Research Profile: Diane Wind Wardell PhD, RN,
WHNP-BC, AHN-BC, CHTP/I
Wind Wardell PhD, RN, WHNP-BC, AHN-BC, CHTP/I
is an Associate Professor in the School of Nursing at
The University of Texas Health Science Center Houston.
Her research career has embraced complementary therapies
and alternative views of health and healing. She was
the Research Director for Healing Touch International,
Inc for a decade from 2000-2009.
My world of research has been one of interesting twists
and turns, not unlike a spiral in which each area builds
upon the next and later interconnects to the whole. The
underlying principle is an exploration and unfolding in
the areas of complementary therapies and women-child
health. The foundation for this work stems from working
with an open mind, developing collaborative teams, and
from a solid clinical base in holistic nursing
practice. In order to study energy therapies one must
be willing to embrace mystery and to create an expanding
view of the science and art of nursing.
Early in my researcher career I collaborated with a
clinical group of nurses to meet the needs of premature
babies who had "lost" the pacifier that was typically
being used for them, that of a bottle nipple stuffed
with cotton and sealed with tape. The funded team
consisted of another holistic nurse researcher, Dr. Joan
Engebretson, and a NICU nurse. This journey took us
through a holistic search of what babies would be doing
"naturally" if still within the womb. Ultrasound
pictures of babies sucking on their thumbs helped lead
us into designing a pacifier that truly "fit" the small
palates of premature infants. The Wee ThumbieŽ is still
in use today, 20 years after it was initially designed
using this holistic approach!
My focus in women's health as a nurse practitioner
in extramural funding received for a
study with Dr. Barbara Czerwinski and military
co-investigators entitled, "Combat readiness: Hygiene
issues related to military women (DAMD 17-96-2-6025)."
Two publications (Czerwinski et al. 2001 & Czerwinski
and Wardell, 2001) resulted from this study and
importantly, a change in the structure of education and
management for military women related to hygiene issues.
Not long afterwards my interest in complementary
approaches to health and healing shifted to energy
medicine. The first studies were done with Reiki and
utilized both psychological and physiological measures.
These studies were funded by an independent Reiki
organization and the American Holistic Nurses
Association. Publications from these studies were
helpful in identifying me as an energy medicine
researcher nationally and internationally.
After a sabbatical with Janet Mentgen in 1998 to gain a
more in-depth understanding of Healing Touch I "knew"
that my research interests were to continue following
the development of energy medicine and the science
behind it. For the last 10 years this has been my sole
focus in the area of research. During this time I have
conducted further studies in Healing Teach and published
a number of articles on energy medicine.
It is my pleasure to consult to various individuals and
groups in the area of energy medicine. I served as the
Research Director to Healing Touch International, Inc.,
member of the Council for Healing, and as a panel
reviewer for the National Institutes of Health National
Center for Complementary and Alternative Medicine
(NCCAM) during the last ten years. I have also consulted
with various individuals interested in energy medicine
and presented on this topic worldwide.
My latest research proposal is in review with NCCAM and
builds on my expertise in energy therapies with a
maternal-child focus. Currently I am working with an
esteemed group of nurses through the AHNA in reviewing
stories of healers. I am currently working on two other
projects: one on the Experience of Healing Touch
(non-funded) and Healing Touch with Elderly funded
through a UT-SON Partners Grant with Dr. Shelia Decker
as the PI.
Being a holistic nurse has always influenced and guided
my research. It has also given me like-minded
colleagues to grow and share with within the healing
Measurement Tools: Comfort Touch
The assessment of patient comfort is a holistic and positive
way to measure the effects of interventions designed to
promote overall health and well being. Kolcaba's technical
definition of comfort is the physical, psychological,
spiritual, social, cultural, and environmental aspects of
human experience which are perceived simultaneously.
Instruments that measure comfort are sensitive to
the previously unmeasurable effects of holistic comforting
actions in research or practice settings. These comfort
outcomes have been consistently positive and have been found
to be reliable predictors for more effective healing and/or
management of chronic health concerns. Comfort also is of
primary importance in facilitating a peaceful death.
The General Comfort Questionnaire (GCQ) is designed to
measure holistic changes in comfort levels. Multiple
adaptations of the GCQ have been developed for specific
purposes. Notable are the instruments developed by Kolcaba
et. al such as the Bladder Function Questionnaire, the
Healing Touch Comfort Questionnaire, the Hospice Comfort
Questionnaire, and the Radiation Therapy Comfort
Questionnaire. These instruments have demonstrated changes
in comfort levels in patients receiving holistic or
complementary interventions in numerous research projects.
In addition, the Verbal Rating Scale for Comfort can be
readily used in practice settings.
In total, 32 instruments are known adaptations of the GCQ:
14 by Kolcaba et al., 8 adaptations by other professionals,
and 10 foreign language translations. All are available at
Kolcaba's Web site:
www.TheComfortLine.com. The award winning Web site
describes how to modify existing comfort instruments and
invites you to do so should you want to measure the outcome
of comfort for specific populations.
Dowd, T., Kolcaba, K. & Steiner, R. (2000). Cognitive
strategies to enhance comfort and decrease episodes of
urinary incontinence. Holistic Nursing Practice,
Kolcaba, K., Dowd. T., & Steiner, R. (2006). Development of
an instrument to measure holistic client comfort as an
outcome of healing touch. Holistic Nursing Practice,
20, (3), 122-129.
Dowd, T., Kolcaba, K., Fashinpaur, D., Steiner, R., Deck,
M., & Daugherty, H. (2007). Comparison of healing touch and
coaching on stress and comfort in young college students.
Kolcaba, K., Dowd, T., Steiner, R. & Mitzel, A. (2004).
Efficacy of hand massage for enhancing comfort of Hospice
Patients. Journal of Hospice and Palliative Care,
Novak, B., Kolcaba, K., Steiner, R., & Dowd, T. (2001).
Measuring comfort in families and patients during end of
life care. American Journal of Hospice and Palliative
Care, 13(3), 170-180.
Kolcaba, K. & Fox, C. (1999). The effects of guided
imagery on comfort of women with early-stage breast
cancer going through radiation therapy.Oncology
Nursing Forum, 26(1), 67-71.
The Serenity Scale - A Review
This study is a factor analysis of a 22 item version
of the Serenity Scale developed by Kruse et. al.
(2005) to measure spirituality and well being in a
sample of 87 post solid organ transplant patients.
Kreitzer et. al. felt the original scale was too
long for such an ill population. Their factor
analysis yielded three subscales: acceptance, inner
haven and trust. The scale was positively associated
with positive affect and mindful awareness and
negatively associated with measures of stress and
depression. Blue (2009) in her companion commentary
of the study supported their conclusions that the
revised tool had merit but that it needed to be
tested with other populations and in other life
circumstances. That the shortened scale is missing
the three factors: belonging, contentment and
cognitive restructuring needs to be carefully
examined in the context of evaluating spirituality.
The Spirituality Scale: Development,
Refinement, and Psychometric Testing of an Instrument to
Assess the Human Spiritual Dimension
Colleen Delaney PhD, RN, AHN-BC
Purpose: Spirituality is a universal
phenomenon in the human health experience. It is a broad and
abstract construct that has been part of human existence
since antiquity yet it continues to evade a consensual
definition and defies definitive description. Mounting
evidence of the positive relationship between spirituality
and health has made the assessment of spirituality an
important consideration for heath care professionals. This
study sought to examine the variables that represent the
human spiritual dimension and to develop, refine and begin
psychometric testing of an instrument to measure these
variables. The Spirituality Scale (SS) is a holistic
assessment instrument that attempts to illuminate the
beliefs, intuitions, life-style choices, practices and
rituals representative of spiritual wellness and is designed
to guide spiritual interventions.
1. Is there evidence to support the factorial structure
of the Spirituality Scale?
2. What is the alpha internal consistency of the
Framework: An extensive review of the
literature was conducted from a broad interdisciplinary
perspective to identify references referring to
spirituality, assessment instruments and research
applications. It was discovered that current instruments
are predominately biased by religion, limited in scope,
and are not representative of the emerging understanding
and multiple expressions of this construct. Following
concept analysis and synthesis, a definition and
theoretical model of spirituality that integrated and
expanded upon the emerging understanding of spirituality
was developed. Spirituality - as a unique human
dimension pertains to a dynamic process that involves a
search for meaning, purpose, truth, love/caring and a
connection to others, nature, and a belief in a Higher
Methods: A researcher-developed
instrument was designed to assess spirituality from a
holistic perspective. Items were generated to measure 4
conceptualized dimensions of spirituality. The
instrument is a 42-item questionnaire in a Likert-type
format. The SS was distributed to 310 adults nursing
students over age 18 in Connecticut. Demographic
characteristics relative to age, gender, race/ethnicity,
marital status, work status, educational level, income
level and religion were collected.
Results and Conclusions: Initial
testing of the SS revealed provided strong evidence to
support the reliability and validity of the instrument.
Principal factor analysis revealed a meaningful 4-factor
solution explaining 53% of the variance. Reliability
estimates ranged from .79 - .87 for the subscales and
.93 for the total instrument. Four factors of
spirituality supportive of the theoretical framework
were identified: Self-Discovery, Relationships,
Eco-Spirituality, and Higher power Additional items in
the revised scale may further broaden the scope and
improve psychometric characteristics of the scale
Implications: The SS offers several
conceptual, methodological, and pragmatic advantages
over current instruments. From a conceptual perspective,
the SABS integrates the emerging knowledge of
spirituality, incorporates its multiple expressions, and
introduces the subscale of eco-spirituality.
Methodological precision is used to provide valid
evidence of reliability and validity. Finally, from a
pragmatic perspective, the scale can be completed in 10
minutes and results can guide interventions to specific
areas of spirituality such as self, relationships,
connectedness, faith or religious concerns.
ANA Smart Briefs is a daily eNewsletter from
American Nurses Association. Editors handpick key
articles from hundreds of publications, do a brief summary
of each and provide links back to the original sources. It
is free to sign up, just
Useful Web Sites
is a free site sponsored by SAGE
publishers. It is a discussion forum on which books
and videos are reviewed and discussions are
occurring on problems one encounters with
The mission of the
is to transform health care
through the scientific exploration of healing. The
vision is a world in which healing processes are the
formative concept for achieving and maintaining
wellness and ameliorating chronic disease. This site
has a research section. The Institute is funding
efforts to support healing environments and to
advance the understanding of healing.
Association for Comprehensive Energy Psychology
(ACEP) is an organization of mental health
professionals and allied energy health practitioners
who are dedicated to developing and applying energy
This web site also has a site on research on
which reviews of research on energy psychology
can be found. The association is particularly
interested in EFT. Emotional Freedom Technique
and demonstrating its effectiveness.
Connections Wants You
are currently seeking book reviews for this newsletter. If
you know of a book that may be useful to other holistic
nursing researchers, please send a short review to Rorry at
firstname.lastname@example.org. We also welcome other relevant articles
An AHNA member has recommended the book Narrative
Matters: The Power of the Personal Essay in Health
Policy. This anthology brings together the personal
stories of patients, physicians, policy makers, and
others whose writings humanize discussions and
deliberations about health policy. Drawn from the
popular "Narrative Matters" column in the journal Health
Affairs, the essays epitomize the policy narrative, a
new genre of writing that explores health policy through
the expression of personal experiences.
Mental Health and Holistic Nurses
In the Oct/Nov, 2009 Vol 15 No. 5 Issue of
Journal of Psychiatric and Mental Health
Nursing are five articles on
Transcranial Magnetic Stimulation and the
implications for nursing science and
practice. This is an alternative treatment
in place of Electro Convulsive Therapy (ECT)
for severe depression.
The following are studies presented in other
mental health journals that are of potential
interest to holistic nurses.
October 2009 was a big month for articles
about CAM efficacy and depression:
S. A. Saeed et al. (Oct, 2009).
CAM for your depressed patient: 6
8, no 10. Audio on the web
Two thirds of severely depressed patients
use some form of CAM to treat their symptoms
in addition to conventional treatment. They
reviewed the evidence for efficacy of these
treatments and concluded that there is
sufficient efficacy to recommend the
following as complementary treatments: Yoga,
Exercise, Bibliotherapy, SAMe,
Polyunsaturated fats, St. John's wort.
Insufficient evidence exists for L-trytophan
Lake, J. (Oct, 2009).
Natural products used to treat depressed
mood as monthoerapies and adjuvants to
antidepressants: A review of the evidence
. Oct, 2009.
In addition to the substances reviewed in
the first article he also provides
information on Folic acid, B vitamins, other
amino acids, DHEA.
In addition, in psychiatric nursing, the
following article investigated the use of
CAM with women with breast cancer.
Wyatt, G., SIkorskii, a. Willis, C.E.,
& Hong, S.A. (2010).
Complementary and alternative medicine use,
spending and quality of life in early stage
. Nursing Research.
59, 1 58-75.
The objective of this study was to
investigate the association between CAM use,
spending, demographic variable, surgical
treatment and QOL.
Method: a secondary analysis with 222 women
with early breast cancer.
The results indicated that the majority of
women used at l CAM therapy with biological
interventions (Vitamins in particular) the
most common. More educated, employed with
lower quality of life were the most likely
to use CAM.