Holistic cert Therapeutic comm.

A therapeutic relationship is a:

professional alliance between the nurse and the client or patient, working together for a defined period of time to accomplish specific health-related goals

Self-development (self-reflection, self-assessment, self-evaluation, self-care)

promotes the recognition of what is going right in life, allowing for the celebration of little successes each day. Coaching is an opportunity to promote and acknowledge success, however small, and then to build on that to achieve further success.

psychological issues that create unhealthy relationships:

psychological defense mechanisms, anger, power and control issues, as well as attachment disorders.

Tools and Practices to Enhance Holistic Communication:

self-knowing, meditation, engaging your observer, CLEAR communication, and drawing out the persons story

healing relationship:

that which puts the patient in the best position for Nature to act on him or her

healthcare providers develop the skills for a client-centered approach that does the following:

(1) assesses core cross-cultural issues, (2) explores the meaning of the illness to the patient, (3) determines the social context in which the patient lives, and (4) engages in a negotiation process with the patient.

Nine primary concepts explain the therapeutic relationship, according to their review of the literature:

(1) demonstrating respect, (2) being genuine, (3) being there/being available, (4) accepting individuality, (5) having self-awareness, (6) maintaining boundaries, (7) demonstrating understanding and empathy, (8) providing support, (9) promoting equality.

Carl Jung Freudian psychoanalytic psychology.

-Concept: Collective unconscious as the inherited human unconscious composed of universal mental images and thoughts, which are archetypes. -Archetypes: Concepts of personality expressed in myths and fairy tales; people fit into these roles interchangeably. -Mother archetype: Most important, role of nurse, Mother of God, grandmothers, church, Earth, and Nature. -Crone archetype: The wise old woman who is a visionary, who at the crossroads of life chooses the path of the soul rather than the ego, and she speaks the truth always.

Angeles Arrien Transpersonal psychology; views life holistically.

-Concept: Evolved Jungian archetypes, four primary archetypes identified. -Healer archetype: Holistic nursing professionals manifest this archetype by relating to others compassionately and with love. Other essential characteristics of the Healer include bringing caring to human relationships, viewing others in a positive light, and bringing emotional comfort. -Teacher archetype: The Teacher represents the mental quality in relationships, helping learners to achieve new knowledge, wisdom, and insight. Teachers are also very open to learning. Holistic nurses often exhibit the teacher quality as well. Warrior archetype: The Warrior symbolizes physical qualities of relationship building. This archetype uses courage to help improve behaviors of self and others, is firm, and uses knowledge, especially facts, effectively. Holistic nurses are very interested in helping patients improve their health and wellness behaviors and can use facts and their knowledge effectively in this endeavor. Visionary archetype: The Visionary archetype symbolizes the spiritual aspect of relationship. The Visionary is nonjudgmental and assists in conflict resolution. This personality model exemplifies sound intuitive knowing to assist others in achieving their highest good. Holistic nurses need to focus on the spiritual aspect of relationship, which, in itself, tends to move others toward their highest potential.

European Americans:

-European ideas of the Age of Reason, dominance over nature, and the belief in progress and technologic advancement. -Their quest for freedom enhanced an abiding value of individualism. -They are generally action oriented, future directed, and focused on progress and productivity. -members of this group may not be as aware of the role that culture plays in their lives as the members of other cultural groups are.

Acknowledgment of the Infinite and Sacred Nature of Being: Holistic nursing acknowledges that people are infinite, sacred, and spiritual beings:

-Florence Nightingale spoke of human beings as a "reflection of the Divine with physical, metaphysical, and intellectual attributes." -Jean Watson teaches that we are "sacred beings," -Martha Rogers speaks of unitary human beings as "energy fields that are infinite in nature." The Model of Whole-Person Caring combines these concepts to define person as "an energy field that is open, infinite, and spiritual in essence and in continual mutual process with the environment. Each person manifests unique physical, mental, emotional, and social or relational patterns that are interrelated, inseparable, and continually evolving

Theory of Integrative Nurse Coaching (TINC): A middle-range nursing theory that contains:

-Healing, the metaparadigm in nursing theory, patterns of knowing, five components— (1) Integrative Nurse Coach Self-Development: Self-Reflection, Self-Assessment, Self-Evaluation, Self-Care; (2) Integral Perspectives and Change; (3) Integrative Lifestyle Health and Well-Being; (4) Awareness and Choice; (5) Listening with HEART =Healing, Energy, Awareness, Resiliency, Transformation —energy fields, and internal and external healing environments.

The Psychology of Optimism: Through CBT, patients can move toward more optimistic perspectives and healthier lifestyle behaviors-

-It was found that positive emotional reactivity increases the pleasure one experiences from enjoyable activities. -positive shifts in perspectives potentiate health-promoting cycles. -positive emotions are associated with observational abilities, flexible attention, and nonreactivity to inner turbulence and empathy.

-Cognitive behavioral therapy helps individuals reappraise or reevaluate their thinking and adopt a healthier perspective. -Referred to as cognitive restructuring The basic principles of CBT are:

-Our thoughts, not external events, create our moods and emotions. -The thoughts that create stress are usually unrealistic, distorted, and negative. -Distorted, illogical thoughts and self-defeating beliefs lead to physiologic changes and perpetuation of painful feelings, such as depression, anxiety, and anger. -By changing maladaptive, unrealistic, distorted thoughts, individuals can change how they feel physically and emotionally

Theory of Human Relatedness, according to Hagerty and Patusky, suggests:

-People are relational beings who experience some degree of involvement with external referents, including people, objects, groups, and natural environments. -emphasizes that some human relationships serve to lessen anxiety and improve wellness, and others promote distress and anxiety.

In preparing to exercise environmental control, the nurse assesses the following parameters as they apply to the client:

-Personal space for comfort, lighting, noise, ventilation, and privacy. -Other people or troublesome objects that may induce anxiety. -Awareness that environmental concerns affect individual and family coping skills. -Awareness of objects or other environmental factors in the physical space that induce comfort or discomfort. -Environmental concerns about the influences on health as well as the family's environmental concerns. -Possible environmental fears (e.g., a feeling of claustrophobia from being confined to a hospital intensive care bed or intravenous lines, or a fear of death because the patient in the next bed just died). -Grief and its relationship to environmental factors: Is the client in the same home atmosphere in which the spouse just died? Are others around the client sad and depressed? Are the colors in the environment dark and heavy? -Personal health maintenance in relation to environmental factors: Can the client easily reach self-care hygiene items? Are throw rugs anchored? Are sunglasses worn outside to prevent glare? -Ability to maintain and manage his or her own home. -Risk of injury associated with factors in the environment. -Activity deficits as a result of environmental factors. -Home environment for its potential influence on effective parenting. -Potential noncompliance because of environmental factors. -Risk of impairment in physical activity because of environmental factors. -Risk of impairment in respiratory function because of environmental factors, such as feather pillows, polluted or stale air, cigarette smoking, known or suspected allergens, or overexertion with chronic respiratory conditions. -Possible sleep deficit because of agents in the environment, such as lighting, noise, overstimulation, overcrowding, or allergenic pillows. -Alterations in thought processes that may be influenced by environmental factors, such as sensory bombardment with noise, lack of sleep, and transient living patterns

The goals of CBT include training patients to do the following:

-Pinpoint the negative, automatic thoughts and silent assumptions that trigger and perpetuate their emotional upsets. -Identify the distortions, irrational beliefs, or cognitive errors. -Substitute more realistic, self-enhancing thoughts, which will reduce the stress, symptoms, and painful feelings. -Replace self-defeating, silent assumptions with more reasonable and flexible belief systems. -Develop improved social skills, as well as coping, communication, and empathic skills.

Peplau identified nursing roles during the course of the nurse-client relationship:

-Stranger, providing acceptance and trust; Resource, answering questions and giving information. -Teacher, giving instruction and analyzing the learner experience. -Counselor, helping the client derive meaning from the current experience. -Surrogate, advocating for the client and clarifying dependence, independence, and interdependence. -Leader, assisting the client to assume maximum responsibility for meeting goals that are mutually established.

Motivational Interviewing Guidelines:

-Validate the patient's feelings and experiences. -Reinforce reasons for change and repeat in simple, direct statements the effects of the patient's choices. -Explore potential concerns -Acknowledge the patient's control of the decision. -Explore the patient's interest in change. -Explore meaning about change -Reinforce the fact that the patient has control. -Explore how things have changed -Reinforce the concerns and the benefits of changing behaviors. -Assess interest, desire, reasons, needs, ability, and commitment as appropriate. -Explore what would need to change for movement toward behavior change -Reframe concern about inability to change. -Offer suggestions that are beginning steps for change. -Reinforce change -Encourage small, initial steps. Assess commitment. -Encourage small, steady steps

Intuition:

-a useful and foundational element. -It is defined as the perceived knowing of things and events without the conscious use of rational processes; using all of the senses to receive information

Caring, Healing, Transcendent Presence- Presence:

-a way of being, a way of relating, a way of being with, and a way of being there -difference btwn holistic communication from other communication is the depth and profound quality of presence. -Watson speaks of the full use of self in the transpersonal caring process.

American Indians and Alaska Natives:

-higher rate of poverty than does the population as a whole. -They often cluster in tribal groups, with the largest concentrations located in the Pacific and western mountain regions of the United States. -elders are typically the community leaders -still adhere to folk healing practices, seeking out local healers before going to a healthcare clinic -Common health problems include diabetes, obesity, infectious disease, alcohol abuse, and diseases associated with poverty.

Margaret Newman's Health as Expanding Consciousness Theory

-is not to try to change another person's patterns but to recognize it as information that depicts the whole and relate to it as it unfolds. -self-knowledge is paramount for the nurse to be effective in a caring, healing relationship.

Relationship refers to:

-kinship, passionate attachment, or a connection between those having relations or dealings. -two or more persons or things working together, belonging together, or being part of a whole, as in relatives within a family

Asian Americans:

-patriarchal, revere their elders, and value achievement and honor. -Certain infectious diseases, such as tuberculosis and hepatitis, are common. -Traditional healing includes the use of herbal preparations, and many families practice traditional dermabrasion procedures such as coining, pinching, or rubbing.

Erickson, Swain, and Tomlin used the work of Maslow, Erikson, Piaget, and Selye (Adaptation Response); Seligman (Positive Psychology); and Bowlby (Attachment Theory) to develop their theory called Modeling and Role-Modeling:

-posits that the nurse-client relationship is the essence of nursing and that it should be interactive and interpersonal. -a theoretical framework that promotes a therapeutic healing relationship & patient-centered nurse-client relationship

Pacific Islanders and Native Hawaiians

-socioeconomically disadvantaged and underserved in terms of access to social and health services. -Pacific Islanders have high rates of health-related risk behaviors, such as smoking, heavy alcohol consumption, and high fat and caloric intake, which leads to obesity.

Peplau, the mother of psychiatric nursing:

-the first to emphasize the nurse-client relationship as being the foundation of nursing practice. -The concept of partnership between nurse and client originated in Peplau's interpersonal model. -the nurse helps guide the patient and the patient takes an active role in the treatment plan. -Peplau's work revolved around the concept of the shared experience. -shifted nursing practice from medical intervention to an interpersonal model- nurse became the therapeutic agent.

How does one address the soul in the process of therapeutic communication? Watson's answer to this is:

-the transpersonal caring relationship. -Engaging with another at the transpersonal level is not a technique that can be learned. -it is the ability of the person to access the higher self and move from that place of higher consciousness in interactions with another. This process calls for the- full use of the self.

African Americans:

-varies in economic status, religion, education, and regional background. -tradition of strong matriarchal family units with a rich oral tradition developed. -health disparities among African Americans may be related to the disproportional rate of poverty

Description of Professional Nurse Coaching Practice:

-work with individuals and groups and are found in all areas of nursing practice, serving as staff nurses, ambulatory care nurses, case managers, advanced practice registered nurses, nursing faculty, nurse researchers, educators, administrators, nurse entrepreneurs, and nurse coaches in full-time private practice. -engage in the total scope of nurse coach practice depend on education, experience, role, and the population they serve.

The following are the four stages of human relatedness:

1. Connection means there is active involvement with another, associated with enhanced comfort and wellness. 2. Disconnection involves lack of involvement and is associated with lack of wellness and distress. 3. Parallelism implies disengagement, or the lack of involvement with others. This can have a positive effect of creating solitude with associated physical and psychological replenishment. 4. Enmeshment often describes negative, overinvolved relationships, fraught with anxiety, distress, and functional disability.

The scientific or biomedical paradigm is characterized by four main concepts:

1. Determinism. A cause-and-effect relationship exists for all natural phenomena. 2. Mechanism. The relationship of life to the structure and function of machines suggests the possibility of control through mechanical or engineered interventions. 3. Reductionism. The division of all life into isolated smaller parts, such as the dualism of mind and body, facilitates the study of the whole. 4. Objective materialism. That which is real can be observed and measured.

patient-centered care includes the following concepts for all healthcare providers:

1. Dignity and respect. 2. Information sharing. 3. Participation. 4. Collaboration

Ten Caritas Processes

1. Embrace altruistic values and practice loving kindness with self and others. 2. Instill faith and hope and honor others. 3. Be sensitive to self and others by nurturing individual beliefs and practices. 4. Develop helping, trusting, caring relationships. 5. Promote and accept positive and negative feelings as you authentically listen to another's story. 6. Use creative scientific problem-solving methods for caring decision making. 7. Share teaching and learning that address the individual needs and comprehension styles. 8. Create a healing environment for the physical and spiritual self that respects human dignity. 9. Assist with basic physical, emotional, and spiritual human needs. 10. Open to mystery and allow miracles to enter.

Hammond proposes eight assumptions about AI that are useful in understanding the AI process as a vehicle for change:

1. In every society, organization, or group, something works. 2. What we focus on becomes our reality. 3. Reality is created in the moment, and there are multiple realities. 4. The act of asking questions of an organization or group influences the group in some way. 5. People have more confidence and comfort to journey to the future (the unknown) when they carry forward parts of the past (the known). 6. If we carry parts of the past forward, they should be what is best about the past. 7. It is important to value differences. 8. The language we use creates our reality.

Kluckhohn identified five categories by which cultures address universal concerns of human nature:

1. Innate human nature as being good, evil, or mixed 2. Human beings' relationship to nature as being subjugated to the forces of nature, harmonious coexistence with nature, or using human abilities to master nature 3. Relationship to time as past oriented, present oriented, or future oriented 4. Purpose of being seen as focused on self-realization or a more action-orientation focus on doing 5. Relationship to other persons as expressed in individual, familial, or communal orientations

five professional nurse coaching core values are adapted from and congruent with Holistic Nursing: Scope and Standards of Practice, 2nd Edition

1. Nurse Coach Philosophy, Theories, Ethics 2. Nurse Coaching Process 3. Nurse Coach Communication, Coaching Environment 4. Nurse Coach Education, Research, Leadership 5. Nurse Coach Self-Development (self-reflection, self-assessment, self-evaluation, self-care)

Hagerty and Patusky further suggest that there are four social competencies vital for relationships:

1. Sense of belonging means there is an appropriate "fit" with the environment, group, or individual. There is a sense of being valued and needed in the relationship. 2. Reciprocity is a positive aspect of relationship in which there is a perceived equal exchange between parties. 3. Mutuality represents how people tend to join with those they believe share similarities to them, or with whom they share an acceptance of differences. 4. Synchrony is a person's perception of congruent feelings or behaviors with another with whom the individual shares a relationship.

Seven of the 12 values include relationship, and they are as follows:

1. The meaning and essence of care are experienced in the moment when one human being connects with another. 2. Feeling connected to one another creates harmony and healing; feeling isolated destroys spirit. 3. The relationship between patients and their families and members of the clinical team belongs at the heart of care delivery. 4. Care providers' knowledge of self and self-care are fundamental requirements for high-quality care and healthy interpersonal relationships. 5. Healthy relationships among members of the healthcare team lead to the delivery of high-quality care and result in high patient, physician, and staff satisfaction. 6. The value of relationship in patient care must be understood, valued, and agreed to by all members of the healthcare organization. 7. A therapeutic relationship between a patient/family and a professional nurse is essential to high-quality patient care.

Erik Erikson Eight psychosocial stages of life; psychoanalytic approach:

1. Trust versus mistrust (infancy) 2. Autonomy versus shame (early childhood) 3. Initiative versus doubt (preschool) 4. Competence versus incompetence (elementary school) 5. Identity versus role confusion (middle/high school) 6. Intimacy versus isolation (college) 7. Generativity versus stagnation (adult) 8. Ego integrity versus ego despair (older age) Concept: Tasks of each age group must be completed; youth often develop identity crisis in their 20s after completing higher education.

Six phenomena found in all cultural groups have variations that are relevant to the provision of culturally competent nursing assessment and care:

1. communication 2. personal space 3. Time 4. social organization 5. Environmental control 6. biological variation

Five significant goals of nursing interventions include:

1. creating trust, 2. assisting the client to maintain control, 3. encouraging a positive orientation, 4. promoting client strength, 5. assisting the client to set goals as well as promoting needs such as love, belonging, self-esteem, safety, and biophysical wellness.

Holistic communication:

A caring, healing process that calls forth the full use of self in interacting with another. It incorporates the constructs and processes of therapeutic communication within a framework that acknowledges the infinite, spiritual, and energetic nature of Being, the centrality of being heart centered, and the importance of intention, self-knowledge, transcendent presence, and intuition in our interactions

Environmental ethics:

A division of philosophy concerned with valuing the environment, primarily as it relates to humankind, secondarily as it relates to other creatures and to the land.

Therapeutic communication:

A goal-directed form of communication used to achieve goals that promote client health and well-being. Empathy, unconditional regard, genuineness, respect, concern, caring, and compassion are conveyed through active listening, active observing, focusing, restating, reflecting, and interpreting

Professional nurse coach:

A registered nurse who incorporates coaching skills into her or his or professional nursing practice and integrates a holistic perspective. This perspective, as applied to both self and client in a coaching interaction, emerges from an awareness that effective change evolves from within before it can be manifested and maintained externally. The professional nurse coach works with the whole person to utilize principles and modalities that integrate body-mind-emotion-spirit-environment.

Professional nurse coaching:

A skilled, purposeful, results-oriented, and structured relationship-centered interaction with clients provided by registered nurses for the purpose of promoting achievement of client goals.

Race:

A social classification that denotes a biological or genetically transmitted set of distinguishable physical characteristics.

Environmental justice:

A subbranch of ethics examining the innate and relational value among organisms and all aspects of their environment.

Toxic substance:

A substance that can cause harm to a person through either short- or long-term exposure through (1) inhalation; (2) ingestion into the body in the form of vapors, gases, fumes, dusts, solids, liquids, or mists; or (3) skin absorption.

Cognitive behavioral therapy:

A therapeutic approach that addresses the relationships among thoughts, feelings, behaviors, and physiology. Based on the premise that stress and suffering are influenced by perception, thoughts that create stress are often illogical, negative, and distorted. thoughts can affect emotions, behaviors, and physiology and influence beliefs. By changing thoughts, the individual can change physical and emotional states.

Forgiveness:

A willingness to acknowledge one's own mistakes and shortcomings and to allow others room to acknowledge their shortcomings as well

Ethnocentrism:

A worldview that is based to a great degree on the socialization of individuals within their own culture, to the extent that such individuals believe that all others see the world as they do.

Interventions Frequently Used in Nurse Coaching Practice:

Affirmation Holistic self-assessments Prayer Appreciative inquiry Humor and laughter Presence Aromatherapy Intention Probing questions Art Journaling Reflection Celebration Meditation Relaxation modalities Client assessments Mindfulness practice Ritual Cognitive reframing Motivational interviewing Self-care interventions Contracts Movement Self-reflection Deep listening Music and sound Silence Exercise Observation Somatic awareness Goal setting Play Stories Guided imagery Powerful questions Visioning

Empathy:

An ability to "sense the patient's private world"; an essential component in understanding another person. Human sensitivity is developed by perceiving others and experiencing an awareness of the situation of the other.

Permaculture:

An approach to designing human settlements and agricultural systems that are modeled on the relationships found in natural ecologies.

Person:

An energy field that is infinite and spiritual in essence and is in continual, mutual process with the environment. Each person manifests unique physical, mental, emotional, and social or relational patterns that are interrelated, inseparable, and continually evolving

Ambience:

An environment or its distinct atmosphere; the totality of feeling that one experiences from a particular environment.

Restorative justice:

An ethical perception that directs that environmental damages not only be curtailed but also repaired and recompensed in some meaningful way.

Xenophobia:

An inherent fear or hatred of cultural differences.

Complementary transaction:

An interaction in which the ego states match, adult-to-adult communication. Complementary transactions support and strengthen relationships.

Prolonged or repeated exposure to stress has been shown to cause or exacerbate disease or symptoms of diseases such as:

Angina, cardiac dysrhythmias, pain, tension headaches, insomnia, and gastrointestinal complaints. Stress has been found to influence the development of coronary artery disease in women and pain perception in older adults

L: Listen with empathy.

Answers lie within the client, and finding them requires listening. Good listening is a complex skill; it is more than asking questions and keeping quiet long enough to hear the reply. Empathy has been defined as a complex, multidimensional phenomenon17 but is typically understood as the ability to identify with the client's difficulties or feelings. The ability to express empathy enhances the ability to engage patients in making necessary health changes and is a key component of MI.

Appreciative inquiry (AI):

Appreciative inquiry is both a philosophy and a methodology for change; the study and exploration of strengths as a way to help patients and organizations function at their best. Instead of solving problems, AI is a process in which positive change is facilitated through identifying creative possibilities.

Boundaries:

Artificial separations between people that define the perimeters of the relationship.

Emotional intelligence:

Awareness and attention to personal emotional needs that allow individuals to be in a position of equality with others, rather than seeking power and control or becoming overly passive.

C.L.E.A.R communication:

C-center L-listen E-empathize A-attention R-respect

the importance of managing stress in the treatment of many diseases including:

Cancer and other diseases of the immune system have been shown to respond to interventions that reduce the stress response, as have arthritis, chronic pain, hypertension and stroke, diabetes, asthma, infertility, and the symptoms of chronic diseases.

Persistent organic pollutants (POPs):

Chemical substances that persist in the environment, bioaccumulate through the food web, and pose a risk of causing adverse effects to human health and the environment.

Phthalates:

Classified as "plasticizers," a group of industrial chemicals used to make plastics such as polyvinyl chloride (PVC) more flexible or resilient. They are also known to be endocrine disruptors

Daniel Goleman

Concept: Began new movement looking at significance of emotional versus intellectual intelligence. Qualities such as optimism, empathy toward others, resilience (the ability to recover from adversity), and ability to adapt to change are considered part of emotional intelligence. Also conscientiousness, goal orientation with delayed gratification to achieve goals, awareness of one's own shortcomings, confidence in being able to handle most problems, and ability to interact well with others, be cooperative, and manage close personal relationships.

Abraham Maslow Father of human psychology.

Concept: Hierarchy of needs. People move from lowest physiologic needs (food, water, oxygen) to safety and security, to love and belonging, to esteem and respect, to the highest level, self-actualization (need to do and be the person one is meant to be). Other significant concepts of humanistic psychology: ■ Identifying one's own voice as the self, rather than listening to society or the parental figure ■ Realization that life is a series of choices, one leading to personal growth and the other to regression ■ Being honest and taking responsibility for one's feelings, even if not popular ■ Being the best one can be in one's work; think outside the box, creative ■ Seeing others at their best, finding the good in others ■ Abandoning psychological defense mechanisms

Isabel Briggs Myers

Concept: Jungian based. Myers-Briggs Type Indicator (MBTI) test widely used to identify personality types. Basis of much psychometric testing; often used to gauge appropriate career choices for individuals, to describe marriage compatibility, and for personal development.

Carl Rogers Humanistic psychologist.

Concept: Patient-centered or client-centered therapy; some people have experienced being in open, trusting dialogue with another, without being judged, and have felt a sense of healing from this relationship. Based on Buber's I-Thou philosophy of treating the other as person, not object. Preferable to listen to what clients are saying, rather than trying to "fix" them. Therapist did not need to remain detached and objective; could respond emotionally to the client.

Stereotyping:

Consigning cultural attributes to a group of people based on assumptions, opinions, or attitudes.

How does culture effect health?

Culture has a significant effect on health and illness behaviors, as well as patterns of response to illness or medical care. directly influences diet and exercise. Cultural beliefs and practices also affect the types of health problems that are attended to and the actions taken to deal with them.

Time:

Cultures vary in their orientation toward time, both social time and clock time. Social time refers to patterns and orientations related to the ordering of social life, whereas clock time represents an objective, ordered approach to viewing time in a linear fashion that implies causality. Some cultures orient around cyclic approaches that attach time to natural events that repeat, such as seasons or migration patterns. For example, in mystical thought, magic or ritual may negate the temporal order of causality and reverse a bad event. All cultures contain the three orientations of future, present, and past, with one being dominant.

Ethnicity:

Designation of a population subgroup sharing a common social and cultural heritage

Environmental control:

Different cultures have different perceptions of the ability of an individual to control nature, the environment, and personal relationships. The locus of control may be external (i.e., an event contingent on luck or fate), internal (i.e., an event contingent on one's own behavior or characteristic), or outside (i.e., an event in harmony with nature, as in some Asian cultures). In folk medicine, for example, events are perceived as natural and unnatural. Natural events have to do with the world as God intended and the laws of nature. Unnatural events upset the harmony of nature and are outside the world of nature.

Careful thought must be given to each stressful situation to choose the most effective coping strategy. few ways to cope:

Distraction. Relaxation. Reframing. Affirmations.

Earth jurisprudence:

Earth law recognizes the Earth as the primary source of law that sets human law in a context that is wider than humanity.

Environment:

Everything that surrounds an individual or group of people: physical, social, psychological, cultural, or spiritual characteristics; external and internal features; animate and inanimate objects; climate; seen and unseen vibrations, frequencies, and energy patterns not yet understood.

Cognitive restructuring:

Examining and reframing one's interpretation of the meaning of an event

Xenoestrogens:

Exogenous (external) substances that can interfere with the functions of the endocrine system.

Social organization:

Families, religious groups, kinship groups, workplace groups, and special interest groups are social organizations. Families vary in structure, dynamics, roles, and organizational patterns. Kinship structures and the relative geographic location of family members have cultural implications. Religious organizations provide not only social connections but also a context in which to understand one's relationship to the world, the cosmos, and the meaning in life.

Superfund sites:

Hazardous waste landfills or abandoned manufacturing sites, names of which appear on the Environmental Protection Agency's National Priorities List.

Culturally competent health care:

Health care delivered with knowledge of and sensitivity to cultural factors that influence the health and illness behaviors of an individual client, family, or community. learned from birth through language acquisition and socialization and is the process by which an individual adapts to the group's organized way of life

Information sharing.

Healthcare practitioners communicate and share complete and unbiased information with patients and families in ways that are affirming and useful. Patients and families receive timely, complete, and accurate information in order to effectively participate in care and decision making.

Dignity and respect.

Healthcare practitioners listen to and honor patient and family perspectives and choices. Patient and family knowledge, values, beliefs, and cultural backgrounds are incorporated into the planning and delivery of care.

Nurse coaching:

Holistic nurse coaching is skilled, purposeful, results-oriented, and structured relationship-centered interactions with clients provided by registered nurses for the purpose of promoting the health and well-being of the whole person. Nurse coaching is grounded in the principles and core values of holistic nursing. Effective nurse coaching interactions involve the ability to create a coaching partnership, build a safe space, and be sensitive to client issues of trust and vulnerability as a basic foundation for further exploration.1 Nurse coaches are able to structure a coaching session, explore client readiness for coaching, facilitate achievement of the client's desired goals, and co-create a means of determining and evaluating desired outcomes and goals

cognitive restructuring goal:

If individuals change the way they think (cognition), they may change their perception of the situation. And if they change their perception of a situation so that they no longer view that situation as threatening, they may not experience stress

Biological variations:

In a pluralistic culture, it is important to distinguish among factors that are strictly biological (i.e., genetic) and those that are ethnic adaptations related to living in a particular environment (e.g., availability of certain types of food) or in certain social conditions (e.g., socioeconomic status, lifestyle). Biological factors to be considered are body size and structure, including variations in teeth, facial features, and skin color; variations in metabolism and enzyme production that result in drug reactions, interactions, and sensitivities; and susceptibility to disease (e.g., hypertension, diabetes, sickle cell anemia). Nutritional issues, including food preferences, habits, and patterns, as well as deficiencies such as lactose intolerance, all have medical implications.

Cognitive distortions:

Inaccurate, irrational thoughts that generate stress-producing thoughts and maladaptive behaviors.

Errors of stereotyping :

It is also problematic to presume that all members of another culture conform to a common pattern without regard to individual characteristics or the variety found within one cultural grouping

U: Understand and explore the client's motivation.

It is the client's reasons for change, not the nurse's, that are likely to trigger change. The nurse explores the client's concerns, perceptions, and motivations. Allowing patients to tell their story and encouraging them to discuss not only their reasons for change but also how they might see themselves make those changes is the core of the partnership

Reframing:

Looking at a situation differently can help individuals cope. A glass filled halfway can be labeled either half full or half empty. This label changes the experience greatly. Illness, for example, can be viewed as catastrophic and life shattering or as an opportunity for reconnection to what is meaningful in one's life.

There are three major types of cross-cultural paradigms:

Magicoreligious, holistic, and scientific. Although aspects of all three are found in most cultures, one usually predominates.

Sustainable future:

Meeting the needs of the present without compromising the needs of future generations

Guiding Principles of Motivational Interviewing:

Motivational interviewing is based on four guiding principles known by the acronym RULE

What do nurse coaches do?

Nurses partner with clients to assess, strategize, and plan. Nurses utilize professional nursing knowledge and skills in their role as nurse coaches. Nurse coaching helps clients to flourish by making healthful choices and adopting healthier behaviors engage individuals in the process of meaningful and health-promoting behavioral change.

Cognitive:

Of or relating to consciousness, or being conscious; pertaining to intellectual activities such as thinking, reasoning, imagining

Collaboration.

Patients and families are also included on an institution-wide basis. Healthcare leaders collaborate with patients and families in policy and program development, implementation, and evaluation; in healthcare facility design; and in professional education, as well as in the delivery of care.

Participation.

Patients and families are encouraged and supported in participating in care and decision making at the level they choose.

Affirmations:

Positive thoughts can be used to recondition one's thinking. For example, individuals frequently tell themselves they cannot do something, and the statement becomes a self-fulfilling prophecy. Affirmations are a way of countering self-defeating silent assumptions. An affirmation is simply a positive thought, a short phrase, or a saying that has meaning for the individual. Patients can be coached to create an affirmation as a way of reframing or choosing a more helpful, reasonable belief system. can help to enhance self-esteem and reduce stress.

The Nurse Coach Five-Step Process actualizes and integrates the TINC (theory of integrative nurse coaching):

Process 1: Connecting to the story Process 2: Deep listening and skillful questioning Process 3: Inviting opportunities, potentials, and change Process 4: Practicing, integrating, and embodying change Process 5: Guiding and supporting the transforming self

Defense patterns:

Protective mechanisms that justify individual action while detracting from relationship building

Chaos Theory:

Sometimes called the new science, this theory offers a way of seeing order and patterns where formerly only the random, the erratic, and the unpredictable had been observed.

Personal space:

Spatial behavior refers to the comfort level related to personal space, meaning the area that surrounds a person's body. Spatial territoriality is the need to have and to control personal space. Cultures vary in the level of proximity to others that is acceptable. For example, Western culture has three zones: the intimate zone (less than 18 inches), the personal zone (18 inches to 3 feet), and the social zone (3 feet to 6 feet). Cultural background also influences aspects of objects within space, such as orderliness, cleanliness, and structural boundaries of furniture and architecture.

The Process of Cognitive Behavioral Therapy:

Step 1: Awareness- identify stressful situations; Step 2: Automatic Thoughts-the automatic thoughts that precipitate the experience, their physical, emotional, and behavioral responses to stress Step 3: Cognitive Distortions-illogical ways of thinking that lead to adverse body-mind-spirit states Step 4: Choosing Effective Coping

Endocrine disruptors (xenoestrogens):

Synthetic hormone-mimicking compounds found in many pesticides, drugs, plastics, and personal care products.

R: Resist the righting reflex.

The "righting reflex" is the natural tendency of the nurse to fix a patient's problems by imposing solutions.17 The nurse must set aside any desire to correct the course and direction of the client. If the nurse is pushing for change and the client is resisting, the nurse is in the wrong role; it is the client who should be voicing the arguments for change. The nurse must suppress what may seem like the right thing to do and instead allow the client to determine what to do

Cognition:

The act or process of knowing

Personal space:

The area around an individual that should be under the control of that individual, including air, light, temperature, sound, scent, and color

Epistemology:

The branch of philosophy that addresses the origin, nature, methods, and limits of knowledge

Ecominnea:

The concept of an ecologically sound society.

Hispanics

The family and extended family are important, and the family unit is traditionally patriarchal. -Many believe that illness may be punishment for sins or the result of witchcraft or brujería, meaning the "evil eye." - Traditional health beliefs regarding hot and cold remedies for various maladies -Healing also incorporates many spiritual elements, such as worship of saints and use of talismans.

Electromagnetic fields (EMFs):

The field force in motion coupled with electric and magnetic fields that are generated by time-varying currents and accelerated charges.

Transtheoretical Stages of Change Model (Transtheoretical Model): The Transtheoretical Stages of Change Model is a model of behavioral change developed by Prochaska and DiClemente in 1984:

The five stages of the model are precontemplation, contemplation, preparation, action, and maintenance. Interventions designed to promote behavioral change are tailored to the individual's readiness for change. Relapses and recycling through the stages frequently occur. Relapse provides valuable information to assist in further change and is not viewed as a failure.

Energy field:

The fundamental unit of the living and nonliving. Field is a unifying concept. Energy signifies the dynamic nature of the field; a field is in continuous motion and is infinite.

Preaccess and Assessment Phase:

The holistic communication process acknowledges the importance of being centered and creating an intention before engaging in a caring, healing interaction with another. These two processes, constitute the preaccess phase involved in holistic interactions.

Detoxification:

The metabolic process by which the toxic qualities of a poison or toxin are reduced or eliminated from the body.

E: Empower and encourage hope and optimism.

The nurse helps the client discover how change can happen. The nurse views the client as the expert consultant as ideas and resources for change are explored. Providing ongoing encouragement to foster the belief that the goals are achievable can help the patient carry out a plan to change behavior. Harnessing intrinsic motivation (the drive to do something because it is interesting, challenging, and absorbing) is a key component to the process and is essential for high levels of creativity.

Watson's description of the art of transpersonal caring:

The nurse is able to form a union with the other person on a level that transcends the physical, and that preserves the subjectivity and physicality of persons without reducing them to the moral of object can potentiate self-healing and discovery in his or her own existence.

Acculturation:

The process of the adaptation or accommodation of an individual immigrant or immigrant group to a new culture

Ecology:

The scientific study of the interrelationships between and among organisms, and among them and all aspects, living and nonliving, of their environment

Cultural incapacity:

The second level of the continuum, corresponding to incompetence, refers to nonintentional practices that may be harmful to clients through ignorance, insensitive attitudes, or improper allocation of resources.

Ergonomics:

The study and realization of the importance of human factors in engineering

Culture:

The values, beliefs, customs, social structures, and patterns of human activity and the symbolic structures that provide meaning and significance to human behavior.

Anthropocentrism:

The worldview that places human beings as the central fact or final aim of the universe

Martha Roger's Science of Unitary Human Beings

Theory that states that human beings and their environments are interacting in continuous motion as infinite energy fields; four dimensions: energy fields, Openness, patterns and organizations, and dimensionality -This implies that all that we are—our thoughts, behaviors, emotions, conscious, and unconscious—interacts and affects everything and everyone

Therapeutic presence:

Therapeutic presence is the conscious intention to be fully present for another person as a way to promote health, healing, wholeness, and well-being. Presence is generally defined as a multidimensional state of being available in a situation or exchange with another, acknowledging the sacred quality and interconnectedness of each person. Presence involves letting go of past or future concerns, resulting in the creation of an opening or opportunity to reveal what is needed in the moment. Presence requires awareness, authenticity, and an appreciation of being in the moment

Communication:

There are cultural variations in expression of feelings, use of touch, body contact, gestures, and verbal and nonverbal communication. Language shapes experiences and influences perceptions and actions. Warmth and humor are two communication factors that are interpreted differently through various cultures. For example, many Asians may not overtly express their emotions because they may fear "losing face."

Appreciative inquiry (AI) is another increasingly popular change method that originated from organizational systems development:

To appreciate is to see the best in a situation or another person, while to inquire is to explore and discover. -AI is a way of asking questions that creates relationships based on the basic goodness in a person, situation, or organization.

Eric Berne

Transactional Analysis. Concept: Three ego states, people move among states; unconscious games played between people may be a substitute for true intimacy. Three ego states are Adult (rational, objective), Parent (authoritative figure), and Child (playful, curious, stubborn). All human beings need social interaction, even if it is negative interaction

Relaxation:

Using relaxation techniques to reduce emotional arousal is a way of coping with a stress that cannot be changed or avoided. Techniques to elicit the relaxation response include meditation, yoga, mindfulness, and tai chi, as well as many others.

Good questions to ask as the holistic nurse:

What do you think is going on with you/ or is happening to you? What do you think would help? allows patients time to tell their story and give their perspective

Precautionary principle:

When an activity raises threats of harm to human health or the environment, precautionary measures shall be taken, even if some cause-and-effect relationships are not fully established scientifically.

From Watson's perspective, "an event or actual caring occasion" occurs when two persons come together with their unique life histories and their phenomenal fields:

When people come together they share a phenomenal field, which becomes part of the life history of both and alters the dynamics of the present and the future. From this perspective, holistic communication can be viewed as a field experience.

Distraction:

Worry about resolving a stress can be put off until the time is right. For example, the patient receives a letter from the manager of the bank asking to speak with the patient as soon as possible, but it is after closing hours. Distraction involves putting this worry aside until the bank opens the next day, at which time the patient can deal directly with the situation. This is different from procrastination or denial because it is a necessary delay as opposed to avoidance. Direct action. The problem can be dealt with directly to resolve it.

Motivational interviewing is especially designed to deal with people who are:

ambivalent about making health changes.

Socioeconomic status underlies three major determinants of health:

access to health care, environmental exposure to health-related agents, and health behaviors.

Motivational interviewing (MI):

an intervention strategy for changing behavior. The purpose is to help patients explore and eventually resolve ambivalence in reference to a current health behavior; emphasizes client choice and responsibility and can be used in a variety of clinical settings.

Rogers uses the term unitary human being in place of person and defines who we are as:

an irreducible, indivisible, pan-dimensional energy field identified by pattern and manifesting characteristics that are specific to the whole and which cannot be predicted from knowledge of the parts.

Race and culture have significant relationships to illness states because:

biological differences can make people vulnerable to specific diseases. genetic predisposition for sickle cell disease affects African and Mediterranean descent; predisposition for Tay-Sachs disease affects Ashkenazi Jews. Also, a combination of genetic predisposition and lifestyle, including diet, are more prevalent

Jean Watson's Theory of Transpersonal Caring and caring science:

defines person as an embodied spirit; a transpersonal, transcendent, evolving consciousness; unity of mind-body-spirit; person-nature-universe as oneness, connected

Centers for Disease Control and Prevention report, some of the key social determinants of health include:

education and income, inadequate and unhealthy housing, unhealthy air quality, and health insurance coverage

Cultural proficiency:

highest level of the continuum, correspond to the movement to patient-centered care, or to what holistic nurses would identify as individually focused holistic care.

Creating Intention:

ideally precedes interaction with a person and is part of the preaccess phase. -the direction of one's inner awareness and focus for healing.

interconnectedness as:

implying that people may share the universal reciprocity of love and responsibility without regard to their culture, politics, or religion

The stress-disinhibition effect:

inability to control health-risking behaviors as a result of increased stress

Nurses can utilize AI principles and processes to assist patients to build on their strengths as a way to design and create their desired future. The main precept of AI is that:

individuals in relationships with one another can co-create an effective future that inspires new possibilities

Professional Nurse Coaching Scope of Practice:

involve the development of a coaching partnership, creation of a safe space, and sensitivity to client issues of trust and vulnerability as a basis for further exploration

Heart-Centering, Heart Coherence, and the Intuitive Heart:

involves focusing attention on the heart, no concerns and thoughts, and connecting with feelings of love and compassion. Maintaining this heart-centeredness throughout interactions has positive effects for the nurse. Positive mental and physiologic effects experienced by the nurse can be transmitted

Newman explains the responsibility of the nurse:

is not to make people well or to prevent their getting sick but to help in recognizing the power that is within and move to higher levels of consciousness. The nurse's awareness of being rather than doing is the primary mechanism for helping. -importance of staying fully present, without trying to fix or intervene:

Cultural imposition:

is the perception that successful cultural adaptation involves a change to the cultural views of the dominant group, regardless of an individual's cultural heritage. This posits an inherent view that the dominant culture is superior, and its values are imposed on others.

Cognitive Behavioral Therapy in Children and Adolescents:

modified to take into consideration the unique developmental needs The same basic principles discussed earlier are applied; however, factors such as cognitive, social, and emotional maturity are taken into consideration . For anxiety and phobic disorders in children and adolescents discusses application of this treatment for generalized and separation anxiety disorders, social phobia, specific phobias, and school refusal

Three dominant cosmology assumptions foundational to Western Judeo-Christian-Islam beliefs are:

monotheism, transcendence, and dualism

The Western view of transcendence:

or relating to God as separate from humans and knowing God through prayer, supplication, and rituals, can be contrasted with the Eastern view of immanence, or finding God by looking inward and doing other spiritual exercises to discover the sacred.

stressful events can increase behaviors such as:

overeating or excessive intake of alcohol. As stress increases, self-control decreases. Lapsing to behaviors that provide immediate gratification is more likely when stress is high.

Problems with cultural blindness/ treating all people the same:

overlooks real diversity and the importance of other perspectives. The concept of the "melting pot" assumes that, in the process of acculturation and assimilation, everyone takes on significant aspects of the dominant culture such that the original culture is largely lost

Monotheism:

the belief in one God or Creator who is separate from humans, contrasts with the beliefs common in many agrarian societies, whose members believe in polytheism-multiple gods with different attributes or pantheism -the locus of the sacred in all living things.

interrelationship implies:

the existence of a subtle web of life that connects all human beings, their environment, and spirituality. Each person's actions can directly and indirectly affect others and can create a healing or toxic response or energy

magicoreligious health paradigm:

the fate of the world depends on God, gods, or supernatural forces.

Cultural competence:

the fifth level, is best described as an ongoing learning process for the provider, who can integrate cultural knowledge into individualized client-centered care.

In the holistic health paradigm:

the forces of nature must be kept in harmony according to natural laws and the larger universe. Emphasizes health, not as much curing disease

Rogers further defines energy field as:

the fundamental unit of the living and non-living. Field is a unifying concept. Energy signifies the dynamic nature of the field; a field is in continuous motion and is infinite.

Cultural destructiveness:

the lowest level of the continuum, corresponds to maleficence in medicine and this is countered through laws such as the Civil Rights Act of 1964 (Title VI), which mandates that healthcare providers do not discriminate according to race, ethnicity, or creed

Stress:

the perception of a threat to one's well-being, and the perception that one cannot cope can cause physical, psychological, behavioral, and spiritual changes

Grounding:

the process of connecting to the Earth and the Earth's energy field to calm the mind and focus one's inner flow of energy to enhance healing endeavors.provides a steady physical, psychological, and energetic platform to anchor the communication process

Western dualism:

the separation of material from nonmaterial aspects of being, is in contrast to monism, or the essential unity found in both the pantheistic and Eastern belief systems. Many "new age" perspectives are exploring these issues as they are exposed to different cultural beliefs.

Cultural blindness:

the third level that corresponds to standardization, is exemplified by treating all patients alike without accommodating or recognizing cultural differences

Western culture and in particular the United States:

these value orientations are reflected in a strong emphasis on individualism, mastery over nature, future-focused time orientation, and an action orientation to being

Three of the most vital concepts in healthy relationships are:

trust, forgiveness, and appropriate boundary setting

Being therapeutic implies:

using oneself as an agent of healing in the dynamic relationship between provider and patient or client

Scientific paradigm is the basis for healthcare systems in Western society:

where disease is viewed as the "enemy," the body is the "battlefield," and the physician is the "general."

Precompetence:

which is the fourth level, corresponding to outcomes-focused care. Providing translators, developing health education aimed at specific cultural groups, and creating programs that address diverse groups' access to care are good examples of cultural precompetence, .

Martin Seligman Father of Positive Psychology.

■ The study of emotions that are positive. ■ The study of traits that are positive, including virtues, intelligence, strength, and athleticism. ■ The study of social institutions or concepts that possess positive qualities (e.g., functional family units, freedom of inquiry, and democracy) and support a virtuous life. Virtues include integrity, loyalty, valor, and equity. Concept: Positive emotions such as trust, hope, and confidence help us most in times of distress. Optimistic people interpret problems as controllable, transient, and limited to one situation. Pessimistic people believe troubles last forever, are uncontrollable, and undermine them. Learned helplessness: Concept that studied human and animal responses to uncontrollable events. Linked to passivity in emotionally stressed and traumatized human beings. Linked to depression and victim abuse because of learned helplessness.