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Being Critically Reflective
Contents:
  1. Effective Factors in Providing Holistic Care: A Qualitative Study
  2. Holistic Nursing
  3. File information
  4. Publications

Effective Factors in Providing Holistic Care: A Qualitative Study

To quote one of the nurses:. Ironically, the latter is more popular with the managers. Routine tasks are considered as evaluation criteria. But data show that the professional environment in Iranian hospitals lacks orientation programs for novice nurses and that most of the managers lack competence for their positions. It was very difficult for me. I was under pressure and lost my motivation to continue my profession, provide proper care and pay attention to the patients and their needs. Participant 7. However, the participants declared that upon entering the clinical environment, they were faced with the limited conformity of their environment with professional norms.

Disregard for the principles of proper nursing forms a sub-category of this phenomenon. The participants stated that upon embarking on their careers, they were faced with a prevalent disregard for the principles of proper nursing, at both the professional and ethical level. Attention to professional principles is the prerequisite of holistic care; but in most cases they are ignored.

To quote a participant:. When I started, I saw that many of the points that were stressed during our education were simply ignored here. Many novice nurses would adopt the same wrong practices and ignore the professional principles; the standards and techniques were pushed aside and the patients forgotten. Disregard for ethical matters in nursing is another component of negligence of proper nursing principles. Many nurses are guilty of such disregard and ignore their patients and their various needs. In this regard, one of the participants stated that:. They would close the doors and drink tea and chat away!

It was not easy to act morally under those circumstances: You could be ostracized. It was like swimming against the current. Unfortunately, many of my friends would imitate them, too, and were totally indifferent to the patients and their needs, as if they were machines. Motivational factors play an important role in encouraging nurses to provide holistic care as well as facilitating such provision. Motivational factors include personality traits, personal experiences of hospitalization, and input sources.

One of the participants pointed out that:.

They also confide in me, which lets me know about and satisfy many of their needs. Being sensitive and compassionate contributes to providing holistic care on the part of nurses. I help my family too and enjoy being a comfort.


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That's why I feel good when my patients are satisfied. The participants stated that the unpleasant experience influenced their perception of patients and their various needs.

Holistic Nursing

One of the participants stated that:. I had to undergo cholecystectomy last year.


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  • Effective Factors in Providing Holistic Care: A Qualitative Study!

Now I realize how painful an operation can be. I understand now what a patient goes through. Participant 1. Another participant pointed out that after the experience of the hospitalization of a family member; she began to view holistic care in a different light:. He had to undergo a heart surgery and we were worried to death. I was waiting nervously outside the operation room, but the ICU nursing staff did not treat me well. I was totally anxious; now I understand patients and their families better.

I put myself in their shoes and that makes me feel closer to them. This can help one understand patients and their multiple dimensions a lot better. Regarding religiousness, one of the participants stated:. My religious beliefs help me to consider a patient's various needs despite the problems at work. I believe God has given me the power to give care to my patients; this idea gives me more energy for a better caring for the patients. The same participant mentioned that religiousness can lead to recognition of the greater effectiveness of meeting a patient's whole needs simultaneously rather than separately:.

By satisfying their needs and witnessing the effect of that on their recovery, I now see every patient as a whole with a number of needs all of which should be taken care of as a whole, and not individually, to quicken treatment. My beliefs make me attend to the different needs of the patients. Participant 4. The manner in which one has been reared has an important impact on the formation of these beliefs.

My father usually advised me to view the patients as my own family and provide the best possible caring for them and attend to all their needs. Commitment, which can increase during work, is usually effective before entering the nursing profession; it is considered as a component of input sources that plays a key role in the formation of holistic care.

One of the nurses remarked:.

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I try to perform my duties in the best way. I think our duty is not limited to some routine tasks. Addressing all of the needs of my patients is my duty as a nurse and I try to resolve their entire problems. When I resolve them, I feel good and my interest in my profession increases. The results of the study show that factors that affect holistic care provision the most are the educational structure, professional environment, and motivational factors. Ahmadi et al. The content of educational programs is not based on the philosophy of holistic care.

Revising nursing lessons seems to be required for the inculcation of holistic care in nursing students. Strandberg has also suggested this matter in his study. However, according to the findings of this study, most nurses believe that their main concern in their courses has been with becoming competent in doing routine tasks and that they had little opportunity to consider the other needs of patients. Meleis and Davies referred to this issue and emphasized its importance. King and Gates, also, stress the role of practical models, teaching methods, and explaining the philosophy of holistic care in the formation of holistic care King and Gates, Professional environment, which consists of workload, management, and the limited conformity of the clinical environment with professional norms, can affect the formation of holistic care and act as a barrier or facilitator to it.

When unsuitable, these components are identified as barriers to holistic care provision in this study. Workload is one of the aspects of practice in nursing environments which affects the quality of caring. The results of this study show that nursing management is inefficient and that the nurses in this study were dissatisfied with the style of management, and do not have any orientation programs. The above-mentioned issues play an important role in the formation of holistic care and, when suitable, can enhance the provision of this mode of caring by creating motivation in nurses and increasing their knowledge.

Strindberg's study in Sweden confirms this fact and emphasizes the role of management in promoting holistic care. Various studies—e. Silva,[ 29 ] Abedi[ 30 ] and Valdez[ 31 ]—recognize the limited conformity of the clinical environment with professional norms as a big challenge which most novice nurses encounter. Personality traits play a major role in expanding relationship with patients, identifying their various needs and developing holistic perception on the part of nurses. As the most important internal factor influencing motivation, personality traits are influential in achieving success at college and at work by creating intimacy, commitment and conscientiousness.

The same studies reveal that these nurses, compared to their colleagues, are not only more dependable, intelligent, flexible, and conscientious, but also more highly motivated. In other words, such experiences can lead to viewing a patient as a whole whose needs should be met in their entirety rather than separately, hence the need for holistic care. McEvoy and Duffy believe that sympathy for and a better understanding of patients can lead to the provision of holistic care.

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The results of the study show that the educational system, working environment, and motivational factors are major factors in providing holistic care. However, the findings reveal that these factors are not appropriate enough in Iran to lead to holistic care, and Iranian nurses tend to stick to their routine duties and satisfy patient's clinical needs only.

Publications

Earlier studies conducted in other countries—e. Strindberg , King , Henderson , Olive —have attested to the importance of the above-mentioned factors in the provision of holistic care, hence the need for closer attention to the compatibility of the educational system with the idea of holistic care, revision of the contents and methods of education, and modification of the conditions at work in order to encourage holistic care.

Personality traits, personal experiences of hospitalization, and beliefs and principles—which go under the heading of motivational factors—also contribute to and facilitate holistic care. McEvoy and Duffy suggest that these factors are vital to holistic care. This study is part of a larger study conducted for a doctoral dissertation that was approved by the ethical committee and was supported with a research grant number for Ph. The authors would like to express their sincere gratitude to this center and all the participants for cooperating in this study.

Source of Support: This study is part of a larger study conducted for a doctoral dissertation that was approved by the ethical committee and was supported by a research grant number for Ph. Conflict of Interest: None declared. National Center for Biotechnology Information , U. Indian J Palliat Care. Author information Copyright and License information Disclaimer. Address for Correspondence: Dr. Madineh Jasemi, E-mail: moc.