Integrative nursing in Europe - A competency profile for nursing students validated in a Delphi-study

Anita Lunde*, Thora Gunnarsdottir, Martine Busch, Marianne J.E. van der Heijden, Torkel Falkenberg, Monique van Dijk, Dorte Wiwe Dürr

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Integrative nursing is a framework for providing holistic care and includes complementary therapies and non-pharmacological interventions. There is no common European approach on how to educate healthcare professionals on complementary therapies and non-pharmacological interventions for symptom management. Nurses report a lack of formal education as the main barrier to applying integrative nursing. Objectives: The aim of this study is to develop and validate integrative nursing learning outcomes in a competency profile for bachelor nursing students. Methods: A two-round Delphi study was conducted with experts on integrative nursing and/or nurse education from eight European countries. The expert panelists rated their level of agreement with learning outcomes in relation to “Knowledge, Skills, Responsibility and Autonomy” on a nine-point Likert scale (1 = strongly disagree/9 = strongly agree) and were invited to add comments in an open text field. The Rand manual's description of levels of appropriateness was used, and experts' suggestions were analyzed thematically and used for reformulating or adding learning outcomes. Results: In the first round, 19 out of 23 experts participated, versus 18 in the second round. In all, thirty-five learning outcomes within the three areas Knowledge, Skills and Responsibility/Autonomy were rated. After two Delphi rounds, twenty-four included learning outcomes were classified as appropriate, with median levels of appropriateness between 7 and 9; none had been classified as inappropriate. The learning outcomes include general knowledge about selected complementary therapies and non-pharmacological interventions, safety, national rules and regulations, communication and ethical skills and competencies for self-care actions and for applying simple evidence-based complementary therapies and non-pharmacological interventions in nursing practice. Conclusions: The competency profile consist of validated competencies; the high degree of consensus from the expert panelists makes the learning outcomes relevant for structuring a teaching module for nursing students about integrative nursing.

Original languageEnglish
Article number105807
JournalNurse Education Today
Publication statusPublished - Jul 2023

Bibliographical note

Funding Information:
This study is part of an EU-funded project by Erasmus+ (KA203 Strategic Partnerships for Higher Education): ‘The Integrative Nursing Education Series’ (2019-1-NL01-KA203-060478).

Publisher Copyright: © 2023 The Authors


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