Research

For you interest we have re-posted articles by Linda Yetman outlining the value / concepts and basic process of research modalities in context to holistic nursing and generally.

We will be posting bibliographies and references here that support research based holistic practices for your information and use. They have been supplied by members and nurses who have done research, post grad work, specializations, and are passionate about evidence based practice.

Feel free to explore these references, dig deeply, and search for the nuggets we need to support holistic nursing practice as valid and valuable. Forward additional content to CHNA.

Please find research resources from the below sources:

Please find Linda’s articles below.

Holistic nurses use various research approaches to support and advance nursing practice. The Fall edition of this newsletter discussed the nature of qualitative research. This edition will highlight the quantitative approach, which is important in holistic nursing because it provides empirical evidence that supports various aspects of patient care. Please bear in mind that this exploration is a cursory review. Quantitative research methods quantify phenomena by collecting numerical data and analyzing it statistically. Like qualitative research, these methods are used in various disciplines such as in psychology, sociology, education, and healthcare. They contrast with qualitative research, which focuses on understanding people’s experiences and social phenomena. Therefore, this method also lends itself to holistic nursing research and practice, which promotes a comprehensive, patient / client-centred approach to care that considers all aspects of a patient’s well-being. Determining the research question is one of the most critical processes when starting a research study, whether it is qualitative or quantitative. The research question should be carefully formulated to determine the appropriate research methodology.

Common Quantitative Research Methods Here are the main quantitative research methods. This list is not exhaustive:

• Descriptive Research
• Correlational Research
• Quasi-Experimental Research
• Experimental Research

These methods differ in their design, level of control, and purpose. For example, experimental research involves manipulating one variable to determine its effect on another, while correlational research examines relationships between variables without manipulation. There are many key characteristics of quantitative research. Some of these include: the use of a structured research instrument, the use of numerical data, objective analysis, and hypothesis testing.

Common Methods of Quantitative Data Collection:

• Surveys and Questionnaires
• Experiments
• Secondary Data Analysis
• Longitudinal Studies Common Quantitative Data Analysis Approaches
• Descriptive Statistics: Used to describe the basic features of the data in a study.
• Inferential Statistics: Used to make inferences about the population based on a sample.
• Regression Analysis: Used to understand the relationship between variables.
• ANOVA (Analysis of Variance): Used to compare the means of three or more groups.
• Chi-Square Tests: Used to determine if there is a significant association between two categorical variables.

Choose each method based on the research question and data nature, as they provide unique insights. There is software available to help researchers in the analysis phase. However, in my humble opinion, and if you are new to quantitative, or mixed methods research it is so valuable to have a person to work with who understands the interpretation of statistical data. These numbers and analyses guide nursing practice and patient care

Polit, D., & Beck, C. (2020). Essentials of nursing research: Appraising evidence for nursing practice. Lippincott Williams & Wilkins. Grove, S. K., & Cipher, D. J. (2020). Statistics for nursing research. Elsevier.

Al-Hammouri, M. M., Rababah, J. A., & Alfurjani, A. M. (2024). The Effect of a Mindfulness-Based Intervention on Family-Work and Work-Family Conflicts Among Nurses: A Randomized Controlled Trial. Journal of Holistic Nursing, 42(4), 323-332. https://doi.org/10.1177/08980101231218361

Soylu, T. G., Roess, A., Boolani, A., Wilson, A. N., Huddleston, K. C., Lawrence, G. N., & Oetjen, C. (2024). Depression, Anxiety, Energy, and Fatigue Among Nurses Who Cared for Patients During the COVID-19 Pandemic: A Cross Sectional Study. Journal of Holistic Nursing, 42(3), 231-242. https://doi.org/ 10.1177/08980101231200352

The Fall newsletter included two links to qualitative research examples. Below are links to two additional examples:

Tengblad, J., Airosa, F., Karlsson, L., Rosenqvist, J., Elmqvist, C., Karlsson, A. C., & Henricson, M. (2024). “I am Here”—The Importance of Caring Touch in Intensive Care. A Qualitative Observation and Interview Study. Journal of Holistic Nursing, 42(3), 254-264. https://doi.org/10.1177/08980101231198723

Lai, W. T., Hsu, M. T., Chou, W. R., & Lee, P. Y. (2024). The Lived Experiences of Palliative Care Professionals in Cultivating Mindfulness: A Phenomenological Study. Journal of Holistic Nursing, 08980101241251508. https://doi.org/ 10.1177/08980101241251508

As noted in the summer edition of this newsletter, holistic nursing research uses various approaches. In this edition, the qualitative approach will be explored. Please bear in mind that this exploration is a cursory review. It does not provide enough information or guidelines to critique a research article! That is for another edition! Qualitative research methods are used to understand people’s experiences, behaviours, and social phenomena. They are often used in sociology, anthropology, psychology, and education disciplines. They contrast with quantitative research focusing on numerical data and statistical analysis. Therefore, this method lends itself to holistic nursing research and practice, which promotes a comprehensive, patient-centred approach to care that considers all aspects of a patient’s well-being. Determining the research question is one of the most critical processes when starting a research study. Careful consideration must be given to developing the question, as it determines which research approach is best to answer it. Common Qualitative Research Methods The most common qualitative research methods are listed below. This list is not exhaustive:

• Phenomenology
• Ethnography
• Grounded Theory
• Exploratory Descriptive
• Historical Research
• Qualitative Research Reviews
• Focus Groups and Case Studies are considered qualitative research approaches by some researchers

Remember that ‘purest’ researchers in these methods also have method-specific research data collection procedures.

• Interviews
• Focus Groups
• Observation Analysis

• Thematic Analysis
• Content Analysis
• Grounded Theory Model
• Narrative Analysis
• Discourse Analysis
• Interpretive Phenomenological Analysis (IPA)

Each method offers unique insights and can be chosen based on the research question and the nature of the data being analyzed.

Two links are provided to articles that illustrate approaches to qualitative research:

Tilburgs, B., Vernoolj-Dasses, M., Koopmans, R., Weidema, M., Perry, M., Engles, Y. (2018). The importance of trust-based relations and holistic approach in advance care planning with people with dementia in primary care: a qualitative study. BMC geriatrics, 18,1-11.
https://link.springer.com/article/10.1186/s12877-018-0872-6

Mozaffari, N., Peyrovi, H.,& Nayeri, N.D. (2015). The social well-being of nurses shows a thirst for holistic support; A qualitative study. International journal of qualitative studies on health and well-being, 10(1), 27749.
https://wwwtandfonline.com/doi/pdf/10.3402/qhw.v10.27749

Dossey, B. M., Keegan, L., Barrere, C. C., & Helming, M. A. B. (2016). Holistic nursing: A handbook for practice. Jones & Bartlett Publishers.

Morse, J. M. (1995). Qualitative research methods for health professionals

One of the most frequent questions the CHNA receives is related to how to practice as a holistic nurse or what holistic nursing is. Therefore, it is fitting to begin there with a brief definition of holistic nursing and the importance of research in this field. Definition of Holistic Nursing Barbara Montgomery Dossey and Lynn Keegan1 , renowned figures in holistic nursing, define holistic nursing as an approach covering basic and advanced holism concepts. They demonstrate how holistic nursing spans all specialties and levels. Holistic nursing, as defined by Dossey and Keegan1 , is not just about treating physical symptoms but also about considering the patient’s physical, social, spiritual, and psychological needs. It is about nurturing the whole person and not just addressing the disease. This approach is fundamental to holistic nursing practice and reflects how holistic nurses conduct their research and practice their profession. Importance of Research in Holistic Nursing Growing rapidly, holistic nursing research is important primarily because it vitally contributes to the advancement of healthcare by promoting a comprehensive, patient centred approach to care that considers all aspects of a patient’s well-being. It does this by enhancing and improving the health outcomes of all populations, improving preventative healthcare, respecting human dignity, addressing the root causes of illnesses, and promoting a comprehensive approach to care. Holistic Nursing Principles Holistic nursing is based on several core principles that integrate the art and science of nursing. These principles below, which are reflected in documents from the Canadian Holistic Nurses Association 2 and the American Holistic Nurses Association 3 , guide nursing research in this field.

Here are the key principles:

• Holistic Philosophy, Theories, and Ethics
• Holistic Caring Process
• Holistic Communication, Therapeutic Environment, and Cultural Competence
• Holistic Education and Research
• Holistic Self-Care Types of Research in Holistic Nursing

Like all research disciplines, holistic nursing research occurs in quantitative, qualitative, and mixed methods perspectives. Our aim for future newsletters is to provide research studies from these perspectives and discuss emerging trends and areas of focus in holistic nursing research. Impact of Holistic Nursing Research Presenting research studies to our membership will illustrate the impact of this research on practice, patient care, and outcomes.

The following list (not exhaustive) highlights the diversity and integrative nature of research in holistic nursing covering the diversity and integrative nature of holistic patient care:

• Integrative Therapies: Mind-Body Practices e.g. Yoga, Meditation, Mindfulness
• Complementary and Alternative Medicine (CAM): e.g. Acupuncture, Aromatherapy, Herbal Medicine
• Energy Healing: e.g. Reiki, Therapeutic Touch, Healing Touch
• Patient-Centered Care: Holistic Personalized Care Plans & Assessments that include comprehensive assessments of Physical, Emotional, Mental, and Spiritual Health
• Stress Management and Reduction: Techniques and Interventions efficacy of various stress reduction techniques e.g. breathing exercises, progressive muscle relaxation, and guided imagery.
• Mental Health and Emotional Well-Being: Holistic Interventions e.g. the use of Holistic Therapies in treating anxiety, depression, and other mental health conditions
• Spiritual Care
• Environmental Health
• Self-Care for Nurses

In conclusion, the impact of holistic nursing research can only happen with the engagement from our membership and your involvement! Please send your questions about what you would like to see in this section of your newsletter to [email protected]

1 Dossey, B. M., Keegan, L., Barrere, C. C., & Helming, M. A. B. (2015). Holistic nursing: A handbook for practice. Jones & Bartlett Publishers.
2 https://www.chna.ca/
3 https://www.ahna.org/

In the last few newsletter issues, research in holistic nursing was explored by looking at the purpose of research in holistic nursing, research methodologies and designs. A critical component of research is the ethics associated with conducting research studies. Ethics are principles that guide researchers and are necessary to ensure that research studies are implemented rigorously, ensuring the well-being and decreased risk to participants. Research studies are generally reviewed through Research Ethics Boards (REB) to determine applicability through strict processes of review and approval. While the overall processes are similar, REBs may have organization specific requirements. In recent years, there has been a movement to ‘standardize’ or streamline the submission processes for research studies. For example, some provinces now have portals for study submission that make it easier for collaborating researchers to be involved in the submission for the approval process. Therefore, researchers need to become acquainted with organizational-specific REB requirements. Organizations that have active research departments often provide guidelines, forms, and checklists to help with getting a research study ready for submission.

For example, an example of the type of language and content expected in an organization’s consent for participation in a research study is a real time-saver. Much of this information is often available on an organization’s website. A needed resource for understanding the importance of the ethics associated with research studies is The Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS 2) – TCPS 2: CORE-2022 (Course on Research Ethics). Available in English and French on a Government of Canada website, this course is free of charge, and modules are self-paced. The knowledge gained from completing the modules is very helpful for writing a successful research proposal!
The link for TCPS 2: CORE-2022:

• https://tcps2core.ca/welcome

References courtesy of her CHNA / TheCIINDE Symposium presentation March 12 / 25: “Sustaining the Nursing Workforce: Systemic and Holistic Strategies to Address Burnout, Compassion Fatigue, and Moral Distress.”

Alhawatmeh, H., Albataineh, R., & Abuhammad, S. (2022). Differential effects of guided imagery and progressive muscle relaxation on physical and emotional symptoms in nursing students taking initial clinical training: A randomized clinical trial. Heliyon, 8(10), e11147. https://doi.org/10.1016/j.heliyon.2022.e11147

Antony. (n.d.). Effectiveness of Mindfulness Meditation on Depression, Anxiety, and Stress …: DISCOVER for Books, Articles and Media. Retrieved March 8, 2025, from https://0-eds-p-ebscohost-com.aupac.lib.athabascau.ca/eds/pdfviewer/pdfviewer?vid=3&sid=9b6f6da7-ef41-4a78-b248-5150358fd974%40redis

Arboleda, M. (2023). Does the implementation of mindfulness during shift huddle help decrease anxiety and stress in critical care nurses? https://doi.org/10.7282/T3-FJ9W-PP38

Bentley, T. G. K., D’Andrea-Penna, G., Rakic, M., Arce, N., LaFaille, M., Berman, R., Cooley, K., & Sprimont, P. (2023). Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature. Brain Sciences, 13(12), 1612. https://doi.org/10.3390/brainsci13121612

Blacher, S. (2023). Emotional Freedom Technique (EFT): Tap to relieve stress and burnout. Journal of Interprofessional Education & Practice, 30, 100599. https://doi.org/10.1016/j.xjep.2023.100599

Browne, C., & Chun Tie, Y. (2024). Promoting Well-being: A Scoping Review of Strategies Implemented During the COVID-19 Pandemic to Enhance the Well-being of the Nursing Workforce. International Journal of Nursing Studies Advances, 6, 100177. https://doi.org/10.1016/j.ijnsa.2024.100177

Chiarpenello, C., & Brodmann, K. (2024). What can the psychoneuroimmunology of yoga teach us about depression’s psychopathology? Brain, Behavior, & Immunity – Health, 42, 100877. https://doi.org/10.1016/j.bbih.2024.100877

Cohen, C., Pignata, S., Bezak, E., Tie, M., & Childs, J. (2023). Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review. BMJ Open, 13(6), e071203. https://doi.org/10.1136/bmjopen-2022-071203

Epstein, E., & Delgado, S. (2010). Understanding and Addressing Moral Distress. OJIN: The Online Journal of Issues in Nursing, 15(3). https://doi.org/10.3912/OJIN.Vol15No03Man01

Figley, C. R. (2013). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Routledge.

Fincham. (n.d.). Effect of breathwork on stress and mental health: A meta-analysis of random…: DISCOVER for Books, Articles and Media. Retrieved March 8, 2025, from https://eds.p.ebscohost.com/eds/pdfviewer/pdfviewer?vid=0&sid=30d2a9aa-29df-40e8-9e79-0cd9b5c5dfaf%40redis

Godfrey, K. M., & Scott, S. D. (2021). At the Heart of the Pandemic:: Nursing Peer Support. Nurse Leader, 19(2), 188–193. https://doi.org/10.1016/j.mnl.2020.09.006

Goetz, J. (2010). Compassion: An Evolutionary Analysis and Empirical Review: DISCOVER for Books, Articles and Media. https://eds.p.ebscohost.com/eds/pdfviewer/pdfviewer?vid=3&sid=741eff40-ff49-4b24-8566-dcdf09508fbc%40redis

Ito, A., Sato, K., Yumoto, Y., Sasaki, M., & Ogata, Y. (2021). A concept analysis of psychological safety: Further understanding for application to health care. Nursing Open, 9(1), 467–489. https://doi.org/10.1002/nop2.1086

Joo, J. H., Bone, L., Forte, J., Kirley, E., Lynch, T., & Aboumatar, H. (2022). The benefits and challenges of established peer support programmes for patients, informal caregivers, and healthcare providers. Family Practice, 39(5), 903–912. https://doi.org/10.1093/fampra/cmac004

Keng, S.-L., Smoski, M. J., & Robins, C. J. (2011). Effects of Mindfulness on Psychological Health: A Review of Empirical Studies. Clinical Psychology Review, 31(6), 1041–1056. https://doi.org/10.1016/j.cpr.2011.04.006

Koo. (n.d.). The Role of Mindfulness and Meditation in Reducing Stress and Anxiety among…: DISCOVER for Books, Articles and Media. Retrieved March 8, 2025, from https://0-eds-p-ebscohost-com.aupac.lib.athabascau.ca/eds/pdfviewer/pdfviewer?vid=5&sid=9b6f6da7-ef41-4a78-b248-5150358fd974%40redis

Liu, Y., Jiang, T., Shi, T., Liu, Y., Liu, X., Xu, G., Li, F., Wang, Y., & Wu, X. (2021). The effectiveness of diaphragmatic breathing relaxation training for improving sleep quality among nursing staff during the COVID-19 outbreak: a before and after study. Sleep Medicine, 78, 8–14. https://doi.org/10.1016/j.sleep.2020.12.003

Lovern, A., Quinlan, L., Brogdon, S., Rabe, C., & Bonanno, L. S. (2024). Strategies to promote nurse educator well-being and prevent burnout: An integrative review. Teaching and Learning in Nursing, 19(2), 185–191. https://doi.org/10.1016/j.teln.2023.09.004

Maher, C., Tortolero, L., Jun, S., Cummins, D. D., Saad, A., Young, J., Nunez Martinez, L., Schulman, Z., Marcuse, L., Waters, A., Mayberg, H. S., Davidson, R. J., Panov, F., & Saez, I. (2025). Intracranial substrates of meditation-induced neuromodulation in the amygdala and hippocampus. Proceedings of the National Academy of Sciences, 122(6), e2409423122. https://doi.org/10.1073/pnas.2409423122

Mariño-Narvaez, C., Romero-Gonzalez, B., Puertas-Gonzalez, J. A., Peralta-Ramírez, M. I., & Castellote-Caballero, Y. (2025). Mindfulness-Based Stress Reduction Program for reducing anxiety and depression in hospital staff during a pandemic: A randomized controlled trial. Journal of Psychiatric Research, 181, 320–329. https://doi.org/10.1016/j.jpsychires.2024.11.073

Maslach, C., & Leiter, M. P. (2016). Burnout. In Stress: Concepts, cognition, emotion, and behavior (pp. 351–357). Elsevier Academic Press.

National Academies of Sciences, E., Medicine, N. A. of, Nursing 2020–2030, C. on the F. of, Flaubert, J. L., Menestrel, S. L., Williams, D. R., & Wakefield, M. K. (2021). Supporting the Health and Professional Well-Being of Nurses. In The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK573902/

Nurse, A. (2017, December 14). EFT: A healing technique for reducing stress and pain. American Nurse. https://www.myamericannurse.com/eft-healing-technique-reducing-stress-pain/

Østergaard, H. D., Pallesen, K. J., Nielsen, M. N., Fjorback, L., Juul, L., & Winterdahl, M. (2025). Effects of mindfulness-based stress reduction on neuropeptide Y plasma levels in stressed individuals. Journal of Psychiatric Research, 181, 400–404. https://doi.org/10.1016/j.jpsychires.2024.12.011

Ranisha. (n.d.). Effect of a yogic stress management technique (cyclic meditation) on stress…: DISCOVER for Books, Articles and Media. Retrieved March 8, 2025, from https://eds.p.ebscohost.com/eds/pdfviewer/pdfviewer?vid=0&sid=09677854-6a4a-42a3-8243-89da9ce69057%40redis

Shaw-Metz, J. L. (2023). Coming up for air: Breathwork practice for stress management in the healthcare setting. Journal of Interprofessional Education & Practice, 30, 100594. https://doi.org/10.1016/j.xjep.2022.100594

Somatic Exercises: The Ultimate Guide To Enhancing Your Well-Being. (2024, March 25). https://www.re-origin.com/articles/somatic-exercises

St. Martin. (n.d.). Exploring the impact of a mindfulness meditation class on college student s…: DISCOVER for Books, Articles and Media. Retrieved March 8, 2025, from https://eds.p.ebscohost.com/eds/pdfviewer/pdfviewer?vid=0&sid=ae4aa7f2-cd2d-4cbc-95e9-bc68a12bb66f%40redis

Tavoian, D., & Craighead, D. H. (2023). Deep breathing exercise at work: Potential applications and impact. Frontiers in Physiology, 14, 1040091. https://doi.org/10.3389/fphys.2023.1040091

References courtesy of their CHNA webinar presentation Nov 13/25: “Holistic Nursing – What Is It & Why Does It Matter?”

American Holistic Nurses Association, & American Nurses Association. (2013). Holistic nursing: Scope and standards of practice (2nd ed.). Nursesbooks.org.

ANA, & AHNA (2019). Holistic nursing standards of practice. ANA Enterprise

Canadian Holistic Nurses Association. (2022). Holistic nursing standards of practice. https://www.chna.ca/chna-standards-of-practice/

Dossey, B. (2008). Theory of integral nursing. Advances in Nursing Science 31(1), E52-E73.

Dossey, B. M., & Keegan, L. (Eds.). (2022). Holistic nursing: A handbook for practice (8th ed.). Jones & Bartlett Learning

Dunn, P.A. (2019). Holistic healing. Theories, practices and social change. Canadian Scholars.

Dyess, S., Prestia, A., Marquit, D., & Newman, D. (2018). Self-care for nurse leaders in acute care environment reduces perceived stress: A mixed methods pilot study merits further investigation. Journal of Holistic Nursing, 36(1), 79-91. https://doi.org/10.1177/0898010116685655

Frisch, N., Howard, K., Campbell, D. & Weir-Hughes, D. (2018). Holistic nurses’ use of energy-based caring modalities. Journal of Holistic Nursing 36(3), 210-217.

Havaei, F., MacPhee, M., Ma, A., Gear, A., & Sorensen, C. (2020a). A provincial study of nurses’ COVID-19 experiences and psychological health and safety in British Columbia, Canada: Final report. 1-131. http://dx.doi.org/10.14288/1.0394563

Judith, A. (2004). Eastern body western mind (Revised). New York: Celestial Arts..

MacPhee, M., Dahinten, S., & Havaei, F. (2017). The impact of heavy perceived nurse workloads on patient and nurse outcomes. Administrative Sciences, 7(7), 1-17. https://doi.org/10.3390/admsci7010007