Holistic CareDR. ALI D. ABBAS/ INSTRUCTOR, FUNDAMENTALS OF NURSING DEPARTMENT, COLLEGE OF NURSING, UNIVERSITY OF BAGHDAD, ALIDUKHAN@UOB.EDU.IQ

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 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).

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, intel lectual, 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 heal ing 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 "consid ers 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 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.

For example, experienced nurses—are often anxious about

caring for a spe cific client. By taking some time to practice self-

awareness, 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

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).