Journal of Holistic Nursing

Introduction: This study examined the relationship between person-centered perioperative nursing care and spiritual support perception of nurses working in surgical units. Design: In this descriptive and correlational study, 426 surgical nurses working in Türkiye between March and November 2024 constituted the sample. Data were collected using Google Forms through a personal information form, the Person-Centered Perioperative Nursing Scale, and the Perception of Spiritual Support Scales. Participants were reached using a virtual snowball sampling method. Results: The mean of the person-centered perioperative nursing scale was 80.07 ± 9.22, and spiritual support scale was 51.13 ± 6.78. There was a statistically significant difference between the institution of employment, participation in a conference on surgical nursing, and any training on person-centered perioperative care and the person-centered perioperative nursing scale (p < 0.05). Person-centered perioperative nursing had a statistically significant and positive effect on the perception of spiritual support (β = 0.265, p < 0.05), and 13% of the variance in the model was explained. Conclusion: The study found that person-centered perioperative care effectively promoted the perception of spiritual support. Therefore, nurses working in surgical settings are recommended to receive training on person-centered perioperative care to improve their perception of spiritual support, thereby enabling them to provide holistic care.

In a world marked by technological acceleration, sociopolitical unrest, and ecological disruption, nursing faces growing fragmentation—of systems, relationships, and meaning. This paper re-envisions holistic nursing not merely as a clinical approach but as an ontological and ethical philosophy of wholeness that sustains nursing's identity amid such complexity. Drawing upon Lonergan's interiority as a foundation for moral awareness, Ubuntu's relational ontology, and Foucault's critique of surveillance and power, the paper develops a philosophical framework that reconnects the nurse's being and action. It proposes that the nurse's moral presence arises from interior reflection and relational accountability, enabling resistance to reductionist and algorithmic forces that dehumanize care. By viewing the nurse as a contemplative witness and ethical actor within fragmented systems, this framework invites a return to nursing's core calling—to honor human dignity, cultivate presence, and nurture authentic relationship as the essence of healing. This renewed philosophy of wholeness offers guidance for nursing education, practice, and policy in an era increasingly defined by disconnection.

Purpose: The purpose is to integrate existing knowledge about spiritual needs and interventions during the perinatal period, including cultural and contextual variation, to inform how spirituality may be further integrated. Study Design: Critical narrative literature review evaluated against the Scale for the Assessment of Narrative Review Articles (SANRA) criteria. Analysis: The thematic synthesis was conducted to identify analytical themes and evidence levels across diverse cultural contexts. Findings: The review was based on 34 diverse sources (ranging from randomized controlled trials [RCTs] and systematic reviews to phenomenological and ethnographic studies). Synthesis revealed a dual nature of spirituality, in which it can act as a protective factor (contributing to meaning-making and coping) or, conversely, increase stress when interpreted as divine punishment or when spiritual needs go unmet. Conclusions: Recognizing and integrating spirituality into perinatal care contributes to holistic, person-centered midwifery and nursing. Practice should prioritize the use of spiritual assessment tools, interprofessional collaboration with spiritual caregivers, and the inclusion of spiritual care competencies in formal nursing education.

Jean Watson's Theory of Human Caring offers a relevant and contemporary framework for holistic nursing care. By redefining traditional paradigms, Watson's model positions transpersonal care as both a theoretical and practical pathway for holistic nursing practice. Empathy, as a foundational human experience present in all care encounters, is central to the holistic development of transpersonal care. This essay explores, from classical and contemporary philosophical perspectives, the concept of empathy within Watson's framework, relating its core concepts to nurse–patient encounters in holistic care. Empathy is examined as an existential mode of being-with-the-other, articulated with concepts such as intercorporeality, comprehensive understanding of the other's experience, and becoming-other. Two of Watson's Caritas^® Processes are analyzed as spaces for holistic openness and empathic presence. The discussion highlights the importance of developing practices that transcend the technical-biological model, emphasizing the appreciation of alterity and the cultivation of dignified, sensitive, ethical, and transformative bonds in holistic care. Empathy is also discussed in relation to mindfulness, understood as an intentional practice that integrates body, mind, spirit, and heart, fostering compassionate listening. The article offers new philosophical perspectives and highlights the relevance of empathy in advancing holistic nursing care.

Hypertension often remains inadequately controlled despite pharmacological therapy, indicating the influence of multidimensional factors on blood pressure regulation. Psychological and spiritual processes contribute to stress regulation and adaptive coping; however, quantitative synthesis of psychospiritual interventions within holistic nursing remains limited. This meta-analysis evaluated the effects of psychospiritual interventions on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adults with hypertension. A systematic review and meta-analysis of randomized controlled trials was conducted following PRISMA 2020 guidelines using databases covering 2000–2025. Twelve studies were included in the qualitative synthesis, with six studies analyzed for SBP and five for DBP. Psychospiritual interventions were associated with a significant reduction in SBP (SMD = −0.91; 95% CI: −1.54 to −0.29; p = .004), but not DBP (SMD = −0.20; 95% CI: −0.77 to 0.36; p = .48). Findings support psychospiritual interventions as complementary non-pharmacological strategies consistent with holistic nursing approaches to hypertension management.

Background: Emergency department (ED) nurses are routinely exposed to high-stress clinical environments, increasing their risk for burnout and emotional exhaustion. In holistic nursing, self-care is viewed as a professional and ethical responsibility essential to delivering whole-person care. This pilot study, guided by the Integrative Nursing Framework, explored the use of a mobile mindfulness app as a holistic intervention to support nurse well-being. Purpose: To explore how ED nurses experience and manage stress and burnout and to evaluate the effects of a mobile mindfulness app on these outcomes. Methods: An explanatory sequential mixed-methods design was used. Eleven ED nurses used the Headspace app for 4 weeks and completed pre- and post-intervention surveys measuring perceived stress, burnout, mindfulness, and well-being. Nine participants also completed post-intervention interviews. Quantitative data were analyzed using Wilcoxon signed-rank tests; qualitative data were analyzed using thematic analysis. Results: Perceived stress significantly decreased, while mindfulness and well-being significantly increased. Burnout scores showed no significant change. Themes included usability, personal impact, barriers to engagement, and recommendations for improvement. Conclusions: This study demonstrates the feasibility of mobile mindfulness as a holistic, self-directed intervention that aligns with holistic nursing values and supports ED nurses’ well-being in demanding care environments.

Purpose: To examine registered nurses’ gastrointestinal health and their use of complementary, alternative, and integrative medicine (CAIM) for constipation, and to explore demographic and professional correlates of CAIM adoption. Methods: A cross-sectional survey was conducted using an online questionnaire to assess demographics, professional background, gastrointestinal health, and CAIM use. Items also captured knowledge sources, perceived barriers, and facilitators related to the use of CAIM. Results: Constipation was reported by approximately one-quarter of the nurses. About 70% of nurses used CAIM for constipation. The most frequently used modalities were probiotics, dietary fiber, lifestyle modification, and abdominal massage. Nurses primarily acquired knowledge from informal sources rather than evidence-based literature. The primary barrier to CAIM use was limited familiarity, and the main facilitator was fewer side effects. CAIM use was more likely among nurses who met recommended physical activity thresholds. It was not significantly associated with other demographic or professional characteristics. Conclusion: Nurses use CAIM for bowel health, yet reliance on informal sources reveals an evidence–literacy gap. Education, better access to high-quality syntheses, and organizational support may advance evidence-informed integration. Future work should expand modality coverage, include psychosocial and occupational measures, and use longitudinal or model-based designs to clarify mechanisms and causality.

Introduction: Emergency surgery for bowel obstruction can significantly impact patients’ coping mechanisms, leading to various physical and psychological complications. The intentional presence of a nurse, as a holistic approach, can aid patients in enhancing their coping strategies and psychological well-being postsurgery. Aim: This study aimed to assess the effect of a nurse's intentional presence, as a holistic intervention, on stress, anxiety, depression, and coping strategies in patients undergoing bowel obstruction surgery. Method: This randomized controlled trial was conducted at Qaem Hospital in Mashhad, Iran, from March 2021 to October 2022. A total of 62 patients were randomly assigned to two groups. The intervention group received nursing care based on the theory of intentional presence over five individual sessions lasting 45–90 min each in the hospital, followed by telephone support for up to 1-month postdischarge. The control group received educational pamphlets. Data were collected using the Filipino Coping Strategies Scale (FCSS) and DASS-21 before, 1 week after, and 1 month after the intervention. Data were analyzed using SPSS 27 with quantile regression models adjusting for baseline covariates. Results: The results showed homogeneity between the two groups regarding age (P = 0.14) and other demographic and disease information (P > 0.05). The Mann-Whitney test revealed significant reductions in anxiety, stress, and depression in the intervention group compared to the control group at 1 month (P < 0.001). Additionally, there was a significant improvement in coping strategies (indicating better adaptation) in the intervention group compared to the control group at 1 month (P = 0.04). Quantile regression confirmed these findings with significant adjusted effects (anxiety: RC = −3.14, 95% CI [−4.89, −1.39]; stress: RC = −1.00, 95% CI [−1.96, −0.04]; depression: RC = −1.00, 95% CI [−1.98, −0.02]; coping: RC = 4.11, 95% CI [1.87, 6.35]). Conclusion: The findings indicate that the intentional presence of a holistic nurse can enhance patient adaptation to disease symptoms after surgery and reduce stress, anxiety, and depression. Further studies with mixed-methods designs are needed to comprehensively assess patient adaptation and the qualitative aspects of the nurse–patient relationship.

Purpose: Multiple sclerosis (MS) disrupts daily life, identity, and anticipated futures. While clinical care has advanced, less attention has been given to how individuals experience changes in meaning, self-concept, and continuity over time. This review synthesizes current evidence on existential disruption in MS and examines how identity and meaning are affected across the disease trajectory. Design: Integrative review. Method: An integrative review was conducted using Whittemore and Knafl's methodology. A systematic search of CINAHL, PubMed, MEDLINE, and PsycINFO identified 25 studies published between 2015 and 2025. Findings: : Existential disruption emerged as a dynamic and recurring process shaped by identity disruption, uncertainty, stigma, and meaning-making across the illness trajectory. These experiences extended beyond diagnosis and were reactivated during disease transitions. Meaning-making processes supported adaptation by maintaining continuity of self rather than resolving disruption. Conclusions: Identity and meaning are central to living with MS yet remain underrecognized in clinical care. This review advances a conceptual understanding of existential disruption as an ongoing process of negotiating self-continuity. Nursing practice may be strengthened by approaches that attend to existential experience as part of holistic, person-centered care.

Purpose: Black communities experience higher rates of preventable health inequities, such as uncontrolled blood pressure (BP), pain, and overall health challenges. The Nurses 4 Black Well-being (N4BW) project explores these inequities through a health promotion lens. Spirituality has been shown to be a positive culturally relevant health factor that is central to holistic nursing efforts. Therefore, this study explored relationships between self-rated spirituality and health outcomes (BP, pain, and overall health) among marginalized Black community adults. Design: A cross-sectional quantitative study was conducted. Methods: Surveys were administered to a convenience sample of N = 203 Black adults across local community sites in marginalized areas in the Midwest United States, with support from key community partners. Theistic and non-theistic spiritual experiences, systolic BP, pain, and self-rated health were assessed using standardized assessments. Findings: Regression analyses found no significant health effects for theistic or non-theistic spirituality across outcomes of systolic BP, pain, and self-rated health. Conclusion: While spirituality remains a central concept in holistic nursing, these findings suggest that its relationship with health may be more nuanced than previously understood.Additional holistic nursing research exploring spirituality's role in the health and holistic well-being of marginalized Black community adults is needed.

Purpose: Discussing death with terminally ill patients is a challenging yet essential part of palliative care nursing. This study explored nurses’ perceptions and experiences, emphasizing holistic care that addresses patients’ physical, emotional, social, cultural, and spiritual needs. Design: A descriptive, exploratory qualitative design was used with content analysis. Methods: Data were collected through in-depth interviews with 16 participants and analyzed using traditional content analysis. MAXQDA software was used for coding and organizing the qualitative data. Results: Four main themes emerged: “Professional Readiness and Communication Competence,” “Experiences in Talking About Death,” “Factors Shaping Death-Related Communication,” and “Internalization of Death and Its Influence on Care.” Nurses stated that talking about death was influenced by patient requests, disease progression, family expectations, and the nurse's communication skills. Training and expertise were seen as essential. Some nurses felt this task was more appropriate for physicians or psychosocial teams. Conversations included both positive experiences (e.g., offering hope) and challenges (e.g., emotional strain, patient resistance). Nurses described death as both a fearful and natural experience. Conclusions: Supporting nurses through communication-focused in-service training, with an emphasis on holistic care principles, is recommended to enhance the quality of end-of-life care and better address the multidimensional needs of patients facing death.

Aim: This study aimed to examine the effect of postpartum mood education on maternity blues and postpartum depression among primiparous mothers. Design: Randomized controlled trial. Methods: A total of 146 primiparous women were randomly assigned to intervention (education) or control groups. Data were collected using the Maternity Blues Scale (MBS) and the Edinburgh Postnatal Depression Scale (EPDS). Results: The intervention and control groups were largely comparable in sociodemographic characteristics; however, significant differences were observed in education level and employment status. No significant differences were found between groups in MBS and EPDS mean item scores (p > 0.05). However, mean scores of the MBS responsibility and socioeconomic subdimensions were lower in the education group (p < 0.05), while the Breastfeeding subdimension score was higher (p < 0.001). Conclusion: Postpartum mood education did not influence overall maternity blues at one week or postpartum depression at 6 weeks. Nevertheless, improvements in subdimensions suggest that education may reduce responsibility and socioeconomic stress while enhancing breastfeeding experiences. From a holistic nursing perspective, these findings indicate that postpartum mood education may contribute to person-centered care. Grounded in Watson's Human Caring Theory, the study highlights the potential of integrating mood education into discharge practices to advance holistic nursing practice.

Mindfulness-based interventions are increasingly applied in health care; however, many remain grounded in secular Western paradigms that insufficiently reflect patients’ spiritual and cultural worldviews. Within transcultural nursing, integrating spirituality into mindfulness may enhance cultural congruence and support holistic care. This systematic integrative review synthesized interdisciplinary evidence on spiritually integrated mindfulness interventions and their relevance for culturally congruent nursing practice. Guided by PRISMA, 28 studies published between 2015 and 2025 were analyzed. Findings indicate consistent improvements in spiritual well-being, psychological distress, coping, and meaning-making across diverse cultural contexts, particularly within Buddhist, Islamic, and Christian traditions. Spiritual mindfulness operates through interconnected mechanisms, including emotional regulation, spiritual connectedness, relational awareness, and compassionate engagement. Integrative synthesis informed by Watson's Theory of Human Caring and CIMO logic suggests that culturally congruent spiritual mindfulness practices facilitate meaning-centered adaptation and person-centered healing. These findings demonstrate the theoretical and practical relevance of spiritual mindfulness for transcultural nursing and highlight the need for culturally grounded and methodologically rigorous research to strengthen evidence-based holistic care.