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

Background: Integrative Nursing is a framework for providing holistic care and includescomplementary therapies and non-pharmacological interventions. There is no common Europeanapproach on how to educate healthcare professionals on complementary therapies and non-pharmacological interventions for symptom management. Nurses report a lack of formal educationas the main barrier to applying integrative nursing. Objectives: The aim of this study is to develop and validate integrative nursing learning outcomesin a competency profile for bachelor nursing students. Methods: A two-round Delphi study was conducted with experts on integrative nursing and/or nurseeducation from eight European countries. The expert panelists rated their level of agreement withlearning outcomes in relation to “Knowledge, Skills, Responsibility and Autonomy” on a nine-pointLikert scale (1 =strongly disagree / 9 = strongly agree) and were invited to add comments in anopen 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/ autonomywere rated. After two Delphi rounds, twenty-four included learning outcomes were classified asappropriate, with median levels of appropriateness between 7-9; none had been classified asinappropriate. The learning outcomes include general knowledge about selected complementarytherapies and non-pharmacological interventions, safety, national rules and regulations,communication and ethical skills and competencies for self-care actions and for applying simpleevidence-based complementary therapies and non-pharmacological interventions in nursingpractice. Conclusions: The competency profile consist of validated competencies; the high degree ofconsensus from the expert panelists makes the learning outcomes relevant for structuring a teachingmodule for nursing students about integrative nursing.