Concept Analysis: Holistic Nursing

Concept analysis is recognized as an effective method to clarify vague and overused concepts. Since the concept of holistic nursing/treatment/healing is often affected by individual perception, it is essential that its meaning is interpreted in the most comprehensive manner; otherwise misunderstanding can reduce its importance and relevance to nursing practice. In addition, a concrete definition of the term can substantially contribute to research and theory development, which is critical for professional advancement of nursing care. The purpose of this paper is to clarify the concept of holistic nursing to enhance the comprehension of the reality of medical practices.

Summary

The main purpose of this study is to advance the concept of holistic nursing for theory development and accurate application to practice. Initially, all uses and definitions of the concept are identified using every possible discipline. Hence, the concept of holistic nursing can be defined as an approach that focuses on the treatment of a person as a whole open live system, taking into account mental and social factors. Careful attention is given to the attributes of the concept. Recent paradigms and traditional approaches to defining the term are also considered. Furthermore, the model, similar and otherwise cases are constructed to provide rich representation of the concept. The true life model case is included in the paper to demonstrate the empirical use of the concept. The paper also presents the related case that contains similar critical attributes. The contrary case depicts the clinical situation when none of the defining characteristics are present, and therefore the holistic approach is not recommended. Additionally, antecedents and consequences are identified in order to provide accuracy and unambiguousness regarding the concept of interest. This study concludes with a discussion of the empirical methods used to measure the concept of holistic nursing.

Presentation of the Concept and Definition

The term holistic derives from the word holos, which in Greek means whole. The origin of the words healing and health is also a Greek word hale, meaning to make whole. Apart from medicine, the term is often used in philosophical works. An African philosopher Smuts introduced the term holistic to define the theory that the parts of the whole are interrelated and, hence, cannot exist as the separate entities. The philosopher believed that South Africa is a more powerful country if united, thereby stating that the whole is greater than the sum of its parts (Dossey & Keegan, 2013).

Nobody would deny the fact that nursing is holistic in its nature. Traditionally, this profession was healing the whole patient as a final goal, taking into consideration the unity of body, spirit and mind, powerfully promoting physiological and psychological health, and encouraging social relationships in the clinical environment (Brooker & Waugh, 2013). During last decades, the term holistic was frequently used in nursing literature. A humanistic theorist Rogers suggested that holistic nursing is an approach in medicine that focuses on humans’ unitary nature, since all elements in the world are closely connected to each other. Levine advanced this theme by describing each patient as a unique human being in terms of the wholeness (Brooker & Waugh, 2013). American Holistic Nurses Association (2015) uses the term solely when referring to the state of balance between body, spirit and mind in constantly changing climate. In fact, this perspective aligns with modern holistic practice and has an increasing emphasis on physical, cultural and social factors. The focus is therefore wider than simply physical aspects of care. Thus, practicing nurses have to be aware of their own wholeness as well as that of the client.

The Attributes of the Concept

Such attributes as body, spirit and mind, wholeness, balance, and harmony constantly appear in nursing literature. Apparently, this view is consistent with more traditional approaches to holistic nursing frequently found in 1990s. In recent years, theorists argue that healing is the defining attribute of holistic nursing care. Hereby, it is necessary to clarify exactly what is meant by healing. Thus, the attribute can be defined as clinical intervention and treatment in terms of spiritual care. While talking about inner harmony, it can be achieved through the provision of great care and attention for patient’s mental state. In fact, the attribute healing is more accurate for characterizing the concept of holistic nursing, as it refers to the process of becoming physically and spiritually healthy. The process encompasses the assessment of the need, strong patient nurse relationship, and intuitive action (Klebanoff & Hess, 2013). Importantly, these attributes highlight the fact that it is almost useless to treat the body if the spirit is destroyed.

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Model Case

Michael Whitmire, a 60-year-old man, experienced cardiac arrest three weeks ago. Apparently, his heart was not severely damaged, and thus the cardiac rehabilitation was taking its normal course. However, his general health state remained rather critical. Notably, about one third of patients after cardiac arrest feel depressed and frightened. Mr. Whitmire had to cope not only with the emotional impact of what had happened to him but also with the fears of sudden cardiac death. While assisting with his dining process, the nurse initiated informal conversation and was attentively listening to his patient in order to ease his emotional distress (harmony). They had a detailed discussion regarding religious issues and fate (spirit). Following this conversation, the nurse noticed that he required help with eating, and therefore the nurse quickly provided appropriate assistance (body, mind and spirit). The patient reported that he felt much better because of spiritual and emotional support offered (wholeness, body, spirit, mind, and healing).

The model case is an account of nurse’s relationship with a patient recovering from a heart attack. Evidently, this case involves many attributes of holistic practices described in the previous section. To be more precise, the nurse successfully assessed the patient’s need to share his fears and concerns. Afterward, effective nurse-patient relationship allowed Whitmire to be comfortable with the situation. Finally, the nurse’s actions were guided by intuition so that mental, bodily and spiritual care was offered. The case epitomizes holistic nursing practice, which is aimed at healing the patient while coping with his daily activities.

Similar Case

As a related case, the nurse assisted Michael Whitmire with patient’s daily activities. The client was delivered to the hospital four days ago so that he required additional care and assistance. After cardiac surgery and recent hospitalization, he began feeling worried about the outcomes of the clinical intervention. The nurse decided to treat such mild form of depression by simply being present and through careful listening (spirit and mind). However, when the nurse noticed that Mr. Whitmire needed nails trimming, she called the chiropodist to address the issue. By refusing to help Michael with this procedure, the health care provider fragmented medical care and, hence, did not use the holistic approach in nursing.

Otherwise Case

If the model case concerned the recovery process of the patient, the contrary case focuses on the situation when the holistic approach is not applicable. Michael Whitmire was forced into retirement, which is why he had an emotional stress that in turn led him to the cardiac event. In this case, it is important that the nurse acted immediately without paying attention to social and mental factors. Thus, the health care professional did not attempt to ease his mental sufferings as long as his life was under the threat. Instead, the primary care was urgently required.

Antecedents and Consequences

For holistic healing to occur, effective nurse-patient relationship built in an ever-changing environment is required. Hence, the major credentials for the nurse include knowledge, expertise, and strong communication skills. Regarding the consequences, both positive and negative factors can be listed. The nurse personally and professionally benefits from practicing holistic care. Therefore, the main consequence is increased personal and professional development. Apparently, this outcome can ultimately lead to self-satisfaction, which in turn provides job satisfaction. The positive consequence for the patient is first and foremost better clinical outcomes. Therefore, a person-centered health system helps the health care providers to respond to the needs of the individual in the appropriate way (Klebanoff & Hess, 2013). The negative consequence associated with holistic care is intrusion, which thus should be avoided. Equally, for the health care professionals, the consequence of providing twenty-four-hour holistic help can be emotionally exhausting and challenging.

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Empirical Methods

Needless to say, practical appliance of holistic approach requires definite methods, which help to measure the concept and provide further clarity regarding holistic practices. First of all, a survey is viewed as one of the valid and reliable methods. The approach helps to measure holistic practice from both patient and professionals’ perspectives and thus optimize holistic practices. The interview is another consideration. With regard to this method, it assists in determining needs and preferences of patients and family members. Moreover, feedback from clinicians is regarded as an effective empirical method to understand care experience from the point of view of health care providers. The data is collected to make the improvements in person-centered communication. Finally, the analysis of routine data is an empirical approach to evaluate the outcomes of a particular intervention (De Silva, 2014). Nurses use the routinely collected data to define whether current person-centered care positively affects the patient.

Conclusion

This paper has made an attempt to conceptualize holistic nursing to contribute to theory development and promote its proper practical application. An important finding to emerge from the concept analysis is that patient care should not be fragmented by interdisciplinary care. In conclusion, it is appropriate to offer a comprehensible definition of holistic care; hereby, holistic nursing practice encompasses the body, mind, and spirit of the individual in a culture that encourages effective nurse patient relationship, which eventually lead to wholeness and healing.

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