Holistic Nursing Practice

Traditional Chinese Medicine and Headache Disorders-A Review of Categorization and Selected Therapeutic Approaches
Pradhan SK, Todeschini G, Gantenbein AR, Wang X, Schürer Q, Lyu X, Chen B, Li Y and Furian M
Headaches have emerged as a prevailing global health concern, impacting millions of individuals and posing challenges to public health care systems. With an escalating number of patients seeking complementary therapies to attain a more holistic approach for headaches, Traditional Chinese Medicine has gained significant popularity. It plays a pivotal role in advancing the safeguarding of health and the alleviation of prevalent, recurrent, and complex medical conditions. Traditional Chinese Medicine covers a diverse array of therapeutic procedures for headaches, incorporating Chinese herbal medicine, acupuncture, auricular acupuncture, and life cultivation. This narrative review delves into the fundamental principles of Traditional Chinese Medicine and its categorization of headaches while exploring the potential selected applications of their treatment. Based on recent scientific findings and the ancient history of Traditional Chinese Medicine in the field of headaches, we conclude that selected Traditional Chinese Medicine therapies can be used as an alternative and complementary therapy against headaches.
Improving Healthcare for Stroke Patients After Discharge: A Main Nursing Perspective
Aghakhani N, Mesgarzadeh M, Eghtedar S and Ewalds-Kvist BM
The Effect of Mindfulness-Based Stress Reduction on Pediatric Oncology Nurses' Stress Level, and Pediatric Oncology Patients' Psychosocial Symptoms and Care Satisfaction: A Prospective Non-Randomized Trial
Semerci R, Sarıbudak TP, Çalışkan BB, Altınel Dalmış N, Yıldız G and Kapancı M
Studies investigating the effects of relaxation practices on nurses and patient outcomes are limited. This study aimed to evaluate the impact of Mindfulness-Based Stress Reduction (MBSR) on pediatric oncology nurses' stress levels, as well as the psychosocial symptoms and care satisfaction of pediatric oncology patients. A non-randomized prospective study with a pretest-posttest design was conducted, involving 112 children and 8 pediatric oncology nurses between November 2021 and August 2022. The study was conducted in 3 stages. First, the children's nursing care satisfaction and psychosocial symptoms were evaluated during the first 3 months before the MBSR intervention. Second, the nurses participated in the MBSR program for 2 months. Third, the children's nursing care satisfaction and psychosocial symptoms were assessed again 3 months after the MBSR intervention. The results showed that children who received nursing care post-MBSR had lower scores in the Psychosocial, Hopelessness, and Communication Difficulty subscales compared to those who received care pre-MBSR. Additionally, these children had higher scores in Evaluation of Quality of Care from the Children's Point of View, Psychosocial, Physical, and Information subscales. There was a significant reduction in the stress levels of nurses between the pre-MBSR and post-MBSR assessments. MBSR is an effective method for reducing pediatric oncology nurses' perceived stress levels and should be utilized to support both pediatric oncology nurses and patients in enhancing their psychosocial functioning.
The Effect of Breathing and Relaxation Exercises on Self-Care, Dyspnea, and Fatigue in Heart Failure: A Randomized Controlled Study
Solmaz G, Mollaoğlu M and Asoğlu R
Dyspnea, fatigue, and self-care are common occurrences of heart failure. This study evaluated the effects of yoga breathing and progressive muscle relaxation exercises on dyspnea, fatigue, and self-care in heart failure. The study conducted between April 2023 and March 2024 randomized 66 heart failure patients into 3 groups (yoga breathing exercise, progressive muscle relaxation exercise, and control). The intervention groups engaged in specific exercises tailored to their assigned regimen for 10 minutes twice daily over a 2-week period, while the control group maintained their pharmacological treatment. At the end of the intervention (second week) yoga breathing exercise notably ameliorated fatigue, dyspnea, and self-care (P < .001), changes in saturation, heart rate, and respiratory rate favoring the intervention groups (P < .05). Yoga breathing exercises enhance self-care, alleviate fatigue, and dyspnea in heart failure. Additionally, yoga breathing and progressive muscle relaxation exercises provide benefits in regulating saturation, heart rate, and respiratory rate in heart failure.
Embarking on Adventures and Charting New Paths
Blunt EM
Effects of Yoga in the Care of Patients With Heart Failure: A Systematic Literature Review
Achury-Saldaña D, Andrade-Fonseca D, Gallego-Ardila AD, Angarita A, Ayala-Gutiérrez J, Sánchez MA and Thriat-Infante M
This review delves into the potential benefits of integrating yoga into the care of patients with heart failure. A systematic literature review was undertaken through electronic searches of indexed databases. Quality assessment utilized the Cochrane risk-of-bias tool, and data on population characteristics, interventions, and clinical, biochemical, and functional outcomes were meticulously extracted. Six randomized trials, encompassing 296 individuals with a left ventricular ejection fraction between 30 and 50%, and functionally classified per the New York Heart Association as I, II, or III, were included. Despite limited published experimental research, yoga demonstrates promising effectiveness in enhancing outcomes such as quality of life, functional capacity, and clinical markers. Notably, safety and adherence outcomes remain unexplored. Future studies should prioritize a representative sample size, methodological rigor, and adherence to established yoga intervention guidelines in randomized clinical trials, ensuring comprehensive evaluation across short-, medium-, and long-term perspectives.
Effects of Yoga on Stress in Pregnant Women
Pais M, Pai M, Kamath A, Lewis L and Nambiar J
During pregnancy, a woman's body undergoes physiological and metabolic changes to nourish the developing fetus. Every woman experiences pregnancy-related stress differently, with symptoms and difficulties ranging from mild to severe. However, various therapies are available to help reduce stress levels. The purpose of this study is to assess the impact of integrated yoga, which includes asanas and pranayama, on stress levels and physiological markers in pregnant women. The study is a prospective, randomized, controlled, single-blind trial with 2 parallel groups. The intervention group was provided with integrated yoga therapy, while the control group was given routine standard care from 18 to 22 weeks to 33-35 weeks of gestation. To measure the stress level, a standardized perceived stress scale was used, which has 10 items with stress scores ranging from 0 to 4, with a maximum score of 40. The average stress score was significantly lower in the intervention group (P < .001) as well as normal physiological parameters when compared to the control group. Findings suggest that practicing yoga during pregnancy is safe and effective in reducing stress and preventing complications. Women who began yoga therapy during their second trimester reported a significant decrease in physiological parameters from baseline to post-intervention. However, further randomized controlled trials are necessary to determine the validity and usefulness of yoga therapy during pregnancy.
The Effect of Reiki on the Self-Efficacy, Death Anxiety, and Sleep Quality of Patients Diagnosed With Chronic Obstructive Pulmonary Disease: A Randomized-Controlled Study
Ünal Aslan KS and Çetinkaya F
Reiki has been used for various medical problems. The present study aims to determine the effects of Reiki therapy on the self-efficacy, death anxiety, and sleep quality of patients diagnosed with COPD. The present used a quasi-experimental model with a pretest-posttest control group. The subjects (n = 75) were recruited from a hospital in Turkey, between February and June 2019. Subjects were then assigned to Reiki (n = 39) and placebo (n = 36) groups. In this study, it was determined that there was a statistically significant difference in the mean scores of self-efficacy, death anxiety, and sleep quality between the Reiki and placebo groups (P < .05).These results suggest that Reiki exercise increased the self-efficacy and sleep quality levels and decreased the death anxiety.
Generative Artificial Intelligence (AI) to Uncover Insights From Breast Cancer Patients' Perceptions to Mindfulness-Based Stress Reduction (MBSR) Interventions
Chang YC, Wu CH, Lupo R, Botti S, Conte L, Vitone M, Massafra R, De Nunzio G and Vitale E
The study's central objective is to harness the power of generative Artificial Intelligence (AI), in particular based on Large Language Models, as a valuable resource for delving deeper into the insights offered by patients with breast cancer (BC) who actively participated in a Mindfulness-Based Stress Reduction (MBSR) program. In a 6-week MBSR program, each session lasted 2 hours and encompassed a range of techniques, including sitting meditation, body scan, Hatha yoga, and walking meditation. A total of 25 participants were enrolled in the study. The majority of these participants reported a high level of satisfaction with the mindfulness course. The application of generative AI enabled a comprehensive analysis of the participants' responses, revealing distinct subgroups among them. The MBSR program was found to be beneficial for most participants, serving as a valuable tool in managing the psychological stresses associated with BC.
Effectiveness of Auricular Acupressure on Improving Pain and Heart Rate Variability in Patients After Cervical Spine Surgery
Liu YY, Chien TW and Li CC
Cervical spine surgery is a common neurosurgical procedure; however, postoperative pain remains a problem. This study aimed to examine the effectiveness of auricular acupressure, which is considered a noninvasive, convenient, and safe method for pain reduction and heart rate variability in patients after surgery. A total of 62 patients who underwent cervical spine surgery were randomly divided into experimental (32 patients) and control (30 patients) groups. Both groups received routine care, whereas the experimental group received auricular acupressure three times a day for four days. The Short-Form McGill Pain Questionnaire was administered, and heart rate variability measurements were obtained on the first, second, third, and fourth postoperative days. The results indicated that auricular acupressure was effective in reducing pain ( P < .05) and improving heart rate variability ( P < .05) in patients. Based on the findings, this study suggests that auricular acupressure can be used as a complementary treatment to reduce pain in patients after cervical spine surgery.
The Effect of Laughter Yoga on Vasomotor Symptoms and Sleep Quality in Menopausal Women: A Randomized Controlled Trial
Aksoy-Can A, Güner-Emül T, Değirmenci F, Buldum A, Aksu A and Vefikuluçay-Yılmaz D
This experimental study aimed to determine the effects of online laughter yoga on the sleep quality and vasomotor symptoms (VMS) of menopausal women through a prospective, randomized controlled trial. About 36 women who attend the Menopause School were randomized into either the laughter yoga (n = 18) or the control group (n = 18). The laughter yoga group participated in eight online laughter yoga sessions, with two sessions per week for four weeks, whereas the control group did not receive any intervention. Data were collected using the Descriptive Characteristics Form, Visual Analog Scale (VAS), and Pittsburgh Sleep Quality Index (PSQI). The laughter yoga group had significantly lower posttest VAS scores compared with the control group in all VMS ( P < .05). Furthermore, the posttest PSQI score of the laughter yoga group was significantly lower than that of the control group ( P < .05). Although there was no significant difference in the pretest and posttest scores obtained by the control group from the VAS and PSQI ( P > .05), the intervention group exhibited a statistically significant difference in their pretest and posttest VAS and PSQI scores ( P < .05; P < .001, respectively). The results indicate that laughter yoga is an effective method for reducing VMS and improving sleep quality.
Self-Compassion and Mindfulness-Based Training Willingness in Preoperative Bariatric Surgery Patients
Wilkinson S
The aim of this study is to assess the knowledge and willingness of preoperative bariatric surgery patients to participate in self-compassion- and mindfulness-based attention training to modify their eating behaviors. Patients received feasibility questionnaires including sociodemographic and willingness questions. Based on these results, it was determined that participants had a high degree of knowledge related to self-compassion and mindfulness with confidence to perform mindfulness and self-compassion exercises without many perceived barriers. Self-compassion and mindfulness are holistic modalities that could easily be integrated into bariatric programs, and this study affirms that patients may accept noninvasive tools that encourage preoperative weight loss and postoperative maintenance of weight loss.
Explore the Status of Communication Between Nursing Staff and Patients on Complementary Therapy Issues
Lee TY, Lin RJ and Huang CY
This study investigates the state of communication between nursing staff and patients concerning complementary and alternative medicine (CAM) in a university hospital in Taiwan. The study employed a validated cross-sectional survey to gather data from 90 nurses in the internal medicine ward. The results indicate a notable need for more initiation and documentation of CAM discussions by nurses, with less than a quarter recording patients' CAM usage. Barriers such as limited time, access to evidence-based information, and workplace culture were identified as significant obstacles. Additionally, nurse characteristics like age, experience, and seniority also played a role in the extent of CAM communication. The study underscores the urgent need for health care institutions to prioritize CAM communication as a vital component of patient-centered care. It suggests the development of strategies to facilitate proactive discussions and referrals.
The Effects of Auricular Acupressure Therapy on Obesity and Sleep in Korean Middle-Aged Women: A Randomized Single-Blind Sham-Controlled Trial
Lee J, Kim B and Park H
This study aimed to evaluate the impact of auricular acupressure therapy on obesity and sleep quality in middle-aged Korean women. The single-blind, randomized, sham-controlled trial included participants aged 40-65 years with a Body Mass Index (BMI) of 25-34 kg/m2, divided into an experimental group (n = 30) and a control group (n = 29). The intervention involved 8 weeks of auricular acupressure using ear seeds on five acupoints associated with obesity and sleep. Obesity outcomes were assessed using anthropometric indices (body weight, BMI, waist circumference, body fat mass, body fat percentage), while sleep outcomes were evaluated using the Pittsburgh Sleep Quality Index and actigraphy. Measurements were taken thrice: before the intervention, and at 4 and 8 weeks post-intervention start. The experimental group demonstrated a significant reduction in obesity measures and improvement in sleep quality over time compared to the control group. The findings suggest that auricular acupressure may serve as an alternative nursing intervention for managing obesity and improving sleep quality in middle-aged women.
Effects of Rosa damascena on Labor Pain and Anxiety in Primiparous Women
Li Y, Zhu Y, Hu Q, Wang J and Li Q
This study aimed to investigate the effect of Damask rose aromatherapy on pain and anxiety in primiparas during the incubation and latent periods of the first stage of labor. The study randomly divided participants into aroma, placebo, and control groups. The control group received daily care, while the aroma group received at least 30 minutes of aromatherapy. The placebo group received the same aromatherapy device as the aroma group but inhaled saline. Pain, anxiety, and uterine contractions were measured at enrollment and at 30, 60, and 120 minutes. Data from 76 participants were analyzed, and the results showed that the aroma group had lower anxiety and pain scores than the placebo and control groups at 60 and 120 minutes. Additionally, the effect gradually appeared and was maintained even with increased contractions. Damask rose aromatherapy can be used as a safe and effective adjuvant therapy for reducing the anxiety and pain of women in the latent period of labor.
Where Has Touch Gone and Why Aren't We Preparing Nurses for It?: An Editorial
Burgess JE
Improved Sympathetic Activity With Short-Term Effects of Yoga in Young Adults
Nakayama N, Kono A, Moriwaki Y, Niihara M, Aizawa R, Ookabe S, Kita E and Kaneko H
The purpose of this study was to clarify the heart rate variability (HRV) transition after a single yoga program. Participants were 22 females who were healthy university students and had never practiced yoga before. They practiced yoga while recording their HRV. Heart rate (HR), high frequency (HF; 0.15-0.4 Hz) as parasympathetic and low frequency (LF; 0.04-0.15 Hz) components were extracted, and then the LF/HF ratio as sympathetic and normalized units of HF HFnu = HF/(LF + HF) as parasympathetic modulation in autonomic activity were calculated. HR and HRV indices after yoga were divided into four 5-minute periods (after 5, 10, 15, and 20 minutes) and compared before yoga. HR and LF/HF at all periods after yoga were significantly lower than before yoga (P < .01, all). HF after yoga was not significantly changed, but HFnu after 5, 10, and 15 minutes was significantly higher than before yoga (P < .01, <.01, and =.02, respectively). The short-term effects of yoga on HRV implied a decrease in sympathetic modulation and a relative increase in parasympathetic modulation. Therefore, yoga may be used as a fast-acting alternative therapy to significantly improve sympathetic activity.
Spiritual Well-Being Levels and Self-Care Agency of Patients Receiving Chemotherapy With Port Catheter: A Correlational, Descriptive Study
Burucu R and Türkben Polat H
This study was conducted to determine the levels of Patients' spiritual well-being (SWB) and self-care agency (SCA) of patients receiving chemotherapy with a port catheter. It was a correlational and observational study. Data were collected between December 2021 and March 2022. The sample was 88 people. Of the participants; 59.1% were women, 88.6% were married, 38.6% were primary school graduates, 47.7% were unemployed, and 51.1% had income equal to their expenses. Furthermore, 38.6% patients had breast cancer diagnosis and 52.3% did not have any chronic diseases. Both scale scores were affected by different variables and there was a positive correlation between SCA and SWB. Better SWB positively affected SCA. Patient age and duration after cancer diagnosis affected SCA and SWB. Notably, SCA and SWB levels of the patients may change with age and disease progression, and patients should also be monitored in this respect.
Farewell Reflections and End Notes
Zuzelo PR
Holistic Nursing Practice: An Editor's Farewell
Donnelly GF
Non-Pharmacological Therapies: A Promising and Safe Alternative for Managing Anxiety and Depression Among Individuals Living With and Beyond Cancer