HOLISTIC CARE; A CARING AND

HEALING PROCESS

SUHARTINI
Holistic Laboratorium Faculty of Medicine
Diponegoro University
Health in

BODY

MIND

SPIRIT
The health continuum is a way to visualize the range of an
individual's health, from highest health potential to death.
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/care
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.
Among the holistic modalities most frequently
used in nursing are the following:
 The holistic nurse is "an instrument of healing and a
facilitator in the healing process (AHNA, 2004).
By does the following: (adapted from Dossey, 1998)

 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
 Wellness is a
responsibility, a
CARING choice, a lifestyle
design that helps
maintain the highest
WELLNESS
potential for personal
health.
HEALING
(Hill & Howlett, 2005)
Wellness
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
►No Smoking
►No Drugs and Alcohol
►Nutrition
►Sleep, Rest, Relaxation, and Exercise
Wellness
Intellectual wellness is the ability to function as an
independent person capable of making sound decisions.
- Clear thinking,
- problem-solving skills,
- good judgment, and the
- desire to continually learn
Wellness
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.
Wellness

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.
Wellness
Spiritual wellness manifests as inner
strength and peace, including faith to God
It encompasses the beliefs that a person has
that give meaning and purpose to their
existence (Fitchett, 2002).
A HOLISTIC NURSING
THEORY
What we
know?
 NURSING APPROACH CLIENTS HEALTH
Head Hand Heart
Knowledge Touch Compassion

illness)
Health Status (wellness-
Caring

Life Span (birth – death)

Objective Outcomes

Subjective Outcomes
Community
Therapies
WM CAM

HOLISTIC NURSING

Person
Theism PNI
Quantum

Philosophies

Conceptual framework for exploration of holistic nursing

Hatthakit, U (2015)
HEAD: Knowledge

◦ HEAD: Cognitive domain

◦ Thinking, being logical
◦ Knowledge (evidence and
specialist knowledge)
◦ Cognitive skills/ communication
 Power of Knowledge

◦ Knowledge: health, medication, health technology, CAMs,

social sciences, and knowledge in philosophy, art, music,
language, religion, history, and ethics including professional
values.
◦ High level of nurses’ knowledge and competency found to
lead to positive health outcomes
◦ Unsatisfactory level of nurses’ knowledge was found in
many studies that led to negative health outcomes (Simonsen,
et al, 2011; WHO, 2010)
HANDS: Touch & Art

◦ HANDS: Psychomotor domain

◦ Skillful in using hands and
technology
◦ Healing touch
◦ Healing hands
◦ Comforting care
◦ Holistic nursing modalities:
relaxation, prayer, massage

Copyright © 2002
 Power of Touch
◦ A very powerful means to enhance communication
(Fraser & Ross Kerr,1993,Tutton, 1987, Sims, 1988)
◦ A very powerful means to comforting, calming (Routasalo, Isoal, 1996;
Fisher, Joseph, 1989; Moore, Gilbert, 1995), reassuring, caring others
(Sammons, 2011)
◦ Studies of aromatherapy massage show greater improvement in anxiety
of cancer patients (Wilkinson, 2010)
◦ Studies of therapeutic touch (off-body/gentle touch) show to facilitate
the flow of energy resulting pain relief.
◦ However, it should be aware of culture and patients’ attitude on touch.
HEART: Compassion, Presence

◦ HEART: Affective domain

◦ Feeling, emotion, living
◦ Compassion
◦ Healing presence (Being with)
◦ Understanding the clients
◦ Ethical and human dimension

Copyright © 2002
 Power of Compassion

• A fundamental element of nursing care (Dietze, Orb,

2007)
• Care provision in a dignified manner, warm, sensitive
and compassionate way to enhance healing, comfort,
satisfaction, peace, acceptance, confidence,
reassurance.
 Power of Presence

◦Being-with; giving full attention to the other in the

moment

“Transpersonal caring is communicated via the

nurse’s energetic patterns of consciousness,
intentionality and authentic presence in a caring
relationship.”
(Watson and Smith)
 Indicators of Holistic Health
Balance of body & mind Healthy behavior
-concentration/ peaceful life - contented lifeway
-life satisfaction/quality of life - health promotion behavior
-harmony/happiness/ - self caring ability
well-being - resilience/ coping
- adaptation
- self-control
CORE VALUE IN THE
HOLISTIC NURSING
Suhartini
◦ CORE VALUE 1 : HOLISTIC PHILOSOPHY, THEORIES AND
ETHICS
◦ CORE VALUE 2 : HOLISTIC NURSING PROCESS
◦ CORE VALUE 3 : HOLISTIC COMMUNICATION, THERAPETIC
HEALING ENVIRONMENT, AND CULTURAL DIVERSITY
◦ CORE VALUE 4 : HOLISTIC EDUCATION AND RESEARCH
◦ CORE VALUE 5 : HOLISTIC NURSE SELF REFLECTION AND SELF-
CARE
CORE VALUE 1
◦ Recognizes the complex dynamic relationship of health, illness
and wellness and the value of healing.
◦ Recognize that patient is the authority on his or her own health
experience.
◦ Holistic nurse acts as guide in the healing process and protect
patient's dignity.
CORE VALUE 2
◦ Provide care that recognizes the totality of the human being (the
interconnectedness of body, mind, emotion, spirit, social/cultural,
relationships, context, environment and energy.
◦ Also practices ANA Standards of Practice.
◦ Nurse should strongly emphasize partnership with
patient in the healing process.
CORE VALUE 3
◦ Ensure nursing care is compassionate, authentic, and sincere.
◦ Be a conscious deep listener with or without preconceptions, busy-
ness, distractions or analysis.
◦ Recognize that nurse is not the "expert" regarding another's health and
illness experience but is a "learner".
◦ Encourage and support others in the use of spiritual and symbolic
practices for healing purposes
◦ Assist individuals to find meaning in their experience
◦ Possess knowledge of cultural traditions and use these understand to
provide culturally competent care.
Core value 4
◦ Provide information on health promotion and disease prevention
and opportunities to enhance well being
◦ Assess health literacy and individualize learning and teaching
◦ Assist others to know themselves and access their own inner
wisdom to enhance growth, wholeness, and well-being.
CORE VALUE 5
◦ Self-reflection and self-care, as well as personal awareness of
and continuous focus on being an instrument of healing, are
significant requirements for holistic nurses.
◦ Value self and mobilize the necessary resources to care for
themselves.
◦ Strive to achieve harmony/ balance in their own lives and to
assist others to do the same.