Holistic Care
D R . A L I D . A B B A S / I N S T R U C TO R , F U N D A M E N TA L S
U N I V E R S I T Y O F B A G H D A D, A L I D U K H A N @ U O B . E D U . I Q
OF
NURSING
D E PA RT M E N T,
COLLEGE
OF NURSING,
As a nurse,
you will be a professional
caregiver. Your intimate contact with clients allows
you the opportunity not only to provide physical and
emotional support but also to teach ways to take an
active role in maintaining health.
1. Interrelated Concepts of Health
Health is "the condition of being sound in body, mind, or
spirit" (Merriam-Webster Online Dictionary, 2008).
The WHO defines health
as follows: "Health is a
state of complete physical, mental, and social well-being and not
merely the absence of disease or infirmity" (WHO, 1974).
Health refers to the total well-being of the whole person.
(Telstar Innovations, Inc., 2000).
Holistic
is a term derived from the Greek word holes, meaning
"whole." Holistic health views the physical, intellectual, sociocultural,
psychological, and spiritual aspects of a person's life as an integrated whole.
These five aspects cannot be separated or isolated; anything that affects one
aspect of a person's life also affects the other aspects.
Healing means to be or become whole. It is a state of harmony or
balance in the body, mind, and spirit connection. (Quinn, 2005)
Homeostasis is the balance or stability that the body strives to
achieve among these aspects of a person's life by continuous adaptation.
The goal of holistic nursing
is
the "enhancement of healing the whole person
from birth to death" (American Holistic Nurses
Association [AHNA], 2004).
The AHNA supports the belief that health involves the
harmonious balance of body, mind, emotions, and spirit
within an ever-changing environment.
The NIH defines holistic care as care that "considers the
whole person, including physical, mental, emotional, and
spiritual aspects.
Among the holistic modalities most frequently used in nursing are the
following:
Biofeedback
Exercise and movement
Goal setting
Humor and laughter
Imagery
Journaling
Massage
Play therapy
Prayer
Therapeutic touch
The holistic nurse is "an instrument of healing and a facilitator in the
healing process (AHNA, 2004). By does the following:
Demonstrates awareness that self-healing is a continual process
Is familiar with self-development
Recognizes personal strengths and weaknesses
Models self-care
Demonstrates awareness that personal presence is as important as technical skills
Respects and loves clients
Presumes that clients know the best life choices
Guides clients in discovering creative options
Listens actively
Shares insights without imposing personal values and beliefs
Accepts client input without judgment
Views time spent with clients as an opportunity to serve and share (adapted from Dossey, 1998)
Wellness is a responsibility, a choice, a
lifestyle design that helps maintain the
highest potential for personal health (Hill &
Howlett, 2005).
The health continuum is a way to visualize the range of an individual's
health, from highest health potential to death.
Abraham Maslow
developed a theory of
behavioral motivation
based on needs. This
theory is often referred to
as Mallow's Hierarchy of
Needs.
2. Providing Quality Care
►The first step in providing quality client care is to be aware of yourself.
What kind of personality do you have?
Is your self-concept positive, or do you have self-doubts and lack selfconfidence?
What are your beliefs and attitudes?
Knowing the answers to such questions will help you in your role as caregiver.
►The next step is taking care of your own needs.
When you attend to the needs in your own life, you are then free to
concentrate on caring for others. Your example of self-care inspires
clients to have confidence that you will provide quality care. Thus,
self-care is a factor in your effectiveness as a caregiver.
Self-awareness
is consciously knowing how the
self thinks, feels, believes, and behaves at any specific time.
Being self-aware is a constant process that is focused on the
present. A person's thoughts, feelings, and beliefs are
interrelated and greatly influence behavior. Being self-aware
influences a person in several ways.
For example, experienced nurses—are often anxious about
caring for a specific client. By taking some time to practice selfawareness, the nurse might discover that the anxiety stems from
never having performed the procedure in question. The nurse can
then deal directly with the situation by reviewing the procedure
and requesting assistance from an instructor or supervisor.
All decisions about client care
must be made in response to the
client's needs, not the nurse's
needs.
Self-concept is how a person thinks or feels about
himself. These thoughts and feelings come from the
experiences the person has with others and reflect how
the person thinks others view him.
For example, an individual who is constantly ignored or who receives
messages such as "Don't bother me," "Can't you do anything right?" or "You
don't have any sense" may very well begin to view himself in these terms, with
the likely result being a negative self-concept. On the other hand, a person
who is shown caring and who hears messages such as "Let me help you in a
minute," "Let's try it this way," or "Have you thought about ... ?" will move
toward a positive self-concept.
3. Self-Care as a Prerequisite to client care
Physical wellness
refers to a healthy body that functions at an optimal
level. To achieve physical wellness, a person must practice:
►Grooming
►Body Mechanics
►Posture
►Smoking
►Drugs and Alcohol
►Nutrition
►Sleep, Rest, Relaxation, and Exercise
Intellectual wellness
is the ability to function as an inde-
pendent person capable of making sound decisions. Such decisions are based
on the individual's needs but at the same time take into account the needs of
others. Clear thinking, problem-solving skills, good judgment, and the desire to
continually learn are all qualities found in the person who is intellectually well.
Sociocultural wellness
is the ability to appreciate
the needs of others and to care about one's environment and the
inhabitants of it. As a nurse, you will care for clients of all ages and
races who speak different languages and come from various
cultural groups.
Psychological wellness
encompasses
the
enjoyment of creativity, the satisfaction of the basic need to
love and be loved, the understanding of emotions, and the
ability to maintain control over emotions.
Spiritual wellness manifests as inner strength and
peace.
Spirituality is
a broad concept incorporating more
than a client's religious affiliation. It encompasses the beliefs
that a person has that give meaning and purpose to their
existence (Fitchett, 2002).