Integrative nursing in bachelor education

Using sequential research design, this PhD project aimed to develop learning outcomes for integrative nursing education and strengthen nursing students’ competencies in providing holistic and integrative care.
To explore existing knowledge a literature review identified 16 educational programs, mainly from non-European contexts, combining theoretical knowledge of complementary therapies with experiential learning. A European mapping study including 31 experts documented primarily elective courses focused on complementary therapies for symptom management and self-care. Both studies highlighted a holistic approach to nursing care and the use of interventions such as massage, meditation, and relaxation. However, limited curricular integration and reliance on individual educators were found as barriers to integrative nursing education. Based on these findings and the principles of integrative nursing, a European Delphi study developed and validated a competency profile for nursing students comprising 24 learning outcomes across knowledge, skills, and responsibility/autonomy. The profile emphasized general knowledge of selected complementary therapies, patient-centered communication, ethical reflections, holistic decision-making, and self-care. Skills to apply complementary therapy were considered less relevant at bachelor level.
The competency profile informed the development of the Integrative Nursing Handbook, which provides teaching materials, methods, and didactic reflections. A course based on these outcomes was subsequently implemented at a Danish University College and evaluated using a mixed-methods approach. Students reported positive learning experiences, broader perspectives on nursing, and increased appreciation of integrative nursing as a complement to biomedical approaches. The thesis discusses opportunities and challenges for implementing integrative nursing education, including the importance of self-care competencies, patient perspectives, and workforce sustainability. While findings demonstrated promising educational outcomes, further research is needed to support implementation across diverse European nursing education contexts.