{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:00:28Z","timestamp":1790341228157,"version":"4.1.0"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"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":"\n Background and Purpose<\/jats:title>\n \n Chronic disease management within contemporary health care systems increasingly relies on nurses functioning in roles analogous to holistic nurse coaches, emphasizing self-management, behavior change, and whole-person care (American Holistic Nurses Credentialing Corporation. (2023).\n Nurse coach role and competencies<\/jats:italic>\n .\n https:\/\/www.ahncc.org<\/jats:ext-link>\n ). Within the Military Health System (MHS), chronic illness further affects readiness, resilience, and long-term force sustainability. Despite these demands, onboarding and continuing education for disease management (DM) nurses remain largely task-based and lack standardized, competency-driven preparation grounded in holistic nursing principles. The purpose of this study was to evaluate the effect of a competency-based training module on nurses\u2019 knowledge of and self-efficacy to deliver holistic disease management services.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A one-group pretest\u2013posttest pre-experimental design was used with registered nurses and advanced practice registered nurses at a large military medical center. Participants completed a DM knowledge assessment and a self-efficacy questionnaire before and after an asynchronous training module grounded in holistic nursing, nurse coaching, and lifestyle medicine competencies.<\/jats:p>\n <\/jats:sec>\n \n Findings<\/jats:title>\n \n Statistically significant improvements were observed in both knowledge (\n p<\/jats:italic>\n \u2009=\u2009.003) and self-efficacy (\n p<\/jats:italic>\n \u2009=\u2009<.001) following the intervention.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Findings support competency-based education as an effective strategy for strengthening holistic nurse coaching capacity, workforce readiness, and chronic disease care delivery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/08980101261487732","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:13:38Z","timestamp":1790165618000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Holistic Nurse Coaching in the Military Health System: A Pilot Study of Competency-Based Training for Disease Management"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0175-1320","authenticated-orcid":false,"given":"Theodore T.","family":"Urbano","sequence":"first","affiliation":[{"name":"Directorate of Education, Training, and Research, Alexander T. Augusta Military Medical Center, Fort Belvoir, VA, USA"},{"name":"Ellmer School of Nursing, Old Dominion University, Virginia Beach, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela J.","family":"Bishop","sequence":"additional","affiliation":[{"name":"Ellmer School of Nursing, Old Dominion University, Virginia Beach, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2021.105057"},{"key":"e_1_3_2_3_1","unstructured":"American Holistic Nurses Credentialing Corporation. (2023). Nurse coach role and competencies. https:\/\/www.ahncc.org."},{"key":"e_1_3_2_4_1","volume-title":"Self-efficacy: The exercise of control","author":"Bandura A.","year":"1997","unstructured":"Bandura A. (1997). Self-efficacy: The exercise of control. W. H. Freeman."},{"key":"e_1_3_2_5_1","unstructured":"Casscells S. W.2008). A report to congress on the design development and implementation of the military health system's program for disease and chronic care management: Fiscal year 2007. Department of Defense. https:\/\/www.health.mil\/Reference-Center\/Reports\/2008\/03\/12\/Program-for-Diseaseand-Chronic-Care-Management"},{"key":"e_1_3_2_6_1","unstructured":"Centers for Medicare & Medicaid Services. (2024). National health expenditure data. https:\/\/www.cms.gov."},{"issue":"3","key":"e_1_3_2_7_1","first-page":"201","article-title":"Holistic nursing practice and nurse coaching","volume":"37","author":"Delaney C.","year":"2019","unstructured":"Delaney C., Bark L. (2019). Holistic nursing practice and nurse coaching. Journal of Holistic Nursing, 37(3), 201\u2013209. https:\/\/doi.org\/10.1177\/0898010119830994","journal-title":"Journal of Holistic Nursing"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0898010119837109"},{"key":"e_1_3_2_9_1","volume-title":"Modeling and role-modeling: A theory and paradigm for nursing","author":"Erickson H. L.","year":"2016","unstructured":"Erickson H. L., Tomlin E. M., Swain M. A. (2016). Modeling and role-modeling: A theory and paradigm for nursing (3rd ed.). CreateSpace."},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/15598276221121580"},{"issue":"1","key":"e_1_3_2_11_1","first-page":"91","article-title":"Chronic disease and readiness in the U.S. military","volume":"186","author":"Meadows S. O.","year":"2021","unstructured":"Meadows S. O., Haltiner C. C., Betz S., Smith J., Nelson B., Ambrosio A. A. (2021). Chronic disease and readiness in the U.S. military. Military Medicine, 186(Suppl. 1), 91\u201398. https:\/\/doi.org\/10.1093\/milmed\/usaa448","journal-title":"Military Medicine"},{"key":"e_1_3_2_12_1","volume-title":"Nursing research: Generating and assessing evidence for nursing practice","author":"Polit D. F.","year":"2021","unstructured":"Polit D. F., Beck C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer."},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20010416"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1063\/1.5110148"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/00405841.2023.2226560"},{"key":"e_1_3_2_16_1","first-page":"35","volume-title":"Measures in health psychology: A user\u2019s portfolio","author":"Schwarzer R.","year":"1995","unstructured":"Schwarzer R., Jerusalem M. (1995). Generalized self-efficacy scale. In Weinman J., et al. (Ed.), Measures in health psychology: A user\u2019s portfolio (pp. 35\u201337). NFER-NELSON."},{"issue":"1","key":"e_1_3_2_17_1","first-page":"6","article-title":"Nurse coaching: Integrative approaches for health and well-being","volume":"39","author":"Southard M. E.","year":"2021","unstructured":"Southard M. E., Bark L., Delaney C. (2021). Nurse coaching: Integrative approaches for health and well-being. Journal of Holistic Nursing, 39(1), 6\u201317. https:\/\/doi.org\/10.1177\/0898010120957874","journal-title":"Journal of Holistic Nursing"},{"key":"e_1_3_2_18_1","volume-title":"The art and & science of nurse coaching: The provider\u2019s guide to coaching scope & competencies","author":"Southard M. E.","year":"2021","unstructured":"Southard M. E., Dossey B. M., Bark L., Schaub B. G. (2021). The art and & science of nurse coaching: The provider\u2019s guide to coaching scope & competencies (2nd ed.). American Nurses Association."},{"issue":"1","key":"e_1_3_2_19_1","first-page":"2","article-title":"Chronic disease management: What will it take to improve care for chronic illness?","volume":"1","author":"Wagner E. H.","year":"1998","unstructured":"Wagner E. H. (1998). Chronic disease management: What will it take to improve care for chronic illness? Effective Clinical Practice, 1(1), 2\u20134. https:\/\/pubmed.ncbi.nlm.nih.gov\/10345255\/","journal-title":"Effective Clinical Practice"},{"key":"e_1_3_2_20_1","volume-title":"Self-efficacy: The theory at the heart of human agency","author":"Weir K.","year":"2025","unstructured":"Weir K. (2025, October 22). Self-efficacy: The theory at the heart of human agency. American Psychological Association. https:\/\/www.apa.org\/research-practice\/conduct-research\/self-efficacy-human-agency."}],"container-title":["Journal of Holistic Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08980101261487732","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08980101261487732","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08980101261487732","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T12:17:09Z","timestamp":1790338629000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08980101261487732"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":19,"alternative-id":["10.1177\/08980101261487732"],"URL":"https:\/\/doi.org\/10.1177\/08980101261487732","relation":{},"ISSN":["0898-0101","1552-5724"],"issn-type":[{"value":"0898-0101","type":"print"},{"value":"1552-5724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]},"article-number":"08980101261487732"}}