hospital exclusive breastfeeding.

Changes in Breastfeeding Exclusivity and Satisfaction During the COVID-19 Pandemic.

BACKGROUND: Because of its many benefits, exclusive breastfeeding for 6 months is a common public health goal. However, only 44% of infants aged 0-6 months are exclusively breastfed worldwide and, in the United States, only 26% of infants are exclusively breastfed for 6 months. The restrictions imposed during the COVID-19 pandemic may have reduced these rates even further. RESEARCH AIM: To examine the differences in breastfeeding exclusivity and satisfaction before and during the COVID-19 pandemic. METHODS: A cross-sectional, two-group survey design was used. Parents (N = 110) of infants born April 1 to December 31, 2019 (pre-pandemic; n = 69), or April 1 to December 31, 2020 (during the pandemic; n = 41), who received lactation support services from an urban academic breastfeeding clinic were surveyed. RESULTS: Respondents who gave birth in 2020 (pandemic year) were no less likely to exclusively breastfeed for the first 6 months of their infant's life compared to respondents who gave birth in 2019 (pre-pandemic year). After multivariable logistic regression, the odds of high breastfeeding satisfaction were 73% lower in respondents with infants born in 2020 than in respondents with infants born in 2019 (OR = 0.27, 95% CI [0.08, 0.89]). The strongest contributor to high breastfeeding satisfaction was a prenatal breastfeeding visit with an International Board Certified Lactation Consultant. CONCLUSIONS: Future research is needed to identify the specific pandemic-related factors that led to the difference in breastfeeding satisfaction between the two groups and to confirm the impact of prenatal International Board Certified Lactation Consultant visits on breastfeeding satisfaction.

Resilience and associated psychological, social/cultural, behavioural, and biological factors in patients with cardiovascular disease: a systematic review.

AIMS: The aim of this systematic review of the literature is to synthesize the evidence regarding the associations between individual-level psychological, social/cultural, behavioral, and biological variables with resilience in patients with CVD. METHODS AND RESULTS: A systematic search of PubMed, PsycINFO and CINAHL was conducted from database inception through March 2020. Studies with a quantitative research design were eligible for inclusion if published in English and focused on resilience among adults with CVD. Of the 788 articles retrieved, 34 studies (35 articles) were included in the review. Twenty-three studies focused on psychological factors, with findings of inverse relationships between resilience and depression, anxiety, and stress. Evidence regarding associations between resilience and social/cultural or behavioral variables was scarce. Four of the 6 studies regarding biological factors found low stress resilience in young adulthood was associated with early diagnoses of stroke, heart failure, and coronary heart disease. CONCLUSION: Enhancing resilience may improve quality of life for CVD patients, but research is needed to further explore the complex relationships between resilience and associated variables. This research should prioritize under-represented groups (i.e. women and minority racial/ethnic groups), with the eventual goal of developing interventions to support resilience in CVD patients.

Coping and healthcare utilization in LGBTQ older adults: A systematic review.

PURPOSE: This systematic review was conducted to identify, synthesize, and elucidate the coping mechanisms described by aging lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults (60+) when utilizing healthcare. METHODS: A comprehensive literature search was conducted in Embase and Ovid databases to identify studies of aging LGBTQ adults using coping mechanisms during healthcare utilization. Qualitative and quantitative studies published in English between 1969 and 2020 were included and assessed with COREQ, STROBE Statement, and CASP instruments. RESULTS: Of 227 articles identified, six were included in the review. The final synthesis revealed that coping mechanisms were associated with social support, social network size, provider competency, and disclosure management. Frequency of appointments varied when seeking healthcare, and one study indicated delay in treatment. CONCLUSION: This systematic review highlights various coping mechanisms associated with healthcare utilization and supports the need to develop research uniquely focused on aging LGBTQ adults.

Human Papillomavirus Vaccination Status and Parental Endorsement Intentions among Undergraduate Student Nurses.

We identified factors associated with student nurses' Human Papillomavirus Vaccine (HPV) vaccination status and their intention to counsel parents on HPV vaccination. Undergraduate student nurses (N = 153) from a large university in the south participated. Descriptive statistics, chi-squared tests, and independent t-tests (p ≤ 0.05) were used to characterize the students' vaccination status. Logistic regression was used to identify factors associated with vaccination status. HPV vaccination rates were low. Students who were older and married or living with a partner were less likely to have completed the HPV vaccine series. The most commonly cited reason for non-initiation and non-completion was the lack of provider endorsement. Vaccination status did not differ significantly according to race/ethnicity, religion, skills, or intention to counsel parents. While intentions to counsel parents on HPV vaccination are high among student nurses, interventions to improve vaccination rates among student nurses are needed.

Physical and Psychological Health Interdependence Among Dyads in Hematological Cancer.

BACKGROUND: Hematological cancer impacts both patients and their caregivers. Although only patients experience direct physical effects from cancer, both patients and caregivers experience psychological effects from cancer-related stressors. Theories suggest that patient-caregiver dyads, although experiencing individual effects from cancer, may also indirectly affect one another's health. This is called interdependence. OBJECTIVE: This study investigated physical and psychological health interdependence among patient-caregiver dyads facing hematological cancer, and whether their relationship quality was a moderator of interdependence. METHODS: Thirty patient-caregiver dyads were assessed for their self-reported physical function, anxiety, and depression using the Patient-Reported Outcomes Measurement Information System and relationship quality using the Mutuality Scale. Data were analyzed using the Actor Partner Interdependence Model, a dyadic data methodology for estimating interdependence. RESULTS: Individual physical and psychological health were related within both patients and caregivers. Patients and caregivers did not significantly differ in their reported depression, anxiety, or mutuality. Partner effects were detected among caregivers' anxiety and patients' physical function and depression. Mutuality did not moderate partner effects. CONCLUSIONS: Findings suggest that health interdependence is present among patients with hematological cancer and their caregivers. In addition, there is a strong link between physical and psychological health within individuals, regardless of role. IMPLICATIONS FOR PRACTICE: Healthcare teams should consider dyadic assessment in their cancer care plans to identify risks for health decline in patients with hematological cancer and their caregivers. Assessment of caregivers, especially their anxiety levels and physical health, may yield integral information about the patients' physical and psychological health status.

Prevention Strategies for Neonatal Skin Injury in the NICU.

PURPOSE: The purpose of this article was to determine specific skin injury prevention interventions for neonates in the NICU. DESIGN: The design was a systematic review. SAMPLE: PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, and Scopus were systematically searched to identify quantitative studies identifying skin injury preventions for neonates in the NICU. OUTCOMES: The outcomes included skin integrity or skin condition. RESULTS: Nineteen studies were included in the review. Twelve studies included a randomized design. Barriers were the main interventions for the prevention of pressure injury, medical adhesive skin injury, diaper dermatitis, and general skin condition. The types of barriers included hydrocolloids, polyurethane-based dressings, film-forming skin protectant, or emollients. Nonbarrier interventions included rotation between a mask and nasal continuous positive airway pressure (NCPAP) interfaces, utilization of prescribed guidelines to decrease pressure injuries, and use of a lower concentration of chlorhexidine gluconate as a disinfectant.

Interdependence of physical and psychological morbidity among patients with cancer and family caregivers: Review of the literature.

OBJECTIVE: Caregivers for patients with cancer have an integral role in maintaining patients' health. Although patients and caregivers experience the impact of cancer individually, studies suggest their health is interdependent. The objective of this review was to synthesize the literature on interdependent physical and psychological morbidity in patient-caregiver dyads published since 2016. METHODS: A search of PubMed, CINAHL, Embase, and PsycInfo databases was performed using Cooper's recommendations and the Preferred Reporting Items for Systematic Reviews And Meta-Analyses Guidelines. Studies were included if they measured individual physical or psychological morbidity in cancer patient-caregiver dyads, evaluated interdependence, and were published in a peer-reviewed journal. RESULTS: Twenty-three studies met criteria, characterized by mainly spousal dyads. Studies included a variety of cancers and methodologies. Findings were inconsistent, indicating varying interdependence. However, the studies demonstrated a stronger relationship between patients' and caregivers' psychological morbidity than between their physical morbidity. CONCLUSIONS: This review revealed a need for continued exploration of dyadic health interdependence. Future studies should consider samples of patients with a single type of cancer, testing cultural mediators/moderators, and using longitudinal designs.

Family Caregiver-Receiver Mutuality: A Concept Analysis.

There are more than 43 million family caregivers in the United States. In studies of family caregivers and receivers, evidence suggests that family caregiver-receiver mutuality is linked to health. Lack of a clear definition of family caregiver-receiver mutuality is an obstacle that prevents scientific progress and effective operationalization of the concept. To address this issue, the authors applied Walker and Avant's method for concept analysis and clarified the concept of family caregiver-receiver mutuality. A standardized definition of caregiver-receiver mutuality is presented along with antecedents, consequences, defining attributes, empirical referents, and case illustrations.

Impact of Pediatric Critical Illness and Injury on Families: An Updated Systematic Review.

PROBLEM: Pediatric ICUs (PICU) that have adopted family-centered care models welcome families to the critically ill child's bedside to partner with clinicians in decision-making and the provision of care. The aim of this review was to synthesize the evidence on the impact of critical illness and injury on families of children admitted to the PICU to identify research needs in pediatric critical care. ELIGIBILITY CRITERIA: This systematic review included quantitative and qualitative studies that examined the experiences of families of children admitted to a PICU published between 2005 and 2019. SAMPLE: 33 articles were selected for inclusion in the final analysis after screening those identified by searches in CINAHL, PubMed, PsycINFO, and reference lists of included publications. RESULTS: Main parental stressors included the sights and sounds within the PICU, child acuity, changes to family functioning and parenting role, and uncertainty of the child's outcome. The most common need of parents was to be well-informed. Psychological, physical, and social impact of hospitalization were experienced by parents from days after admission to years after discharge. Spirituality was identified as a coping mechanism in half of the studies. CONCLUSIONS: Parents experience negative effects of the ill child's admission to the PICU and to PICU exposure. IMPLICATIONS: Careful consideration of the impact of the PICU admission on family members of critically ill or injured children is needed when implementing family-centered care strategies. Future research on other family members including the healthy sibling needs to be conducted.

A Systematic Review of Physical Activity and Exercise on Physiological and Biochemical Outcomes in Children and Adolescents With Type 1 Diabetes.

PURPOSE: In this systematic review we aimed to evaluate the effects of physical activity (PA) and exercise on biochemical and physiological outcomes in children and adolescents with type 1 diabetes (T1D). DESIGN: The review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. METHODS: The search of literature was performed using PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, the Cochrane Library, Scopus, Medline, PsycINFO, the Nursing Reference Center, and Google Scholar. The search was limited to include peer-reviewed articles published in English from May 2012 to May 2018 and included adolescents <19 years of age with T1D. Twenty-seven studies met the inclusion criteria: 8 interventional and 19 observational studies. FINDINGS: Both observational and interventional studies showed considerable agreement that supervised regular moderate to vigorous physical activity (MVPA) is more effective on adiposity and cardiorespiratory fitness than habitual PA. Further, it was reported that PA of different intensities improves insulin sensitivity and decreases daily insulin dosage. Results of glycemic control were equivocal. Although observational studies reported improvement in glycemic control with PA of different intensities, most of the experimental studies revealed no significant associations. A consistent agreement among the studies revealed a considerable benefit of regular habitual PA of light to moderate intensity on blood glucose regulation and lipid profile. CONCLUSIONS: The reviewed studies showed that regular MVPA was associated with several health benefits in adolescents with T1D; however, additional studies are needed to fully understand the effect of PA on health outcomes. CLINICAL RELEVANCE: Regular MVPA (at least 4 hr per week) with good glycemic control is a promising option for adolescents with T1D when risk management of hypoglycemia is appropriately taken.