Anthroposophic Nursing (AN) is an integrative, holistic nursing approach based on the principles of Anthroposophic Medicine created by the physician Dr. Ita Wegman, and based on the philosophic principles of Dr. Rudolf Steiner. AN enhances allopathic nursing care with an anthroposophic understanding of the human being (concept of four-foldness) and human body functionality (three-foldness and twelve senses). As a holistic nursing model, it emphasizes a spiritual understanding of health and illness.
A fundamental construct of AN are the tailored use of the twelve nursing gestures (Heine 2007, von Dach, 2008). These AN care observations are based on the understanding and the awareness of the meaning and value of the inner mood or the inner gesture of a nurse while caring for a patient.
The inner mood or gesture of nursing is a crucial aspect distinguishing AN. It involves the question, not merely of what we do for patients, but of the intention and way in which we provide care. Therefore, the inner gesture which guides AN is a central influence in providing care. The traditional AN’s daily practice is nursing care but also enhances the care through the use of external applications, (such as compresses, or wraps with different healing substances) and Rhythmical Einreibung (rhythmic oil application). The use of Anthroposophic Medicine enhances the foundation of AN. Dr. Rudolf Steiner identified the external treatments as a cornerstone of Anthroposophic Medicine. From the beginning of Anthroposophic healthcare, both Medicine and Nursing, Dr. Ita Wegman prescribed many external treatments.
Evidence-based practice is informed by many different qualitative and quantitative sources (Melnyk and Fineout-Overholt, 2011): evidence-based literature, patient preferences based on their lived experience and clinical evaluations. AN is based strongly on both clinical expertise and patient preference. To analyse the outcomes of AN, various research instruments are used depending on the nature of the question and often includes qualitative and quantitative tools with many studies utilizing of the Living body mixed methodologies. The phenomenological approach (especially of the Living body per Merleau-Ponty, Waldenfels, Fuchs) and others fits very well into the philosophical understanding upon which AN is based.
Currently, the limited evidence-based literature includes the mechanism of action of the Rhythmical Einreibung, of Solum Uliginosum by Bertram, and the effect of ginger compresses by Therkleson.
It is a call of our current time to advance clinical nursing research into the benefits, both to patients and nurses, of AN care. There is also a need to accumulate evidence demonstrating and revealing both the mechanism of action and effectiveness of the external treatments, especially wraps and compresses.
June 2018
Author:
Dr. Christoph von Dach (RN, MSc. Pall. Care, ANS, DNP)
International expert panel:
Germany
Dr. rer. medic. Mathias Bertram, (RN, ANS)
Japan
Sakura Fujiwara (RN, MSN), Japan Eiko Taylor (RN, MSN)
USA
Dr. Val Lincoln (RN, PhD), Laurie Schmiesing (RN, MSN, ANS, CBP, QTTP)
Exemplary literature
Batschko E (22010). Einführung in die Rhythmischen Einreibungen. Info 3 Verlag, Frankfurt a.M./DE.
Beeri T, Deckers B, Förster I, Klauber S, Kusserow M, Menne M, Soldner U, Weiss C (Editorial group of the International Forum for Anthroposophic Nursing/IFAN). Vademecum for External Applications,
www.pflege-vademecum.de
Bertram M, Kolbe HJ (Hg) (2016). Dimensionen therapeutischer Prozesse in der Integrativen Medizin. Ein ökologisches Modell. Springer, Berlin, Heidelberg/DE.
Bertram M (2005). Der therapeutische Prozess als Dialog. Strukturphänomenologische Untersuchungen der Rhythmischen Einreibungen nach Wegman / Hauschka. Pro Business Verlag,Berlin/DE.
Bertram M (1999). Komplementäre Pflegemethoden (Wickel, Auflagern, Aromatherapie). Modul TP44 Fachhochschule Jena, Fachbereich Sozialwesen. Studienbrief, als Manuskript gedruckt. Jena/DE.
Fingado M (32012). Rhythmische Einreibungen – Handbuch aus der Ita Wegman Klinik. Natura Verlag/Verlag am Goetheanum, Dornach/CH.
Fingado M (2012). Compresses and other therapeutic applications. A handbook from the Ita Wegman clinic. Floris Books, Edinburgh/UK.
Fingado M (2011). Rhythmic Einreibung. A handbook from the Ita Wegman clinic. Floris Books, Edinburgh/UK.
Fingado M (52012). Therapeutische Wickel und Kompressen. Handbuch aus der Ita Wegman Klinik. Natura Verlag/Verlag am Goetheanum, Dornach/CH.
Heine R (Hg) (2017). Anthroposophische Pflegepraxis. Salumed Verlag, Berlin.
Heine R (2015). Das Konzept der pflegerischen Gesten beim Krebskranken. In: Fintelmann V (Hg).Onkologie auf anthroposophischer Grundlage Bd. 3:1-19.
Heine R (2007). Die pflegerische Geste – Ein Konzept der anthroposophischen Pflege. Dr. med. Mabuse – Zeitschrift für alle Gesundheitsberufe 32:30-33.
Layer M (22014). Praxishandbuch Rhythmische Einreibungen nach Wegman / Hauschka. Hogrefe Verlag, Bern.
Ostermann T, Blaser G, Bertram M, Michalsen A, Matthiessen PF, Kraft K (2008). Effects of rhythmic embrocation therapy with solum oil in chronic pain patients: a prospective observational study. Patients. Clinical Journal of Pain 24(3):237-243, DOI:
https://doi.org/10.1097/AJP.0b013e3181602143
Therkleson, T (2010). Ginger compress therapy for adults with osteoarthritis. Journal of Advanced Nursing 66(10):2225–2233. DOI:
https://doi.org/10.1111/j.1365-2648.2010.05355.x
Therkleson T, Sherwood, P (2004). Patients' experience of the external therapeutic application of ginger by anthroposophically trained nurses. Indo-Pacific Journal of Phenomenology 4(1): 1-11. DOI:
https://doi.org/10.1080/20797222.2004.11433892
Therkleson T, Stronach S (2015). Broken heart syndrome. A typical case. Journal of Holistic Nursing 33(4): 345-350. DOI:
https://doi.org/10.1177/0898010115569883
Therkleson T (2012). The effect of ginger therapy on symptoms of osteoarthritis: an open pilot study. Abstract No. 1556 ACR/ARHP Annual Meeting.
http://acrabstracts.org/abstract/the-effect-of-ginger-therapy-on-symptoms-of-osteoarthritis-an-open-pilot-study/
von Dach C (2017). Integrative Palliative Care. In: Steffen-Bürgi B, Schärer-Santschi E, Staudacher D, Monteverde S. Lehrbuch Palliative Care. Verlag Hans Huber, Bern.
von Dach C (2008). Die zwölf pflegerischen Gesten. Krankenpflege 3:25-27.
von Dach C, Osterbrink J (2013). Spiritualität der Pflege. Spiritual Care. Zeitschrift für Spiritualität in den Gesundheitsberufen 3:21-30.
von Dach C, Heine R, Heiligtag HR (2009). Anthroposophische Pflege von Krebskranken. Der Merkurstab 4:330-343. DOI:
https://doi.org/10.14271/DMS-19468-DE.