Jul 2026· Journal of Holistic Nursing· pp.
8980101261467548
· 0 citations· 34 references
Medicine
TL;DR
The "Bonds that Transform, Care that transcends" model provides a new framework for holistic hospital nursing practice that prioritizes holistic care for patients and their families to ensure clinical excellence and safety in nursing services.
Abstract
PurposeTo develop a professional nursing professional practice model (PPM) to guide performance at a university hospital.DesignSequential multimethod design for theory development.MethodThe study was executed in four sequential phases: (1) identification of the need for a PPM; (2) preliminary model design; (3) internal and peer validation; and (4) evaluation against international standards.FindingsThis PPM prioritizes holistic care for patients and their families to ensure clinical excellence and safety in nursing services. It integrates synergistic management, organizational structures, and continuous quality improvement to address contemporary healthcare challenges within a holistic care philosophy.ConclusionsThe "Bonds that Transform, Care that transcends" model provides a new framework for holistic hospital nursing practice. Grounded in humanistic perspectives, the model posits that therapeutic relationships transcend clinical procedures through high-quality interactions among staff, patients, and families. By fostering mutual growth, this care extends beyond the hospital to transform individuals, strengthen autonomy, and dignify the human condition. Broadly, this framework bridges theoretical holism with clinical pragmatism, promoting nursing leadership, facilitating education, advancing research, and offering a scalable roadmap for humanizing high-complexity healthcare institutions.
Objective: To elaborate and present an integrated conceptual definition of clinical leadership in nurses, empowering, based on the results of a systematic literature review.
Methodology: This study used Walker and Avant’s approach, which consisted of eight systematic steps. The literature search was conducted using electronic data from PubMed, Scopus, Science Direct, Sage Journal, ClinicalKey Nursing, and Proquest published from 2021 until 2025.
Results: An integrated conceptual framework identified three key antecedents (structural empowerment, supportive leadership climate, clinical leadership capabilities) and four core attributes, including transformational influence, enabling empowerment, relational and collaborative competencies, and ethical and professional integrity. The consequences include nurse well-being and growth, clinical excellence and safety, innovation and service improvement.
Conclusion: This conceptual analysis resulted in an integrated clinical leadership framework, conceptualizing clinical leadership in nurse empowerment as a system-level construct with interdependent components. These findings provide a strong theoretical foundation for the development of valid measurement instruments and the design of targeted interventions in clinical settings.
Mazly Astuty, T. Hariyati, Tuti Nuraini et al.· Rawal Medical Journal· 0 citations
Introduction: Continuous professional growth is essential for nurses to maintain competence, promote patient safety, and respond effectively to increasingly complex healthcare demands. Although established nursing and educational theories explain the development of clinical competence, experiential learning, caring practice, and self-efficacy, they do not explicitly integrate the psychological mechanisms that initiate and sustain nurses’ professional growth. Objective: This article presents the Curiosity–Courage–Confidence (3C) Theory of Professional Growth in Nursing, a conceptually derived, practice-informed middle-range theory that explains the psychological processes underlying nurses’ continuous professional growth. Methods: The theory was developed using Walker and Avant’s theory synthesis and theory derivation strategies. The development process incorporated a structured literature review, concept analysis, conceptual integration, and practice-informed observations. Established perspectives from nursing, psychology, and experiential learning informed the construction of the theoretical framework. Results: The resulting theory comprises three interrelated constructs: curiosity, which initiates knowledge-seeking and lifelong learning; courage, which enables nurses to apply knowledge despite uncertainty or perceived risk; and confidence, which develops through successful experiences and reinforces professional engagement, autonomous clinical judgment, and leadership. These constructs operate within a continuous, self-reinforcing cycle influenced by organizational and environmental conditions. Conclusion: The 3C Theory provides a theoretically grounded and practice-informed framework for understanding the psychological processes that support nurses’ professional growth. It offers potential applications in nursing education, clinical practice, leadership development, and future empirical research.
Jonathan M. Laranang· Celebes Nursing Journal· 0 citations
INTRODUCTION
Internationally, nurses need to learn and develop relational skills that enable them to engage therapeutically with patients. Relational skills are crucial in contexts of socioeconomic deprivation, where patients face high levels of adversity, inequality, and poor health. They are defined as the interpersonal skills needed to bring about clinical change, while also enhancing staff well-being and support. Educators continue to grapple with how best to design and deliver educational programs that enhance relational skills in the nursing workforce. We report on a realist evaluation of a psychodynamically informed relational care educational program for primary care nurses, identifying outcomes, impacts, and mechanisms of change.
METHODS
Mixed methods with a prospective cohort, within a realist evaluation framework. Predefined outcomes were assessed at pre, mid, post, and 3-month follow-up, using validated measures (Professional Quality of Life V and Therapeutic Relationship Assessment Scale-Nursing). The context and mechanisms through which outcomes were realized, and impacts were investigated through multiple data sources over the course of the program.
RESULTS
Statistically significant increases were observed in compassion satisfaction, self-awareness, and knowledge. Reductions were observed in burnout and secondary traumatic stress. Empathy toward service users increased. Participants reported multiple well-being and patient-focused impacts associated with program engagement. Early indicators suggest these were sustained over time.
DISCUSSION
Results highlight the value and impact of psychodynamically informed, relationally focused education approaches for staff working with service users experiencing high levels of health inequality and multimorbidities. A pedagogical model for effective delivery is presented. Future research should test the theory of change and outcomes under experimental conditions and long-term follow-up of outcomes.
C. Foster, Emma Tague, G. Winship et al.· Journal of Continuing Educat...· 0 citations
The nursing process provides a structured framework for the delivery of holistic, person-centered care, yet increasing healthcare complexity challenges its implementation in practice. This discussion paper examines the relevance of Marjory Gordon's functional health patterns (FHP) as a guiding framework for contemporary nursing practice. FHP supports systematic assessment by integrating the biological, psychological, social, cultural, and spiritual dimensions of health. However, contemporary healthcare demands require a critical reinterpretation of the framework. This paper argues that the contemporary value of FHP extends beyond assessment. Rather, FHP may be reconceptualized as a dynamic conceptual resource that helps nurses operationalize holistic care, strengthen clinical reasoning, support nursing diagnoses, and individualize care planning.
Cristina Barradas, Susana Miguel, Laura Rossi et al.· Nordic Journal of Nursing Re...· 0 citations
BackgroundIntegrity is a foundational value in nursing, essential for ethical practice, professional accountability, and maintaining patient trust. Growing evidence of dishonest behaviors in academic and clinical settings highlights the complexity of practice, where boundaries between honesty and dishonesty are not always clear-cut. Despite this, limited research has explored how senior nursing leaders conceptualize integrity and dishonesty across the academic-clinical continuum.AimThis study aimed to explore senior nursing leaders' perceptions of integrity and dishonesty, the underlying factors contributing to unethical behaviors, and potential strategies for addressing these challenges in educational and clinical contexts.DesignA qualitative study was conducted. Data was collected through semi-structured, in-depth interviews and analyzed using thematic analysis to identify patterns and themes.ParticipantsThe study included ten senior nursing leaders from academia, hospitals, and the Ministry of Health. All participants held managerial roles and had experience in nursing education or training, allowing for perspectives across the educational-clinical continuum.Ethical considerationsEthical approval was obtained from the institutional review board. Informed consent was secured from all participants, and principles of confidentiality, anonymity, and voluntary participation were strictly maintained.FindingsThree themes emerged: (1) integrity and dishonesty were perceived as existing along a continuum rather than as dichotomous constructs, with patient safety serving as a key moral boundary; (2) dishonest behaviors were shaped by a combination of individual, cultural, and systemic factors, including organizational pressures and inconsistent enforcement; and (3) leadership practices, particularly education, role modeling, and case-by-case management, were viewed as central to promoting integrity.ConclusionsIntegrity in nursing is not solely an individual attribute but is co-constructed within organizational and educational systems. Promoting ethical practice therefore requires integrated approaches that combine education, supportive organizational cultures, and clear policies, while acknowledging the complexity and ambiguity inherent in real-world clinical practice.
Efrat Danino, Elena Maoz· Nursing Ethics· 0 citations
A comprehensive four-stage nursing engagement framework is proposed that spans the entire DTx lifecycle of design, implementation, evaluation, and ethical governance, highlighting the indispensable role of nurses in the clinical deployment of DTx.
Yu-Hsiu Lin· Hu li za zhi The journal of...· 0 citations
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