Sunday, 31 July 2011

Holistic Health and Spirituality

In this article we will explore the fairly new Whole Person Caring Model (WPCM) and review relevant published literature. Originally searching The Cumulative Index of Nursing and Allied Health Literature (CINAHL), out of 673 articles that came up while searching in terms wholistic health, holistic, nursing models, three articles were directly relevant to the framework of Whole Person Caring Model.  Medline, ProQuest and Google Scholar were also explored for direct framework articles, yielding no results. After contacting the author Thornton by email, she sent a few more relevant articles and directed me to her Web site, providing additional information on the WPCM she wrote.  Thornton speaks to the model’s efficacy in helping hospitals decrease costs and improve patient satisfaction and included additional articles that speaks about two of the key concepts the model provides and how they were implemented (Personal Communication, Lucia Thornton, May 1, 2011). The Whole Person Caring Model (WPCM) incorporates physical, mental, emotional and spiritual aspects of patients and nurses life to improve one’s health (Thornton, 2010).
Review and Synthesis of Literature Related to Whole Person Care Model
The Whole Person Caring Model is born from experience and derived from nursing, physics and system analysis theories. It provides a framework for organizations to create a healing and nurturing environment for consumers (patients) and healthcare personnel (nurses). WPCM is easy to understand and interdisciplinary, having a practical application, that embraces our infinite and spiritual nature (Thornton, 2005). WPCM is considered a behavioral model for creating healing and transformational relationships (Donadio, 2005). WPCM is also an award -winning model that provides a common framework so various disciplines and cultural backgrounds are effectively able to work together to provide quality and compassionate care services. Thornton (2010) states the WPCM defines who we are from a more expansive and holistic perspective.  The model transcends the current paradigm and acknowledges the energetic and spiritual nature of our existence.  This viewpoint helps us perceive the inherent unity of life by moving beyond our cultural, religious, social and economic differences. The WPCM is based on nursing theorists Jean Watson, Martha Rogers and Florence Nightengale. Thornton, Gold and Watkins (2002) define person as “an energy field that is infinite and spiritual in essence and in continual mutual process with the environment. Each person manifests unique physical, mental, emotional and social-relational patterns that are interrelated, inseparable, and continually evolving.” Environment is defined as “An energy field beyond and inclusive of the person. Because person and environment are in a state of constant mutual process, there is no distinction from an energetic perspective” (Thornton et al., 2002). Health is defined as “The subjective experience of well-being” (Thornton, 2005). Thornton (2005) defines Whole Person Caring Model as “the delivery of care and services to promote well-being. Whole-person caring is based on the concepts of sacredness of being; therapeutic partnering: self-care and self-healing; optimal whole-person nourishment; transformational health care leadership; and caring as sacred practice” (Thornton, 2005). Spiritual is defined as:
The spiritual dimension is a unifying field that integrates the physical, mental, emotional, and social/relational aspects of being. The spiritual dimension is the essence of self and also transcends the self. It is our closest, most direct experience of the universal life force. (Thornton et al., 2002)
Tjale and Bruce (2007) conducted a qualitative, interpretive, explorative and contextual research design study to gain understanding and meaning of holistic nursing. A series of searches of the EBSCO Host, CINAHL, OVID, MEDLINE, Pubmed, PsycINFO, Medline and Sociological databases were completed to conduct an analysis of the concept and meaning of holistic nursing care.  The following search criteria and search terms were used: “holistic nursing care and definition, holistic care and
holism, holistic nursing care and health, holistic nursing care and child, holistic nursing care and paediatrics, holistic nursing care and pediatrics, holistic care and complimentary medicine”(pg 45). Seventy-seven articles on holistic nursing care were analyzed and labeled according to criteria.  Rodgers' evolutionary method was utilized to conduct the concept analysis and the objectives of this study were set in two phases:
1. Phase one was conducted to analyze the concept of holistic nursing care and obtain viewpoints of holistic nursing care from paediatric nurses working in academic hospitals.
2. Phase two the identified the characteristics and dimensions and characteristics of holistic nursing care to develop a framework of holistic nursing care for paediatric nurses working in academic hospitals and to validate and refine the framework for paediatric nursing. 
Varying qualitative and quantitative studies indicate the most prominent findings were the similarity of definitions and descriptors of holistic nursing care observed from many disciplines. Attributes of holistic nursing care yielded two dimensions: whole person and mind-body-spirit dimension. The indicated descriptors of whole-person include physical, mental, emotional and spirit. Spirituality is the predominant antecedent. Holistic nursing care is described to be the recognition of an individual as a spiritual being with a mind-body-spirit dimension. Spirituality is a present force pervading all human experience and existence. Complimentary alternative medicine (CAM) was identified as a surrogate term. The connection of CAM with holistic nursing care is the focus of therapeutic interventions that are directed to the mind-body-spirit dimension and are designed to meet the needs of the whole-person (Tjale & Bruce, 2007). Clark (2008) informs us that we are now the only country in the world that does not prepare and require a nurse, to quote the International Council of Nurses’ policy, “the capacity and authority to practice competently primary, secondary, and tertiary care in all settings and fields of nursing.” Clark (2008) notes that nursing education tends to favour a hospital-based, task-oriented training curriculum leaving specialty and community based education out. Clark (2008), states that many nurses who claim to offer holistic care, really don’t have a full understanding of holistic care and makes an observation that nurses are unable to meet the mental health needs of adult patients, people with mental illness are nursed by nurses who are unable to meet their physical health needs, and children are taken care of by nurses who know little about child development. 
Finfgeld-Connett (2008) conducted a meta-syntheses qualitative study from articles developed between 1993 and 2007 for the convergence of three nursing concepts: art of nursing, presence and caring. Results led to development of a theoretical framework of nursing practice to illustrate the areas of convergence among the concepts: art of nursing, presence and caring. Nursing involves an intimate relationship-centered partnership between the patient and nurse. A value system of holistic beneficence and patient empowerment are based on specific nursing actions are derived from multiple forms of personal and professional knowledge. Nursing actions are promoted by a conducive work environment and result in enhanced well-being among patients and nurses. Continued research and work is recommended to expand the proposed framework, especially due to the wide variety of nurse–patient relationships that exist. The art of nursing, presence and caring take place within an atmosphere of interpersonal sensitivity and intimacy, which is characterized by open and honest interactions.
Personal insights are disclosed in verbal and non-verbal ways, and the nurse unobtrusively grasps the patient’s needs and responds in a kind and compassionate way. Empathy is expressed through words and actions, and a supportive nurse–patient partnership is cultivated.  Additionally, the art of nursing, presence and caring take place within an atmosphere of interpersonal sensitivity and intimacy, characterized by open and honest interactions. Nurses then unobtrusively grasp the patient’s needs and respond in a kind and compassionate way, while a supportive nurse–patient partnership is cultivated (Finfgeld-Connett, 2008). 
Gold (2003) emphasizes that caring simply comes from our hearts and nurses need to speak and listen from their hearts. The Whole Person Care Model considers caring for people as sacred work. There are many differences between the biomedical model and the Whole Person Care Model. As the biomedical model has an organized structure depicted as a pyramid with the most valuable people on the top, the WPCM requires therapeutic partnering which all parties are respectful and non-hierarchical. To aid in nurse and patient satisfaction the interdisciplinary model encourages mentoring programs and does not tolerate negativity as this is a reflection of the care the patient receives. The model encourages an atmosphere of cooperation, unity, cohesiveness, continuity of care, productivity and creative synergy in the workplace to provide patients with optimal care and nurses with job satisfaction. It encourages that self-care is an absolute crucial element in employee satisfaction and subsequently organizational health and wellbeing (Gold, 2003). 
Review of Literature related to Holistic Nursing and Nurse/Patient Satisfaction 
The WPCM pilot study, funded by Union Hospital enrolled 50 patients from the Cardiac Rehabilitation Department at Union Hospital in Lynn, Massachusetts, which is part of the North Shore Medical Center and a member of the Partners HealthCare System, founded by Massachusetts General Hospital and Brigham and Women's Hospital, both teaching hospitals of Harvard Medical School. Study population included a heart transplant recipient, patients with varying levels of heart disease, patients with multiple pathologies and patients who were obese, alcoholic and addictive. The patients were initially evaluated using SE-36, a quality of life validated survey instrument widely used to measure quality of life, as well as the Clinical Data Collection Inventory (CDCI), a non-validated internal instrument. Patients were contacted by letter, those agreeing to participate completed SF-36 and CDCI questionnaires and met with a whole health educator for a series of 6 one-on-one sessions. Six months later they completed the SE-36 and CDCI again to reevaluate treatment. Pilot studies were compared to historical data. The historical data included cardiac rehab patients without receiving WPCM. These patients completed baseline and follow-up (6 months) SF-36 and CDCI questionnaires as well. 
Six certified whole health educators and six New England School of Whole Health Education (NESWHE) interns participated. The principal investigator for the pilot study is a cardiologist and Medical Director of the Department of Cardiac Rehabilitation at Union Hospital.  The investigational review board at Union Hospital approved the study. The focus and intention is to bring the nurse and physician toward in-the-moment, compassionate, relationship-centered care regardless of the amount of time spent with the patient and becomes the foundation for all future interactions.  This study is not considered a controlled study and was not powered to reach statistical significance. According to Pelzang (2010) healthcare is rapidly changing to provide Patient Center Care (PCC), which is treating our patients as unique individuals. This standard of practice demonstrates respect for the patient, as a person and taking into consideration the patient’s circumstances and point of view in the decision-making process regarding their healthcare. PCC needs a clear definition and methods of measurement, as implementation has been hampered due to lack of understanding the core elements of PCC by nurses and healthcare providers. The underlying philosophy of PCC is to understand the patient as a person rather than as a cluster of diseases.  PCC is considered to come from a systems model and a process model. The basic aspect of PCC is to respect, care and consider the patient as a whole. Pelzang (2010) found during his literature review that PCC indicates improved continuity of care and integration of nurses and health professionals collaborating on behalf of their patients, increasingly providing autonomy to patients, empowering staff members to plan and execute their work in ways that are most responsive to the patient needs, wants and preferences. Providing patients with abundant opportunities to be informed and involved in care decision-making. Furthermore, PCC is considered to deliver more holistic care; facilitates a team approach, shifts emphasis to total body care; enhances communication skills between relatives, patients and healthcare providers, as well as between family members. The outcome of PCC for the patient includes: satisfaction with care, involvement with care, improved health, feeling of well-being and creating a therapeutic culture.
Miller et al. (2008) conducted a Qualitative study and collected data in 2006 using non-participant observation, shadowing and semi-structured interviews with nursing, medical and allied professionals in the internal medicine wards of three urban hospitals in Canada. The findings of the study indicate nurses’ collaborations with other professionals are influenced by emotional work considerations. The establishment and maintenance of a nursing esprit decorps corridor conflicts with physicians, and the failure of the interdisciplinary team to acknowledge the importance of nursing’s core caring values are important factors underpinning nurses’ interprofessional disengagement. The conclusion is that longstanding emotion work issues must be addressed before nurses will engage collaboratively. We suggest improving nursing collaboration through the refining of holistic nursing information, and reflections on practice by all interprofessional team members.
Agrimson and Taft (2009) states the term spiritual crisis has been used ambiguously in the literature, resulting in lack of clarity. A holistic approach includes spirituality in nursing care of the whole person. Articles with search terms spiritual crisis, spiritual emergency, spirituality and life crisis between 1998 and 2007 were retrieved for analysis. Using Walker and Avant’s method of concept analysis, a definition of spiritual crisis was identified. Spiritual crisis is often described as a unique form of grieving or loss, with a profound questioning of lack of meaning in life, in which person or community reaches a turning point, that leads to a significant change in the way life is viewed. Possible reasons for this include loss of important relationships and sudden acute illness. The results of the study indicate people that are experiencing terminal illness, depression, or grieving may be at special risk for a spiritual crisis. The literature suggests that an interdisciplinary approach, nurses’ self-exploration of their own spirituality, and the ability to refrain from defining spirituality by religious affiliation will help improve nursing practice and patient centered care.
Summary
Whole Person Caring Model, holistic nursing and spirituality are intertwined. Articles articulating that mind, body and spirit makes up the patient as a whole and all aspects need to be treated for holistic health care practices.
Conclusions
Further research using the WPCM is indicated
WPCM comes from nursing theorist Florence Nightengale, Martha Rogers and Jean Watson
WPCM indicates each person is a unique individual with physical, mental, emotional and social-relational aspects  
Interdisciplinary approach to nursing care is indicated having nurses first exploring their own spirituality
The term spiritual crisis is a unique form of grieving or loss questioning of the meaning in life that leads to a significant change in the way life is viewed
Most nurses do not have a clear understanding of holistic care 
Incorporating a patients’ spirituality is lacking in most nursing practices
Holistic health is considered somewhat synonymous with spirituality 
The studies show a correlation between holistic care and service indicating a positive professional and scholarly perspective 
References
Agrimson, L.B., & Taft, L.B. (2009). Spiritual crisis: A concept analysis.  Journal of Advanced Nursing, 65(2), 454-61.
Clark, J. (2008). Protectionist nurses stand in the way of truly holistic patient care. Nursing Standard, 22(29), 26. 
Donadio, G. (2005). Improving healthcare delivery with the transformational whole person care model. Holistic Nursing Practice, 19(2), 74-77.
Finfgeld-Connett, D. (2008). Qualitative convergence of three nursing concepts: Art of nursing, presence and caring. Journal of Advanced Nursing, 63(5), 527–534.
Gold, J. (2003). Therapuetic partnering and caring as a sacred practice. Bridges ISSSEEM Magazine, 14(2), 8-17.
Miller, K., Reeves, S., Zwarenstein, M., Beales, J.D., Kenaszchuk, C., & Conn, L.G.  (2008). Nursing emotion work and interprofessional collaboration in general internal medicine wards: a qualitative study. Journal of Advanced Nursing, 64(4), 332-343.
Pelzang, R. (2010). Time to learn: understanding patient-centered care.  British Journal of Nursing, 19(14), 912-917.
Thornton, L. (2005). The model of the whole person caring, creating and sustaining a healing environment. Holistic Nursing Practice, 19(3), 106-115.
Thornton, L. (2010). Creating Healing Environments for individual, communities and organizations. Retrieved from http://www.luciathornton.com
Thornton, L., Gold, J., & Watkins, M. (2002). The art and science of whole-person caring: an interdisciplinary model for health care practice. International Journal for Human Caring, 6 (2). 38-47.
Tjale, A.A., Bruce, J. (2007). A concept analysis of holistic nursing care in paediatric nursing. Curationis, 30(4): 45-52.

Homeopathy and Depression

Living in the 21st century makes us all prone to depression, but when we use the tools we have to manage our mental health, we begin to see the glass as half-full instead of half-empty.
Some homeopathic remedies used to ease depression are:
¥ Natrum mur - for feelings of depression, irritability and wanting to be alone and cry
¥ Ignatia - for grief and/or mood disorders
¥ Phosphoricum acidum - for mental exhaustion and feeling overwhelmed. It is also helpful when experiencing difference to loved ones
¥ Argentum nitrate - Feeling of Isolation
¥ Pulsatilla - Feelings of isolation
(Sachs, 2000)
As stated in Sachs (2000) “Take the homeopathic remedy that most closely matches your symptoms until one level of your problem seems to ease; then switch remedies to deal with any new levels.”
The 2004-2005 Australian Bureau of Statistics Survey for the Australian Institute of Health and Welfare found that 1,052,600 Australians reported depression as a long-term health condition. These numbers well exceed heart disease, chronic obstructive pulmonary disease and diabetes as in the survey for the same year 2004-2005 (Medhurst, 2008).
Turning to natural therapies helps prevent dependence and side effects for pharmacological medications few Medications or herbs have as much to offer depressive people as homoeopathy does. In all cases, homeopathic medicines are best prescribed on the basis the person's entire symptom picture (Medhurst, 2008).
However, where it's not possible it may be worth looking at a group of remedies that notable authors have identified as useful in the management of depression. Arsenicum alum, Aurum metallicum , Graphites, Ignatia, Lycopodium, Natrum Mur, Nux vomica, Phosphoricum acid, Phosphorous, Platina, Pulsatill and Sepia are of the common remedies historically used for management of depressive patients when the constitutional is unknown (Medhurst, 2008a).
Researchers at the Federal University of Sao Paolo in Brazil enrolled 91 people who had been diagnosed with depression, using the DSM-IV criteria. Using a randomized, double placebo-controlled design, in the study and randomly assigned them to receive either individualized homeopathy, fluoxetine (Prozac) or a placebo version of both. At the end of the fourth and eighth weeks, all participants were re-assessed for depression. Analysis found that both interventions were equally successful, with outcome scores for homeopathy slightly ahead of those for fluoxetine, and homeopathy adverse reaction rate assessed at less than half of that for fluoxetine (Medhurst, 2008b).
References
Medhurst, R. (2008a). Homeopathy for depression. Journal of the       
            Australian Traditional- Medicine Society 14 (4), 225-226.
Medhurst, R. (2008b). More research on Homeopathy. Journal of the 
            Australian Traditional-Medicine Society, 16(3), 157-159.
Sachs, J. (2000). Health in balance. Natural strategies to ease depression.
             Better Nutrition, 62(2), 72.

Lateral Violence In the Workplace

Introduction
        The major topics of conflict management that will be discussed within this discussion seminar are; what causes conflict, types of conflict, conventional conflict resolution and an exploration of new approaches to conflict management styles and policies. Highlights on the four types of conflict: Interpersonal conflict, intrapersonal, intergroup conflict and organizational conflict play an integral role in nursing practice and education settings, as well as, the management of political conflict (Mason, Leavitt & Chaffee, 2007). Interpersonal relations between nurses are a topic of considerable importance particularly with ongoing challenges such as; retention of nurses in the profession, the focus on
increased productivity and cost containment in the healthcare system (Duddle & Boughton, 2007).  Much research has also indicated that nurses’ workplace relationships with each other are problematic, have poor colleague relationships, which result in conflict and aggression (Whitworth, 2008). Role conflict, communication conflict, goal conflict, personality conflict, ethical conflict and values are common factor that relate to nursing. Basic strategies of the Thomas-Kilman’s model for conflict resolution include competition, avoidance, accommodation, compromise and collaboration (Zerwekh & Claborn, 2006).
        In 2007, a case study of one Interdisciplinary Research (IR) team, composed of five researchers from nursing and social work disciplines. The controversial IR topic, experience of gay men and lesbians in long-term care facilities, was relevant to both disciplines. The purpose of this case study is to analyze the interpersonal interactions of an IR team and steps taken when conflict interfered with the team's work (Curry, Jenkins, Walker, Cohen, & Hogstel, 2009). Upon initial analysis, five major categories for resolving conflict and achieving outcomes emerged: 1. Revealing threats to identity 2. Embracing conflict 3. Accepting personal responsibility 4. Engaging the process 5. Building team cohesion (Curry et al, 2009).
        Emotional Intelligence (EI) is imperative for nurses to learn how to effectively handle conflict in the work environment. Developing the competencies of EI and understanding how to effectively handle conflict is necessary for nurses (Morrison, 2008).
According to Morrison (2008):
        Effective leadership management includes conflict management and             
        collaboration. The art of relationship management is necessary when 
        handling with other people’s emotions. When conflict is approached
         with high levels of EI, it creates an opportunity for learning effective
         interpersonal skills. Understanding how EI levels and conflict skills
         correlate can be used to improve interpersonal relationships in a
         healthcare facility. 
        Alternative Dispute Resolution (ADR): a tool for managing conflict. Is a established conflict management tool widely used to shift norms and values with governmental policies. These policies emerge through a political process shaped by context. Nurses possess substantial values, responsibilities and skills needed for ADR conflict management techniques.
References
Curry, L., Jenkins, D., Walker, C., Cohen, H., & Hogstel, M. (2009).
 Negotiating peace and power in an interdisciplinary research team: 
A case study. Southern Online Journal of Nursing Research, 9(3).
Duddle, M. & Boughton, M. (2007) Intraprofessional relations in nursing.
Journal of Advanced Nursing 59(1), 29–37.
Mason, D., Leavitt, J., & Chaffee, M. (2007). Policy and politics in nursing and
 healthcare. St. Louise: Saunders.
Morrison, J. (2008). The relationship between emotional intelligence competencies
         and preferred conflict-handling styles. Journal of Nursing Management 16
        974–983.
Whitworth, B. S., (2008).  Is there a relationship between personality type and
         preferred conflict-handling styles? An exploratory study of registered nurses
         in southern Mississippi. Journal of Nursing Management 16, 921-932.
Zerwekh, J. & Claborn, J. (2006). Nursing today transition and trends. St. Louise:
 Saunders.

Clean vs. Sterile Technique in Chronic Wounds

Clean Technique vs. Sterile Technique in Chronic Wounds
Definitions:
According to Torre and Chambers (2008) a chronic wound is a wound that has “failed to proceed through an orderly and timely process to produce functional integrity.”
Common chronic wounds are diabetic foot ulcers, pressure or venous stasis ulcers, traumatic, surgical or neoplastic wounds.
Facts about Chronic Wound Care:
According to Zaleski (2008) Chronic wounds represent a significant burden to patients, healthcare professionals and the US healthcare system: 
Affects 5-7 million patients and costing an estimated 20 billion dollars annually 
98% of chronic wounds are contaminated with aerobic organism and the infection rate of a chronic wound is estimated at 2.1%
Wound care products cost the US healthcare system over $7 billion in 2007 
An estimated 1.3 to 3 million US individuals are believed to have pressure ulcers 
As many as 10% to 15% of the 20 million diabetics are at risk for developing diabetic ulcers 
Sterile Technique:
Defined by the - Wound Ostomy Continence Nurse Association (WOCN) as “strategies used in patient care to reduce exposure to microorganisms and maintain objects and areas as free from microorganisms as possible. This includes, use of sterile field, meticulous hand washing, use of sterile gloves, and use of sterile dressings and instruments.
Clean Technique:
Defined by the WOCN as “strategies used in patient care to reduce overall numbers of microorganisms from one person to another of from one place to another.” This includes, maintaining a clean field, meticulous hand washing, use of clean gloves and prevention of direct contamination of supplies and materials.
                                      Reference
Zaleski, T. (2008). Active products drive wound-care
     market. Infection Control Today, 28(9),2. 

Human Cells, Organelles and their Functions

14 Organelles and their functions
Lysosome- An organelle that serves as the principal site of digestion with in the cell.
Nucleus- The command center of the cell containing almost all the genetic information.
Nucleolus- A specialized region within the nucleus that forms and disassembles during the course of the cell cycle.  It plays a role in the generation of ribosomes, organelles involved in protein synthesis.
Ribosome- The site where protein synthesis begins in a cell.  It consists of two subunits, each containing ribosomal RNA and proteins.
Rough Endoplasmic Reticulum (RER)- Endoplasmic reticulum that is studded with ribosomes.  It produces membrane.
Golgi Complex- An organelle consisting of flattened membranous disks that functions in protein processing and packaging.
Microfilament- A component of the cytoskeleton made from the globular protein actin.  Micorfilaments from contractile units in muscle cells and are responsible for amoeboid.
Plasma Membrane- The thin outer boundary of a cell that controls the movement of substances into and out of the cell. 
Cytoplasm- The part of the cell that includes the aqueous fluid within the cell and all the organelles with the exception of the nucleus.
Vacuole- A cavity or vesicle in the cytoplasm of a cell usually containing air or fluid. 
Centrioles- A structure found in pairs with in a chromosome.  Each centrioles is composed of nine sets of triplet microtubules arranged in a ring.
Smooth Endoplasmic Reticulum (SER)- Endoplasmic reticulum without ribosomes.  It produces membrane and detoxifies drugs.
Microtubule- A component of the cytoskeleton made from the globular protein tubulin.  Microtubules are responsible for the movement of cilia and flagella and serve as tracks for the movement of organelles and vesicles.
Mitochondrion- An organelle within which most of cellular respiration occurs in a eukaryotic cell.  Cellular respiration is the process by which oxygen and an organic fuel such as glucose are consumed and energy is released and used to form ATP.

Foods That Heal

Banana - high in fiber, great for young children, high in potassium, feed out natural acidophilus bacteria in the bowel, sugars are readily assimilated.
Cucumber - alkaline, cooling on the body and blood, non starchy vegetable, good digestive aid with a purifying effect on the bowel.
Garlic - High in iodine and sulfur, considered a medicinal plant, contains a bacteriocide called crotonaldehyde with makes it very antiseptic for the entire body. Widely used for High Blood Pressure, worms, infections and goiters (d/t the high iodine content). Garlic is really an awesome plant. It gives energy and is just great for so many things. Like a medicine chest necessity in the kitchen. Aloe would be another one of the kitchen medicinal necessities. You can combine parsley with garlic and that helps a bit with the odor and also aids in digestion.
Grapes - are high in Magnesium. Promotes good bowel movements, alkaline to the blood, high in water content. Good for the kidneys and bladder.
Kale - High in Calcium, vitamin A and iron.
Lemon - rich in alkaline elements, high in vitamin C, high in potassium, rich in vitamin B1, Great for ridding body of toxic materials. Wonderful for throat problems, catarrh (mucus), great antiseptic.
Oranges are very high in Vitamin C and good for the immune system and they are actually alkaline-reacting and good to rid the body of acid and catarrhal (mucus), and good for elimination as well. Good for arthritis.
All fruits and vegetables are valuable source of energy, vitamins and minerals and do much much more then what has been listed above. These are just some highlights fir quick reference and knowledge. 
Jenson, B. ( 1993). Foods that Heal: A guide to 
    Understanding And Using The Healing Powers of 
    Natural Foods. Garden City Park, New York; Avery
     Publishing Group.