Connections in Holistic Nursing Research
September 2012 
Volume 4 Issue 4

In This Issue
Research and Practice: A Culture of Holism
 
Announcements
 
Research Profile: 
Joan Engebretson

 
Research Award Winner
 
Advocacy Corner
 
Research in the News
 
AHNA Researchers in Action
 
Research Glossary: Phenomenology
Quick Links
 

Research and Practice: A Culture of Holism

Jackie Levin, RN, MS, AHN-BC, CHTP and Jen Reich, PhD, RN, ANP-BC, Connections Co-Editors

 

As holistic nurses, we are attuned to connection of mind, body and spirit when helping a patient or client on her/his healing journey. Since we appreciate the deeper meanings embedded within the healing experience in both our personal and professional lives, we may question why it is necessary to conduct research in holistic nursing. The answer can be found in our own culture of holism. We cannot separate research and practice as research validates the science of holism and incorporates holistic nursing theories. Holistic nursing practice provides the ground for research questions and studies. We need holistic nurses to consider conducting research at their institutions and to share the projects that are completed or in progress to create, model and define what is holistic nursing research. Published research adds to our body of knowledge and will become a new standard from which all areas of research can study health and illness from a holistic paradigm.

 

In recent years, we have seen the expansion of the AHNA Research Committee, the addition of the Research Electronic Newsletter, and an increase in research sessions at the annual conference as ways to support and encourage holistic evidenced based practice. Consider ways in which research has influenced your practice and how your practice caused you to search out patterns and themes. This is applied research in your own personal sphere. It is the hope of the AHNA Research Committee to expand our individual constellations into a unified universe of theory, research and practice. We look forward to increasing our visibility with your research!

Announcements

AHNA's 33rd Annual ConferenceSubmit proposals for our 2013 Annual Conference
 
Proposals are being accepted for pre-conference workshops, general workshops, focused dialogues, research papers, research posters and non-research posters. Eligible proposals must reflect the theme, purpose, and objectives of the conference and topics may apply to practice, education, research, aesthetics and personal & professional development.  All submissions must be relevant to nurses. Workshop proposals will be accepted until Wednesday, October 10, 2012. Research Papers, Non-Research Posters and Research Poster abstracts will be accepted until Saturday, December 1, 2012.


Click for Submission guidelines and instructions

Or go to www.ahna.org/proposals

 

AHNA Research Grant Opportunity

The AHNA is offering a competitive research grant for $500 to $1,500. Completed research proposals are due no later than Friday, February 15, 2013. Please refer to the AHNA website at www.ahna.org/ResearchGrant 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, jplodek@me.com, or Cindy Barrere, cynthia.barrere@quinnipiac.edu.

 

The Eastern Nursing Research Society (ENRS) is now accepting abstract submissions for the 2012 Scientific Sessions. Submissions are due September 19, 2012. This year's theme is Nursing Research: A Bridge to the Future of Healthcare; Celebrating 25 Years of Eastern Nursing Research Society. The conference will be held April 17-19, 2013, at the Renaissance Boston Waterfront Hotel in Boston, MA. ENRS welcomes the submission of abstracts for original contribution to the field of nursing research. 


Submit abstracts
Guidelines on how to submit your abstract

*Abstract Submissions for BS, MS, Early Doctoral & DNP Posters will be accepted starting September 24 through December 1, 2012.

Research Profile:  Joan Engebretson, DrPH, AHN-BC, RN

Interview by Jackie Levin, RN, MS, AHN-BC, CHTP, Connections Co-Editor


Joan EngebretsonI had the wonderful opportunity to speak with Joan Engebretson, DrPH, AHN-BC, RN, in early August. Dr. Engebretson is the Judy Fred Professor in Nursing from the University of Texas Health Science Center-Houston and brings a rich history of holistic nursing research experience to AHNA, her students, and to nurses everywhere. Her research methodology is cutting edge and enhances our understanding of cultural influence in one's choices of health practices and is applicable to every health care provider across all settings.

 

Dr. Engebretson, what is your current area of research?

My current area of research is focused medical ethnography, which examines constructions of health and healing.  Many people think that ethnography is only studying the "other" or people in foreign cultures or minorities in our own.  It is important to understand our own culture as well as the culture of biomedicine.  My most current studies are in understanding how people with chronic conditions navigate everyday life in contemporary culture, which entails how they construct their disease and how they understand health. I also consult and work with others on the patient experiences with chronic conditions.

 

What are some of the signature aspects of Ethnographic research?

Long interviews, loosely structured questions. For example, "Tell us what it's like to be living with your condition?" Or, "What do you do to get well or to stay healthy?" I particularly like to know where they get their information for health from and how do they determine what information they can trust. I think this is really important to understanding the choices people make or don't make regarding health and healing. The researcher does fieldwork; goes to where the informants are. The goal of the fieldwork is to spend a lot of time with the informants in order to explore their personal experiences of chronic illness, medical procedures, and the health care system. How people think about health and healing is pretty much culturally derived. This helps us go beyond cultural stereotyping because there is such diversity within cultural groups. We must start with the holistic perspective that everyone is an individual. Additionally, how a person constructs health and healing embraces traditional cultural practices and beliefs and frames their expectation and perceptions of biomedicine as well as their utilization of other traditional therapies.  When I was doing research with Vietnamese patients with sepsis, one informant who had just contacted an asian herbalist said after a long open-ended interview, " I go to biomedicine to kill the virus, but all that time, not one person has done something to nurture my organs." 

 

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

My clinical background was in public health in which I had several years of home visiting with a variety of cultural and socioeconomic groups with a focus on maternal child health. This provided a foundation in respect for the myriad ways people approached health and attendant health behaviors. My first research study was the development of a pacifier for low-birth weight infants.  The model was the infant thumb, which the fetus sucks in utero.  I collaborated with Dr. Wardell and consulted with Dr. Gene Anderson in non-nutritive sucking in the development and testing of the prototype.  I became aware of the importance I placed on natural behaviors in health and healing. For my doctorate in public health I was very interested in the practices and behaviors that people used to promote health and healing. I got involved with a group of lay healers using Reiki and forms of touch. My committee members were a medical anthropologist and a sociologist who encouraged me to study ethnography. This study yielded a number of publications and presentations and a heterodox or multiparadigm model of healing (that incidentally included biomedicine and CAM in one model).  I did some experimental studies of Reiki after that, along with other studies on oral stimulation.  I returned to ethnography and conducted studies on menopause and women's experience with HRT.  I also collaborated on several other qualitative studies related to chronic conditions.  In the PhD program I teach the qualitative aspects of research.  I have collaborated with a number of students and other faculty on a variety of patient studies.  In most of these studies, we have used a medical ethnographic approach which allows for an exploration of how people cognitively construct and navigate daily life with chronic conditions.  More recently, I have served as a consultant and/or collaborator with other professionals on cultural competence and in medical ethnographic studies of different patient populations.  This research approach has broadened to mixed methods which have been used in several of the more recent studies.  I am also very interested in applying an action approach to research.

 

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

The biggest challenge is to try to apply linear, reductionist methods to holistic issues...Read More.

 

Research Award Winner: Wendy Rolf

We were excited to learn what it meant to Wendy Grace Rolf, MSN, CHTP, AHN-BC  to receive this years AHNA Research Award for her study entitled Investigating the Effect of Healing Touch on Post-Operative Recovery of Pediatric Tonsillectomies and Adenoidectomies Patients Ages 3 & 4. Wendy is a nurse at Cincinnati Children's Hospital Medical Center. The research team included Devin Adler, MS, RN, Clinical Manager PACU, Lois Bogenschutz, BS, RN, CCRP, Li Lin, MS, Monica Meier, RN, CHTP, Diane Wardell, PhD, RN, CHTP/I (Consultant), and Michelle H Zimmer, MD. Please join us in congratulating Wendy on her achievement.

 

Research E-news (RE-News): Were you surprised?

Wendy Rolf: I feel honored and humbled to have been awarded this grant.  The AHNA membership includes the cream of the crop of nurses.  My goodness, look at their credentials, degrees, accomplishments... and more importantly their work, commitment and vision.  Don't you see them as the leaders in steering our profession where it needs to go?  So that I.... oh my gosh...was awarded this grant... well I am awed.

 

The first is that I am a novice researcher. As a holistic health specialist my work is 70% direct patient care and education and research need to be squeezed in. The AHNA gave me education & support in how to write a grant (It's right on the website by grants). Now isn't that very helpful and kind?

 

I believe my topic, Healing Touch with Children, and holistic nursing are implicitly connected.  To me Healing Touch is all about a centered, loving & compassionate connection with another WHOLE person-in this case a child, which includes their intertwining aspects: the physical, emotional, mental, spiritual, developmental, cultural aspects of the child & it includes their family. We treat the whole. In Healing Touch we center and connect with the client and our intention is for their highest healing, i.e. their wholeness, their holiness. It is all about relationship isn't it. Now isn't that the definition of what a Holistic Health Nurse does?  

 

Applying for this grant powerfully brought this home to me.  Every time I come to a patient/family to do Healing Touch, I come as a Holistic Health Nurse. 

 

RE-News: What did it mean to you?

Wendy Rolf: I feel that the $5000 came from many, many, many holistic nurses, each contributing because they feel this work is important.  I feel empowered & supported and I feel a deep responsibility to the AHNA (and to all those who contributed) to have this study be rigorous and completed in a timely manner and to share the outcomes.

 

RE-News: How did your institution receive the news?

Wendy Rolf:  My institution, like most large medical centers at this time, is particularly budget conscious. This grant concretely gave me needed resource to conduct this research.  Research and evidence based practice are highly valued in this institution.  This research, and evidence to support outcomes of Healing Touch and our Integrative Care Department are strongly needed. I think being awarded this grant elevated the value of this research to a higher level AND I think it may have contributed to our department's work being more valued at a very critical time.   

 

RE-News: At the end, Wendy wrote if she had only one line, "Please tell them thank you. I am deeply honored, humbled and empowered."

Advocacy Corner

Draft House Bill May Cut Funding for Evidence-Based Research

The House Appropriations subcommittee on labor, Department of Health and Human Services (HHS), and education approved a draft bill which would wipe out the HHS's Agency for Healthcare Research and Quality (AHRQ), which funds studies of the value of medical treatments. The bill also bars National Institutes of Health (NIH) from funding research where socio-economic status, wealth or income are variables.  In addition, the bill targets discretionary funding for patient outcomes research, cutting almost half of the projected 2013 budget for the new Patient-Centered Outcomes Research Institute (PCORI) created by the Affordable Care Act. The August issue of Beginnings features  an article about PCORI and the potential opportunities it offers holistic nurses.

Research in the News

Tai chi may have anti-depressive benefits for the elderly. The article "Tai Chi and reduction of depressive symptoms for older adults: A meta-analysis of randomized trials" published in Geriatrics & Gerontological International (June 2012), identified 4 studies meeting high or moderate quality inclusion criteria evaluating the possible effect of Tai Chi on the elderly with depression. The meta-analysis found significant improvement in depressive symptoms in the elderly who participated in a Tai Chi program compared with the waitlist control groups.

 

Mental health nurses' perceptions of good work in an acute setting was the title of the article published in the International Journal of Mental Health Nursing. 2012 May 15 (web abstract published ahead of written publication). This study's aim was to make what are typically invisible aspects of mental health nursing work more visible and describable. This qualitative study asked acute inpatient mental health nurses in Sydney, Australia, to describe nursing achievements and good nursing work. Five broad themes were identified: i) teamwork; (ii) interpersonal interactions with patients; (iii) providing practical and holistic support to patients; (iv) patients' mental health improvements; and (v) optimism-pessimism continuum. The significance of this type of study was that nurses defined nursing care beyond the mechanical medical model. Future holistic nursing research could focus on any one of the broad themes identified above with aim of demonstrating impact on patient outcomes, nursing satisfaction and reduced healthcare costs.

 

Keep up your mindfulness practice and introduce it to your coworkers and patients! In the July issue of the Annals of Family Medicine a research study "Meditation or Exercise for Preventing Acute Respiratory Infection: A Randomized Controlled Trial" showed that Exercise and Meditation both significantly impacted cold and flu symptoms. One hundred forty nine participants were divided into 3 groups: waitlist control and an 8-week mindfulness course or an 8-week exercise program group matching in class and homework time and attention. The results of the study showed that those in the mindfulness group had 40-50% less incidence of acute respiratory infections (ARI) and the exercise group had 30-40% less incidence of ARI than the control group. In addition the mindfulness group had 27 ARI episodes (257 days of illness) and the exercise group had 26 ARI episodes (241 total days of illness) compared to the control group which had 40 ARI episodes (453 days of illness). Both the mindfulness and the exercise group missed less days of work compared with the control group as well. Of note is that the yearly flu vaccine usually only covers 3 types of flu, when our patients and we may come in contact with many more.

AHNA Researchers in Action

Roxane Chan, RN, PhD (c) from the University of Michigan is the PI for the study "Mindfulness meditation intervention in the COPD population".  She received an NRSA grant from the NIH for $70,000.00 and a $3,000.00 grant from the University of Michigan School of Nursing graduating class of 1959.  Her faculty adviser is Dr. Janet Larson, PhD, RN, FAAN. For more go to clinicaltrials.gov.  Data collection is completed.

 

Valerie Eschiti, PhD, RN, AHN-BC, CHTP, CTN-A from the University of Oklahoma Health Sciences Center College of Nursing has been invited to serve as a PCORI (Patient-Centered Outcomes Research Institute) as reviewer of research applications. The PCORI review process differs from other peer review processes as special importance is placed on how patients are engaged in the research itself. PCORI's interest is also focused on the impact the research will have on clinical practice and patient outcomes.

 

Diane Wind Wardell, Sheila Decker, & Joan Engebretson.  (2012) Healing Touch for older adults with persistent pain. Holistic Nursing Practice, 26(4), 194-202.


Sheila Decker, Diane Wind Wardell, & Stanley G. Cron. (2012). Using a Healing Touch intervention in older adults with persistent pain: A feasibility studyJournal of Holistic Nursing,30(3),  (June 19, 2012 online ahead of print).

 

Diane B. Monsivais & Joan Engebretson. (2012) "I'm just not that sick": Pain medication and identity in Mexican American women with chronic pain. Journal of Holistic Nursing. 30(3), (June 19, 2012 online ahead of print).

 

Jo Lynne W. Robins, R.K. Elswick, Nancy L. McCain. (2012). The story of the evolution of a unique Tai Chi form: Origins, philosophy and researchJournal of Holistic Nursing, 30(3),(June 19, 2012 online ahead of print). 

 

Carlin, N., Rozmus, C., Spike, J., Willcockson, I., Seifert, W., Chappell, C., Hsieh, P., Cole, T., Flaitz, C., Joan Engebretson, Lunstroth, R., Amos, C., & Boutwell, B. (2011) The Health Professional Ethics Rubric: Practical assessment in ethics education for health professional schools. Journal of Academic Ethics (August 2011 online ahead of print)

 

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@ahna.org

Research Glossary: Phenomenology

Definition by Jen Reich, PhD, RN, ANP-BC, Connections Co-Editor

 

Phenomenology is both a philosophical tradition and human science method (Dowling, 2007, Wojnar & Swanson, 2007, Van Manen, 2002). Phenomenology seeks a deep understanding of lived experiences in our human world (Starks & Brown Trinidad, 2007, Van Manen, 1990). Van Manen (1990) noted that a real understanding of phenomenology can only be done by doing phenomenology. He explained that in the process of doingphenomenological research, we become connected to it, thus we "become the world." (Van Manen 1990, p. 5). Heidegger terms this being in the world "dasein" (Koch, 1995).

 

A major concept in phenomenology is intentionality. Crotty (1998) explained that that intentionality in the phenomenological sense is means referentiality, relatedness, "aboutness", rather than purpose or deliberation (p.44). Intentionality posits a relationship between conscious mind and object of consciousness (Crotty, 1998). Existential phenomenologists would explain this as a "radical interdependence of subject and world." (Crotty, 1998, p.45). This unity of subject and object that intentionality posits requires a rejection of objectivism and subjectivism (Crotty, 1998).

 

Of the two major schools of phenomenology, Heideggerian and Husserlian, Heidegger's version of phenomenology is more existential, seeking the meaning and understanding of our being in the world (Koch, 2005). Husserl's method is descriptive, and stems from the Cartesian tradition, describing phenomena as brought through consciousness (Koch, 2005).

 

Since Husserl and Heidegger, there have been seven unique perspectives of phenomenology identified (Wojnar & Swanson, 2007). Max van Manen, a phenomenologist from the Utrecht (Dutch) tradition, has guided the research of many in the health profession and education fields (Dowling, 2007). Van Manen expressed that the ultimate goal of phenomenology "is to effect a more direct contact with the experience as lived" (Van Manen 1990, p.78). His work is considered a combination of descriptive and interpretive phenomenology (Dowling, 2007).

 

In both descriptive and interpretive traditions, phenomenology is intended to be an initial critique and not a be-all, end-all method (Crotty, 1998). Crotty explained that it is a valuable starting point in social inquiry, with research for the phenomenologist an attempt to "break free and see the world afresh." (Crotty, 1998, p. 86).

 

REFERENCES

Crotty, M. (1998). The Foundations of Social Research. London: Sage

 

Dowling, M. (2005).  From Husserl to van Manen: A review of different phenomenological approaches International Journal of Nursing Studies, 44, 131-142.

 

Koch, T. (1995).  Interpretive approaches in nursing research: The Influences of Husserl and Heidegger. Journal of Advanced Nursing, 21: 827-83

 

Starks, H & Brown-Trinidad, H (2007).  Choose your method: A comparison of phenomenology, discourse analysis and grounded theory. Qualitative Health Research, 17: 1372-1380

 

Van Manen, M. (2002).  Phenomenological Inquiry. Phenomenology Online. 

Retrieved: http://www.phenomenologyonline.com/inquiry/1.html

 

Van Manen, M. (2000).  Phenomenology Glossary. Phenomenology Online. 

Retrieved: http://www.phenomenologyonline.com/inquiry/1.html

 

Van Manen, M. (1990). Researching Lived Experience: Human Science for an Action

Sensitive Pedagogy. New York: SUNY Press.

 

Wojnar, D. M., & Swanson, K. M. (2007). Phenomenology: An exploration. Journal of

Holistic Nursing, 25(3), 172-180

 

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

 
 

The Voice of Holistic Nursing 

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


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Connections in Holistic Nursing Research 
Editor-in-Chief:
Diane Wind Wardell, PhD, RN, WHNP-BC, AHN-BC, CHTP/I  Co-Editors:

Jackie Levin, RN, MS, AHN-BC, 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.