{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T18:34:06Z","timestamp":1786732446597,"version":"build-2736575974"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Holist Nurs"],"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Delirium and depression are common and serious complications among intensive care unit (ICU) patients and are associated with adverse clinical outcomes, prolonged hospitalization, and increased mortality. Although the clinical management of these conditions has been widely studied, less is known about how nurses integrate physical and psychological care to support patients experiencing these complex challenges.\n                    <jats:bold>Aim:<\/jats:bold>\n                    This study explored intensive care nurses\u2019 experiences of providing holistic care for patients with delirium and depression through the lens of Neuman's Systems Model (NSM).\n                    <jats:bold>Study Design:<\/jats:bold>\n                    A qualitative phenomenological approach was used. Semistructured, in-depth interviews were conducted with 23 intensive care nurses working in a tertiary hospital. Data were analyzed using thematic analysis.\n                    <jats:bold>Results:<\/jats:bold>\n                    Six interconnected themes illustrated how nurses balanced physical and psychological care while responding to patient, environmental, and organizational stressors. The findings highlighted the perceived impact of delirium and depression on patient recovery, the central role of non-pharmacological interventions, the emotional and professional burden of care, institutional challenges influencing practice, the effects of stressors on both care quality and nurse well-being, and recommendations for strengthening holistic care. Interpreted through NSM, nurses\u2019 experiences reflected layered preventive practices operating across primary, secondary, and tertiary levels of intervention to maintain patient stability.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Holistic care for patients with delirium and depression extends beyond symptom management and requires attention to psychological, environmental, and organizational dimensions of care. Nurses play a pivotal role in promoting patient stability through therapeutic relationships, environmental regulation, psychosocial support, and interdisciplinary collaboration. NSM offers a valuable framework for guiding preventive, holistic nursing interventions in intensive care settings.\n                  <\/jats:p>","DOI":"10.1177\/08980101261477959","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T18:50:59Z","timestamp":1786560659000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intensive Care Nurses\u2019 Experiences of Holistic Delirium and Depression Care: A Phenomenological Study Guided by Neuman's Systems Model"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4421-3089","authenticated-orcid":false,"given":"F\u00fcsun","family":"Af\u015far","sequence":"first","affiliation":[{"name":"Yalova University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4892-8313","authenticated-orcid":false,"given":"\u015eenay","family":"\u00d6zt\u00fcrk","sequence":"additional","affiliation":[{"name":"Maltepe University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_3_3_2_1","article-title":"Intensive care unit (ICU)-related post-traumatic stress disorder: A literature review","volume":"16","author":"Abdelbaky A. M.","year":"2024","unstructured":"Abdelbaky A. M., Eldelpshany M. S. (2024). Intensive care unit (ICU)-related post-traumatic stress disorder: A literature review. Cureus, 16, Article e57049. https:\/\/doi.org\/10.7759\/cureus.57049","journal-title":"Cureus"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.29332\/triss.v6n1.77"},{"key":"e_1_3_3_4_1","volume-title":"Holistic nursing: Scope and standards of practice","author":"American Holistic Nurses Association","year":"2023","unstructured":"American Holistic Nurses Association. (2023). Holistic nursing: Scope and standards of practice (4th ed.). Nursesbooks.org.","edition":"4"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.19131\/rpesm.362"},{"issue":"8","key":"e_1_3_3_6_1","first-page":"1","article-title":"Sa\u00fade mental de profissionais de enfermagem: O cuidar de quem cuida em ambientes de alta exig\u00eancia","volume":"7","author":"Da Matos J. C.","year":"2025","unstructured":"Da Matos J. C., Silva A. J., De Sousa F. A. (2025). Sa\u00fade mental de profissionais de enfermagem: O cuidar de quem cuida em ambientes de alta exig\u00eancia. ARAC\u00ca, 7(8), 1\u20139. https:\/\/doi.org\/10.56238\/arev7n8-020","journal-title":"ARAC\u00ca"},{"key":"e_1_3_3_7_1","article-title":"Betty Neuman\u2019s theory in holistic nursing care for cancer patients: A reflective essay","volume":"28","author":"Das Neves J\u00fanior T. T.","year":"2024","unstructured":"Das Neves J\u00fanior T. T., Gon\u00e7alves R. G., Neves M. C. D. C., de Lima J. S. A., Ara\u00fajo R. O., de Menezes R. M. P. (2024). Betty Neuman\u2019s theory in holistic nursing care for cancer patients: A reflective essay. Escola Anna Nery, 28, Article e20240014. https:\/\/doi.org\/10.1590\/2177-9465-EAN-2024-0014en","journal-title":"Escola Anna Nery"},{"key":"e_1_3_3_8_1","first-page":"117","volume-title":"Passport to successful outcomes for patients admitted to ICU","author":"Dawson D.","year":"2020","unstructured":"Dawson D., Johansson L. (2020). The intensive care unit environment: Impact and prevention. In: Passport to successful outcomes for patients admitted to ICU (pp. 117\u2013133). Springer. https:\/\/doi.org\/10.1007\/978-3-030-38916-1_9"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12111134"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610222000060"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.6018\/eglobal.15.1.210841"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.23865\/inspira.v19.6068"},{"key":"e_1_3_3_13_1","article-title":"The experiences of intensive care nurses caring for intubated patients with delirium","author":"Iyiola C. E.","year":"2019","unstructured":"Iyiola C. E., Schmollgruber S., Bruce J. C. (2019). The experiences of intensive care nurses caring for intubated patients with delirium. Sigma Repository. https:\/\/sigma.nursingrepository.org\/handle\/10755\/21151","journal-title":"Sigma Repository"},{"issue":"4","key":"e_1_3_3_14_1","first-page":"530","article-title":"Difficulties faced by intensive care nurses in caring for patients with delirium: A cross-sectional, multicentre study","volume":"37","author":"Jiang T.","year":"2024","unstructured":"Jiang T., Tung T. H., Wang Y., Zheng X. T., Jia L., Zhang W. (2024). Difficulties faced by intensive care nurses in caring for patients with delirium: A cross-sectional, multicentre study. Australian Critical Care, 37(4), 530\u2013538. https:\/\/doi.org\/10.1016\/j.aucc.2023.12.004","journal-title":"Australian Critical Care"},{"issue":"4","key":"e_1_3_3_15_1","article-title":"Outcomes of applying Neuman system theory in intensive care units: A systematic review","volume":"9","author":"Khatiban M.","year":"2016","unstructured":"Khatiban M., Oshvandi K., Borzou S. R., Moayed M. S. (2016). Outcomes of applying Neuman system theory in intensive care units: A systematic review. Journal of Critical Care Nursing, 9(4). https:\/\/doi.org\/10.17795\/CCN-8886","journal-title":"Journal of Critical Care Nursing"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/geroni\/igae098.3354"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.3928\/00485713-20250528-01"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.58807\/revtesela20247062"},{"issue":"8","key":"e_1_3_3_19_1","article-title":"Psychiatric management of patients in intensive care units","volume":"64","author":"Marwale A. V.","year":"2022","unstructured":"Marwale A. V., Phadke S., Kocher A. (2022). Psychiatric management of patients in intensive care units. Indian Journal of Psychiatry, 64(Suppl 8), S292\u2013S307. https:\/\/doi.org\/10.4103\/indianjpsychiatry.indianjpsychiatry_28_22","journal-title":"Indian Journal of Psychiatry"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10071-24884"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0044-1791696"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/PSN.0000000000000427"}],"container-title":["Journal of Holistic Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08980101261477959","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08980101261477959","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08980101261477959","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:56:32Z","timestamp":1786730192000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08980101261477959"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":21,"alternative-id":["10.1177\/08980101261477959"],"URL":"https:\/\/doi.org\/10.1177\/08980101261477959","relation":{},"ISSN":["0898-0101","1552-5724"],"issn-type":[{"value":"0898-0101","type":"print"},{"value":"1552-5724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]},"article-number":"08980101261477959"}}