Holistic Nursing - Healing the Whole Person

HOLISTIC
NURSING
– healing the
whole person

“Just as the body cannot
exist without blood,
so the soul needs the
matchless and pure strength
of faith.”
-MAHATMA GANDHI

INTER RELATED 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 fol-lows:
"Health is a state of complete physical,
mental, and social well-being and not merely
the absence of disease or infirmity" (WHO,
1974).

• 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.

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A
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L
SO
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A
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Health Illness Continuum
Model
• According to this model,
health is a dynamic state
that fluctuates as a person
adapts to changes in the
internal or external
environments to maintain a
state of well-being.

• Illness is a process in which the
functioning of a client is diminished or
impaired when compared with his/ her
previous condition.
• In this model, high-level wellness and
severe illness are at opposite ends of the
continuum
• The person moves back and forth
(forward) within this continuum day by day

• Wide ranges of health or illness are
present.

H
e
a
lthB
eliefM
o
d
e
l
• Rosenstoch and Becker and Maiman
proposed the Health Belief Model.
• This model addresses the relationship
between a person’s beliefs and
behaviors.
• The Health Belief Model helps to
understand the factors influencing
patients’ perceptions, beliefs, and
behaviour to plan the care.

C
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S
1.Individual’s perception of susceptibility to
an illness
2. Individual’s perception of the
seriousness of the illness
3. Likelihood of taking
preventive action

The word holistic was coined
in 1926 by Gen. J.C. Smuts
(1870-1950) and based on the
Greek root “holos”, which means
‘whole’.

Holistic health views the
physical, intellectual,
sociocultural, psychological ,
and spiritual aspects of a
person's life as an integrated
whole.

HOLOS
(entire or
whole)
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HOLISM

CONCEPT :
When applying
the concept of
holism to states
of health , ellicited
that health can be
influenced by an
individual’s ability
to adapt to:
CONCEPT :
When applying
the concept of
holism to states
of health , ellicited
that health can be
influenced by an
individual’s ability
to adapt to:
Changing
environments
Aging
Times of
suffering
Expectation of
death

CONCEPT
• This implies that
individuals have the
potential to influence
their own lives and
that holistic care
should consider the
whole human
experience.

• Ancient approach 5000 years ago in
India and China, stressed living
healthy way of life in harmony with
nature.
• An approach to health based on a
love of life, not a fear of death.
• Leads to high level of wellness for
the total person throughout the total
life style.

Facets of holism
❑ Personal/ inner
resources are as
important as
external ones
❑ Link between the
body and the
mind.
❑Personal/ inner
resources are as
important as
external ones
❑Link between the
body and the
mind.

Facets of Holism
Ind
Indiv
iviidu
d
ual
al
I
In
nne
ner
r
R
Reso
esourc
es
urces
Physical
Spiritual Individual
Inner
Resources
Psychological
Social

• What is holistic
nursing ?????

• Holistic nursing
focuses on
promoting health
and wellness,
assisting healing
and preventing or
alleviating
suffering.

A philosophy of nursing practice that
takes into account total patient care,
considering the physical, emotional,
social, economic, and spiritual needs
of patients, their response to their
illnesses, and the effect of illness on
patients' abilities to meet self-care
needs.

• Uses medical knowledge + complementary,
alternative and integrative methods to care for
the patient as a whole.
• Insists that total good health and well being
can be achieved by understanding the whole
person in a perspective that includes his
physical, mental, emotional, social and
spiritual dimensions”.

•GOAL OF HOLISTIC
NURSING ……..

• The goal of holistic
nursing is the "enhancement
of healing the whole person from
birth to death" (American Holistic
Nurses Association [AHNA], 2004).

the harmonious
•Involves
balance of body, mind,
emotions, and spirit within an
everchanging environment.
• “Considers the whole person,
including physical, mental,
emotional, and spiritual aspects.

Body, Mind and Spirit
Relationship
• The individual according
to Indian scriptures is
‘Prakriti’ and ‘Purusha’.
Nature (Prakriti) is said to
be the formation of body
and ‘Purusha’ the soul.
• Spirit is the cause of
expression of pleasure
and pain guided by mind,
intellect, ego etc.

Mental Conditions Affecting
Bodily Functions
•
•
•
•
•
Our emotions and strong feeling affect the body inwardly
and outwardly.
Unpleasant emotions such as fear, anger, worry cause
headache, insomnia, indigestion and various neurotic
diseases.
Deep thinking and concentration can cause physical
fatigue.
Mind motivates all physical and motor activities.
Emotional conflicts are responsible to cause various
illnesses such as hysteria, gastrointestinal troubles like
peptic ulcer, ulcerative colitis, flatulence etc.

HISTORICAL
PERSPECTIVES
❑Based on Florence nightingale work
❑1970- nurse scholars start concerned with
concept of “whole person”
❑Dossey developed a theory builds upon a
solid holistic, integrated, and
multidimensional theoretical nursing
foundation.

➢1980- American Holistic
Nurses Association was
founded
➢1993-94 Steps towards certification
for holistic nursing
➢1995- Revised standards of
holistic nursing
➢1997- development of basic
core curriculum

1997- American Holistic Nurses
Certification Corporation (AHNCC)
was founded
2003- development of core curriculum
for advanced holistic nursing
2006- recognition as a specialty area
in nursing practice in ANA
2007- revision of basic and advance
practice standards

❑ All people have innate healing powers.
❑ The patient is a person, not a disease.
❑ Healing takes a team approach
involving the patient and doctor, and
addresses all aspects of a person's life
using a variety of health care practices.
❑ Treatment involves fixing the cause of
the condition, not just alleviating the
symptoms.

DIFFRENCE BETWEEN
TRADITIONAL AND
HOLISTIC NURSING

TRADITIONAL VS HOLISTIC
•
•
Traditional
Have knowledge related
to nursing
Limited methods of care
• Treats all patients
• Uni level care to patient
•
•
•
•
Holistic
Needs additional
knowledge
Creativity and unlimited
methods of care
Usually treat patients with
severe conditions
Tri level care to patient

Traditional
• Found at every health
care facility
• Easy to get job as
traditional nurse
Holistic
•
•
Found at more
specialized health care
facilities
Need special areas to
provide care

• Health care considers emotional and
spiritual wellbeing and other dimensions
of an individual as important aspects of
physical wellness.
• The holistic health model of nursing
attempts to create conditions that promote
optimal health.

• • In this model, consider patients to be
the ultimate experts concerning their
own health and respect patients’
subjective experience as relevant in
maintaining health or assisting in healing.
• Involvement of
patients by assuming some responsibility
for health maintenance

• Nurses using the holistic nursing model
recognize the natural healing abilities of
the body and incorporate complementary
and alternative interventions such as
music therapy, relaxation therapy,
therapeutic touch, and guided imagery.

• Nurses use holistic therapies either alone
or in conjunction with conventional
medicine. For e.g.,
a.Music therapy in OT creates a soothing
environment.
b. Relaxation therapy during a
painful procedure such as a dressing
change.

CORE VALUES OF
HOLISTIC CARE
PRACTICE …...

CORE VALUE 1
• Holistic Philosophy: develop and expand
overall philosophy in the art and science of
holistic nursing
• Holistic Education: acquire and maintain
current knowledge and competency in
holistic nursing practice

CORE VALUE 2
•
•
•
Holistic Ethics: hold to a professional ethic of caring
and healing that seeks to preserve wholeness and
dignity of self, students, colleagues, and the person who
is receiving care
Holistic Nursing Theories: recognize that holistic
nursing theories provide the framework for all aspects of
holistic nursing practice and transformational leadership
Holistic Nursing and Related Research: provide care
and guidance to persons through nursing interventions
and holistic therapies consistent with research findings
and other sound evidence

CORE VALUE 3
• Holistic Nurse
Self-Care : engage
in self-care and
further develop
their own personal
awareness of being
an instrument of
healing to better
serve self and
others

CORE VALUE 4
•
•
•
Holistic Communication: engage in communication to
ensure that each person experiences the presence of
the nurse as authentic and sincere;
Therapeutic Environment: recognize that each
person’s environment includes everything that surrounds
the individual, both the external and the internal
(physical, mental, emotional, social, and spiritual) as well
as patterns not yet understood.
Cultural Diversity: recognize each person as a whole
body-mind-spirit and mutually create a plan of care
consistent with cultural background, health beliefs,
sexual orientation, values, and preferences

CORE VALUE 5
• Holistic Caring Process
A.Assessment: Each client is assessed holistically using
appropriate traditional and holistic methods while the
uniqueness of the client is honored
B.Patterns/Problems/Needs: Actual and potential
patterns/problems/needs and life processes related to
health, wellness, disease, or illness, which may or may
not facilitate well-being,
C.identified and prioritized Outcomes: Each client’s
actual or potential patterns/problems/needs have
appropriate outcomes specified

▪
▪
▪
Therapeutic Care Plan: Each client engages with the
holistic nurse to mutually create an appropriate plan of
care that focuses on health promotion, recovery or
restoration, or peaceful dying so that the person is as
independent as possible
Implementation: Each client’s plan of care is prioritized,
and holistic nursing interventions are implemented
accordingly
Evaluation: Each client’s responses to holistic care are
regularly and systematically evaluated, and the
continuing holistic nature of the health process is
recognized and honored

Quality Nursing Practices
❖Individual viewed as biopsychosocial being
in continuous total interaction of biological,
psychological and social aspects.
❖When all aspects are completely balanced
the person experiences an excellent state of
health.
❖Potential alterations in health exist when any
of these areas of the being becomes less
stable.

The Characteristics of Holistic
Health
•
•
•
•
•
•
•
Person oriented rather than disease oriented.
Objective is full, vibrant health (Positive wellness) not
symptom amelioration.
Respect the valid contribution of current medical
science and practice.
Democratic & tolerant rather than authoritarian.
Focuses on internal healing as a useful supplement to
surgery, radiation, and drug therapy.
Tri level (physical, emotional, spiritual) not uni level
(physical only).
Life cycle oriented (Longitudinal), not event specific
(cross-sectional)

• Focuses on primary prevention rather than crisis
intervention.
• Places major responsibility for health on the client,
not the professional.
• Long term ongoing and continuous effort and is not
fragmented.
• Recognizes that not all illness is “bad” and “to be
eliminated” at the earliest possible moment. Some
symptoms represent detoxification, or signal the need for
balancing.
• Focuses on primary prevention rather than crisis
intervention and it goes beyond prevention.
• Recognizes that medicine and health are not
synonymous, but are vitally interdependent.
• Process of centering, integrating, balancing,
harmonizing and vitalizing.

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1. Nutritional awareness
• Some principles :
✓Have more natural food, fruits and vegetables and a
balanced diet
✓Avoid overcooking, too much oil, processed food, refined
food, food additives/ preservatives
✓Limit or avoid non-vegetarian food
✓Drink lots of water
✓Take high fiber roughage
✓Enjoy eating

2. Over eating – a big problem
• A keep healthy, one must remain always a little
hungry.
• In addition to the quality of food it is also
necessary to think of its quantity. Moreover in
our society, regarding people with food is
considered a token of affection.
• So we would be aware of the proper diet in
proper age, time and amount.

3. Physical fitness
• “Prevention is better than cure”. We should maintain our
physical fitness by :
❑Maintaining personal hygiene
❑Regulating diet
❑Exercise, activity
❑Yoga, meditation
❑Regular adequate sleep
❑Prevention of fatigue, over work etc.

Stress awareness and
management
➢Have a clear picture of life’s goal and meaning
of life, develop positive attitude
➢Nurture faith dimensions, look at the bright side
of life
➢Develop caring relationship
➢Restrictive positive environment
➢Learn to say “no” when it is beyond your ability
➢Have adequate sleep, rest, exercise and diet

➢Bring variety in daily living/routine
➢Be cheerful, laugh, smile have a sense
of honor
➢Relax, have a vacation
➢Think that you are the unique person in this
world
➢Love and respect self.
➢Observe thought patterns for few
minutes daily
➢Practice meditation for some time daily

5. Environmental sensitivity
•
•
•
•
One of essential elements of life – air, water and
sunlight.
Humans need to co-exit in harmony with our natural
environment in order to survive.
Today the main causes of human deaths are cancer and
diseases of heart and brain.
Survey shows that 75% of cancer is caused by
environmental pollution and various carcinogenic
chemicals absorbed by human.

Health Care Settings for Holistic
Nursing Practice
•
•
•
•
Seeking cost effective ways to deliver an ever
increasing range of services
Demand of greater accessibility to quality health care
services at affordable costs.
Nursing need to be theoretically and practically equipped
with use of technological advances, biomedical research
and state-of-the-art clinical equipment and facilities.
Nursing preparation needed to work within health care
delivery system that is complex, involving myriad
providers such as organization, institutions, groups and
individuals, ,consumers and settings.

NURSE’S ROLE IN HOLISTIC
HEALTH
•
•
•
•
•
To begin with, nurses themselves have to be a holistic
persons and they need to accept the responsibility of
their own people and follow the practices of holistic
health.
Nurses responsibility is to bring awareness to positive
life style.
They need to encourage positive attitude towards living.
Use of Holistic Health approach in specific conditions,
e.g. Labour.
Develop and initiate programme in different settings, like
work places, screening, crisis situation.

❖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
opportunity to
spent
serve
with clients
and share
as an
(adapted
from Dossey, 1998)

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

1. Demonstrate Awareness
• Wellness
responsibility, a
is a
choice, a
lifestyle design that helps
maintain the
for personal
highest
health
potential
(Hill &
Howlett, 2005).

The health continuum is a way to
visualize the range of an individual's health, from
highest health potential to death.

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 self-confidence?
• What are your beliefs and attitudes?
• Know-ing 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 con-centrate 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.

• 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.

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 inhab-itants 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 cre-ativity, 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).

• BENEFITS OF
HOLISTIC HEALTH
CARE

Quicker relief for pain
Improvement of overall general health
Understanding the need for a well-balanced
lifestyle
Awareness of keeping environment safe and
healthy
Use of more natural resources – natural herbs
and medicines
Application of more natural methods to cure
illness such as proper nutrition, exercise,
detoxification and other natural non-invasive
treatments

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