Since nursing school, I have heard about the importance of providing holistic (wholistic) health to all people. The problem is apart from describing the definition of holistic nursing, as the art of caring for the whole person’s physical, emotional, spiritual, and mental needs, I didn’t receive training on how this idea could really be integrated into practice.
Although I still don’t have the answers for holistic nursing, I have studied this idea throughout my career and recently uncovered that shared partnership rather than holism may be a more practical way to support the patient’s idea of health.
Holistic Health Defined
Holistic health is defined as a state of general physical, emotional, spiritual, and mental well-being that influences how you relate to the people around you and the environment in which you live.
This view of health looks at how the mind, body, and spirit are interrelated, meaning that when one aspect of health (physical) is affected the individual’s sense of well-being is also changed in a positive of negative way. Holistic health is commonly held by Indigenous peoples who see health in a broader context of land, community, culture, relationships, and nature.
Too many people well-being is maintained within the community, family, or another group when the social, emotional, and cultural needs are also in harmony. This means health, as defined by mainstream providers, cannot be separated into nine categories of mental, physical, emotional, social, and spiritual needs.
Mainstream Health Defined
The mainstream definition of health has centered on the “absence of disease”. This is a reductionist approach to health where the parts are separate from the whole, which has more use in acute situations but is less helpful after discharge when the individual is expected to make lifestyle changes.
For example, a patient who comes into the emergency department suffering from a head trauma will receive emergency treatment for the injury they sustained. Thankfully the attempt to assess, intervene, and evaluate their cultural, emotional, and social needs will receive less priority than their need to receive advanced life-support measures.
This type of situation warrants healthcare strategies that are aimed at treating the injury to restore physical balance by separating the parts from the whole. Although this definition of health works in the acute care setting, it is less effective when the patient is discharged home.
Defining Health Today
The World Health Organization created a new definition of health that was encompassing and moved away from health is merely the absence of disease. The WHO definition of health is defined as:
A state of complete physical, mental and social well-being and not merely the absence of disease (WHO 1946 in Koutoukidis et al, 2013)
One positive aspect of this definition of health was the attempt to move away from health being merely the absence of disease to a more encompassing view.
However, many have criticized this definition for creating an idealistic view of health that is unattainable in today’s complex health care system. Even if this is true, I’m not sure the mainstream health care system has the duty to attain this level health for all patients. So maybe the goal should be to create an empowered patient through shared partnership rather than adopt a new definition of health.
Patients, nurses, and other healthcare providers all have their own unique definition of health. Many times the definitions patients and providers hold do not match. The shared partnership model of care doesn’t seek to align provider and patient definitions of health but rather seeks to create a mutually respectful model of care.
This occurs when the nurse asks the patient what level of health they hope to attain in the hospital, community, or other health care setting and works in partnership with the patient to achieve the desired level of health. Of course, this idea of shared partnership is not new and won’t work in all situations, such as the emergency department, but it does have the potential to be integrated into complex mainstream health care systems because it supports diverse views of health.
You see a partnership model transfers the focus of attention away from the mainstream health care system or provider toward the patient. This works because eventually the patient will be discharged home and needs to be feel capable of managing their disease, reducing their risk factors, or taking steps to prevent another medical event.
The pursuit of common goals shared responsibility, and mutual respect between the patient and provider is broad enough to encompass differing views of health because it focuses on the patient’s strengths and capabilities as the patient relates to others and the surrounding environment.
With a shared partnership, healthcare professionals can provide high-quality care to all people, regardless of their view of health, by being mindful of their own values, respectful of the patient’s views, and by highlighting the strengths of the patient.
This model of care builds a relationship that empowers the patient to participate in their own care, interdependently meet their needs, and obtain the necessary resources they need to function in the hospital and home. Adopting a shared partnership model of practice is worth considering.
Koutoukidis G, Stainton K, & Hughson J. (2013). Tabbner’s Nursing Care Theory and Practice 6th
Ed. Chatswood, Victoria Avenue, Churchill Livingston: Elsevier.