In this issue: Promoting Research in Holistic Nursing through Consultation, Research Profile:  Sue Robertson, Research Study Conducted by a Staff Nurse, Hybrid Model of Concept Analysis, AHNA Research Grant Opportunity and more...

Connections in Holistic Nursing Research
October 2013                                                                                                        
Volume 5 Issue 4

In This Issue
Promoting Research in Holistic Nursing through Consultation
Opportunities for Researchers
Doctoral Mentors
Sue Robertson, RN, PhD, CNE
An Interview with Kelly Hilcove, RN, BSN, HNB-BC
AHNA Researchers in Action
Call for Research
Hybrid Model of Concept Analysis
Quick Links

Promoting Research in Holistic Nursing through Consultation

AHNA Research Consultation Service Opens

This program is for those nurses who want to conduct research, but need some guidance. If you are a new researcher who would like some assistance, the AHNA Research Consultation Program is for you.


To purchase either 1 (ONE) or 3 (THREE) Research Consultations in the AHNA Shop online, click here.  The member price for this service is $20 for 1 (ONE) Research Consultation and $50 for 3 (THREE). Consultations are expected to last less than an hour in length, 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


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.

Opportunities for Researchers
The AHNA is offering a competitive research grant for $500 to $1,500. Completed research proposals are due no later than Friday, February 1, 2014. Please refer to the AHNA website at for the following information: the grant application form, guidelines about the application process, and information describing how to write a research proposal. For more information, please contact Jeanette Plodek,, or Cindy Barrere,

Doctoral Mentors

These two nurse researchers have volunteered to mentor doctoral students.

Bunny B. Stanfield, RN, MPH, PhD, 269-1525


Kate Johnson, PhD, MSN, MBA, BSN, APHN-BC, Assistant Professor of Nursing, Westfield State University,, (413) 427-6223


Thank you Kate and Bunny!

Research Profile:  Sue Robertson, RN, PhD, CNE

Sue Robertson, RN, PhD, CNE
Sue Robertson, RN, PhD, CNE, Associate Professor, School of Nursing, Coordinator, Nurse Educator Concentration, California State University, Fullerton
In this issue we profile Sue Robertson, RN, PhD, CNE, 

Associate Professor, School of Nursing, Coordinator, Nurse Educator Concentration, California State University, Fullerton. Sue is Chair of the Research Committee of AHNA and an active holistic nursing researcher.


What is your current area of research?

I am working with Colleen Delaney, Cindy Barrere, and Rorry Zahourek on a self-care intervention study. 


Could you tell us how you got started in research and how it evolved over the years?

I participated in research while working at the San Diego VA Medical Center, but my dissertation research was my first study.  It looked at how individuals define health following a near-death experience (NDE).  Not surprisingly, it is a holistic process of understanding the meaning of the NDE, applying that meaning to health beliefs and behaviors, and manifesting that in the complexity of one's life. 


Since I began teaching, my research has primarily focused on classroom and online pedagogy.  One area of interest is how to make holistic practice explicit in pedagogical models - do we need to modify existing models or develop new models?  A second area is identifying successful holistic teaching/learning strategies.  After working with stressed students, I am also interested in how to promote student self-care.  Nursing programs are intense, and students feel they have little time for themselves.  How do we best promote self-care and what strategies are most effective?

What were some of your biggest challenges, surprises and joys in doing holistic nursing research?  

My initial challenges were finding holistic researchers who share the same research interests and research mentors.  Becoming a member of the Research Committee (RC) provided incredible opportunities to meet and network with other holistic nurse researchers.  My colleagues have influenced my thinking about and understanding of holistic research in many ways.  Rorry Zahourek, especially, has been a wonderful mentor.

What are you excited about as you lead the Research Committee?

I am excited about working with a great leadership team, the new programs we are implementing, and collaborating with the talented members of the RC.  Colleen Delaney has made research much more visible to the Board of Directors, and is the RC champion.  Cindy Barrere is implementing an innovative Research Consultation Program that will provide much needed support to holistic nurse researchers.  Michalene King, Pamela Crary, and Sue Roe are putting their imprint on the Research e-Newsletter and the RC website, and Evelyn Clingerman is the RC "voice" on the 2014 Conference Planning Committee.  We are building on the work of the many holistic nurse researchers who have guided and influenced our thinking about and practice of holistic nursing research.     


The first Research Webinar (Bernadette Lange, Wendy Stiver, and I) will be in October, and will be hosted by the RC and Education and Practice Committees.  Beginning in February, 2014, the RC will have four research webinars each year, with topics of interest to both holistic nurse researchers and holistic practitioners who want evidence for practice.  We initiated the Research Journal Club in August, 2013; Barry Gallison discussed his research on spiritual care practices of acute care nurses.  


What are your goals for the Research Committee?

The RC goals are to continue to identify member needs related to holistic nursing research, explore best methods of making research (evidence, how-to) accessible to members, support holistic nurse researchers, and both expand RC membership and increase member involvement in RC activities.  The last is so important. We cannot move forward without the active participation of RC members, but with their expertise and commitment, we can accomplish so much!

An Interview with Kelly Hilcove, RN, BSN, HNB-BC - A Research Study Conducted by a Staff Nurse

by Sue Roe, DPA, MS, BSN, RN


Yoga Kelly Hilcove, a staff nurse on the Oncology Unit at Scottsdale Healthcare Shea (SHC), was Primary Investigator and Study Coordinator in an Institutional Review Board approved trial, investigating whether "Mindfulness Based Yoga Decreased Stress Levels in Healthcare Professionals."


A Glimpse into Kelly's Holistic Nursing Journey

Kelly's journey into holistic healing started at a very young age in South Africa where she was born.  She grew up in a family who embraced natural healing modalities as a complement to traditional medicine. Kelly came to the US in 2001 and pursued a degree in nursing. Since that time Kelly has become a certified holistic nurse, a certified Yoga instructor, a certified Yoga Nidra Facilitator (Guided Relaxation), a certified Brain Management Consultant, and a certified Healing Touch Level 3 Practitioner.


The Study, Results, and Impact on Practice

Kelly felt the pressure and stress that her colleagues were surrounded by daily and knew she had a tool to help them recharge. She said, "I noticed that my day unfolded in a totally different way if I had done my yoga practice."


Her study emanated from her experience with SHINE, Scottsdale Healthcare's Investment in Nursing Excellence, a program open to Registered Nurses which encourages professional growth and development. She conducted a change project entitled "Helping Nurses Stay Healthy" which offered free yoga classes as a way to relieve stress and tension, lower anxiety, and prevent burnout. 


Group yoga session That change project led to this study funded by Scottsdale Healthcare. It was a randomized control trial of 80 healthcare professionals conducted from February 2011 through July 2011. Methodology included the completion of pre and post intervention measurements of burnout, stress, vitality and sleep.  The treatment group (n = 41) attended a weekly yoga class and practiced yoga at home for six weeks.  Significant differences were noted on the Perceived Stress Scale, Vitality Scale, and Pittsburgh Sleep Quality Index and the Maslach Burnout Inventory when comparing the Yoga group with the control group.


The positive effects of this study went way beyond the outcomes that were measured. Some comments from participants in the study:


I have incorporated the techniques I have learned to help reduce stress and tension. It is much more rewarding to take care of others when you are taking care of yourself.


I feel that I can approach patients in a more relaxed state, transferring that feeling onto my patients.


I use the yogic breath with my patients before painful procedures or when I see or sense they are stressed.


Challenges Conducting the Study

Initially, recognizing the volume of work that went into planning and implementing the study was a challenge. It became two full time jobs for a period of time.  Kelly also commented that it was not easy taking a leadership role and holding people accountable, especially if you are the one with a BSN and everyone else on the study team had a master's or higher degree.


What Was Learned and the Surprises

Kelly learned that research takes time and being passionate about what is being studied is paramount. She saw the study as an awesome opportunity to reflect once again and recognize the importance of taking care of herself as a Holistic Nurse. Surprises were how much more participants got out of the study beyond the selected measurement tools.


The importance of Research for Holistic Nursing Practice

It provides a starting point for one's own thinking and understanding and it encourages questioning and exploration. New insights and knowledge are gained. More importantly the key is putting what is being taught into practice - to experience growth as a whole person.


Advice for Staff Nurses Who Would Like to Conduct Holistic Nursing Research

Be sure to select a topic you are passionate about so when the going gets tough you can remember "why" you set out to do it. When asked if she would conduct research again, she enthusiastically said YES, it was my joy and honor to share and inspire others to be the best they can be.

If anyone would like to reach out to Kelly she can be contacted at

AHNA Researchers in Action

Marlaine C. Smith, Rothlyn Zahourek, Mary Enzman Hines, Joan Engebretson, and Diane Wind Wardell. (Sept. 2013). Holistic Nurses' Stories of Personal Healing. Journal of Holistic Nursing, 31(3), 173-187.

Note: Full text available to AHNA member. Learn how.


Phyllis Krug, Deborah Kramer, Rochelle Bukatman, Phyllis Gordon, and Pamela Mermelstein (Sept. 2013). Energy Dialogue Technique in Healing and Health: Relieving Side Effects and Thyroid Dysfunction in a Male With Hemophilia Receiving Pegylated Interferon and Ribavirin Treatment for Hepatitis C Virus-An Anecdotal Case StudyJournal of Holistic Nursing, 31(3), 204-213.

Note: Full text available to AHNA member. Learn how.


Colleen Delaney, Apostolidis, B., Morrison, H., Smith, L., & Fortinsky (2013). A randomized trial of telemonitoring and self-care education in heart failure patients following home care discharge. Home Health Care Management & Practice, 25(5), 187-195. 


Colleen Delaney, PhD, RN, AHN-BC, Cynthia Barrere, PhD, RN, AHN-BC, Rothlyn 
Zahourek, PhD, RN, PMHCNS, AHN-BC and Sue Robertson, PhD, RN were awarded a $1,000 research grant from the Sigma Theta Tau Mu Chapter for their study entitled The Use of Simulation to Instruct Nursing Students in Stress Management: Pilot Testing of the NURSE Intervention. The aim of this experimental pilot study is to evaluate a simulation-based educational program that assists nursing students to develop stress management plans. The intervention, termed NURSE (Nurture nurse, Use resources, Resilience, Stress and Environment management) is used to describe components of a comprehensive stress management education program. 


Valerie Eschiti Valerie Eschiti, PhD, RN, AHN-BC, CHTP, CTN-A, long-time AHNA member and Research Committee member:

"Determination of Oklahoma American Indian Preferred Smokeless Tobacco Cessation Strategies, Perceived Barriers, Facilitators, and Motivators." In this mixed methods study utilizing a CBPR approach, an interdisciplinary team of investigators seek to discover which smokeless tobacco cessation interventions are preferred by adult American Indians in Oklahoma, as well as perceived barriers, facilitators, and motivators to cessation. We will be working with the seven tribes of southwest Oklahoma (Apache, Caddo, Fort Sill Apache, Comanche, Delaware, Kiowa, and Wichita tribes), Choctaw Nation, Chickasaw Nation, and Indian Healthcare Resource Center of Tulsa. 7/1/13-6/30/14. Eligible to apply for continuance of additional one year of funding. Oklahoma Tobacco Research Center. Funding: $50,358. Role: PI. Co-PI: Janis Campbell, PhD; Co-I's: Lancer Stephens, PhD, Nasir Mustaq, PhD, Jessica Blanchard, PhD, Michael Peercy, MPH, MT (ASCP)H, and Tracy Davis, RN; Community Outreach Specialists: Stacey Sanford, LPN and Stacy Berg, MS, LPC.


Valerie has also been selected to serve on an NINR study section. The NRRC is a standing Study Section in the NINR, and it reviews Fellowship (F) and Career Award (K) applications, focusing on fostering the training and career development of junior investigators. Valerie's expertise in minority health using CBPR and mixed methods was sought for this committee. The NINR Initial Review Group (NRRC 58) meeting will be held on October 21-22 at Bethesda, Maryland. 


Valerie's Recent Publications:


Cowens-Alvarado, R., Vogel, O., Valerie Eschiti, Samos, M., Wiener, D., Ohlander, K., & Royals, D. (2013, online first). Circle of Life revision: Giving voice to American Indian and Alaska Native communities. Journal of Cancer Education.


Johannigman, S. & Valerie Eschiti. (2013). Medical use of marijuana in palliative care: Oncology nursing considerations. Clinical Journal of Oncology Nursing, 17(4), 360-362. Oncology Nursing Society Mentor/Fellow Writing Project submission.


Valerie Eschiti, Weryackwe, L., Sanford, S., & Flores, Y. (2013). "My mammogram was my best friend": Donna Wahnee's story. Native People's Wellness: Breast Cancer Prevention, Detection, and Care, inside cover. Centers for Disease Control and Prevention. Available at


Valerie Eschiti, Weryackwe, L., Sanford, S., & Flores, Y. (2013). Go pink day: The Comanche Nation celebrates National Breast Cancer Awareness Month (October). Native People's Wellness: Breast Cancer Prevention, Detection, and Care, p. 8. Centers for Disease Control and Prevention. Available at 


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 For publications, click on the article title for link to abstract (if available).

Call for Research
Corey Benziger, RN, MSW is a member of the AHNA, a board member (Secretary) for the Touch for Health Kinesiology Association (TFHKA), and a certified Touch for Health Instructor/Consultant. TFHKA is educational nonprofit, teaching a holistic health system developed in the 1970's. They certify instructors and have begun a consultant program for people working one to one with individuals. Their instructors are able to award continuing education (CE's) credits to RN, acupuncturists, professional trainers and massage therapists.

Corey is requesting research be conducted using their system that has been in practice for 40 years and has helped people all over the world live better lives.

If you feel like this could be a viable research topic for a PhD nursing student please contact Corey. She would love to discuss ideas with you regarding generating more research in the area of holistic or CAM therapies. Corey's number is (910) 520-3422 and her email is 
Research Term:  Hybrid Model of Concept Analysis

By Anita Catlin, DNSc, FNP, FAAN, Research and Ethics Consultant, Pope Valley, California 


graphic-book-adventure.jpgConcept analysis in nursing refers to a multifaceted analysis of a term.  Examples for holistic nurses might be deeper looks into the concepts of therapeutic touch, caring or alternative medicine. The concepts chosen for analysis by nurses are often those felt deeply about and used in research and practice. 


Concept analysis is initiated by thinking: 

  • "What is it that I am interested in?" 
  • "How would this term be defined in the Webster's or Oxford dictionary?" 
  • "What similar terms can describe this concept?" 

This would be followed by a literature search. The intent is to find a term or terms similar to the one being looked at. Decisions are made on time frames. Data may come from long ago, when Florence Nightingale, for example, defined "hygiene," or from more recent times, such as "what is a rapid response?" Articles are sorted into which articles actually contributed to the meaning of the term, and which articles were not useful in the analysis. It is common to start off with more than 100 abstracts and hone down to 25 articles. The literature is then closely scrutinized to develop a definition of the concept for nursing. Defining the concept begins with several components: 

  • attributes of the concept ("What is contained in it?"),
  • antecedents to the concept ("What has to occur for the concept to take place?"),
  • and consequences of the concept ("When the concept occurs, what happens?").

Cases are then developed; a perfect example of the concept in narrative form, borderline cases, and opposite cases. At the end, a discussion occurs as to how the concept can be theoretically applied to nursing and implications for clinical practice.


After some years of conducting concept analyses, Schwartz-Barcott and Kim (1993) took the analysis further calling the process hybrid analysis and included fieldwork. It was suggested that after the literature review, definitions, attributes, antecedents and consequences were studied, the researcher must go into the clinical area and test the concept.

  • "Did the concept appear in reality as it did in theory?" 
  • "Were the definitions correct?" 
  • "Do the people affected by this concept agree?" 
  • "What are their opinions of how the concept is used?" 
  • "How do nurses apply the concept?" 
  • "Will it work in clinical practice?"

Various methods of testing the concept can be done such as focus groups, surveys, and interviews. The researcher attempts to gather real time information from those who use or will use the concept. Clinical reality may influence, change and/or verify that the concept is correctly defined and useable. 


An example of concept analysis in holistic nursing is Makaroff (2012) who provided an interesting analysis on the "unsayable." Going back to 1959, she reviewed 1557 articles and texts that might contribute to when there were topics in patient care which simply could not be talked about, were taboo, or were not consciously expressed through language.


In another example, Catlin and colleagues (2008) were concerned about patients at the end of life receiving technological life extending therapies which seemed to be causing suffering. The concern was that the nursing care being delivered was not of benefit to the dying patient and was perhaps causing harm. Conscientious objection to care orders that cause suffering at the end of life was considered. A concept analysis of the literature was conducted with much of it from the military rather than from nursing. After defining the concept, attributes, antecedents, and consequences of conscientious objection, these researchers surveyed 66 nurses concerning their feelings about conscientious objection to futile care in neonatal and pediatric patients. Recommendations for practice came from both the theoretical work and clinical reports of the surveyed nurses.


Concept analyses provide clarity when a nurse wishes to implement a new program or begin an intervention study. Holistic nurses will find that using concept analysis will benefit patients through increased knowledge of the evidence backing the care provided.



Bonis, S. A. (2013). Concept analysis method to enhance interdisciplinary conceptual understanding. Advances In Nursing Science, 36(2), 80-93.


Catlin, A., Armigo, C., Volat, D., Valle, E., Hadley, M., Gong, W., Bassir, R., & Anderson, K. (2008). Conscientious objection: A potential neonatal nursing response to care orders that cause suffering at the end of life? Study of a concept. Neonatal Network, 27(2), 101.


Cronin, P., Ryan, F., & Coughlan, M. (2010). Concept analysis in healthcare research. International Journal of Therapy & Rehabilitation, 17(2), 62-68.


Makaroff, K.L.S. (2013). The unsayable: A concept analysis. Journal of Advanced Nursing, 69(2), 481-492.


Rodgers, B.L. & Knafl, K.A. (1993). Concept development in nursing. Philadelphia, PA: W.B. Saunders.


Schwartz-Barcott, D. & Kim, H. (Chapter 8, 1993) in Rodgers, B.L. & Knafl, K.A. (1993). Concept development in nursing. Philadelphia, PA: W.B. Saunders.


Walker, L.O. & Avant, K.C. (2000). Strategies for theory construction in nursing. Upper Saddle River, NJ: Pearson, Prentice-Hall.


Wilson, J. (1963). Thinking with concepts. London: Cambridge University Press.


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




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   
Michalene A. King PhD, RN, CNE 

Pamela Crary PhD, RN

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.