Burnout of nurses is a global occupational hazard characterized by emotional exhaustion, cynicism, and reduced care quality. Often framed as a nurse resilience issue, other evidence suggests organizational and systemic contributors such as workload, staffing shortages, and toxic leadership. This article introduces a holistic, tarot-informed framework for nurse self-reflection based on the Rider-Waite process organized around the Celtic Cross card-position structure. This framework uses card positions and symbolism as prompts to explore psychological, social, professional, and structural influences that inform nurses' experiences of burnout, rather than using tarot for prediction or divination. The 10-card position spread supports meaning-making, mindfulness, and professional identity to explore nurses' work experiences; tarot cards can be added for deeper symbolic meaning. This interconnected framework provides a pathway to nurse resilience and holistic insight. Individual reflection alone is insufficient; sustainable change also requires leadership accountability and organizational commitment to healthy work environments. Nursing is based on human caring, which also includes caring for ourselves.
This systematic review and meta-analysis evaluated the efficacy of traditional Chinese medicine (TCM) nursing interventions for breast cancer-related lymphedema. A comprehensive search of 6 databases identified 26 randomized controlled trials involving 2315 participants. TCM nursing significantly improved the overall clinical response rate (risk ratio = 1.22, 95% confidence interval [CI], 1.18-1.27, I 2 = 0%), reduced Visual Analogue Scale pain scores (mean difference = −1.20, 95% CI, −1.41 to −1.00), and enhanced upper limb function (standardized mean difference = −1.33, 95% CI, −1.56 to −1.09). Subgroup analyses for affected limb circumference showed potential benefits, but substantial heterogeneity ( I 2 = 91%) precluded overall pooling. No severe adverse events were reported. Current evidence suggests TCM nursing may be an effective and safe adjunctive therapy for breast cancer-related lymphedema; however, methodological limitations, including a lack of blinding, warrant cautious interpretation. Further rigorous trials are needed to confirm these findings.
Complementary and alternative medicine (CAM) is widely used in Saudi Arabia, yet nurses' readiness to provide safe, evidence-informed guidance remains unclear. This study assessed nurses' knowledge, information-seeking ability, attitudes, and practice related to CAM and identified demographic and professional predictors of competency in 2 Ministry of Health tertiary hospitals in the Western Region. A cross-sectional survey of 501 registered nurses used validated measures of CAM familiarity, access to information, attitudes, and practice behaviors. Overall familiarity was low to moderate, and 64.5% reported difficulty locating reliable information. Attitudes were generally positive (42.7% very high), while practice levels were mostly moderate (84.6%); only 7.6% had prior CAM training. Higher education and previous CAM training were significant predictors of better familiarity, information-seeking, and practice. Despite supportive attitudes, gaps in knowledge and training limit safe integration, underscoring the need for structured education and institutional guidance.
Psychiatric nurses experience elevated burnout rates due to emotionally demanding environments. Mindfulness-based interventions (MBIs) have emerged as promising strategies for burnout reduction. This study aimed to examine evidence on MBIs for reducing burnout in psychiatric nurses through narrative synthesis. Systematic CINAHL search (January 2025) using Boolean operators yielded 276 articles. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 12 studies (2020-2024) were selected examining mindfulness interventions and burnout outcomes in nursing populations. Eight-week MBSR programs demonstrated large effect sizes (standardized mean difference: -4.27 for emotional exhaustion, -2.89 for depersonalization). In psychiatric nurses, 75% achieved meaningful burnout reduction versus 40% controls. Benefits persisted at 3-month follow-up. MBIs represent evidence-based strategies for nursing burnout, particularly in psychiatric settings. Implementation requires organizational support. Future research should examine long-term sustainability and psychiatric nursing-specific adaptations.
Toenail disorders (eg, onychomycosis) are common among older adults and may cause pain, impaired mobility, and reduced quality of life. Despite aiding early detection and management, toenail observation is often overlooked in nursing. This cross-sectional survey included registered nurses at a single hospital without specialized foot care training. Associations between case-based observational performance and reasons for not routinely observing toenails were examined using the Mann-Whitney U test. Among 28 respondents, 25 (89.2%) reported that they "sometimes did not" or "did not" routinely observe patients' toenails. Median observational performance and reporting judgment were 60.0% (interquartile range: 43.4-80.0) and 56.7% (20.0-80.0), respectively. The most common reasons were the absence of habitual toenail observation and no prior consideration of toenail care; nurses selecting these reasons had lower observational performance. Routine toenail observation was uncommon and related to these factors.
This study aims to assess the impact of herbal medicines on sleep quality in postpartum mothers. All randomized clinical trials were retrieved from the Cochran library, SID, Magiran, Scopus, PubMed, and Web of Science databases without a time limit. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flowchart was utilized to report the study selection process. STATA software was used to analyze the data. Out of the 463 studies retrieved, 11 were systematically reviewed. Of the 11 studies, 7 were included in the meta-analysis. The results of the meta-analysis indicated a statistically significant difference between the intervention and control groups ( P =.014), with the mean overall sleep quality score in the intervention group being lower than that of the control group (standard mean difference = -0.89) and a confidence interval of (-1.61 to -1.18), demonstrating that herbal medicines improved the sleep quality. Herbal medicines improve the sleep quality of postpartum mothers, therefore, it is recommended to use these plants in postpartum care.
In ambulatory oncology settings, some of the most meaningful healing occurs not during active treatment but within the quiet spaces surrounding it. This reflective essay explores therapeutic silence and attuned presence as holistic nursing interventions that support emotional, relational, and spiritual well-being for individuals receiving cancer treatment. Drawing on mindfulness-based nursing literature, communication theory, and co-regulation neuroscience, it examines how nurses create conditions of safety and connection even in time-pressured environments. De-identified clinical narratives illustrate how silence can regulate the nervous system, facilitate meaning-making, and honor the patient’s inner experience. The essay concludes with practical reflections on cultivating presence within busy infusion settings and emphasizes the essential role quiet accompaniment plays in holistic oncology care.
This meta-analysis aims to assess the impact of pregnancy yoga on the mental health of women. Conducted without any temporal restrictions, our study collected data from PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK Thesis Center databases from September to December 2023. Following a thorough review, 9 studies were included in the analysis. Our meta-analysis indicated that the application of yoga during pregnancy significantly contributed to reducing depression (SMD: − 0.496, 95% CI: − 0.752 to −0.241; Z = − 3.807; P < .05) anxiety levels among pregnant women (SMD: − 0.739, 95% CI: − 1.22 to −0.256; Z = − 2.99; P < .05). The study concludes that yoga is an effective intervention for enhancing the mental health of pregnant women, leading to reduced anxiety and depression levels. Pregnancy yoga is suggested as a supportive practice to maintain the overall well-being – physical, mental, and spiritual – of expectant mothers, contributing to their adaptation to the challenges of parenthood by positively influencing the physiological and psychological transformations experienced during pregnancy.
Intensive care unit (ICU) nurses are frequently exposed to suffering and emotional distress, placing them at risk for burnout, compassion fatigue, and moral distress. Mindfulness practices can nurture presence, resilience, and compassionate care, yet many structured programs are too time-intensive for busy clinical environments. The Brief Intentional Grounding (BIG) Moment, a nurse-developed, 1- to 3-minute mindfulness practice, was created to restore balance, reduce stress, and support holistic well-being within the flow of care. In this pre-post intervention study, 30 ICU nurses at an urban safety-net hospital participated in a 3-month program including a 20-minute educational video and encouragement to practice The BIG Moment once or twice per shift. Perceived stress, measured with the 10-item Perceived Stress Scale, decreased significantly from baseline to 1 and 3 months ( P < .001). Results demonstrate that The BIG Moment is a brief, sustainable, and integrative practice that promotes nurse well-being and strengthens the healing environment.
Doctoral nursing students experience high stress levels and mental health challenges, impacting resilience and professional readiness. Teaching wellness practices is essential to support student well-being and retention. High rates of stress and attrition among new nurses highlight the need for wellness-focused education, yet traditional teaching methods may not effectively promote self-care and stress reduction. Guided by Kolb’s Experiential Learning Theory and the American Association of Colleges of Nursing Essentials Domain 10, this practice improvement project involved evaluation of a 40-minute guided meditation for Doctor of Nursing Practice students. The intervention included breath work, emotional grounding, and cognitive recentering. Using a pre-posttest design, 39 participants reported significantly reduced stress ( P < .001) and increased relaxation ( P < .001). Nearly all endorsed benefits to personal well-being and recommended future integration. Findings suggest experiential meditation fostered resilience and self-care, offering nurse educators a practical strategy to enhance student wellness, professional development, and workforce sustainability.
This randomized controlled experimental study investigated the effects of laughter yoga on vital signs and test anxiety among nursing students. The sample consisted of 136 nursing students (68 experimental and 68 control) from a university in eastern Turkey. The experimental group participated in laughter yoga sessions twice weekly for 4 weeks, while the control group received no intervention. Data were collected using a Personal Information Form, vital sign Chart, and Test Anxiety Scale. Descriptive statistics and independent and paired t tests were used for analyses. The experimental group showed significantly lower systolic and diastolic blood pressure and test anxiety levels, as well as higher oxygen saturation compared with the control group. These findings suggest that laughter yoga may be an effective, low-cost complementary intervention to improve physiological parameters and reduce test anxiety in nursing students.
While medical advancements have significantly increased breast cancer survival rates, current survivorship often remains trapped within a biomedical framework that views physical alterations merely as deficits to be fixed. Consequently, the lived experience of survivors involves persistent body surveillance and cultural stigma that conflict with societal norms. Guided by Georges Canguilhem’s philosophy of normativity, this scoping review maps social constraints in breast cancer survivors using the Arksey and O’Malley framework and Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Analysis of 13 eligible studies reveals that stigma—manifesting as self-stigma and cancer-stigma—serves as a primary antecedent to social constraints, with cultural background significantly influencing its intensity. These constraints often force survivors into silence and isolation, reinforcing the perception of altered bodies as pathological. From a holistic nursing perspective, however, physical changes should not be viewed as failures of recovery but as the genesis of new biological constants. This review argues for a paradigm shift from mere coping to renorming—empowering survivors to establish a valid new normal. This approach honors the survivor’s agency in reclaiming ownership of their health, aligning with the core tenet of holistic practice: the integration of the altered self into a meaningful, integrated whole.
This study's objective was to understand the multidimensionality of comfort experienced by patients receiving palliative care, considering Katharine Kolcaba's Comfort Theory. It consisted of exploratory research based on a qualitative approach and interpreted according to Kolcaba's theoretical framework. The study was conducted through interviews with 17 patients receiving palliative care at 2 public hospitals in the Federal District, Brazil, between December 2020 and December 2022. The interviews were transcribed, and the resulting corpus was submitted to content analysis and interpreted considering Katharine Kolcaba's Comfort Theory. The analysis made possible the understanding of perceptions of comfort across its different senses and contexts. It was possible to develop an overview of the structure designed by Kolcaba, consisting of 12 cells divided among the senses and contexts of comfort, thus confirming its multidimensionality. The theory proved to be clear, simple, precise, and general, attesting that it could be applied to patients receiving palliative care.
Diabetes is a chronic, complex condition, which requires intensive daily management for adequate glycemic control. The burden of daily tasks necessary for diabetes self-management can negatively impact psychosocial outcomes. The practice of gratitude in patients with chronic conditions has demonstrated improvement in poor psychosocial outcomes. The purpose of this review is to examine the effect of gratitude interventions on glycemic and psychosocial outcomes in individuals with diabetes. We searched 5 databases in September 2024 to identify research articles that met inclusion criteria. Six studies met inclusion criteria. Interventions included gratitude journaling, gratitude therapy, writing a gratitude letter, and gratitude reflection. Results indicate gratitude is a feasible intervention and may improve anxiety and depressive symptoms, quality of life, and coping with diabetes. There was heterogeneity in intervention delivery and results. Further research is required to ascertain the extent of correlation between gratitude, and glycemic and psychosocial outcomes.
