In this issue: PCORI Funding Opportunities, Research Profile: Rorry Zahourek, AHNA 2012 Conference Research Activities, Community Cancer Connection and much more.

Connections in Holistic Nursing Research
June 2012
Volume 4 Issue 2

In This Issue
PCORI Funding Announcements
Research Profile:
Rorry Zahourek
Community Cancer Connections
Request to Participate in a Study
Research at AHNA's 2012 Conference
Research in the News
AHNA Researchers in Action
Research Glossary: Dissemination
Quick Links

Co-Editor's Welcome

by Jackie Levin, RN, MS, Connections Co-Editor


Soon many of us will be meeting at the AHNA annual conference in Snowbird, Utah. This year I am fortunate to be able to attend and I am looking forward to connecting face to face with colleagues who also care deeply about holistic nursing. As the time draws near, I realize that this face-to-face time with other holistic nurses is both nurturing and professionally exciting. In a world that is more and more wirelessly interconnected, this time with one another takes on certain preciousness. Still, I, too, greatly appreciate the instant access to research, health information news, stimulating online educational programs and patient educational materials available on the internet; much of it free or at low cost. In this issue we are able to bring you both. Rorry Zahourek, PhD, PMHCNS-BC, AHN-BC, our cameo researcher, shares her work on Intentionality and insights from her career in holistic nursing research. We also have a piece by Cathy Michaels, PhD, RN, FAAN, FNAP describing how one organization is using a web-based program to share holistic research and resources with cancer patients. In addition, we hope you'll look at the many research offerings we have at Conference this year.

And if you are traveling to Conference, the team from AHNA Research Electronic Newsletter looks forward to connecting with you. If not, we look forward to seeing you in Cyberspace.

PCORI Funding Announcements

The Patient Centered Outcomes Research Institute (PCORI) has released its first primary research funding announcements to support comparative clinical effectiveness research that will give patients and those who care for them the ability to make better-informed health care decisions.


PCORI will award $120 million this year for innovative projects that effectively incorporate patients and stakeholders in research teams and address the areas of focus of PCORI's National Priorities for Research and Research Agenda. The four PCORI Funding Announcements (PFAs) involve up to $96 million in funding and correspond to the first four areas of focus in PCORI's National Priorities for Research and Research Agenda. For more information, visit

Research Profile: Rothlyn (Rorry) Zahourek, PhD, PMHCNS-BC, AHN-BC

Interview by Jackie Levin, RN, MS, AHN-C, CHTP, Connections Co-Editor
AHNA Network Activity

Rothlyn (Rorry) Zahourek, PhD, PMHCNS-BC, AHN-BC is an Adjunct Faculty University of Mass. Amherst, MA and the outgoing Chair of the AHNA Research Committee. Dr. Zahourek joins us in describing her start as a research nurse and her current work on Intentionality.

Dr. Zahourek, how did you begin in your career as a research nurse?

My first job right out of my master's program in Colorado was as the 'research nurse' in a comprehensive community mental health center. I participated in several projects and was actually quite pleased with how my rudimentary research knowledge from graduate school helped me in the position. One study was particularly relevant to my developing career as a clinician and researcher. The study was investigating depression in women following stillborn loss. I conducted the interviews and administered depression scales as soon after the delivery as possible, at six weeks postpartum and then at a year. The most remarkable result was that women were heavily medicated when a stillborn delivery was imminent. These women later had a sense that they never had a baby and wanted more than anything to have been able to see and hold the baby. They felt that not seeing the baby impeded their grief process. As a result, we changed practice in that hospital and began educating clinicians in the community to do the same. As we were publishing our results another larger study was published with similar results. Practice across the country has changed over the years. I have continued to be impressed with how both quantitative and qualitative data are useful when considering implications for practice.

Tell us a little bit about you research in intentionality.

I started this research with my dissertation at NYU. I was interested in what seemed to make a therapeutic relationship actually work or put into holistic nursing terms what seemed to promote and influence healing. I came across this term intentionality that many stated was essential for healing. But I wondered, "What actually is it?" I started researching it in the literature and ended up in complex philosophical works l could barely understand not having a background in philosophy. In the healing literature it was poorly defined and more or less related to purpose and setting a goal or an intention. I first did a concept analysis and a review of literature and then decided to do a qualitative grounded theory study with nurse healers and their clients. I learned a lot and enjoyed working with the participants. I then struggled with the data until I came up with the theory: "Intentionality the Matrix of Healing." Since then I have expanded the study since my original participants were all white, relatively middle class women. I am now interviewing a variety of caregivers from multiple disciplines, from different parts of the country and representing more ethnic diversity. Another nurse, Lauri Deary, did a research project using the theory and has expanded the original theory. At this point the original research and a secondary analysis have been published and the work leading up to the theory has as well.

The Theory posits that intentionality is different from and greater than intention. It is rather the capacity for intention. As humans we all have intentionality and are capable of forming various intentions or goals. Intentionality is more related to our overall purpose, our search for meaning and a meaningful presence in the world; intention is creating a more specific goal. Intentionality is characterized by a spiraling, non-linear and recursive evolutionary process. In the original grounded theory study three forms were identified in the context of a healing relationship between a nurse healer and her healee patient. These forms include: 1) Basic generic: the innate capacities for intentional being and behavior, 2) Healing intentionality: a practicing learning form; and 3) Transforming intentionality in which the individual feels a sense of shift and clarity. In the context of healing, the transforming intentionality form in which the individual has a new or modified sense of self and wholeness resembles the context-healing.

Why do you think it is important for Holistic Nurses to define and refine the concepts we use in practice and research?

I think our concept and theory development is essential, particularly in holistic nursing. When we talk, our ideas and concepts seem vague to our more conventional and traditional nursing and health care colleagues. Such terms as energy, healing, presence, intention, self care are all ambiguous to many and that creates a problem of working collaboratively with others as well as doing and communicating the results of holistic nursing research.

Here I think we are not that different from our colleagues in psych-mental health where the therapeutic relationship is so valued. Since I'm a psychiatric nurse clinical specialist am very familiar with concepts that are somewhat ambiguous. Therapeutic presence and relationship are two such concepts that we share with psych-mental health in holistic nursing. In addition, the concept of 'cure' related to mental illness most often needs to be modified to understanding outcome of treatment as recovery, healing and reduced symptoms. In holistic nursing we too often are working with people who have illnesses or health challenges that are not readily resolved or 'cured' by standard medical means...Read More.

LinkIN! Community Cancer Connections:

Expanding Options for Cancer Survivorship through Holistic Nursing Practice

By Cathy Michaels, PhD, RN, FAAN, FNAP


LinkIN! Community Cancer Connections, a University of Arizona College of Nursing nurse-managed program, has a mission to facilitate long-term wellbeing for cancer survivorship. The LinkIN! website provides access to survivorship information, resources and services, as well as to conventional and integrative health providers. Although the website is designed primarily for people who have experienced cancer, their family members, and those wanting to prevent cancer, healthcare providers can also benefit from the information. The LinkIN! long-term vision is to be the premiere resource for informed decision making in comprehensive cancer care.


The most frequently accessed resources on the website are the robust cancer survivorship information for use by the public and healthcare providers (Directory of Program Resources and Services), the vetted community-based integrative therapists (Directory of Integrative Therapy Providers), and calendars of cancer-related one-time and ongoing events across Southern Arizona and Phoenix. We augment this basic information with guides that can be used to decide which integrative therapy would be most useful, given the evidence and individual values and preferences. We've started with decision guides for Meditation and Bowenwork and plan to add about a dozen more this summer.


LinkIN! supports self-determination and individual choice by providing directories and the decision guides from which people can build their knowledge and select the best options. Using these decision guides, cancer survivors, family members, or conventional providers can review the scientific evidence, as well as a description of the integrative therapy to determine if this therapy would be useful as a complement to cancer treatment or to post-cancer treatment. Self-determination, individual choice and self-awareness are key to well-being over time, beyond the diagnosis of cancer and active treatment.


LinkIN! is guided by a Community Advisory Council that includes cancer survivors and family members and a Professional Advisory Council composed of conventional healthcare oncology nurses and oncologists, end-of-life providers, and integrative therapists, including body-mind counselors, music therapists, energy workers, naturopathic and integrative medicine physicians. In brokering information gathered we endeavor to move beyond a network to create a supportive community for cancer survivorship.


Our intent is to extend community support to a fully comprehensive approach to cancer care that represents an integrative approach. We also intend to extend community support beyond the cancer diagnosis and active treatment to well-being over time with novel and current approaches to long-term health planning. On occasion, where there are gaps in service, we will create a new service, but we do not intend to duplicate services already offered in the community. For example, when we saw a gap in service for gentle group exercise for cancer survivors, we supported the development of a faculty practice called Survivor+cize.


LinkIN! enables us to practice holistically at a community level using the Internet. Although there are other nurses who use the Internet to reach select patient populations and even facilitate virtual discussions between those impacted by a particular illness, we are not aware of any other website for cancer survivorship like this one. Our practice is not only innovative but integrative, as it focuses on the whole person's experience of cancer over time, not just during diagnostic workup or active cancer treatment, but living with cancer as a chronic disease with potential late-term effects from cancer treatment. Comprehensive cancer care, in our view, is integrative cancer care. We believe that integrative therapies can contribute to a sense of well-being throughout cancer survivorship. Therefore, we provide information about the integrative therapies that includes both evidence and a description--people can match their values and preferences with the integrative therapy, as well as evaluate the evidence for effectiveness for particular needs. This is an advocacy process that contributes to well-being, as well as raises health literacy so that people can better be self-advocates or when feeling the need for additional support, can reach out for a nurse as advocate.

Request to Participate in a Study: Therapeutic Touch and Post Traumatic Stress Disorder (PTSD)

Claudia Kreipl and Rebecca Good have been awarded a grant from Therapeutic Touch International to investigate how many Therapeutic Touch practitioners have used Therapeutic Touch with individuals with PTSD, and to determine if Therapeutic Touch and PTSD are worth further research. The proposal has IRB approval from Southern Utah University where Claudia is a Professor of Nursing and is administered through Survey Monkey. This request was approved by members of the research committee and participation is completely voluntary.


The results of the survey may be used for:

  1. Publication;
  2. As a needs assessment document to conduct future research on Therapeutic Touch and PTSD

The study needs as many TT practitioners to respond as possible. Please follow the link to the survey: Additionally, please forward this to appropriate programs or organizations.


Direct questions to Rebecca Good MA, RNC, LPC, QTTT or Claudia Kriepl MSN, RN

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

AHNA's 32nd Annual ConferenceThe AHNA 2012 conference will have many stimulating opportunities for holistic nursing research exposure. During pre-conference on Wednesday, June 13th, members of the research committee will offer a full day workshop on "Holistic Nurses Create Change through Translational Research." The workshop will discuss 'translational research' in the morning with examples given of specific holistic research and its application in practice. In the afternoon of the same day "research team building" will be the topic. Participants will work together in groups and look at how they might form a research 'team' around an idea or question. At lunch Rorry Zahourek, outgoing research coordinator, will provide a discussion on the development and challenges of holistic nursing research and research in AHNA.


Six research papers and 11 research posters will also be presented at conference.


Research Papers:

  • Helping family caregivers access their inherent power to foster strong support systems in caring for persons with Parkinson's disease. - Maryann Abendroth, PhD, RN
  • Research Needs Assessment of Members of the American Holistic Nurses Association -Colleen Delaney PhD, RN, AHN-BC, Debra Lee James BSN, RN, BA, HNB-BC, Ruth McCaffrey ND, ARNP, Sue Robertson, RN, PhD, & Rorry Zahourek, PhD, PMHCNS-BC, AHN-BC
  • Nurses' Attitudes and Barriers to Providing Spiritual Care - Barry Gallison MS, MSN, APRN-BC, NEA-BC
  • Promoting wellness behaviors as informed by self-determination theory and mindfulness principles - Diane R. Lauver, PhD RN FNP
  • The Effects of Daily Usui Ryoho Reiki Self-Treatment on the Perceived Stress of the Staff Nurse - Jeanette Lee Plodek, PhD
  • Testing feasibility of a brief mindfulness program among rural, low socioeconomic workers. - Rebecca West, PhD, RN, FNP-BC, Diane R. Lauver, PhD, APRN, FNP-BC, FAAN, Amit Sood, MD, MSc

Research Posters:

  • Effect of Healing Touch on Post Surgical Adult Outpatients- Joan Anderson RN, HTPA, Mary Kay Foley PT, GCFP, CHTP, Laurie Mallea RN, HTPA, Karen Morrison, RN, Marty Downey, PhD, RN, AHN-BC
  • Impact on Perceptions and Level of Stress of Students Learning Healing Touch Program Level 1 Curriculum - Denise Anthes RN, BSN, MBA, HNB-BC, HTCP/I
  • Quality of Life and life satisfaction of cancer survivors after completing a community-based Integrative Therapy Program: Partners in Wellness- Bonnie Berk MS, RN, HNB-BC, ERYT, Gigi Jantos RMT, Camille Baughman LMT, Meredith Frohman BA, Kaixan Liu BA, David Sarcone, PhD, J.A. Skelton, PhD
  • A Stress Management and Resiliency Training (SMART) Program for Newly Hired Nurses- Sherry S. Chesak MS, RN, Susanne Cutshall RN, CNS, Amit Sood MD, MSc, Denise A. Foy MSN, RN-BC, Darrell R. Schroeder MS
  • How can teachers foster nursing students' competence and emotional wellbeing? -Pamela Crary PhD, Yacob Tedla MS, RN, & Diane Lauver, PhD, RN, FNP-BC, FAAN
  • Intentionality and Hatha Yoga: An Exploration of the Theory of Intentionality, the Matrix of Healing, Using Narrative Analysis to Test Theory- Lauri Deary BSN, RN, RYT, CBS, Rothlyn (Rorry) Zahourek PhD, PMHCNS-BC, AHN-BC, Joan Roche PhD, RN, Karen Plotkin, PhD, RN
  • Empowering Nursing Students to Practice Holistically - Dorothy J. Dunn PhD, APN, FNP-BC, AHN-BC
  • Healing Pathways - An Integrative Resiliency Training Program for Health Care Professionals- Michael Earley, DMEd, Michael D. Earley, MEd, Bonnie Tarantino, MFA, Donna Audia, RN
  • Holistic Nurse Educators Transcend- NaRisa Yvette Holt-Waldo PhD, RN, HTSM-CP
  • Reiki in Combination with Hypnotherapy to Prepare for Gastric Bypass Surgery- Karen Pischke BSN, RN, RMT, NSMC, Sandra Skinner RN, MA, Frederick O. Buckle, Jr. MD, Cheryl Williams, BSN, CRT, TTS
  • Impact of Music Therapy on Patients and Family Members in Outpatient Chemotherapy - Mary Allison Beckham RN, BSN, OCN; Kelly Phair; Judith Seipp RN, BSN, OCN, NE-BC; Susan E. Appling PhD, CRNP

The research committee meeting will be Friday evening 6:00-7:00 PM. All are welcome. We look forward to seeing you in Snowbird, Utah.

Research in the News

Sitting versus Standing Does Make a Difference

Kelli Swaden, RN, conducted a pilot study looking at the effect of standing compared with sitting at patient's bedside with actual versus patient perceived duration of the clinician's visit. The study of 120 consultations concluded that patients perceived clinicians spent 5-15 minutes longer than the actual time when the clinician sat down. The nurse researcher chose a physician for the study who had a reputation of always being in a hurry. "It has made a profound difference, " she said. "Patient satisfaction scores were not high. Patients were frustrated with his bedside manner. His scores are excellent now." (Nursing News, March 8, 2012)


Amoxicillin versus Placebo for Sinusitis

The February 15, 2012 issue of JAMA reported that Amoxicillin (the number one antibiotic prescribed for sinusitis) is no better than placebo in sinusitis. Dr. Jane Garbutt at the Washington University School of Medicine randomized 166 adults to either 1,500 mg/d Amoxicillin or placebo. The outcomes showed after 7 days the Amoxicillin group had an insignificant improvement and at 10 days both groups no longer had symptoms. Controversy continues to spark discussions if this should reduce the use of other antibiotics for sinusitis. (Journal of the American Medical Association, February 15, 2012)


Homeopathy Possible Alternative to Antibiotics in the Treatment of Sinusitis

Homeopathy may be beneficial in the treatment of Chronic Sinusitis (CS). In the April 2012 Journal of Homeopathy the authors of a multi-site study (patient as control) in India report that there was a statistically significant reduction in CS (P= 0.0001) after a 3 month and 6 month follow-up. This was not a RCT and therefore we don't know if the Homeopathic Remedies are better than placebo. (Homeopathy, April 2012)


Aromatherapy for Dysmenorrhea

Massage using a blend of 3 essential oils (Lavandula officinalis, clary sage (Salvia sclarea) and marjoram (Origanum majorana) may be useful in the treatment of dysmenorrheal reports the Journal of Obstetric Gynaecological Research. In this Randomized Double-Blind Clinical Trial, all participants were asked to use a cream while massaging their lower abdomen from the end of their last menstrual cycle to the beginning of their next menstrual cycle. Twenty-four participants were assigned to the treatment group with the essential oil blend. The study concludes that abdominal massage in both groups significantly reduced the pain of dysmenorrhea, but the duration of the dysmenorrhea was significantly reduced in the intervention group. (Journal of Obstetrics and Gynaecology Research, May 2012)


Tai Chi for Alzheimer's Patients and their Caregivers

A Tai Chi protocol was used to study the effects on fall risk reduction and functional mobility in persons with Alzheimer's Disease (AD). Study participants were 22 dyads (persons with AD and their caregivers. The participants were trained in a 16-week Tai Chi protocol using pre/posttest design. The study measured the Unipedal Stance Time (UST) and Timed Up and Go (TUG) tests. Results showed that 86.4% completed the study and improvement was significant for both measures. (P=0.05). (Western Journal of Nursing Research, April 19, 2012)

AHNA Researchers in Action

Congratulations to Dr. Rew, Dr. Barrere and Dr. Eschiti for their achievements.


Lynn Rew, EdD, RN, AHN-BC, FAAN, Denton & Louise Cooley and Family Centennial Professor in Nursing at the University of Texas at Austin, received a notice of award from the National Institutes of Nursing Research for an R21 feasibility study titled, "Enhancing Psychological Capital in Homeless Young Women".


Cynthia Barrere, PhD, RN, AHN-BC, Professor of Nursing, was awarded the Faculty Scholarship Award sponsored by Quinnipiac University. This annual award is given to faculty who have demonstrated a consistent agenda of research and publication that has added to the body of knowledge in the discipline (in this case, Nursing). Dr. Barrere's primary areas of investigation include: spirituality-based interventions for adults and older adults with cardiovascular disease, evidence-based interventions to enhance care of older adults with depression, nurse-patient communication, end-of-life care, holistic nurse education, and the use of clinical simulation technology for teaching.


Valerie Eschiti, PhD, RN, AHN-BC, CHTP, CTN-A from the University of Oklahoma Health Sciences Center College of Nursing was accepted for participation in the Early Career Reviewer (ECR) program at the Center for Scientific Review (CSR), National Institute of Health.


Burhansstipanov, L., Krebs, L. U., Seals, B. F., Watanabe-Galloway, S., Petereit, D. G., Pingatore, N. L., & Valerie Eschiti. (2012). Preliminary lessons learned from the "Native Navigators and the Cancer Continuum" (NNACC). Journal of Cancer Education, 27(1), S57-65.

Carol Green, Bennett Green (May/June 2012). Efficacy of Guided Imagery to Reduce Stress via the Internet: A Pilot Study. Holistic Nursing Practice.26(3):150-163, May/June 2012.

doi: 10.1097/HNP.0b013e31824ef55a


Christina Jackson, (May/June 2012). Ballistic, Holistic Nurses: Developing Ourselves as Healers. Holistic Nursing Practice. 26(3):117-119, May/June 2012.

doi: 10.1097/HNP.0b013e318252e6e0


Gloria F. Donnelly, (May/June 2012). Health Care and the Renaissance of Holism. Holistic Nursing Practice. 26(3):115, May/June 2012. doi:10.1097/HNP.0b013e31824fe309


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
Research Glossary: Dissemination

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


Reading Journal of Holistic NursingDissemination is the final step in the research process. In an evidenced based practice project this would be the implementation step. It is critical that the information be shared. It is the responsibility of the team to disseminate the results especially when individuals (both human and/or non-human) have given of their time and energy to participate in the project. It is a moral responsibility.


Many granting agencies request specifics on the audiences and mechanisms that will be utilized to meet this goal. Usually the proposal (grant, dissertation, project, etc) identifies the areas were this information will be clinically significant, for example, by suggesting the journals that would be interested in the findings. No matter the size of the study, a review of the findings can be made in some public venue at the local, regional, national or international level. Posters may be a first step as criteria for acceptance are usually less stringent. Posters provide an opportunity to synthesize the study from the conceptual framework, question to be answered, methods used, the sample characteristics, findings, through the discussion. Poster sessions give individuals an opportunity to ask questions and share their ideas on a one-on-one format. Podium presentations still require the same information but there is a specific timeframe in which the content is to be delivered. A larger audience may be reached in this context and often the abstract and/or presentation is published in the meetings proceedings. Both of these steps provide the opportunity to organize the material in a meaningful way and helps in the preparation of a manuscript. Manuscript preparation should involve the team with each person contributing in some way to the final product. It is good, however, to designate the primary author up front so this person can be responsible for keeping the writing on task. It is also helpful to have a journal in mind when writing as it can help target specific requirements that might be request (i.e. nursing journals often want a conceptual framework which might not be asked for in other professional journals). If asked to do major edits to the manuscript by the editor it is usually wise to attend to this request by addressing each question specifically. Identify what has been changed or why not in the response to the editor recognizing that the person who made the suggestion may very well review this response. The wider audience you wish to reach with your findings can be influenced by the journals availability through a national search engine like PubMed. Additionally, journals are given an "impact score" which is assigned by such things as the numbers of readers/subscriptions and commonality of citations.


Dissemination can be made more difficult when the findings are not significant or do not provide a clear explanation of the results. However, it is still critical that this information be shared. Posters and presentations are still available. Publication is also important to identify both the strengths and weaknesses of approaches (i.e. timing of and modifications to the intervention, sample population and size). More attention can be placed in the discussion section to explain the possible reasons for the results.


This final step in the research process is an invaluable contribution and one that requires fortitude and integrity. Holistic nurses often have complex studies to present as they are interested in the body-mind-spirit and how it is sustained for healing of the self and others. The greater the body of research literature we have the more support there is available for others to provide holistic care.


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


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
Jen Reich, PhD, RN, ANP-BC
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.