The 20th International Nursing Caring Conference was held in Philadelphia, Pennsylvania at the Sheraton Society Hill Hotel from Sunday April 26, 1998 to Tuesday April 28, 1998. The Conference was attended by 150 registrants; undergraduate, master's, and doctoral students participated in the sessions and festivities.

Conference hosts included the International Association for Human Caring and local hosts: La Salle University, School of Nursing; Allegheny University of the Health Sciences, School of Nursing; Holy Family College, Department of Nursing; Immaculata College, Department of Nursing; Rutgers, The State University of New Jersey, School of Nursing; Thomas Jefferson University, College of Health Professions, Department of Nursing; University of Pennsylvania, School of Nursing; University of Wisconsin, Eau Claire, School of Nursing; Villanova University, College of Nursing; Widener University, School of Nursing.

The conference emphasized outcomes of caring in practice, the experience of teaching caring to staff nurses and nursing students, and the meta-synthesis of research studies in caring, as well as conceptual papers, aesthetic projects or other expressions of caring.

Conference attendees enjoyed being in easy walking distance to many historic Philadelphia landmarks. They sampled various cuisines, including Italian, French, Southwest US, Chinese, and others. Some used the PHLASH, the purple visitor bus, to see various points of interest in the City of Brotherly Love.

The pre-conference Ecumenical Service held at St. Peter’s Episcopal Church, 313 Pine Street, Philadelphia, on Saturday evening encouraged attendees to center on the values and knowledge of caring. Sunday morning, Zane Robinson Wolf welcomed attendees to the Caring Conference during opening ceremonies. The Gospel Choir from La Salle University followed, with the International Flag Ceremony, the Quilt Display with three conference quilts designed by Eunice King, and commented on by Kathleen Valentine, The IAHC Ritual was led by Sue Thomas who explained the Aboriginal Caring Sticks to the audience. Next, the Presidential Address by Kathleen Valentine challenged the audience to question the effects of caring during her speech, A Convincing Argument for Effectiveness: Is Caring More than Nice People Doing Nice things?

Max van Manen delivered the Keynote Speech - Caring as Worry: The Ethical Encounter with Other. Dr. van Manen’s speech was sponsored by CIGNA. Dr. van Manen also signed posters that were sold out at the IAHC Merchandise table. Concurrent Sessions completed Sunday’s scholarly offerings: Educating for Caring Development; Methodology and Caring; Educating for Caring Development; Caring Within Context; Communicating Caring; Historical Perspectives of Care/Caring; and Caring and Culture.

The Founder’s Reception was held Sunday evening and honored Madeleine Leininger, Founder of IAHC. Dr. Leininger reminisced about the early years of the organization and encouraged partnerships with other organizations. She received an etched crystal bowl to mark her accomplishments on behalf of IAHC. The Independence Foundation sponsored the Reception with a generous grant. Susan Sherman, President of the Independence Foundation, encouraged members to continue their commitment to the study of caring in nursing. Delores Gaut, charter member of the organization, was commended for her vision and commitment to IAHC.

Monday, Dr. Peg Heinzer greeted attendees on the second day. The keynote speech by Dr. Ann Boykin and Dr. Savina Schoenhofer, Outcomes of Caring: the Value of Enhancing Personhood, was followed by Dr. Margaret Miller’s speech, Meta-synthesis of Presence in Nurse Caring. Concurrent sessions focused on Nurses’ Caring; Caring In Patients; Nurses’ Caring; and Caring Theory and Model Development. On Monday evening, some attendees joined charter members of IAHC for networking dinners.

Dr. Margaret Miller introduced the last general session of the conference on Tuesday. Dr. Cornelia Tsakiridou presented her keynote speech, The Aesthetics of Caring. Concurrent sessions included: Caring Aesthetics; Caring in Students; and Caring in Teachers. Dr. Marilyn (Dee) Ray gave the endnote speech, The Future of Caring in the Challenging Health Care Environment.

Zane Robinson Wolf, PhD, RN, FAAN
President-Elect, IAHC
Dean and Professor, La Salle University

Presidential Remarks

In April, the International Association for Human Caring held its twentieth anniversary celebration in historic Philadelphia . While there, all of the participants were treated to the hospitality of the city and of our hosts Dr. Zane Wolf and the local planning committee. Kudos go to the group for creating a festive atmosphere in the opening ceremony with gospel music, a flag ceremony and recognition of the quilts created in honor of each year’s gathering by Eunice Hill. Dr. Malcom MacDonald started the tradition of banners at the Ottawa Conference, and Eunice Hill has captured the spirit of each of the last three conferences through her creations "Universal Connections" Rochester, Minnesota), "Circles of Caring" ( Helsinki, Finland) and "Celebration of Caring" (Philadelphia, Pennsylvania).

The "Celebration of Caring" quilt was based on the poster design created by Zane Wolf that conveyed the conference theme "Communicating Caring: The Essence of Nursing". In the center was a bell motif indicative of the host city’s Liberty Bell but, also symbolic of communication as the core to caring. A bell is a means of communication used to send messages, tell time, send out warnings and signal joy. The quilt also had 20 stars for the 20th anniversary and symbolic of how each person, like a point of light, brings special talent and ability to the gathering. The quilt had a bright border, representing the excitement felt when people are working together synergistically. Throughout the conference the "Celebration of Caring" quilt served as a festive and beautiful reminder of our need to connect, renew, and communicate with one another and others about the advancement of caring scholarship over the past two decades and into the future.

Throughout the conference participants had the opportunity to hear excellent keynote speakers who talked about "Caring as Worry" Max van Manen ; "The Aesthetics of Caring" , Cornelia Tsakiridou; and "The Future of Caring in the Challenging Health Care Environment", Marilyn Ray. Each of these three plenary speakers stretched our consciousness and challenged us to reflective action. The themes about caring that emerged throughout the conference from these speakers and others were these:

Intentionality:
articulating caringcommunicating itreflecting with it

Time/Space:
making space for caring
taking space for caring
giving space for caring
and moving through space with a consciousness of caring

Aesthetics:
Wholeness and beauty in the person and in the space in which persons live
Nurse/art
Celebrations of caring though aesthetic expression

Creating Community:
Joining together to renew a commitment to caring
Connecting to heal through caring community
Political advocacy to create communities that can care
Thus, life imitated the quilt’s art as caring was communicated and expressed as time, message, joy and energy.

Festivities continued through the reception hosted by the Independence Foundation to honor Dr. Madeleine Leininger’s early contributions to the founding of the organization, the charter members; presidents (past, present and future); and of course the loyal support of the membership and board of the International Association for Human Caring. Special gratitude and recognition was given to Dr. Delores Gaut for providing a place for the organization and for serving as IAHC’s business office consultant.

Dr. Gaut helped the board in its transition to Blue Chip Management as our new office site. We look forward to a good working relationship with Deborah Engell, Executive Vice President. Please note new address, phone number, E-mail and Fax as listed in this issue.

Two other events occurred that are noteworthy. One is that the board authorized funding for a "Synthesis Challenge" and the second is a renewed effort for IAHC chapter establishment.

The "Synthesis Challenge" arises from developmental stage of the IAHC. Now twenty years old, with ten books published and a new journal initiated; it is important to ask the question "Is IAHC fulfilling its mission relative to the generation and dissemination of care scholarship ? " " Do we have a convincing argument for the effectiveness of caring ?" In a competitive market environment characterized by managed care that requires the use of data based economic decision criteria, can we show that caring practices are revenue generating/ or cost saving ?

With the assistance of two graduate students I conducted an integrated review of care literature, that will be published in a future issue of the International Journal for Human Caring that addresses these questions in greater detail. For these remarks I’d like to share a few highlights.

• Impact of IAHC Scholarship Dissemination
• Published 10 books in 17 years resulting in 157 Articles
• 57% of the articles were focused on theory, education, or concept analysis
• 43% of the articles were focused on clinical or system caring perspectives
• The studies included 1,995 patients; 27,758 nurses; 31 members of other disciplines; 500,564 participants in systems.
• International Journal for Human Caring
• Was initiated as a peer-reviewed, all volunteer journal indexed by CINAHL in 1998
• Publishing 3 issues a year is a 160% increase in the rate of scholarship dissemination in the first year.

Caring and Outcomes

• From the published books, 4% of IAHC articles examined the link between caring and outcomes
• From IJHC, 33% of the articles examine that link
• This represents a 789% rate of increase in reporting how caring matters to outcomes
• 20% of all articles searched through CINAHL about concepts of caring as they relate to outcomes come from IAHC publications.
• Therefore, IAHC is fulfilling its mission.

Caring and Outcomes: Literature Review

• Searched 1988-1997-8 CINAHL and 20 Years of IAHC publications for articles that focused on clinical interventions, outcomes and caring
• This yielded 42 Articles
• 74% of the articles studied patients and/or families and 45% of the articles had nurses as subjects ( articles could have both)
• The review used Gwen Sherwood’s categories of caring interventions that categorize activities as: Interactions related to healing, knowledge or intentional response or outcomes related to healing, resolving physical/affective needs, or positive growth enhancing relationship.

Scholarship Impact:

All 42 articles used in the integrated review had all three Caring Interventions: Healing, Knowledge, Intention

For Caring Outcomes:

• All articles had at least one link between caring interventions and outcomes and most of these inferential links (72%) were strongly supported by data. The focus of the articles used in the review were:
• 50% Healing outcomes
  43% Resolving physical/affective needs
  57% Positive growth enhancing relationship
• Therefore, IAHC is on the leading edge of examining caring and its relationship to outcomes.

The Synthesis Challenge:
This was a small sample using a restricted search methodology. A broader search yielded 303 articles related to caring interventions and outcomes. That is the essence of the "Synthesis Challenge". Broaden the search of caring interventions and their relationship to outcomes and perform an integrated review of the literature. Help to be part of constructing the data base for how caring contributes to healing within the human condition. Use the support of colleagues in IAHC and the IJHC to build a convincing argument for caring through examining the patterns of evidence that can then be used to guide practice.

Even if you could not attend the 20th Anniversary Celebration of IAHC you can be part of the advancement of caring for the next twenty years through:

• Becoming a member
• Starting a chapter
• Joining in the synthesis challenge
• Attending the next Caring Conference in San Antonio Texas April 18-20
• Submitting manuscripts to the International Journal for Human Caring
• Becoming a peer reviewer
• Making your caring practices visible and understood
• Celebrating caring in everyday life.

See you in San Antonio!

Kathleen Valentine, PhD, RN
President IAHC
Managing Editor IJHC

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