Unlocking Better Health Outcomes: The Use of a Holistic Perspective

USE OF A HOLISTIC PERSPECTIVE

Holism and Health Assessment

Holism is a foundational concept in nursing that emphasizes the importance of treating the patient as a whole rather than focusing solely on individual health problems. This holistic approach is particularly crucial for Advanced Practice Registered Nurses (APRNs) who assess not only the physical condition of their patients but also their life goals, functional interests, and overall health risks. This comprehensive approach is essential in preserving the patient’s quality of life, especially when dealing with chronic conditions or life-threatening illnesses.

When working with a relatively healthy individual, the APRN seeks to understand the person’s life goals and how to maintain their quality of life in the future. Conversely, when dealing with an ill patient, the APRN’s focus shifts to understanding the patient’s perspective on their health problems, their responses to these challenges, and the implications these have on their daily lives and long-term goals.

The Integral Role of Holism in Patient-Centered Care

Holism is at the core of nursing’s patient-centered care, as highlighted by the American Association of Colleges of Nursing (AACN, 2021). APRNs are trained to understand the interactions between the body, brain, mind, and spirit—not only within the patients themselves but also in how these interactions manifest in the patients’ relationships with others, their communities, and their environment. This comprehensive understanding is essential for providing care that truly addresses all aspects of a patient’s life.

Incorporating Social Determinants of Health

In today’s complex healthcare environment, it is imperative that APRNs incorporate social determinants of health into their care plans. Social determinants, such as socioeconomic status, education, physical environment, employment, and social support networks, can significantly impact an individual’s health. The National Academies of Science, Engineering, and Medicine (NASEM, 2021) emphasizes the importance of screening for social needs and engaging interdisciplinary colleagues in creating a holistic care plan for patients with increasingly complex needs.

Holism in Nursing Education

Holistic care is also a critical component of nursing education. Faculty members are responsible for role-modeling the provision of holistic care from a nursing perspective, incorporating values such as understanding the patient’s physical condition, actively listening, and being present with patients during the creation of a care plan (Brykczynski, 2012; Kinchen, 2019). APRNs partner with patients to define health, identify their values, and guide their care according to the patient’s preferences, ensuring that the care provided is both patient-centered and holistic.

Functional Assessment in Holistic Care

The ability to function in daily activities and maintain relationships is a crucial consideration for patients when evaluating their health. Thus, it is an essential focus for holistic, person-centered assessment. Most functional assessment formats cover the following areas:

1. Patient’s View of Their Health or Quality of Life: Understanding how the patient perceives their health condition is fundamental in tailoring the care plan to their specific needs.

2. Self-Care and Household/Job Responsibilities: Assessing how patients manage their daily responsibilities provides insight into their functional status and any assistance they may need.

3. Social, Physical, Financial, Environmental, and Spiritual Factors: These factors can either enhance or hinder the patient’s ability to function, making them critical components of a holistic assessment.

4. Coping Strategies: Evaluating how patients and their families cope with life’s stresses and problems helps in providing the necessary support and resources to improve their quality of life.

Holistic Approaches in Pediatric and Adult Care

Holistic approaches are also applied in pediatric care. For example, functional status measures have been developed for children with asthma, as recognized by the Centers for Disease Control and Prevention (CDC, 2013). In adult care, APRNs may use disease- or problem-focused tools, such as those that measure functional status in patients with heart failure (Rector et al., 2006), symptom distress in cancer patients (Chen & Lin, 2007; Cleeland et al., 2000), or function and disability in geriatric patients (Denkinger et al., 2009). The widely used Short Form-36 Health Survey is another example, measuring overall health, functional status, and well-being in adults across various languages (Ware & Sherbourne, 1992).

The Role of APRNs in Facilitating Holistic Care

APRNs are often seen as leaders in facilitating holistic care, especially in complex healthcare environments. Their advanced training equips them with the skills necessary to coordinate care among various providers while maintaining a focus on the patient as a whole. This leadership role is particularly evident in palliative care, where APRNs combine holistic care with treatment interventions aimed at alleviating symptoms, all while evaluating care within a broader system context to ensure the appropriate use of resources.

Practical Application of Holistic Perspective in Healthcare

Applying a holistic perspective in healthcare requires a shift from traditional symptom-focused care to a more comprehensive approach that considers all aspects of a patient’s life. This includes not only their physical health but also their emotional well-being, social circumstances, and spiritual beliefs. The goal is to create a care plan that is not only effective in treating the patient’s condition but also aligns with their values and life goals.

Challenges in Implementing Holistic Care

While the benefits of a holistic approach are clear, implementing this perspective in clinical practice can be challenging. One of the primary challenges is the need for additional time and resources to fully understand and address all aspects of a patient’s life. Additionally, there may be conflicts between the patient’s values and the standard medical practices, requiring careful negotiation and compromise. However, with proper training, collaboration among healthcare providers, and a commitment to patient-centered care, these challenges can be successfully managed.

FAQs

What is a holistic perspective in healthcare?
A holistic perspective in healthcare involves treating the patient as a whole, considering all dimensions of their life, including physical, psychological, social, and spiritual aspects.

Why is a holistic perspective important in nursing?
A holistic perspective is crucial in nursing as it ensures that care is tailored to the unique needs of each patient, leading to better health outcomes and increased patient satisfaction.

How do APRNs incorporate a holistic perspective in their practice?
APRNs incorporate a holistic perspective by considering the patient’s overall health, life goals, and social determinants when creating a care plan. They work collaboratively with other healthcare providers to ensure comprehensive care.

What are the challenges of using a holistic perspective in healthcare?
Challenges include the need for additional time and resources, potential conflicts between patient values and medical practices, and the complexity of coordinating care among multiple providers.

Can a holistic perspective be applied to all areas of healthcare?
Yes, a holistic perspective can be applied to all areas of healthcare, although the approach may vary depending on the patient’s condition and context.