Wholistic Health Care: Evolutionary Conceptual Analysis

A cross-cultural concept analysis of healing in nursing: a hybrid model

BACKGROUND

As a familiar yet abstract and vague concept for nurses, healing is affected by the cultural needs of different communities. The concept of healing is nowadays recommended in nursing theories, and its clarification can develop healing-based nursing care. The present study was conducted to objectify and clarify the concept of healing in nursing care.

METHODS

The present research employed a hybrid concept analysis model developed by Schwartz-Barcott and Kim. The conceptual analysis model of Walker & Avant was used in the theoretical phase, i.e., literature review, where relevant articles in PubMed, ISI, Google Scholar, Scopus, SID and Magiran were reviewed irrespective of publication time. Unstructured interviews were conducted with ten participants in the field data collection phase. A final analysis was performed by combining the two phases.

RESULTS

The theoretical phase identified healing characteristics such as balancing and hope-making originated from mental and spiritual states. Analyzing the data in the fieldwork stage extracted five main themes, i.e. "comprehensive psychophysical health", "cure, a small part of healing", "healing, a spiritual recovery", "an individual's own role in healing" and "healing, an unexpected event". During the patient care process, nurses can help patients heal by establishing appropriate communication and comprehensive understanding of the patients by designing and implementing appropriate interventions and integrating healing strategies into their comprehensive care measures.

CONCLUSIONS

The concept of healing in nursing care is a general and complex process, and different people can interpret it differently on their road to health. Properly understanding the concept of healing enables nurses to assist patients in achieving health and healing through proper communication, holistic care, empowering patients to perform self-care and providing spiritual care.

Using Nursing Interventions Classifications to Document Faith Community Nursing Transitional Care

ABSTRACT

One out of five Medicare beneficiaries is readmitted within 30 days after hospital discharge, and as many as three in four readmissions are preventable. This study describes transitional care interventions (TCIs) delivered by one faith community nurse (FCN) to at-risk seniors living in a certain ZIP code. Two years of nursing documentation (2,280 interventions) were translated into Nursing Interventions Classification standardized nursing language. Results indicate the FCN provided priority TCIs including spiritual care. In fully describing TCIs using a nursing language, results support that the FCN transitional care model is a method worth exploring to provide wholistic transitional care.

Possibilities and paradoxes in medicine: love of order, loveless order and the order of love

We have a desire to discover and create order, and our constitution, including our rational faculties, indicates that we are predisposed for such productivity. This affinity for order and the establishment of order is fundamental to humans and naturally also leaves its mark on the medical discipline. When this profession is made subject to criticism, frequently in terms of well-used reproofs such as reductionism, reification and de-humanisation, this systematising productivity is invariably involved in some way or other. It is, however, problematic that we rarely delve deeper and ask what order means, or reflect on its underlying, omnipresent and self-evident role. In order to approach this challenge, we initially and briefly place order in a conceptual and historical context. In what follows, we examine order explicitly, i.e. made an object of study, by taking a closer look at extensive multidisciplinary efforts to uncover the secrets of all its facets. Here we also try to identify some systems of order in medical science, including methodological and procedural order, which are indispensable as well as a source of problems. In the sections that follow, order is not defined as an explicit object of study, but comes to light in some exploratory and philosophising projects based on physics, mathematics and phenomenology . Each of these lets order and that which is ordered emerge in ways that may also shed light on opportunities and paradoxes in the medical domain. Key themes here include the Gordian knot of psyche – soma, the order of disorder and the patient as Other.

Wounded Healers: Job Termination in Faith Community Nursing

ABSTRACT

Research regarding faith community nursing termination is scarce. Ziebarth (2018) surveyed faith community nurses (FCNs) who had experienced termination of their position. This article explores FCN feelings related to termination and provides an evidence-based practice component to translate the research into practice. Given that FCNs engage in deep relationships with clients, their feelings following termination express grief and lack of support. Support strategies as well as preemptive strategies that may be useful to prevent loss of an FCN position or ministry are presented.

The Impact of the Theory of Nursing for the Whole Person on the Professional Practice of Nursing School Graduates

The Theory of Nursing for the Whole Person (TNWP) is a wholistic theory that focuses on the integration of body, mind, spirit, individual, family, and community. A qualitative descriptive research study explored Oral Roberts University graduates' perceptions of their use of the TNWP in practice. Analysis revealed six major themes. Respondents felt that the TNWP was a necessary tool to truly care for patients.

Comorbidities are prevalent and detrimental for employment outcomes in people of working age with multiple sclerosis

Background:

More work is needed to understand the burden of comorbidities in people with multiple sclerosis (MS).

Objective:

To assess prevalence of 30 comorbidities and impacts of comorbidities on employment outcomes in a working-aged MS cohort.

Methods:

Participants were from the Australian MS Longitudinal Study ( n = 929). Information on specific comorbidity was obtained (whether or not each was present, doctor-diagnosed, limited their activities and being treated).

Results:

Comorbidities most frequently reported to limit activities were osteoarthritis (51%), migraines (40%), anxiety (33%), depression (29%) and allergies (18%). Mean MS-related work productivity loss in past 4 weeks was 1.3 days for those without comorbidities and 2.5 days for those with any comorbidity. The annual population costs of work productivity loss were highest for people with depression, allergies, anxiety, migraines and osteoarthritis. Higher number of comorbidities was associated with more work productivity loss and a higher likelihood of not working. These associations were substantially reduced after adjustment for MS symptom severity.

Conclusions:

Comorbidities substantially impact employment outcomes and these effects were mainly mediated through MS symptom severity. This suggests that optimal and simultaneous management of comorbidities may be a viable strategy to reduce MS symptom severity, which in turn could improve employment outcomes.

Definition of whole person care in general practice in the English language literature: a systematic review

OBJECTIVES

The importance of 'whole person' or 'holistic' care is widely recognised, particularly with an increasing prevalence of chronic multimorbidity internationally. This approach to care is a defining feature of general practice. However, its precise meaning remains ambiguous. We aimed to determine how the term 'whole person' care is understood by general practitioners (GPs), and whether it is synonymous with '[w]holistic' and 'biopsychosocial' care.

DESIGN

Systematic literature review.

METHODS

MEDLINE, PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, Proquest Dissertations and Theses, Science.gov (Health and Medicine database), Google Scholar and included studies' reference lists were searched with an unlimited date range. Systematic or literature reviews, original research, theoretical articles or books/book chapters; specific to general practice; relevant to the research question; and published in English were included. Included literature was critically appraised, and data were extracted and analysed using thematic synthesis.

RESULTS

Fifty publications were included from 4297 non-duplicate records retrieved. Six themes were identified: a multidimensional, integrated approach; the importance of the therapeutic relationship; acknowledging doctors' humanity; recognising patients' individual personhood; viewing health as more than absence of disease; and employing a range of treatment modalities. Whole person, biopsychosocial and holistic terminology were often used interchangeably, but were not synonymous.

CONCLUSIONS

Whole person, holistic and biopsychosocial terminology are primarily characterised by a multidimensional approach to care and incorporate additional elements described above. Whole person care probably represents the closest representation of the basis for general practice. Health systems aiming to provide whole person care need to address the challenge of integrating the care of other health professionals, and maintaining the patient-doctor relationship central to the themes identified. Further research is required to clarify the representativeness of the findings, and the relative importance GPs' assign to each theme.

PROSPERO REGISTRATION NUMBER

CRD42017058824.