| Important
Dates |
Proposals for 2012 Conference
Due September 7,
2011
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Mentoring: Making a
Difference
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By Jackie Levin, RN, MS, AHN-C,
CHTP
Connections in Holistic Nursing Research Co-Editor
There
are many ways of making a difference in nursing and mentoring the
novice nurse researcher is one of them. I still feel awe and
appreciation for my first mentor, Dr. Marilyn Bookbinder RN, Ph.D.
who, throughout my year as Nurse Fellow for Beth Israel Medical
Center's Department of Pain Medicine and Palliative Care (DPMPC),
cultivated my inquiring mind.
Under
Dr. Bookbinder's method of inquiry and mentoring, I steadily
identified gaps in my skills of observation. Holding steady to the
precepts of scientific rigor, my replies of, "I don't know" were
unacceptable. Question after question, she forced me to dig deeper
and further into the whys and wherefores of holistic nursing
practice fostering in me a systematic pursuit of
self-examination.
As a researcher, Dr.
Bookbinder's ability to see everyday nursing practice issues as a
potential Quality Improvement (QI) project opened me up to a whole
new world of research: the pilot study. Because of my mentor's
zeal, she nurtured in me both the appreciation and the passion that
through research nurses have the power to improve practice at the
bedside. So when it came to her attention that nurses in the
endoscopy suite wanted to improve pain management, she asked me to
design a pilot study using a holistic intervention to address their
issues. As a novice researcher I could wrap my head around a small
practical study that would benefit both nurses and patients at the
point of care. The result was a QI project funded by the AHNA in
2000, assessing and titled, "The effects of a relaxation technique
(therapeutic suggestions) on pain and anxiety on first time
colonoscopy patients." To read more about this specific study, click here.
As a
mentor, she simplified the IRB process, worked to remove barriers,
opened doorways, de-cluttered confusion, and provided moments of
solace and many moments of humor. When feeling swayed off course by
powerful doubtful voices (both inner and outer), Marilyn never
allowed me to let go of my dreams, passions, and innovations
For me, the mentoring
relationship is more than student/teacher, though there are
components of this. This is a relationship that at its core is
Love. Love of the person, love of our practice, love of nursing.
This love is not always easy, uncomplicated or even fun. The mentor
has to risk pushing their mentee beyond their perceived limits,
otherwise how do we evolve ourselves and nursing practice? Because
my mentor did this for me, the analytical skills gained early in my
career for both thinking about a clinical problem and for
developing a research project are now well integrated into my
nursing practice.
The rewards? In my
experience, being mentored, and then carrying that forward as I
mentor others in their discovery and growth in the practice of
inquiry, is transformative. The whole of the experience, the
cherished moments as well as the challenges, continue to inform me.
From time to time in the midst of my workday, I hear Marilyn's
voice, coaching and guiding me still. In those moments, I drop her
an email thanking her. Her vital energy given so generously
sustains me still.
If you have had mentoring experiences you would like to share,
either positive or negative, please share that on our Discussion Board. Please be
judicious in your use of identifying either your mentor or mentee
keeping propriety and professionalism in mind.
We need volunteers to
mentor or to provide short-term consultation. If you are willing,
please send your area of expertise, availability and contact
information to Amber (amber@ahna.org).
We are also seeking short term consultants for the 2011 conference.
Please contact Leighsa Sharoff (leighsa220@aol.com) if you are willing to be a
consultant.
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Response
to Mentoring Editorial |
By Jen Reich MA, MS, ANP-BC,
ACHPN
Connections in Holistic Nursing
Research Co-editor
In reading Jackie's mentoring editorial, I reflect on my own
experiences with mentors who have touched my life through their
wisdom and teaching. Like Jackie, I also had the great fortune of
mentoring from Marilyn Bookbinder in my first advanced practice
role as Palliative Care Nurse Fellow at Beth Israel Medical Center
in NY. Among many things, Marilyn stressed to me the important
link between practice and research and encouraged me to pursue my
PhD. She connected me with other nurse leaders practicing in
Integrative and holistic settings who have become an important part
of my growth and development.
Since I began in nursing a decade ago, I have been blessed with
mentors who have taught me the art and science of becoming a
nurse. I joined AHNA as a Nurse Practitioner student and have met
mentors through the organization who have given me the courage to
bring my research ideas to fruition. Now, as I write my
dissertation, I look forward to passing on this new knowledge with
the students who will become the next generation of holistic nurse
researchers. And to all my mentors, I share this poem in thanks
for all you do.
Mentors
All souls need mentors
Inventors of creative living
Giving guidance from the heart-
Doing their part to share what they
know
So that others may grow and do the
same-
Jen Reich
Anacortes, WA
8-26-10
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Research Mentoring at AHNA |
Creating new
knowledge in a systematic and scientific way is essential to the
health and well being of any profession. Holistic nursing is no
exception in this area. Understanding and appreciating the values
of holistic nursing can only be accomplished through research.
Research in holistic nursing includes investigations of
alternative and complementary therapies but also the ideas of
authentic presence, compassion, intention and the idea that each
person is whole and complete in the moment. In order to
foster and support research within AHNA, research mentoring is
available. Mentoring is a way for beginners and advanced
researchers to discuss ideas, refine methodologies, and gather
recourses to assist with the research endeavor. The research
committee at AHNA has held one-on-one mentoring sessions at the
last four yearly conferences with great success. Mentors are
volunteers who wish to give some time to mentoring another
researcher or someone who is relatively new to the idea of holistic
research. If you would like to be a research mentor or if you
would like research mentoring by one of our volunteers please
contact Amber Cline, Research Liaison for AHNA, at amber@ahna.org. Please include
in your e-mail your area of interest or expertise, the type of
research you are most comfortable with and the best time and way to
contact you.
We are
also seeking members willing to act as short term research
consultants at the AHNA conference in June 2011. Please contact
Leighsa Sharoff (leighsa220@aol.com) with your willingness to be
a consultant. Please include your area of interest or expertise. If
you would like to receive a consultation session at conference, you
can register for Workshop 28 when you register for
conference.
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| Research Grant Proposals are due
February 1, 2011 |
AHNA
members are encouraged to submit topics concerning healing through
holistic nursing. Nationally, research goals are evolving with a
new foci on real life clinical situations: patient centered
outcomes and comparative effectiveness research designs. These
changes are congruent with holistic nursing research and we
enthusiastically encourage applicants interested in this new foci
to submit proposals. Grant application instructions, submission
guidelines, and the grant review forms are available on the AHNA Web site. The budget for
your grant proposals should be no greater than $4000.
Please e-mail grant proposals to
both Kim Stiles (kstiles@ohlone.edu) and Jeanne Crawford (director@ahna.org). Consultation may be
available as an aspect of the grant. For questions about the grant
application process, please contact Kim Stiles (kstiles@ohlone.edu). For research consultations
or mentor information, contact Ruth McCaffrey (rmccaffr@fau.edu).
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| Request for
Proposals |
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| Poster Presentations at
AHNA 2010 Conference |
AHNA will hold its 31st Annual National Conference,
Holistic Nursing: Tending to the Sacred Flow of Life,
from June 2-5, 2011 in Louisville, KY. AHNA invites you to submit
poster proposals for this conference and help create our best
conference yet!
Poster proposals will be accepted until December 1,
2010. Submission guidelines are
available online.
Visit the Research section of the AHNA Web
site for information on creating a workshop or poster
proposal.
Missed the workshop proposal deadline? Get started on your
2012 proposal. The deadline for presentation proposals for
AHNA's 2012 conference will be September 7, 2011.
Submission guidelines will be available in July 2011.
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| Research Glossary |
Have you heard??? The Research
Enews team invites your research
word!
We are currently seeking to build a
glossary of research terminology that will serve the holistic
nursing community. Each Research Enews, a new term will be
featured and the glossary will be on the website as well. If you
have a research term you think would benefit AHNA members, and
would like to be a guest contributor to our glossary, please
contact amber@ahna.org
with your recommendation.
The RCT: Randomized controlled
trial
Randomized
controlled trial: (RCT) An experimental design in which
individuals are assigned randomly to two or more groups: a
treatment group (experimental therapy) and a control group (placebo
and/or standard therapy) and the outcomes are compared. Someone who
takes part in a randomized controlled trial (RCT) is called a
participant or subject. RCTs seek to measure and compare the
outcomes after the participants receive an intervention. Because
the outcomes are objectively measured (instruments and/or
physiological data) RCTs are quantitative studies. The RCT is
currently the most accepted scientific method of determining the
benefit of a drug or a therapeutic procedure. It is one of the
simplest and most powerful tools in clinical research.It can
represent the "best" evidence available, which is integrated into
the final decision about the management of a condition by
healthcare practitioners in what is called evidence-based
healthcare but is limited by its generalizability to groups.
In sum, RCTs are
quantitative, comparative, controlled experiments in which
investigators study two or more interventions in individuals who
are assigned to receive an intervention in random order. Sources:http://www.medterms.com
MedTerms is the Medical Dictionary of MedicineNet.com;
Millodot: Dictionary of Optometry and Visual Science, 7th edition.
© 2009 Butterworth-Heinemann; www.wickipedia.com
Numerous forms of
the RCT designs exist. This approach, while the 'gold standard' for
scientific and often clinical evidence, has been criticized by many
as a research approach that does not account for the numerous
factors involved in behavioral sciences including holistic
nursing, and in integrative, complementary and alternative
practices. Currently there is national emphasis on multiple
approaches to research that capture the complexities of clinical
practice. (see report of integrative health care conference
link).
Effectiveness versus Efficacy
These two terms have
recently been discussed in evaluating the usefulness and
applicability of research results. Research that aims for efficacy
most often utilizes the RCT. Statistically significant results of a
treatment or intervention in a controlled situation is an example.
Effectiveness on the other hand, attempts to evaluate treatments
and approaches in real clinical situations. Effectiveness is
associated with 'what works most of the time'. Such interventions
may not meet consistent statistically significant results when
tested on controlled situations. People reporting greater comfort
after a healing touch procedure while their blood pressures may not
decrease significantly is an example.
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| Complexity
Science |
by
Joan Engebretson DrPH, AHN-BC, RN
 Complexity science is emerging as a powerful
force in the progression of nursing research, science and
understanding the world. Complexity science has its origins in
physics and mathematics and is based in non-linear dynamics. Many
scientists postulate that complexity science will be the paradigm
of the 21st century and there are several calls for applications of
complexity to address many of the behavioral and social issues in
health care. Many of the concepts are similar to the systems
orientation of holistic nurses.
Complexity is differentiated from complicated which is described by
Glouberman et al. (2006) in the analogy of an automobile as a
complicated system with many parts, but changing the oil doesn't
alter the behavior of the headlights. In contrast, in a complex
system, the parts continually interact and change in ways that
cannot be deduced from any of the parts in isolation. Much of the
current scientific base for medical research and subsequent
clinical practice is grounded in a mechanistic model, and reduces
phenomena to measurable variables and analyzes them through linear
mathematics. The goal of much medical research seeks to discover
relationships among variables with the ultimate aim of testing
interventions, with the randomized controlled clinical trial as the
gold standard. This has been extremely useful and has yielded
tremendously valuable insights and understanding about disease and
treatment of disease. However, humans and communities are complex
systems, as are most living organisms. At this level, the
framework of complex adaptive systems may be a better conceptual
fit. Complexity science seeks not to measure the relationship
between variables, but rather to explore what actually happens
between or among them. So rather than looking at correlations and
predictions among variables, complexity science seeks to discover
what happens in the relationship between variables. Nursing has
long oriented around a systems theoretical perspective as befitting
the idea of caring for the whole person, family or community.
Therefore, it is important for nurses to become familiar with the
language, metaphors and concepts of complexity as these represent
the emerging science. This report will focus on the concepts in
Complex Adaptive Systems which are based on some of the
mathematical principles and may be thought of as complexity
theories or complexity frameworks.
To
read the complete article, click here.
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Report on Integrative Health
Care Policy Consortium |
Rorry Zahourek, AHNA Leadership Council
Research Coordinator, recently attended a conference on the
implications of healthcare reform on integrative medicine. She
shares the implications for holistic nursing research in a report
on the AHNA's web site. Read Rorry's report.
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| Research
Reviews |
Reviewed by Jackie Levin RN, MS,
AHN-BC, CHTP, Connections Co-Editor
The Sept/Oct 2010 issue of Alternative Therapies in Health and
Medicine (ATHM) is entirely devoted to nursing practice and
research. This is a big breakthrough into a forum largely devoted
to medicine. Two articles from that journal are reviewed in this
issue of AHNA Research Enews. Many of the articles published in
this issue of ATHM are written by AHNA members, including an
article by AHNA Executive Director Jeanne Crawford and former
President Lucia Thornton titled "Why Has Holistic Nursing Taken Off
in the Last Five Years . . .
What Has Changed?"
Thought leaders from the nursing industry provide their unique
insights and opinions on a variety of topics surrounding nursing's
role in integrative health and healing. The result is a lively
discussion of challenges facing nurses in the field, the
recognition of nursing-led initiatives, nurses as leaders, and
more.
From now until the end of the year, you can access these full-text
articles for free. Click here to gain access to the
articles through the AHNA Article Library.
Gross, CR, Kreitzer,
MJ., Thomas, W., Reilly-Spong, M., Cramer-Bornemann, M., Nyman,
JA., Frazier, P., & Ibrahim, HN. (2010). Mindfulness-Based
Stress Reduction for Solid Organ Transplant Recipients: A
Randomized Control Trial. Alternative Therapies in Health and
Medicine. 16(5): 30-38.
In a health care
environment in which our time with patients is limited, it's vital
that our encounters and interventions have sustainable impact. This
is one of the several important contributions from the study
Mindfulness-Based Stress Reduction for Solid Organ Transplant
Recipients: A Randomized Control Trial. The participants were
first stratified by disease and then randomized into one of 3
groups: the Mindfulness-Based Stress Reduction (MBSR) intervention
group, a health education group and waitlist group which was later
randomized again into one of the two other arms. The MBSR
intervention group attended an 8-week mindfulness-training program.
The other participants attended a peer-led educational program
focused on chronic disease self-management. The results for the
MBSR group were statistically significant on the primary outcomes
of anxiety and sleep and for secondary outcomes of quality of life
and perceived health when compared with the health educational
program and a waitlist groups. MBSR also demonstrated positive
effect for depression. Of note is the durability of the MBSR
program results when compared with the other two groups, with the
improvements gained sustained at the one year follow up. The
design and methodology are excellent models for anyone desiring to
study the effects of MBSR on other patient and provider groups
Findlay, B., Smith,
K., Crawford, C. Coulter, I., Khorsan, R., & Jonas, W. (2010).
Methodological Complexities Associated with Systematic Review of
Healing Relationships. Alternative Therapies in Health and
Medicine. 16(5): 40-46.
Findlay et al.
(2010), study set out to answer the question, "What is the return
on investment to hospitals that implement programs aimed at
enhancing healing relationships?" The research team conducted a
comprehensive literature search of randomized control studies and
descriptive studies examining healing relationships. What the
authors uncover is that applying this gold standard to new and
emerging holistic fields of study might prematurely determine the
intervention's value. The challenges and constraints identified
were 1) concept descriptors of healing relationships have not yet
been clearly defined and agreed
upon, 2)
methodologically strong studies did not provide the most meaningful
information as those defined as methodologically weak, and 3) MeSH
headings have a "biomedical bias" and do not yet capture the subtly
or diversity in the concept of healing relationships. To maximize
the literature search results, the authors recommend the use of an
interdisciplinary research team, review of qualitative studies to
discover emerging themes and language, and creation of a common
framework and terms for more instructive systematic reviews.
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Self-care in AHNA's Nursing
Population a project and study conducted at the AHNA 2010
conference
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 A group of nursing students from Colorado State
University-Pueblo (CSU-P) (Class of 2010) with the guidance of
their instructor Beverly Sesters conducted a projec t and descriptive research at the 2010 AHNA
annual conference in Colorado Springs. Their concern is nurses'
stress and burnout and the potential for self care to ameliorate
that process. They provided a questionare and props at the lovely
reflection room sponsored by Aromaceuticals at the
conference. The complete report by Bethany DeMarco can be found on
the AHNA Web site.
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| AHNA Researchers in
Action |
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Colleen
Delaney, Cynthia Barrere, &
Mary Helming. (2010). The influence of a
spirituality-based intervention on quality of life, depression, and
anxiety in community-dwelling adults with cardiovascular disease: A
pilot study. Journal of Holistic Nursing. Published
online ahead of print. August 16, 2010 as
doi:10.1177/0898010110378356
Note: This article is based in part on research
done with an AHNA grant received by Colleen Delaney in 2007. Grant
proposals are due February 1, 2011. Learn more.
Mary M. Madrid, Elizabeth A. M. Barrett, and
Patricia Winstead-Fry. (2010). A study of the feasibility of
introducing therapeutic touch into the operative environment with
patients undergoing cerebral angiography. Journal of
Holistic Nursing. 28(1), 168-174.
Deborah
McElligott, Kathleen Leask Capitulo, Diana Lynn Morris,
and Elizabeth R. Click. (2010). The effect of a holistic program on
health-promoting behaviors in hospital registered nurses.
Journal of
Holistic Nursing. 28(1), 175-183
Note: AHNA
members have full access to JHN archives. Learn more.
Christina
Jackson. (September/October
2010). H1N1 pandemics and disease mongering: Applying
holistic philosophy to counteract Fear.Holistic Nursing
Practice. 24(5):247-251.
Ruth McCaffrey, Claire
Hanson, & William McCaffrey. (September/October 2010).
Garden walking for depression: A research
report. Holistic Nursing
Practice. 24(5):252-259.
Ann L. Baldwin, Anne Vitale, Elise Brownell, Jan
Scicinski, Mary Kearns, & William Rand. (September/October
2010). The Touchstone Process: An ongoing critical
evaluation of Reiki in the scientific literature. Holistic Nursing Practice.
24(5):260-276.
Leighsa
Sharoff. (September/October 2010). Social networking, holistic nursing, and
self-care. Holistic Nursing
Practice. 24(5):301-302.
The
following are articles from Alternative Therapies in Health and
Medicine. (See Research Reviews above for more information.)
To access the full articles for free until the end of the year, visit AHNA's Article
Library.
Michele
Mittelman.(September/October 2010). Nursing: Education, research, and
practice. Alternative Therapies in Health and
Medicine. 16(5)
Marla
Salmon.(September/October 2010). The Commons: Nursing education,
societal relevance, and going it together.Alternative Therapies in
Health and Medicine. 16(5)
Louise Palmer, Allison
Cook, Brigette Courtot.
(September/October 2010). Comparing models of maternity care serving women
at risk of poor birth outcomes in Washington,
DC. Alternative Therapies in
Health and Medicine. 16(5)
Barbara Dossey. (September/October 2010).Holistic nursing: From Florence Nightingale's
historical legacy to 21st-century global nursing.
Alternative Therapies in Health and Medicine.
16(5).
Jeanne Crawford,
& Lucia Thorton. (September/October 2010). Why has holistic nursing taken off in the last
five years? What has changed? Alternative Therapies
in Health and Medicine. 16(5).
Cynthia R. Gross, Mary Jo Kreitzer, William Thomas, Maryanne
Reilly-Spong, Michel Cramer-Bornemann, John A. Nyman, Patricia
Frazier, & Hassan N. Ibrahim.(September/October 2010).
Mindfulness-based stress reduction for solid organ
transplant recipients: A randomized controlled trial.
Alternative
Therapies in Health and Medicine. 16(5).
Susan Luck. (September/October 2010). Changing the health of our
nation-The role of nurse coaches.
Alternative Therapies in Health and Medicine.
16(5).
Michele Mittelman, Sunny Yim Alperson, Patricia Martin
Arcari, Gloria Ferraro Donnelly, Loretta C. Ford, Mary
Koithan, & Mary Jo
Kreitzer.(September/October 2010). Nursing and integrative health care.
Alternative
Therapies in Health and Medicine. 16(5).
AHNA members names in bold. We
would love to hear about your research. Send your "Researcher in
Action" to amber@ahna.org
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| Report from the
Road |
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| Picture from left to right:
Marguerite Purnell, Marlaine Smith, Dot Dunn, Rorry Zahourek,
Richard Cowling, Ruth McCaffery |
Several AHNA members presented at
the Society of Rogerian Scholars meeting, "Advancing Rogers'
Science of Unitary Human Beings through Praxis" October 8-10, 2010.
Hosted by Florida Atlantic University. Marlaine
Smith RN, PhD, AHN-BC, FAAN has been the president for the
last year. Richard Cowling BS, MS, RN, PhD,
APRN-BC, AHN-BC did a keynote: "Unitary Science Praxis: An Avatar
of Nursing." Dorothy Dunn Ph.D., ARNP,
FNP-BC presented "A Unitary View of Intentional Compassion Energy."
Marguerite Purnell RN, PhD, AHN-BC presented a
study by Ruth McCaffery ND, ARNP "Garden Walking
for Depression in Older Adults: Investigating the Integration of
the Human and Environmental Energy Fields." Rorry
Zahourek PhD, APRN, BC, AHN-BC presented "Intentionality:
A Linear or a Unitary Phenomenon."
We recognize many of our members attend conferences that have
relevance to holistic nurses and our research efforts. Please send
us a brief summary and we will share it in a future issue. Send
summaries to amber@ahna.org
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| Updates on Research in Healing
Touch |
By Diane
Wind Wardell PhD, RN, WHNP-BC, AHN-BC
Three interesting and divergent articles have been published on
Healing Touch recently. A highly articulate and scientific article
was published by Dr. Susan Lutgendorf and her team at Iowa
University. The article is in press and can be found with the
journal Brain, Behavior and Immunity and is entitled "Preservation
of immune function in cervical cancer patients during
chemoradiation using a novel integrative approach. " This was a
prospective randomized clinical trial using Healing Touch compared
to relaxation training and usual care. Sixty women were randomized
to receive usual care or either Healing Touch or relaxation therapy
immediately following their radiation treatment for cervical
cancer. Three time intervals were assessed. Healing Touch
patients had a significantly minimal decrease in natural killer
cell cytotoxicity (NKCC) which is needed an indicator of immune
compromise as compared to the other groups which had a sharp
decline. The Healing Touch group also showed greater decreases in
depressed mood but there was no difference in quality of life,
treatment delay or clinically-rated toxicities between groups. The
authors provide an extensive discussion on the key findings of
preservation of NK cell activity and improvement in depressed
mood. They provide a physiological explanation as well as
proposing that there might have been some effect on the
hypothesized biofields. Read
more...
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| Research in the
News |
Does a good massage do more than just relax
your muscles? To find out, researchers at Cedars-Sinai Medical
Center in Los Angeles recruited 53 healthy adults and randomly
assigned 29 of them to a 45-minute session of deep-tissue Swedish
massage and the other 24 to a session of light massage. To their
surprise, the researchers, found that a single session of massage
caused biological changes. Volunteers who received Swedish massage
experienced significant decreases in levels of the stress hormone
cortisol in blood and saliva, and in arginine vasopressin, a
hormone that can lead to increases in cortisol. (New York
Times, 9/10)
Following Lifestyle Tips Could
Prevent 23% of Bowel Cancer Cases
Almost a quarter of colorectal (bowel) cancer cases could be
prevented if people followed healthy lifestyle advice in five areas
including diet and exercise, says a new study published on bmj.com
today. Researchers from Denmark found that following
recommendations on physical activity, waist circumference, smoking,
alcohol and diet could reduce the risk of developing bowel cancer
considerably - by 23%. (e! science
news, 10/10)
A
long-term U.S. study found that adults who walked six to nine miles
weekly had slower gray matter tissue deterioration and reduced
their risk of developing cognitive impairment by 50% compared with
those who didn't. The findings suggest that "we can retain our
brain tissue and retain our memories well into late adulthood by
maintaining an active and engaged lifestyle," the lead researcher
said. (HealthDay, 10/10)
Click on each title to read
article.
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| Research Web
Library |
If you would like your published research included in the Web
Library, contact Amber at amber@ahna.org.
Please include the citation for the book or article, a URL to the
abstract or full text article, a short description (optional) and
suggested category or categories.
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