2013-2016 Faith Community Nursing Research

We have seen a steady growth in Faith Community Nursing (FCN) research. In 2013, only 12 articles represented the practice and very few of those were actual research. In 2014, the number of articles doubled to 24. In 2015, there were 28 published articles in the specialty of FCN with most using a research methodology. So far in 2016, there are 35 published articles describing some facet of FCN.
What has happened in Faith Community Nursing in four short years to promote such a surge in research? There are 5 major influences:

  1. The certification of the faith community nurse specialist by the American Nursing Association funded by the Health Ministries Association has pushed the specialty forward with increased credibility among peers;
  2. The development of the International Journal of Faith Community Nursing, supported by Faith Community Nursing International, has provided access to limitless distribution through the digital commons at no additional cost to authors;
  3. The Westberg Institute’s (WI) strategic plan prioritizing research, which has yielded several published research articles;
  4. WI’s development of an electronic platform for real-time FCN group discussions and resource sharing (research group); and
  5. More research begets more research.

Fueled by a good economy, more FCNs are practicing and writing articles that are tackling the central issues in nursing (transitional care, economics, community-based nursing, and chronic disease management). We are also seeing FCN publications accepted in more mainstream peer-reviewed nursing journals. I would be remised if I did not mention the continuous support the practice receives from the Journal of Christian Nursing, by InterVarsity Christian Fellowship. It has been a quick publisher of Faith Community Nursing research.

Matrix: Faith Community Nursing Research 2015-2016 (…up to July).

Citations from 2015 & 2016 (up to July-2016)

Type of research study

Outcomes

Implications for the FCN practice

Abell, C. H., Bragg-Underwood, T., Alexander, L., Abell, C. E., & Burd, V. (2015). Nurses’ Knowledge and Attitudes toward Implementation of Electronic Medical Records. International Journal of Faith Community Nursing, 1(3), 74. Quasi-experimental by utilizing a modified version of the EMR questionnaire to examine nurses’ knowledge and attitudes regarding EMRs. As age increased, the level of experience regarding EMRs decreased. No difference was noted between the computer skills of RNs with an ADN and RNs with a BSN degree. There are barriers to documenting by FCNs. Age could be a barrier to using an EMR.
Ayton, D., Manderson, L., Smith, B. J., & Carey, G. (2015). Health promotion in local churches in Victoria: an exploratory study. Health & social care in the community. Qualitative with in-depth interviews with ministers from 30 churches in urban and rural Victoria, and case studies of 10 of these churches. The traditional churches were involved in disease screening and health education with their own, older congregation members. The new modern churches have the material and human resources (FCNs) to do health promotion activities involving members and others. Emerging churches, engaged in broad health promoting activities, including disease prevention, lifestyle activities and socio-ecological approaches at a community level. A deeper understanding of churches and the various roles they and FCNs play in health promotion. Three expressions of church are identified: traditional, new modern and emerging.
Balint, K. A., & George, N. (2015). Faith Community Nursing Scope of Practice: Extending Access to Healthcare. Journal of Christian Nursing, 32(1), 34-40. Case Study of FCN interventions in a faith-based triad model between the archdiocese, the faith-based outreach program, and collaborating community partners. The outreach staff has committed to forming relationships with clinics, healthcare providers, pharmacists, and other nonprofit groups and coalitions aimed at building community capacity. The relationship between the FCN and the patient illustrates an ongoing process that takes commitment from both parties and includes the FCN’s unique practice in caring for the mind, body, and spirit. The FCN has knowledge in providing care focused on healing the body through the development of interpersonal relationships based on commitment, respect, and the belief that healing is more than hands-on. Providers need to be cognizant of the community resources available where their clients live. Further, they need to learn to work with faith-based community health partners, such as FCNs, in extending a safety net for clients who may be spiritually, economically, and socially isolated. The relationships between FCNs, their clients, and communities represent a nursing practice culture that embodies spirituality and inserts the power of healing into healthcare management and treatment.The clash between socio-structural and personal determinants of health calls for knowledge of both public and individual factors affecting health.
Branstetter, M., Main, M., & Bragg-Underwood, T. (2015) “Practice Matters: Screening and Monitoring Hyperlipidemia,” International Journal of Faith Community Nursing: Vol. 1: Iss. 2, Article 3. Review of Literature to provide FCNs with current information on hyperlipidemia, a chronic disease responsible for the leading cause of death worldwide. Current guidelines for cholesterol screening and a risk calculator resource for estimating cardiovascular risk are provided. Myths and truths are presented for review with patients. Suggestions and resources for lifestyle modifications and patient education are included. Faith Community Nurses are at the center of community health and actively involved with improving health outcomes related to chronic disease.
Callaghan, D. M. (2015) “The Development of a Faith Community Nursing Intervention to Promote Health across the Life Span,” International Journal of Faith Community Nursing: Vol. 1: Iss. 2, Article 2. The meta-analysis study involved the merging and analyzing of data collected from previous studies that investigated the relationships among self-care agency, self-care self-efficacy, and health-promoting self-care behaviors in older adult, adult, and adolescent populations. Construct validity and adequate internal consistency reliabilities were reported in Callaghan’s previous studies and for this meta-analysis study ranged from .83 to .93. The HPLPII scale was used to measure Health-Promoting Self-Care Behaviors. Effective faith community nursing-led health promotion programs are developed using theoretical frameworks that direct the content and teaching strategies used in the implementation of the programs.
Callaghan, D. M. (2016). Implementing Faith Community Nursing Interventions to Promote Healthy Behaviors in Adults. International Journal of Faith Community Nursing, 2(1), 3. Quasi-experimental The health promotion program was presented by this researcher, who is the faith community nurse for this parish, for two hours per week for six consecutive weeks. Older adult couples were more interested in participating in health promotion activities than adolescents or adults most likely due to having the time to commit to these activities. Health promotion interventions that focus on spirituality as the foundation of health and are led by faith community nurses can be effective in increasing the practice of healthy behaviors in adults. Faith community nurses play an integral role in the promotion of the health and wellness of persons within and outside of the walls of their churches. By promoting health of faith community members where they work, go to school, and socialize it increases the likelihood of participation in health promotion activities. Spirituality has an impact on health and the role the faith community nurse plays a role in accomplishing the intentional care of the spirit, especially for those not belonging to a specific faith community.
Carson, P. H. D. (2015). The Role of the Faith Community Nurse in Fostering Spirituality in those with Alzheimer’s Disease. International Journal of Faith Community Nursing, 1(3), 7. This expert opinion article explores the spiritual needs and care of AD patients and families and the unique opportunity faith community nurses have to help the AD patient and their support system. Presents the FAST Scale: A Functional Assessment Staging Scale for People with Alzheimer’s disease. The faith community nurse has an important role to play in the care of someone with Alzheimer’s as well as in the support of that person’s primary caregiver.
Chase-Ziolek, M. (2015). Reclaiming the churches role in promoting health: a practical framework. Journal of Christian Nursing. 32 (2). 101-107. This expert opinion article explores the changing healthcare environment and offers a model/framework for the work of Faith Community Nursing. LOOKING INWARD: HONORING THE BODY  You are made in God’s image (Genesis 1:27) is to treat your whole being with respect. The challenge for the church in honoring the body is to articulate scriptural support for self-care and to address where church tradition has separated body, mind, and soul.

REACHING OUT: COMPASSION AND MERCY. The Church’s Health Ministries of Compassion and Mercy. Caring for the ill and injured is the health ministry area most consistently engaged by the church.

STANDING TOGETHER: HEALTH JUSTICE If each person is created in the image of God, then the well-being of others and not only of self is a concern, recognizing that although compassion cares for those who are ill, justice seeks to change that which causes people to be ill.

FCNs can use this model to present faith community nursing to their congregation and underpin their ministry.
Cooper, J., & Zimmerman, W. (2015). The Evaluation of a Regional Faith Community Network’s Million Hearts Program. Public Health Nursing. Quasi-experimental

Twenty-two faith community nurses identified 58 participants who were either known to be hypertensive (i.e., blood pressure ≥120/80), at higher risk based on known risk factors of obesity, poor diet, smoking and presence of other chronic conditions, and/or who self-identified for participation.

Outcomes: A total of 42 participants (82%) had a decrease in systolic and/or diastolic blood pressure over 3 months. Outcomes; Twenty-two faith community nurses taught blood pressure self-monitoring and assessed lifestyle focus areas at the initial meeting, held a total of three to four coaching sessions with each of the 51 participants, and collected blood pressure readings and self-rated lifestyle area scores from 48 participants by June 30, 2014. Improvement was seen in 6 out of 7 lifestyle areas. Faith community nurses help pts meet health goals and learn skills of self-management through trusted relationships, therefore positively influencing hypertension control locally and in the state of Maryland.
Cooper, K. C., King, M. A., & Sarpong, D. F. (2015). Tipping the Scales on Obesity: Church-Based Health Promotion for African American Women. Journal of Christian Nursing, 32(1), 41-45. Quasi-Experimental

Project TEACH—Transforming, Empowering, and Affecting Congregation Health. This project was  designed to determine effectiveness of a faith-based, culturally competent nutrition and exercise program. The program was implemented over 12 weeks, in hopes of establishing new habits. And was followed by interviews.

In this study, participants lost an average of 4.4 lbs by program completion. Weight loss continued during the follow-up period, with a mean loss of 10 lbs at one year. To utilize culture as a key component, used culturally specific dance to decrease obesity in AA women. The intervention group had a 1.4% decrease in body fat, whereas the control group had a 1% increase in body fat. A Spiritual Relevance session included discussions on personal interpretation of viewing the body as a temple (1 Corinthians 6:19), and references and teachings from the Bible to reiterate the relevance of caring for oneself spiritually, physically, and emotionally. TEACH was inspired by Standard 5B of the Faith Community Nursing: Scope and Standards of Practice, which directs faith community nurses “to employ to promote health, wholistic wellness, and a safe environment” (American Nurses Association & Health Ministries Association, 2012, p. 29) within the faith community.
Crisp, C. L. (2016). Faith, Hope, and Spirituality: Supporting Parents When Their Child Has a Life-Limiting Illness. Journal of Christian Nursing, 33(1), 14-21. Review of Literature of how families employ faith, hope, spirituality, and biblical perspectives as their child becomes critically ill and faces death. ·         FAITH: AN IMPORTANT TOOL

·         HOLDING ON TO HOPE

·         SPIRITUALITY IN THE FACE OF DEATH

·         COMMUNICATING ABOUT DYING

·         LOOK AT THE ANGELS!

·         EFFECTIVE COMMUNICATION

·         CARE FOR PROVIDERS

The journey is difficult for children with life-limiting illness, their families, and their healthcare providers. Learning how to support children’s and families’ faith, hope, and spiritual needs can help make the journey more passable.

FCNs who are strong in their faith can be of great comfort to families as their child nears the end of life. Words, gestures, and appropriate touch from nurses are vitally important to families when their child is close to death. Being fully present with the child and family assures them they are not alone.
Daffron, C. (2015). Faith Community Nursing Education: A conceptual Model. International Journal of Faith Community Nursing. 1(2). A Conceptual Analysis presents a model for Faith Community Nursing Education Several theories intertwine to create the environment in which faith community nurse education occurs: (a) General Systems Theory, (b) Holistic Health Model, and (c) Humanistic Learning Theory. The central overarching theme of educational events should be holism and spirituality that inspire therapeutic interactions with others and is mediated by the omnipresent God. Education is a critical component for both entering and practicing faith community nursing.  A number of FCN curricula are offered across the United States.  Attendance at Foundations of Faith Community Nursing Curriculum continues to escalate.  The need for ongoing continuing education specific to faith community nursing and the recent introduction of FCN certification through portfolio accentuate the significance of education in the FCN specialty practice
Garrett Wright, D M.; Main, M E.; and Branstetter, M L. (2015) “Practice Matters: Screening and Caring for Those with Hypertension,” International Journal of Faith Community Nursing: Vol. 1: Iss. 1, Article 3. Review of best practices for screening and monitoring hypertension for Faith Community Nurses (FCNs). Epidemiological data regarding hypertension along with current guidelines for blood pressure monitoring. Information on lifestyle modification and patient education resources is included to assist the FCN to improve service to patients at risk for and with current hypertension. FCN use current disease information related to screening and monitoring hypertension
Gaut, M. M. (2016). The Tree of Life Model of Faith-Based Living: A Practice Model for Faith Community Nursing. International Journal of Faith Community Nursing, 2(2), 10. Conceptual Analysis

Concepts of the nursing metaparadigm are defined from a faith perspective and Tree of Life and assumptions are shared.

The Tree of Life Model of Faith-Based Living, an adaptation of the Activities of Living Model, recognizes the diversity of experiences shared among individuals, families, and faith communities. Concepts of the nursing metaparadigm are defined from a faith perspective and assumptions are shared. The Tree of Life Model of Faith-Based Living, an adaptation of the Activities of Living Model, supports the faith-based practice of Faith Community Nuring
Grebeldinger, T. A., & Buckley, K. M. (2016). You Are Not Alone: Parish Nurses Bridge Challenges for Family Caregivers. Journal of Christian Nursing, 33(1), 50-56. Exploratory qualitative descriptive study was designed to offer insight into the roles parish nurses employ in meeting the needs of family caregivers. The purpose of the study was to examine family caregiver: (a) burdens and stressors, (b) sources of social support, and (c) perceptions of support provided by parish nurses. 15 family caregivers who were predominantly female, African American, middle-aged, college educated, and Protestant The family caregivers described several stressors that contributed to the amount of burden they experienced including: (a) having difficulty during times of transition of the loved one between healthcare settings and home, (b) making lifestyle adjustments, (c) communicating with healthcare providers, and (d) difficulty finding community resources.

FCNs were described as

1.       The gift of presence.

2.       Bearer of blessings

3.       Messenger of spiritual care.

4.       Bridging challenges.

Family caregivers found great value in the unique support provided by parish nurses, who offered not only healthcare expertise but spiritual support. Support was found in the nurses being present and listening to concerns, education to prepare family caregivers for their roles, counseling to help them anticipate future options, spiritual interventions, and consultation in garnering support from community resources.
Henderson, D. L., & Powers, C. F. (2016). Are Faith Community Nurses Using the Scope and Standards of Practice?. Journal of Christian Nursing, 33(1), E1-E6. A quantitative, descriptive study of the self-reported frequency with which FCNs apply the Standards of Practice in providing care raises questions about FCNs’ understanding of the Standards and related competencies. The FCN Standards that participants perceived they applied the most in their practice, as evidenced by the number of FCNs choosing most of the time were:

·         Ethical practice (n = 141), Practice in an environmentally safe and healthy manner (n = 133),

·         Attain knowledge and competence that reflects current nursing practice (n = 130),

·         Contribute to quality of nursing practice (n = 123), and

·         Communicates effectively in a variety of formats (n = 123)

Recommendations for practice include additional education for FCNs to assure awareness of the FCN Standards competencies, and different ways to articulate the application of the Standards in congregational care.
Kenna, M. (2016). Faith Community Nursing: Bridging the Gap between Effective Healthcare and Biblical Ministry.

A Senior Thesis submitted in partial fulfillment of the requirements for graduation in the Honors Program Liberty University Spring 2016.

Review of Literature to provide Faith Community Nurses with current resources about Faith Community Nursing to present to a Christian Church Faith community nursing is a viable and effective option for long-term preventative

management of chronic illnesses. In this way, the nurse takes on a

similar role to that of the early deacon in recognizing who is in need, reporting this to the

pastoral team so funds can be allocated, and directing.  Unlike many acute care providers, FCNs have the freedom and flexibility to meet with patients on a continual basis for extended periods of time.

FCNs also offer mental health support to communities. This tool is used to calculate the cost saved by using a projected cost per day for medical care that could have been incurred if a patient had not been identified and sent to treatment early by an FCN. When clergy were asked to take a survey to assess their knowledge of FCNs and the work they do, the clergy were found to be mostly positive toward the idea of having an FCN as a part of their ministry.

Faith community nursing fits both the mission of the Christian church and the needs of the healthcare community. It takes back the Christian healing heritage and offers a ministry outlet deeply grounded in serving and caring for others as the New Testament prescribes. FCNs offer churches a tangible example of how funds can be used to serve their communities and a convicting reminder that even so-called “secular” skills can be used for the glory of God.
Link, K., Garrett Wright, D. M., & Branstetter, D. N. P. (2015). Practice Matters: Screening and Referring Congregants with Major Depression. International Journal of Faith Community Nursing, 1(3), 81. Review of Literature to provide Faith Community Nurses with current recommendations regarding screening and caring for individuals with major depression. Epidemiological data on major depression, along with recommended screening tools to assist in detecting major depression. Recommendations for the management of major depression The FCN provides care and education to individuals with major depression.
Mattingly, C. N. & Main, M. E. (2015) “Examining Faith Community Nurses’

Perception and Utilization of Electronic Health Records,” International Journal of Faith Community Nursing: Vol. 1: Iss. 1, Article 2.

Quantitative exploratory research study utilizing a cross-sectional researcher-developed 39-item questionnaire. Surveys were distributed by mail and e-mail to faith community nurses practicing in South-Central Indiana and Western Kentucky. Positive correlations were found between both perceived usefulness and perceived ease of use and intention to adopt with a stronger correlation associated with perceived usefulness. Participants reported financial challenges as most significant barriers to electronic health record adoption while the highest rated benefits were associated with record access, enhanced care coordination, and improved ability to identify and communicate FCN practice to decision makers. FCNs have barriers to electronic health record adoption such as age and costs. The highest rated benefits were associated with record access, enhanced care coordination, and improved ability to identify and communicate FCN practice to decision makers.
Meyer, J. L., & Holland, B. E. (2016). Health Coaching in Faith-Based Community Diabetes Education. International Journal of Faith Community Nursing, 2(1), 16. Pre-test/post-test format for data collection. A survey consisting of two evidence-based tools, the Short Diabetes Knowledge Instrument and the Diabetes Self Efficacy Scale along with demographic data was utilized for the pretest. Data analysis included t-tests and Pearson Correlation. Diabetes knowledge levels and self-efficacy were significantly improved from pre-test to post-test in all participants FCN provide diabetes education that increase diabetes knowledge levels and self-efficacy.
Opalinski, A., Dyess, S., & Gropper, S. S. (2015). Do faith communities have a role in addressing childhood obesity? Public Health Nursing. doi: 10.1111/phn.12226 A qualitative descriptive design informed by ethnographic methods and triangulation of multiple data sources was utilized to assess the cultural beliefs of faith community leaders. A purposive sample of 13 leaders (nine females, four males) from seven multicultural and multigenerational local faith communities participated in the study. No more than three participants from any one faith community were enrolled in the study. The first research question explored the general cultural beliefs of the faith leaders about childhood obesity. Busy schedules that impacted lifestyle choices in both food offerings and physical activity. The second research question was what are the cultural attitudes of faith leaders regarding the role of the faith community as a resource for health promotion programs related to childhood obesity? Leaders expressed understanding of needed intentionality around what food was served within their setting and activities. These findings pointed to the dichotomy between individual and social responsibility for childhood obesity. Descriptions fluctuated between concepts of individual responsibility for the causes of childhood obesity primarily at the family level to the concept of a community and/or social responsibility for addressing the phenomenon. While many studies have confirmed factors contributing to childhood obesity, the role of faith communities in helping address these issues is not clearly articulated. Before interventions can be developed in faith community settings, there needs to be a preliminary understanding of the faith community’s beliefs and attitudes surrounding childhood obesity and perceived needs of beneficiaries of the programs. This study has provided foundational work in understanding the faith communities’ potential role for supporting individual, family, and community health specifically as it relates to childhood obesity.
Pullen, L., McGuire, S., Farmer, L., & Dodd, D. (2015). The relevance of spirituality to nursing practice and education. Mental Health Practice, 18(5), 14-18. This expert opinion article discusses the relevance of spirituality to nursing practice and education, particularly in the field of mental health. It also describes and some tools that can be used to assess spirituality. Being present to the person and listening respectfully are often the most important factors in attempting to provide such needs. However, many nurses do not feel adequately prepared to assess and identify these needs, and they are poorly resourced to provide interventions. This has significant implications for overall nursing education. Some FCNs are not confident about addressing spiritual aspect of care, yet the spiritual needs of mental health patients have a fundamental role in nursing and recovery. Some spiritual assessment tools are provided.
Sheehan, A., & Miller, S. M. (2016). Nursing’s Critical Role in the Shifting Landscape of Mental Health. Journal of Christian Nursing, 33(2), 92-97. This expert opinion article presents the role of the FCN in caring for the mentally ill. 1.       Integrate mental health into general care.

2.       Further develop the specialty of mental health among nurses.

3.       Allow nurses to move between tiers of care

4.       Educate to reduce stigma.

5.       LEVERAGE FAITH COMMUNITY NURSES

Faith communities can respond to mental illness in three broad ways that have the opposite effect of healing. First, they may ignore it. They simply do not discuss it. When members of the congregation share prayer requests, they mention an upcoming knee replacement, bypass surgery, or cancer treatment. But few will say, “Please pray for me because I have panic attacks” or “I’m depressed.” In fact, people with mental illness, or who have a family member with a mental illness, may quietly disappear from the church. If it is not safe to talk about mental illness, then it is certainly not safe to have a mental illness.

While nursing as a whole represents a workforce well-placed to address mental wellness, faith community nurses have particular opportunities. Faith communities are social organisms that can provide protective and preventive measures, such as regular positive relational interactions, safe and welcoming forms of social participation, and a supportive network that cares for both body and spirit. Congregations have a built-in capacity to address issues of prevention and healing, including healing from mental illness, because they are inclusive social structures with a web of relationships.
Smith PhD, A. P. R. N., PMHNP, F., Lynette, S., Bragg-Underwood, D. N. P., Cole, M. S. N., & Spencer, W. (2016). Practice Matters: Red Flags in Adults with Mental Illnesses. International Journal of Faith Community Nursing, 2(2), 39. Review of best practices for caring for adults with mental illnesses for FCNs. FCNs’ screening strategies to identify red flags, potential community referral sources, and lifestyle recommendations for adults with mental illnesses.   The article addresses

1.       Mental illnesses

2.       Epidemiology

3.       Pathophysiology

FCNs use current mental health information and need to have evidenced based and current resources.
Sturgeon, L. P., Bragg-Underwood, D. N. P., Tonya, M., & Blankenship, D. N. P. (2016). Practice Matters: Prevention and Care of Individuals with Type 2 Diabetes. International Journal of Faith Community Nursing, 2(1), 32. Review of best practices for caring for patients with Diabetes Type 2 for FCNs. Diabetes Type 2 Epidemiology Pathophysiology Risk Factors Blood Glucose Testing and Monitoring Lifestyle Recommendations Patient Education Resources FCNs use current disease information for patient education
Weathers, E., McCarthy, G., & Coffey, A. (2015). Concept analysis of spirituality: an evolutionary approach. Nursing forum. Conceptual analysis of spirituality using Rodgers’ evolutionary conceptual analysis and a framework was presented. Three defining attributes of spirituality were identified:

1.       Connectedness

2.       Transcendence

3.       Meaning in life

A conceptual definition of spirituality was proposed based on the findings. Also, four antecedents and five primary consequences of spirituality were identified.

FCNs provide spiritual care and can test or use the framework in their work.
West, A. M. (2015). Faith Community Nursing–A Specialty within the Profession of Nursing.

International Journal of Faith Community Nursing, 1(3), 2.

Expert opinion presenting the History of Faith Community Nursing International A group of faith community nurses began discussing the possibility of a professional organization solely for faith community nurses. As a result of these discussions, Faith Community Nurses International was conceived in the fall of 2013. Initial presentations were made at the Westberg Symposium in 2014 and 2015. A vision statement, guiding principles and goals were developed that focused on faith community nurses. Memberships were accepted starting in 2014 at Westberg. Since that time, the members have ratified bylaws for the organization. The goals of our organization are: · Advance faith community nursing as a nursing specialty. · Connect faith community nurses worldwide. · Promote financial sustainability of the specialty. · Support research in faith community nursing. · Provide continuing education for FCNs. · Develop an on-line, peer reviewed nursing journal. · Advocate for FCNs locally, nationally, and internationally. History of the Faith Community Nursing International organization.
Westberg, J. (2015). Gentle Rebel: The Life and work of Granger Westberg, Pioneer on whole person care. Church Health. Memphis, Tenn. Book The Life and work of Granger Westberg, Life story of Granger Westberg and the history of Parish Nursing/Faith Community Nursing in the United States.
Wordsworth, H., Moore, R., & Woodhouse, D. (2016). Parish nursing: a unique resource for community and district nurses. British journal of community nursing, 21(2). This expert opinion article discusses the relevance of the Parish Nursing practice in the UK health scene with reference to both quantitative and qualitative outcomes. It discusses the reasons why faith communities might embark upon health initiatives, and describes the practice of parish nursing and its history and development in the UK. In the USA, Canada, and Australia, there is increasing peer-reviewed evidence around the work that parish nurses (or faith community nurses).

PNs can take direct referrals from physicians, work collaborative work with other health care providers, and lead volunteers efforts. They provide:

1.       Spiritual care interventions

2.       Preventive interventions

3.       Mental health interventions

4.       Other supportive interventions

Exploitation of parishes occur because they are seen as cheap labor and are at risk of being exploited by other health providers. This risk can be mitigated to some extent by regular reflection sessions with a professional mentor, and the presence of a support group within the church comprising other health professionals, church leadership representatives, and administrative assistance.

Parish Nursing Ministries UK, a registered charity, is the infrastructure through which parish nursing is promoted and supported. It provides introductory training for registered nurses, continuing professional development, regional coordination, and support.

Parish nursing is an international movement that is taking a foothold in churches of all denominations in the UK. As the NHS seeks to contain health-care costs, partnerships with parish nursing services should be seen as a mutually beneficial opportunity for mainstream community and district nursing services to collaborate with the local community to meet health needs. Parish nurses are already providing a wealth of interventions to diverse populations in the UK, and the potential to increase their geographical footprint and do more targeted work is significant.
Wordsworth, H. A. (2015). Rediscovering a Ministry of Health: Parish Nursing as a Mission of the Local Church. Wipf and Stock Publishers. Book Parish Nursing as a Mission of the Local Church. History of Parish nursing in the United Kingdom.
Young, S. A. (2015). Urban Parish nurses: A qualitative analysis of the organization of work in community-based practices. Journal of Nursing Education and Practice, 6(2), p19-27. Mixed method with in-depth semi-structured interviews and a survey.

Sample: 23 nurses from 22 urban congregations

Parish nurses/FCNs tasks are influenced by religion (i.e., Christianity) and location of their work. Their basic interventions are health screenings, education and sharing resources. These tasks require training and experience that would be utilized in most other clinical settings. The broader common dimensions of their practice is unique to nursing and includes ministry, relationships, advocacy, and visibility. Parish Nurses work is population specific based and aligns along broader common dimensions of their practice. Their basic interventions are health screenings, education and sharing resources.
Ziebarth, D. (2015). Why a faith community nurse program: A five finger response. Journal of Christian Nursing. 32 (2), 88-93. In this expert opinion article, a 5 finger model provides a value-added response to the question, “Why a Faith Community Nurse Program?” This article presents a concise, evidence-based response to this question and demonstrates the value of a hospital-supported FCN program FIRST FINGER: MISSION AND VISION Faith community nurses need to make the connection that the FCN Program helps meet the mission of the hospital. The following specific points can be made about mission. Point One: Extraordinary Care and Point Two: Extraordinary Care Starts in the Community.

SECOND FINGER: CARE CONTINUITY An FCN Program provides continuity of care and transitional care, delivered in the community. Point One: Continuity of Extraordinary Care Improved health outcomes are mentioned by participants in several FCN studies and Point Two: Transitional Care. THIRD FINGER: NEW PARTNERSHIPS AND OPPORTUNITIES An FCN Program creates new community partnerships, offers marketing opportunities, and can attract new grant dollars. Point One: Community Partnerships, Point Two: New Funding Sources and Point Three: Marketing.

FOURTH FINGER: MEETING HEALTH GOALS FCN Programs help the hospital obtain organizational and national health-related goals. Point One: Reaching Organizational Goals and Point Two: Reaching National Goals.

FIFTH FINGER: COMMUNITY BENEFIT Hospitals with tax-exempt, nonprofit status are expected by the federal government to give back to the community. An FCN Program fulfills the hospital’s community-benefit expectation. Point One: Nonprofit Obligation.

A concise “elevator speech” is an important strategy to provide a quick response in scheduled, intended, opportunistic, or spontaneous informal interactions in hospitals, and impact stakeholder perception of FCN program value.
Ziebarth, D. J. (2015) Factors That Lead to Hospital Readmissions and Interventions that Reduce Them: Moving Toward a Faith Community Nursing Intervention, International Journal of Faith Community Nursing: Vol. 1: Iss. 1, Article 1. Systematic Review of Literature of N-62 articles. The first group was factors that increased hospital readmissions. Second group was interventions that decreased readmissions prior to discharge. The third group was interventions that decreased readmissions post discharge or after

hospitalization.

The first group was factors that increased hospital readmissions: Medicare and Medicaid payer status, elderly with complex medical, social and financial needs, absence of a formal or informal care giver, markers of frailty, living alone, disability, poor overall health condition, poor health literacy, multi-chronic diseases, heart failure, vascular surgery, cardiac stent placement, COPD, pneumonia, diabetes or glycemic complication, stroke, major hip or knee surgery, self-rated walking limitation, psychosis, depression and/or other serious mental illness, major bowel surgery, gastrointestinal in terms of functional status, recent loss of ability for self-feeding, underweight, pressure sores, and/or subjective reported health outcome.

Second group was interventions that decreased readmissions prior to discharge: Early discharge planning. Case management. Education. Tools. Collaboration. Diverse community

Third group was interventions that decreased readmissions post discharge or after

Hospitalization: Follow-up. Clinic visit. Telehealth. Community-based nurses.

A new FCN Transition Care Program was described that included interventions that were found to decrease readmission as identified in the literature. The purpose of the program is to provide

whole health care transitional support to improve the discharge experience, ensure post-discharge support and reduce re-hospitalization of patients. The systematic integrative review was done to provide the underpinnings for the FCN Transition Care Program. In addition, the review was done in preparation for

a research study that aims to describe FCN transitional care and interventions used.

Ziebarth, D. (2015) Demonstration: Development of a Minimum Set of Parish Nurse Educational Outcomes and Behavioral Objectives, International Journal of Faith Community Nursing: Vol. 1: Iss. 3, Article 4. A six-year demonstration project presented in a case study. Development of educational outcomes and behavioral objectives for FCNs in Wisconsin Faith Community Nursing educators in Wisconsin have standardized educational outcomes and behavioral objectives.
Ziebarth, D. (2016). Altruistic and Economic Measurements used for Prevention Health Services: Faith Community Nursing Program. Journal of Evaluation and Program Planning. 57 (2016): 72-79. DOI:10.1016/j.evalprogplan.2016.02.004 Systematic Review of Literature

N-32 articles were found with only two describing the economic effectiveness of a nurse-led prevention program. After reading the abstracts, N=11 articles were chosen.

A review of both altruistic and economic measurements methods (i.e., storytelling, documentation activity reports, net benefits, cost benefit, fixed and variable cost percentage equations) was done to help Faith Community Nursing advocates to evaluate program effectiveness and to refine and influence stakeholder’s value   perceptions. FCNs can use diverse altruistic and economic measurements for assessing the effectiveness of prevention health services in their Faith Community Nursing programs.
Ziebarth, D., & Campbell, K. P. (2016). A Transitional Care Model Using Faith Community Nurses. Journal of Christian Nursing, 33(2), 112-118. Transitional Care Model was developed from systematic literature review of predictive factors of readmission and pre- and post-discharge interventions that decrease readmission. The model presents specific FCN care that occurs pre- and post-hospital discharge to support the patient in transitioning from one level of care to another, move toward wholistic health, and avoid unnecessary readmission. Based on literature, a theoretical model for FCN transitional care was developed. Faith community nurse transitional care is defined as care provided by an FCN and a faith community to support the patient’s experience of transition from one level of care to another. The FCN Transitional Care Program goals are to: (1) Endorse whole-health by using FCNs and faith communities to provide transitional care; (2) Enhance patient discharge experience from hospital to home; (3) Engage patients in their care, thereby increasing self-efficacy and positive health outcomes; (4) Eliminate unnecessary hospital admissions; and (5) Encourage collaboration and shared visioning between healthcare institutions and faith communities. The activities are presented in a linear fashion that moves from a pre-discharge phase to a post-discharge phase. Certain essential nursing interventions are achieved during each phase. Concepts for phase goals, such as trust and being approachable and accessible, were borrowed from the Conceptual Theory of Faith Community Nursing. The model was developed with the paid FCN position in mind; however, the unpaid FCN volunteer role may also benefit from the model. FCNs can provide transitional care by using this model, which is evidence based and specific to the practice of Faith Community Nursing.
Ziebarth, D. (2016). Wholistic Health Care: Evolutionary Conceptual Analysis. Journal of Religion and Health. Pg 1-24. DOI 10.1007/s10943-016-0199-6 Evolutionary Conceptual Analysis

63 sources of literature were used to answer questions:

How is the concept wholistic used in literature in regards to health care delivery?

What is wholistic health care?

What essential attributes of the conceptual model: Faith Community Nursing align with the essential attributes of wholistic health care?

Wholistic health was extensively explored and the concepts of Wholistic Health; Wholistic Health Care; Wholistic Illness; Wholistic Healing; Wholistic Health Care; Provider(s); Patient; and Consequence of Wholistic Health Care were all defined.

Essential attributes were found to be the same as the practice of Faith Community Nursing, which are faith integrating, health promoting, disease managing, coordinating, empowering, and accessing health care.

The descriptor wholistic comes from Granger Westberg and his work with wholistic health centers in churches. This led to the nurse in the parish model, now referred to as Faith Community Nursing. The descriptor wholistic continues to describe the practice and interventions provided by FCNs.
Ziebarth, D. J. (2016). Transitional Care Interventions as Implemented By Faith Community Nurses. University of Wisconsin Milwaukee. UWM Digital Commons. P.1-138. Mixed Methods: Quantitative and Qualitative Descriptive study The purpose of this study was to describe transitional care as implemented by

faith community nurses using a standardized nursing language: the Nursing Intervention

Classification (NIC) using

18 months of FCN documentation.

There are 26 essential NICs that describe Faith Community Nursing transitional care.

The most frequent Classes of NIC were Coping Assistance, Communication

Enhancement, Patient Education, Medication Management, Risk Management, Drug

Management, Lifespan Care, Physical Comfort Promotion, Cognitive Therapy, Activity and

Exercise Management, Health System Mediation, Psychological comfort Promotion, Nutrition

Support, and Behavioral Therapy. The three Classes containing the most frequently reported

interventions (77%) were Coping Assistance, Communication Enhancement, and Patient

Education.

FCN provide “priority” or evidenced based transitional care interventions. In addition, they provide coping and spiritual care interventions.

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