Dungan model of dynamic integration

Religious Values and Biobanking Decisions: An Integrative Review

Biobanking may include research procedures that violate the religious values and preferences of some patients. This integrative literature review evaluated the influence of religious values on participants' decisions to donate biospecimens to biobanks for research. The review followed the method of Whittemore and Knafl (2005). PubMed, CINAHL, and Google Scholar databases were searched for studies published between January 1, 1994 and March 31, 2014. The influence of religious values on decision making in biobanking included the following themes: (a) religious prohibitions, (b) pursuit of health, (c) decisional conflict, and (d) scope of consent. Participants' decisions reflected that they wanted to benefit from scientific advancements and to help others but wanted to do so in accordance with their religious values. The consideration of religious values in decisions about biobanking is an international phenomenon occurring across cultures. Limiting the scope of consent may help to accommodate religious values and preferences. Researchers need to respect the religious values of patients by fully explaining the implications of research procedures in biobanking. Nurses should advocate for the consideration of patients' religious values in this new age of technological advancements.

Chronic illness: the process of integration

AIM

The aim of this study was to explore how adults with a chronic illness integrate the illness experience into their life context.

BACKGROUND

Adults with chronic illnesses are challenged to learn self-management strategies to prevent complications and achieve an acceptable quality of life. Integration represents the process undertaken by an individual to achieve a sense of balance in self-managing a chronic illness and living a personally meaningful life.

DESIGN

A mixed-method descriptive design was employed to recruit English-speaking adults with a chronic illness. A semi-structured interview was completed, transcribed verbatim and content analysed. Descriptive data were collected on demographics, co-morbidity and depressive symptoms. The research was undertaken in Connecticut, USA.

RESULTS

The sample (n = 26) was diverse with respect to age (25-80 years), education (8-24 years), duration of illness (1-39 years), gender (63% female) and ethnicity (63% white). Participants reported a mean of four chronic illnesses and 31% of the sample had increased depressive symptoms. The process of integration was complex and multifactorial. Themes of integration included: shifting sands, staying afloat, weathering the storms, rescuing oneself and navigating life. Numerous factors including treatment side effects, a progressive or uncertain illness trajectory, co-morbidity, bad days, financial hardships and interpersonal/environmental challenges contributed to a disruption or difficulty in the integration process.

CONCLUSION

All participants made considerable effort to integrate the illness into their life context and participate in a personally meaningful life. However, it was easy to be consumed with 'living an illness' as the daily tasks, the changing symptoms and the fluctuating emotions could be overwhelming. There was a complex co-existence between 'living a life' and 'living an illness'.

RELEVANCE TO CLINICAL PRACTICE

There were numerous challenges to the process of integration and ongoing self-management, psychosocial, vocational and existential support appears indicated, particularly with individuals with multiple chronic illnesses, progressive chronic illnesses and limited resources.

Reaching across the pond: a global exchange between health systems

AIM

This article describes a unique programme begun in 2001 through a partnership between the historic St Bartholomew's Hospital and the London National Health Service Trust, in London, England and Valley Health in Winchester, Virginia, USA. Dubbed the RN International Exchange Program, selected registered nurses have the opportunity to experience first-hand healthcare delivery in another country and participate in a creative way of expanding knowledge about nursing.

BACKGROUND

Professional nurses are persistent in seeking new ways to enhance nursing practice and improve patient care. This happens in several ways, including academic study, research, continuing education and dialogue with other healthcare professionals. One method to advance nursing practice is through the sharing of knowledge between nurses, both at home and across the globe.

CONCLUSION

Participating nurses see this type of global educational opportunity as a once-in-a-lifetime experience that could never be duplicated in the traditional classroom setting.

Analysis of Integration in Nursing Science and Practice

PURPOSE

To clarify the definition of integration and to identify universal aspects of the experience of integration related to healing, health, and nursing care.

DESIGN

An integrative review concept analysis method was used. Relevant reports were identified by a computer-assisted search using the keyword integration in CINAHL from 1966 to 2004 and by reviewing the reference lists of retrieved reports. The final sample included 56 reports; 36 were empirical and 20 were theoretical.

METHODS

Data were extracted from primary sources on the definition of integration, aspects of the process, antecedents, consequences, and facilitators. Data display matrices were used and were iteratively compared to derive a process model of integration related to health.

FINDINGS

A wide range of primary sources indicated that integration is an important aspect of healing or recovery from illness. Integration is defined as a complex person-environment interaction whereby new life experiences (i.e., illness) are assimilated into the self and activities of daily living, thereby contributing to overall life balance.

CONCLUSIONS

Results of this analysis indicate the importance of the concept of integration to the science and practice of nursing. The process of integration appears to be a significant phase that occurs between a diagnosis of illness and subsequent physical and emotional healing.