2. Williams conducted a study of 94 hospitalized medical patients at two rural hospitals in the southeastern United States to determine patients' feelings and satisfaction with holistic nursing care (Williams, 1997, 15-29). All the patients were over age 18 and being prepared for, or recovering from, an extremely invasive procedure (17). Patients were tested using the HCI, an instrument designed to measure the holistic, humanistic, caring component of the health care provider-patient interaction. Four dimensions of nursing care were identified through factor analysis: physical caring; interpretive caring, which assists patients in discussing and interpreting their feelings; spiritual caring, which focuses on the spiritual needs of the patient; and sensitive caring, which is sensitivity to the individual's feelings and needs.

The patients in this study were not very happy with their nursing care (Williams, 1997, 20). Patients rated interpretive and spiritual caring the lowest, and sensitive and physical caring highest. Sensitive caring was the best predictor of patient satisfaction. This suggests that barriers to a therapeutic nurse-patient relationship include a lack of sensitivity, a lack of

Taylor, K. (2000). Review of AHNA Standards of Holistic Nursing Practice. AORN Journal, 72(6), 1080.

Holistic nurse practitioners blend Western medicine and complementary and alternative medicine to treat the whole person - body, mind, and spirit (Diluzio, 2002, 32). Holistic practitioners are trained to assess a person's physical, mental, social, and spiritual states and identify areas of their lives that need change (33). The AHNA endorses several baccalaureate and master's degrees in holistic nursing, and RNs can earn a certificate in holistic nursing (HNC) (34). The AHNA is developing a national certification exam for HNPs.

Williams, S. (1997). The relationship of patients' perceptions of holistic nursing caring to satisfaction with nursing care. Journal of Nursing Care Quality, 11(5), 15-29.

physical caring, a lack of interpretive caring, a lack of spiritual caring, and also a lack of establishing a trusting relationship with the patient. If the nurses had established a trusting relationship with their patients to begin with, their other needs would have been met.

philosophy and education; holistic ethics, theories, and research; holistic nurses self-care; holistic communication, therapeutic environment, and cultural diversity; and holistic caring process (AHNA, 2004). The first core value, holistic philosophy and education includes such issues as recognizing a person's capacity for self-healing and using it to one's advantage (T