In this issue: Call for Research Paper and Poster Abstracts, Research Profile: Ruth McCaffrey, Grant Deadline is February 1st, Native Navigation and much more.

Connections in Holistic Nursing Research
November 2011 
Volume 4 Issue 1

In This Issue
Research Profile: Ruth McCaffrey
Native Navigation
Call for Research Papers and Poster Abstracts
Research Grant Proposals are due February 1
Grant Reviewers Needed
Please Vote
Glossary: Power Analysis
News Briefs
Researchers in Action
Quick Links

Don't Forget...



By Rorry Zahourek, PhD, PMHCNS, BC
Coordinator for Research


Three years ago we started research e news (Connections). It was Amber Cline's brilliant idea. It has been a wonderful experience working with her and with Diane Wardell to put out 4 issues a year. In the summer of 2010 we introduced our two new editors: Jackie Levin and Jen Reich. We have had great feedback from members all along. I recently learned that Deb Shields, one of our education coordinators, requires her students to use the research web site for a class. Others have said how helpful it is in reading reviews of some of the latest research coming out as well as the research accomplishments of AHNA members. We have done profiles on 8 leading researchers in AHNA, provided review articles and started a glossary of research terms. All of this is available on the web site. Now that we have our two newest editors fully oriented and contributing to the newsletter I decided it was time for me to say goodbye to this wonderful project. I have loved doing this but we need to nurture new and, dare I say, younger members into roles like this. We need their fresh ideas and approaches to issues specifically related to holistic nursing research. I'm sure that in the future I'll write an article or two for the newsletter but I won't be in the driver's seat any longer. My best wishes to Diane, Jen, Jackie and, of course, Amber for all they have done so far and continued great success in the future.


Farewell Rorry

from Diane Wardell

Rorry has demonstrated the values of a true leader in her role as Research Committee chair for AHNA. She has birthed many new ideas (the e-news only one of many) and facilitated others development through a generous and caring mentorship process. Her attention to detail and to the many arms of the research committee has included grant management, surveys, research, and updating the website.   Her bright personality has engendered many of us to follow her lead. It is a talent to make change both desired and embraced. As she moves to her new role she will be missed from the nitty-gritty daily workings but we know she is holding the vision for research within AHNA at the leadership level.


Our commitment remains the same: to deliver four high quality editions a year, bringing you cameos of holistic nurse researchers, members' research and achievements, research terms from the holistic nursing perspective, as well news and editorials on issues important to holistic nursing research.  We invite you to share with us your interests, publications and comments. Contact us at

Research Profile:   Ruth McCaffrey, DNP

In this issue, we thank Dr. Ruth McCaffrey, DNP, Sharon B. Raddock Distinguished Professor in Holistic Nursing at Florida Atlantic University, for sharing with us her recent research on the effect of garden walking on elders with depression and her experiences as a holistic nurse researcher.


DO NOT USE NOT PAID FORHow have you come to study garden walking for older adults with depression? 
 I have been working over the last three years on developing an evidence-based program using reflection during garden walking to increase life satisfaction and reduce depression. The work began as collaboration between the Morikami Japanese Museum and Gardens and myself. The Morikami has had many people write letters and tell them that the gardens had a healing quality and helped them in a time of great sadness or in a time when strength was needed. The garden designer has created several gardens in the Japanese healing traditions and uses the idea of nine healing elements in nature. We were able to apply for and receive a grant from the Institute for Museum and Library Services to create a research study with three different interventions, individual reflective walking, guided imagery walking and a comparison group who had art therapy. From that work we developed a book for use in an individual reflective walking program through the garden with a group session at the beginning of the walks, after three weeks and again after six weeks. This program has proved to be very successful and popular. We have just received a grant from the Astellas Pharmaceutical Company to pay for 30 groups to participate in the reflective walking. These groups would consist of caregivers, those in support groups and professional care givers such as nurses, physicians, teachers etc. We plan to hold an international conference at the Morikami to share findings from our work with other gardens around the country.

What is it like to be studying this topic?
Studying this topic has been a great pleasure. Not only have I been able to work to create a beautiful and meaningful program but also I have met so many wonderful individuals who have completed the walks. To hear the stories of people that feel the program changed their lives and provided them with a new outlook on life has been extremely gratifying.

Tell us how your work has evolved?
The current program has been on going for three years with walking programs in the fall and spring. The program consists of 12 themed walks that take the participant from awareness to fulfillment. One of the members of the board of trustees from the Morikami participated in the walks and found that it dramatically changed his life. He said that when he started the walks (at age 84) he felt his life was almost over. As he finished the walks he said he realized that there was so much more open to him and that his life had been rich and blessed in many ways that he could now share with others.

What are your biggest challenges in doing holistic nursing research? 
I am very blessed to live and work in a community that values holism and holistic care. My mentor in holistic nursing Eleanor Schuster was one of the early Holistic Nurses of the Year for AHNA and someone who guided not only my growth and understanding of holistic nursing but created a foundational acceptance of holistic nursing in the south Florida community of nurses. Since then the Christine E Lynn College of Nursing has had a tradition of fostering and honoring holistic nursing in education, practice and research. Our university has just opened a medical school and I am honored to present a lecture to medical students each year on holistic health as well as complementary and alternative therapies. The biggest challenge I have found in holistic research is to find ways to take therapies that essentially affect the whole person and measure the outcomes in ways that more traditional researchers find acceptable as evidence.

What advice can you share with holistic nurses that want to do research?
Be as creative as possible in research design and in attempting to secure funding for large projects. Creating partnerships for holistic research is also very useful. There are many groups outside of nursing who could become partners in order to show the effects of holistic care, interventions and the importance of outcomes of this type of research. People are interested in ways to maintain their own health and take charge of their well being. Many desire using therapies and concepts based on holism and evidence based programs that foster well being are exciting to individuals, groups and communities.

What keeps you inspired to keep doing research?
The inspiration comes primarily from the wonderful research participants and partners that come together for the purpose of exploring and understanding holistic therapies and becoming more enlightened about themselves and the world in which they live. 

GardenMcCaffrey, R. , Hanson, C., MLS, McCaffrey, W. (2010) Garden Walking for Depression: A Research Report. Holistic Nursing Practice, 24(5):252-259.

Native Navigation: Tailoring Cancer Educational Modules and Goals for Comanche Nation

Valerie Eschiti, PhD, RN, AHN-BC, CHTP, CTN-A; Jana Lauderdale, PhD, RN; Stacey Sanford, LPN; Leslie Weryackwe; and Yvonne Flores


Background: Native Americans (NAs) in the Lawton, Oklahoma area, including Comanche people, have excessive cancer incidence and mortality rates. Native Navigators (NAs who assist people in a NA community by guiding them through and around barriers in the complex healthcare system) may be an effective intervention to alleviate cancer disparities. This is a particularly appropriate strategy for NAs, who have a historical mistrust of outsiders.


Methods: This multidisciplinary (nursing, public health, and statistics) 3-year project, funded by the National Institute of Nursing Research, employs a community-based participatory approach (CBPR). This is a collaborative approach to the research process, in which partners equitably contribute and share decision-making and ownership. CBPR is ideal for working with minority populations, such as NAs, who have historically been the recipients of abuse by outside researchers.

In this abstract, Year 1 activities are reported, which focused on tailoring and goal development related to cancer educational modules to Comanche Nation via qualitative methodology (focus groups). An exploratory, descriptive, qualitative design was utilized. Native Navigators assisted with and moderated the focus groups. They contributed to data analysis and subsequent changes in educational materials and goals. Analysis incorporated content analysis, using the transcribed data, field notes and observations. Codes, categories, and themes were identified. Member checking was included as a means of validation.


Results: Five major themes were identified: 1) Screening = Protection, Knowledge = Power; 2) Waiting not acting: Fears associated with screenings; 3) Living "Native Strong": Assessing personal risk; 4) Nourishing our body, mind, and spirit; Connecting with our past; and 5) Keeping learners interested: Educational engagement.


Conclusions: Members of the Comanche Nation community need cancer educational modules and goals tailored to their culture in order to become engaged and maintain interest in educational sessions so that realistic, achievable goal-setting is experienced.

Years 2 and 3 will focus on goal-setting measurement, based on principles of Goal Attainment Scaling (GAS) to be implemented with NA participants in community cancer education workshops presented by Native Navigators, as a means of assisting NAs to make progress towards achieving behavior change. Cancer-related knowledge will be assessed pre-and post-workshop.


looking forwardWe asked Dr. Eschiti some questions that focus on her experience of being a holistic nurse researcher:.


How did you go about finding a granting agency?

There are a number of ways to find out about funding opportunities, whether for small or large amounts. In the case of this particular project, a request for applications was released by the NIH for funds available through the stimulus program.

What was it like to actually "do" the study? 

We are still in the process of conducting the study; we have about 1.5 years left in the 3-year project. As a member of AHNA since 1989, all the ways I learned to relax and stay centered have really come in handy! I have an assortment of aromatherapy at my computer, and often listen to relaxing music when I am writing up project reports and analyzing data.

I have switched mental gears from "I" to "We." Because we have a team approach involving Comanche tribal members as staff, as well as an Advisory Board, I cannot make decisions on my own. I need to consult the rest of the team. This has been a paradigm shift for me. It is "our" project, not "my" project.

We are fortunate to have consultants to assist us. Jana Lauderdale, PhD, RN, is a Comanche tribal member who serves as Assistant Dean for Cultural Diversity at Vanderbilt University School of Nursing. She has provided assistance with qualitative analysis and feedback regarding Comanche cultural issues. Linda Burhansstipanov, MSPH, DrPH, President of Native American Cancer Research, Inc., has provided informative training regarding Native Navigation and cancer for the research team.

Research is incredibly difficult work, especially when there is are added layers of tribal permissions and cultural differences. I often quote a former AHNA member and mentor, Roxanne Struthers, who once emailed me this message: "Research is hard work. I think that is why we see such few good researchers. It is back breaking, sweat toiling labor."

 What did you learn personally?

I have learned that research involves much more human relations skills than I ever imagined! One envisions a researcher toiling in a lab with specimens and juggling numbers. However, in nursing research one is often involved in working with others who have different ideas of how to accomplish a task, and it involves suspending judgments on my part to see the beauty of how another perceives something to best be done. I have found that a lot of letting go of control is needed when using a community-based participatory approach, and trusting the process. In fact, when I have done so, the results have been much better than if I had done it all my own way.

AHNA's 2012 Conference
Holistic Nurses: Catalysts for Conscious Change
June 13 - 16, 2012, in Snowbird,

Request for Research Paper and Poster Abstracts
AHNA invites you to submit Research Paper & Poster abstracts for the 2012 Annual Conference by December 1, 2011.  Poster abstracts may be for research or non-research posters.


To learn more or submit a proposal click here.


Research Grant Proposals are due February 1, 2012

AHNA members are encouraged to submit topics concerning healing through holistic nursing. Nationally, research goals are evolving with new foci on real life clinical situations: patient centered outcomes and comparative effectiveness research designs. These changes are congruent with holistic nursing research and we enthusiastically encourage applicants interested in these new foci to submit proposals. Grant application instructions, submission guidelines, and the grant review forms are available on the AHNA Web site. Grant funding amounts vary from $1000- $5000.


Please e-mail grant proposals to both Jeanette Plodek ( and Jeanne Crawford ( Consultation may be available as an aspect of the grant. For questions about the grant application process, please contact Jeanette Plodek ( For research consultations or mentor information, contact Ruth McCaffrey ( 

Grant Reviewers Needed

We need you if you have a doctoral degree and are willing to volunteer to be a reviewer for AHNA research and/or practice grant proposals; please contact Jeanette Plodek (as soon as possible. In early February, Jeanette will send you 2-3 blinded study proposals with review forms for you to complete and return via e-mail within 3-4 weeks. Please volunteer!

Please Vote for AHNA Research Coordinator

AHNA Leadership Council Election ballots were recently sent to members. Help shape the future of AHNA - Please vote online or return your paper ballot by December 16, 2011, midnight EST.


One of the offices being voted on is Research Coordinator. Meet the candidates here.

If your membership is current and you have not received your ballot by mail or email, please contact Debbi at


Voting ends December 16, 2011!

Research Glossary: Power Analysis

Power Analysis

Melodee Harris, PhD, APN, GNP-BC

Associate Professor, Harding University-Carr College of Nursing

Researchers use a power analysis to determine the sample size before conducting the study and to determine statistical significance after the study is completed.  This is important when one is conducting a study that has as its purpose determining the benefit of one treatment/intervention over another.  There are a variety of computer programs that may be used to calculate a power analysis.  In holistic nursing research this may be more of a challenge as multiple factors  may be contributing to the affect a particular treatment/intervention has on the participant.


Power is a function of effect size and sample size.  Effect size denotes the degree of relationship between the research variables..  A power analysis  is the combined effect size and sample size and is used to make a more precise prediction of the study results.  A small effect size requires a larger sample size.  If the intervention has a large effect size, fewer responses or participants are needed. Cohen sets a range to determine a small, medium, and large effect size.  Effect size may be referred to as Cohen's d.  Sometimes the ranges are used to estimate these values and sometimes the effect size is estimated from previous research. 


A power analysis that meets ethical standards is performed prior to conducting the study in order to determine resources needed to carry out the research.  A sample size that is larger than necessary wastes valuable resources and places an unnecessary burden on participants.  A sample size that is underpowered will not determine conclusive results of a study.  It is important to remember that a power analysis is only a calculated estimate that provides the researcher with an objective means for guiding a scientific basis for the statistical significance of the study.


Borestein, M., Rothstein, H. & Cohen, J. (2001). Power and precision. Englewood, NJ: Biostat Inc.


Polit, D.F. & Beck, C.T. (2011).  Nursing Research: Generating and Assessing Evidence for Nursing  Practice (9th ed.).  Philadelphia, PA:  Lippincott Williams & Wilkins.


View AHNA's growing research glossary. To contribute a definition or suggest a term, please contact

News Briefs

Mediation Research is Blossoming

By Rorry Zahourek


A poster at the 2011 meeting of the American Psychiatric Association (, August, 2011) reported that not only did meditation decrease depression in caregivers of people with dementia but it also improved their cognitive and mental functioning. The study was a randomized controlled pilot study of 29 caregivers comparing a specific form of meditation with relaxation training. The caregivers had been caring for a family member for 4-5 years, Both groups were similar in pre-test HAM-D scores (a self-rating depression scale). Participants in the meditation group practiced Kirtan Kriya which involved chanting, breathing and finger poses. Participants in the relaxation group listened to relaxation tapes. Each group practiced for 20 minutes a day for 8 weeks. .


Both groups improved on the HAM-D scales but the differences were not significant. Significance was noted on the Global Mental Health Score as 52%of the meditation group showed at least a 50% improvement compared with 19% in the relaxation group. Cognition measures on the mini mental status exam increased significantly in the meditation group. These preliminary data indicate other biological differences in outcomes including increased immune function. Read more.


Another recent study, "Mindfulness Meditation is Associated with Structural Changes in the Brain" was reported on the NCAAM web site and published.(1)  Researchers from three institutions took brain MRI images of 16 participants 2 weeks before and after they engaged in a weekly meditation group with home practice. They were compared with a control group who did not meditate over a similar period of time. Members of both groups completed a questionnaire that measured five aspects of mindfulness: observing, describing, acting with awareness, non-judging inner experience, and non reactivity to inner experience. Brain imaging in the mediation group revealed increased gray matter in the left hippocampus which is involved with learning memory and emotional control. Three of the five aspects of mindfulness were improved in the meditation group but not the control.


1. Hozel, BK, Carmody, J, Vangel, M. et al. (2011) Mindfulness practice leads to increases in regional brain gray matter density, Psychiatry Research: Neuroimaging. 2011; 191(1); 36-43.

More Power to the Cranberry: Study Shows the Juice is Better than Extracts at Fighting Bacterial Infections

Researchers from the Worcester Polytechnic Institute have shown that cranberry juice is more effective in preventing UTIs than an extract of what was thought to be the active ingredient, demonstrating that the benefits derived from a whole food is more complex than distilling out the supposed "magic bullet" ingredient. (Click on title to read more)

AHNA Researchers in Action
Lauri Deary, Joan Roche, Karen Plotkin, Rorry Zahourek, (Nov. 2011). Intentionality and hatha yoga: an exploration of the theory of intentionality, the matrix of healing--a growth model, Holistic Nursing Practice, 25(5): 246-253.


Juyoung Park, Ruth McCaffrey, Dorthy Dunn, Rhonda Goodman, (Nov 2011). Managing osteoarthritis: Comparisons of chair yoga, reiki, and education (pilot study). Holistic Nursing Practice, 25(5): 316-326.


Michalene A. King, (Nov 2011).  Parish nursing: Holistic nursing care in faith communities, Holistic Nursing Practice, 25(5): 309-315.


Karen Avino, (Nov 2011).  Knowledge, attitudes, and practices of nursing faculty and students related to complementary and alternative medicine: A statewide look, Holistic Nursing Practice, 25(5): 280-288.

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 

The Voice of Holistic Nursing 

American Holistic Nurses Association
323 N. San Francisco St. #201
Flagstaff, AZ 86001
(800) 278-2462

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
Diane Wind Wardell PhD, RN, WHNP-BC, AHN-BC, CHTP/I

Jackie Levin RN, MS, AHN-C, CHTP

AHNA Leadership Council Coordinator for Research:

Rorry Zahourek PhD, PMHCNS-BC, AHN-BC 

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.