Clinical Holistic Medicine: Holistic Treatment of Mental Disorders

OpenAIRE

Ventegodt, Søren; Andersen, Niels Jørgen; Neikrug, Shimshon; Kandel, Isack; Merrick, Joav

2005-01-01

We believe that holistic medicine can be used for patient's with mental health disorders. With holistic psychiatry, it is possible to help the mentally ill patient to heal existentially. As in holistic medicine, the methods are love or intense care, winning the trust of the patient, getting permission to give support and holding, and daring to be fully at the patient's service. Our clinical experiences have led us to believe that mental health patient's can heal if only you can make him or he...

Effective factors in providing holistic care: a qualitative study.

Science.gov (United States)

Zamanzadeh, Vahid; Jasemi, Madineh; Valizadeh, Leila; Keogh, Brian; Taleghani, Fariba

2015-01-01

Holistic care is a comprehensive model of caring. Previous studies have shown that most nurses do not apply this method. Examining the effective factors in nurses' provision of holistic care can help with enhancing it. Studying these factors from the point of view of nurses will generate real and meaningful concepts and can help to extend this method of caring. A qualitative study was used to identify effective factors in holistic care provision. Data gathered by interviewing 14 nurses from university hospitals in Iran were analyzed with a conventional qualitative content analysis method and by using MAXQDA (professional software for qualitative and mixed methods data analysis) software. Analysis of data revealed three main themes as effective factors in providing holistic care: The structure of educational system, professional environment, and personality traits. Establishing appropriate educational, management systems, and promoting religiousness and encouragement will induce nurses to provide holistic care and ultimately improve the quality of their caring.

Effective factors in providing holistic care: A qualitative study

Directory of Open Access Journals (Sweden)

Vahid Zamanzadeh

2015-01-01

Full Text Available Background: Holistic care is a comprehensive model of caring. Previous studies have shown that most nurses do not apply this method. Examining the effective factors in nurses′ provision of holistic care can help with enhancing it. Studying these factors from the point of view of nurses will generate real and meaningful concepts and can help to extend this method of caring. Materials and Methods: A qualitative study was used to identify effective factors in holistic care provision. Data gathered by interviewing 14 nurses from university hospitals in Iran were analyzed with a conventional qualitative content analysis method and by using MAXQDA (professional software for qualitative and mixed methods data analysis software. Results: Analysis of data revealed three main themes as effective factors in providing holistic care: The structure of educational system, professional environment, and personality traits. Conclusion: Establishing appropriate educational, management systems, and promoting religiousness and encouragement will induce nurses to provide holistic care and ultimately improve the quality of their caring.

Advanced Metrics for Assessing Holistic Care: The "Epidaurus 2" Project.

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Foote, Frederick O; Benson, Herbert; Berger, Ann; Berman, Brian; DeLeo, James; Deuster, Patricia A; Lary, David J; Silverman, Marni N; Sternberg, Esther M

2018-01-01

In response to the challenge of military traumatic brain injury and posttraumatic stress disorder, the US military developed a wide range of holistic care modalities at the new Walter Reed National Military Medical Center, Bethesda, MD, from 2001 to 2017, guided by civilian expert consultation via the Epidaurus Project. These projects spanned a range from healing buildings to wellness initiatives and healing through nature, spirituality, and the arts. The next challenge was to develop whole-body metrics to guide the use of these therapies in clinical care. Under the "Epidaurus 2" Project, a national search produced 5 advanced metrics for measuring whole-body therapeutic effects: genomics, integrated stress biomarkers, language analysis, machine learning, and "Star Glyphs." This article describes the metrics, their current use in guiding holistic care at Walter Reed, and their potential for operationalizing personalized care, patient self-management, and the improvement of public health. Development of these metrics allows the scientific integration of holistic therapies with organ-system-based care, expanding the powers of medicine.

Existential and spiritual needs in mental health care: an ethical and holistic perspective.

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Koslander, Tiburtius; da Silva, António Barbosa; Roxberg, Asa

2009-03-01

This study illuminates how existential needs and spiritual needs are connected with health care ethics and individuals' mental health and well-being. The term existential needs is defined as the necessity of experiencing life as meaningful, whereas the term spiritual needs is defined as the need of deliverance from despair, guilt and/or sin, and of pastoral care. It discusses whether or not patients' needs are holistically addressed in Western health care systems that neglect patients' existential and spiritual needs, because of their biomedical view of Man which recognizes only patients' physical needs. It excludes a holistic health care which considers all needs, expressed by patients in treatment of mental illness. Addressing all needs is important for patients' improvement and recovery. For some patients, this is the only way to regain their mental health and well-being.

[Personalized holistic approach to a patient with mixed leg ulcer].

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Kovacević, Jadranka; Sinozić, Tamara

2014-10-01

Holistic approach as the philosophical orientation to care underpins the fundamental wholeness of human being and emphasizes the importance of balance within the person and between the person and his/her environment. It includes elements of the physiological, sociological, economic, psychological and spiritual dimensions, and thus providesan opportunity to assess the patient as a whole and in relation to his/ her living context. Such an integrated approach is part of the basic knowledge and skills of general practitioners/family doctors and makes them equal members of a multidisciplinary team in chronic wound patient care. In this case report on a patient with mixed leg ulcer, we will try to bring closer holistic approach in care for this kind of patients in daily practice of general practitioners/family doctors.

"Open your heart first of all": perspectives of holistic providers in Costa Rica about communication in the provision of health care.

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Geist-Martin, Patricia; Bell, Keely K

2009-10-01

Research documents how the care the holistic providers offer represents the quality communication that patients often do not receive from their biomedical providers. However, research investigating the perspectives of holistic providers concerning the role they see themselves playing in the provision of health is limited. This research explores the perceptions of holistic providers in Costa Rica about their communication with their patients. The results reveal two practices of communication-authenticating and integrating as central to providers' communication with patients in the provision of holistic health care. Providers describe their communication as an exploration of an anatomy of pain/suffering, including investigating the location, timing, length, intensity, and overall rhythm of the patient's condition and sense making that leads them to seek the care of a holistic provider. Most holistic providers see their role as being careful or full of care and suggest that they have an obligation to open their heart first of all.

Alternative therapies for the holistic care of the HIV / AIDS patient ...

African Journals Online (AJOL)

Alternative therapies that can be used for the holistic nursing care of HIV / AIDS infection include psychological, mental and emotional therapies, therapeutic touch, nutrition, vitamins, minerals and nutritional supplements, herbal medicine, Chinese medicine and homeopathy, traditional medicine, lifestyle changes and ...

Advanced Metrics for Assessing Holistic Care: The “Epidaurus 2” Project

Science.gov (United States)

Foote, Frederick O; Benson, Herbert; Berger, Ann; Berman, Brian; DeLeo, James; Deuster, Patricia A.; Lary, David J; Silverman, Marni N.; Sternberg, Esther M

2018-01-01

In response to the challenge of military traumatic brain injury and posttraumatic stress disorder, the US military developed a wide range of holistic care modalities at the new Walter Reed National Military Medical Center, Bethesda, MD, from 2001 to 2017, guided by civilian expert consultation via the Epidaurus Project. These projects spanned a range from healing buildings to wellness initiatives and healing through nature, spirituality, and the arts. The next challenge was to develop whole-body metrics to guide the use of these therapies in clinical care. Under the “Epidaurus 2” Project, a national search produced 5 advanced metrics for measuring whole-body therapeutic effects: genomics, integrated stress biomarkers, language analysis, machine learning, and “Star Glyphs.” This article describes the metrics, their current use in guiding holistic care at Walter Reed, and their potential for operationalizing personalized care, patient self-management, and the improvement of public health. Development of these metrics allows the scientific integration of holistic therapies with organ-system-based care, expanding the powers of medicine. PMID:29497586

Religion, Spirituality and Speech-Language Pathology: A Viewpoint for Ensuring Patient-Centred Holistic Care.

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Mathisen, Bernice; Carey, Lindsay B; Carey-Sargeant, Christa L; Webb, Gwendalyn; Millar, CaraJane; Krikheli, Lilli

2015-12-01

This paper presents a viewpoint concerning the largely neglected clinical relevance of spirituality and religious belief in speech-language pathology (SLP) assessments, interventions and outcomes across the lifespan. An overview of the refereed SLP literature is presented with regard to religion and spirituality. It was found that while there is increasing research with regard to spirituality, health and well-being, there is very little specific to SLP. What is available and clinically relevant, generally relates to holistic care and/or cultural and linguistic diversity. Amidst the health care literature, however, there is a growing number of recommended instruments (for religious/spiritual screening) sensitive to intercultural and interfaith issues that are currently available to medical, nursing, allied health and chaplaincy practitioners. These instruments can also be of value to SLPs to ensure holistic assessments and interventions. It would seem timely for SLPs (and other allied health practitioners) to consider including spiritual screenings/assessments as part of their clinical practice so as to ensure appropriate holistic care. This would also mean undertaking research and including relevant education within tertiary institutions and professional development programs.

A concept analysis of holistic nursing care in paediatric nursing

OpenAIRE

A.A. Tjale; J. Bruce

2007-01-01

Holistic nursing care is widely advocated and is espoused in the philosophy of the South African Nursing Council. This concept is unclear, variously interpreted and poorly understood in paediatric nursing. This study was undertaken to examine the meaning of holistic nursing care and to develop a framework for holistic nursing care, which can be utilised in nurse education settings and in clinical nursing practice in the context of paediatric nursing. A qualitative, interpretive, explorative a...

Holistic needs assessment in advanced, intensively treated multiple myeloma patients.

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Boland, E G; Boland, J W; Ezaydi, Y; Greenfield, D M; Ahmedzai, S H; Snowden, J A

2014-10-01

It is recommended that patients with multiple myeloma should be assessed for unmet holistic needs at key times in their disease trajectory. The aim of this exploratory study was to characterise the holistic needs of advanced, intensively treated multiple myeloma using a structured assessment tool. Patients with multiple myeloma who had undergone a haematopoietic stem cell transplantation and subsequent treatment for at least one episode of progressive disease but were in stable plateau phase were included in the study. Patients' holistic needs were assessed using the self-reporting tool, Sheffield Profile for Assessment and Referral for Care (SPARC). Thirty-two patients with a median age of 60 years at assessment and a median of 5.5 years from diagnosis were recruited. Using the SPARC, half of the patients reported tiredness as 'quite a bit/very much,' while one third complained that daytime somnolence and insomnia were 'quite a bit/very much.' Forty-four percent of patients reported pain. One third of patients were bothered and distressed by the side effects from their treatment and were worried about long-term effects of their treatment. Thirty-one percent of patients felt that the effect of their condition had an impact on their sexual life, and 40 % were worried about the effect that their illness was having on their family or other people. This is the first study to use a self-reported holistic needs assessment tool in multiple myeloma. A multidimensional structured questionnaire like the SPARC could provide a useful first step in the effective delivery of supportive and palliative care for patients with multiple myeloma.

A holistic approach to pastoral care and poverty

Directory of Open Access Journals (Sweden)

Johan Janse van Rensburg

2010-03-01

Full Text Available The previous approaches to pastoral care are no longer adequate or effective for addressing the many issues related to poverty. The church has done wonderful work in terms of Christian charity. However, more needs to be done to improve the worsening situation of the poor significantly. The clear distinction between pastoral care and Christian charity is a luxury that is no longer affordable. Once we have a holistic understanding of pastoral care and counselling, we will find that we cannot possibly restrict our pastoral attention to encouraging the poor, to giving random advice and to praying. A holistic pastoral theology could lead to empowerment and should be a key concept in pastoral care with poor people and societies. The article offers a theological theory for a holistic approach and some implications of the praxis of counselling.

Holistic Nursing Simulation: A Concept Analysis.

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Cohen, Bonni S; Boni, Rebecca

2018-03-01

Simulation as a technology and holistic nursing care as a philosophy are two components within nursing programs that have merged during the process of knowledge and skill acquisition in the care of the patients as whole beings. Simulation provides opportunities to apply knowledge and skill through the use of simulators, standardized patients, and virtual settings. Concerns with simulation have been raised regarding the integration of the nursing process and recognizing the totality of the human being. Though simulation is useful as a technology, the nursing profession places importance on patient care, drawing on knowledge, theories, and expertise to administer patient care. There is a need to promptly and comprehensively define the concept of holistic nursing simulation to provide consistency and a basis for quality application within nursing curricula. This concept analysis uses Walker and Avant's approach to define holistic nursing simulation by defining antecedents, consequences, and empirical referents. The concept of holism and the practice of holistic nursing incorporated into simulation require an analysis of the concept of holistic nursing simulation by developing a language and model to provide direction for educators in design and development of holistic nursing simulation.

Working the way up in neurological rehabilitation: the holistic approach of nursing care.

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Portillo, Mari Carmen; Cowley, Sarah

2011-06-01

To provide understanding of the nurses' role in neurological holistic rehabilitation and identify strategies for the enhancement of rehabilitation services. Although acute and chronic neurological patients and relatives experience emotional and social changes, most rehabilitation programmes do not deal with non-physical needs or involve nurses, leading to a poor definition and specialisation of the nursing role. Action research. The project took place in two neurological wards of a highly specialised hospital in Spain and lasted 30 months. An individualised nurse-led social rehabilitation programme was planned, implemented and evaluated. The nursing role and care in rehabilitation were explored with 37 nurses and 40 neurological patients and 40 relatives (convenience sampling). Semi-structured interviews and participant observations were developed. Content (QSR NUDIST Vivo v.2.0) and statistical (SPSS v. 13.0) analyses were run. The lack of time, knowledge and experience, the poor definition of the nursing role and ineffective communication with users limited holistic care in the wards. Some enhancing nursing strategies were proposed and explored: promotion of acceptance/adaptation of the disease through education, reinforcement of the discharge planning and planning of emotional and social choices based on the assessment of individual needs and resources at home. Nursing professionals are in a privileged position to deal with neurological patients' and carers' holistic needs. Several attributes of the advanced nursing role in rehabilitation teams have been proposed to deal with non-physical aspects of care. • Rehabilitation needs of neurological patients and carers at hospital have been described. • Nurses' perceptions of their work and role in rehabilitation have been presented. • Clinical strategies to develop the advanced nursing role in holistic neurological rehabilitation have been highlighted. © 2010 Blackwell Publishing Ltd.

Holistic Medicine: Advances and Shortcomings

OpenAIRE

Shapiro, Edward

1982-01-01

Holistic medicine is an attitudinal approach to health care rather than a particular set of techniques. It addresses the psychological, familial, societal, ethical and spiritual as well as biological dimensions of health and illness. The holistic approach emphasizes the uniqueness of each patient, the mutuality of the doctor-patient relationship, each person's responsibility for his or her own health care and society's responsibility for the promotion of health.

Holistic Health Care for the Medically Uninsured: The Church Health Center of Memphis

OpenAIRE

Morris, G. Scott

2015-01-01

The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry,...

Palliative Nursing and Sacred Medicine: A Holistic Stance on Entheogens, Healing, and Spiritual Care.

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Rosa, William E; Hope, Stephanie; Matzo, Marianne

2018-04-01

The fields of palliative and holistic nursing both maintain a commitment to the care of the whole person, including a focus on spiritual care. Advanced serious illness may pose a plethora of challenges to patients seeking to create meaning and purpose in their lives. The purpose of this article is to introduce scholarly dialogue on the integration of entheogens, medicines that engender an experience of the sacred, into the spiritual and holistic care of patients experiencing advanced serious illness. A brief history of the global use of entheogens as well as a case study are provided. Clinical trials show impressive preliminary findings regarding the healing potential of these medicinal agents. While other professions, such as psychology, pharmacy, and medicine, are disseminating data related to patient outcomes secondary to entheogen administration, the nursing literature has not been involved in raising awareness of such advancements. Research is illustrating their effectiveness in achieving integrative experiences for patients confronting advanced serious illness and their ability to promote presence, introspection, decreased fear, and increased joy and acceptance. Evidence-based knowledge surrounding this potentially sensitive topic is necessary to invite understanding, promote scientific knowledge development, and create healing environments for patients, nurses, and researchers alike.

Holistic System of Care: a ten-year perspective.

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Nebelkopf, Ethan; Wright, Serena

2011-01-01

The Holistic System of Care for Native Americans in an Urban Environment is a community-focused intervention that provides behavioral health care, promotes health, and prevents disease. This approach is based on a community strategic planning process that honored Native American culture and relationships. Substance abuse, mental illness, homelessness, poverty, crime, physical illness, and violence are symptoms of historical trauma, family dysfunction, and spiritual imbalance. The holistic model links treatment, prevention, and recovery. The link between prevention and treatment is early intervention. Peer support is the link between treatment and recovery. Recovering individuals serve as role models linking recovery to prevention. Culture and spirituality build a strong and resilient foundation for recovery. This article documents the effectiveness of the holistic model over a ten-year period that it has been implemented at the Family & Child Guidance Clinic of the Native American Health Center in the San Francisco Bay Area. The holistic model has produced statistically significant reductions in substance abuse among adult Native American women, men, reentry, and homeless populations; reductions in substance abuse among Native American adolescents; reductions in HIV/AIDS high-risk behavior among Native American men, women, and adolescents; and decreases in acting out behavior among Native American severely emotionally disturbed children.

[Holistic therapy of chronic heart failure].

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Feldmann, C; Ertl, G; Angermann, C E

2014-06-01

The rising prevalence and increasing disease-related costs render chronic heart failure a rapidly growing socioeconomic challenge. The concerted action of guideline-adjusted therapy and holistic patient care is essential to achieve improvements in mortality, morbidity, functional status and quality of life of patients with symptomatic heart failure. Holistic care strategies comprise consideration of comorbidities and individual needs, lifestyle recommendations and multidisciplinary management programs for high-risk symptomatic patients in addition to basic medication and surgical therapies. For optimal patient care and coaching, seamless interaction is required between in-hospital treatment and outpatient facilities. Moreover, the palliative needs of heart failure patients need to be considered, a topic that is currently not receiving enough attention.

Holistic ultrasound in trauma: An update.

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Saranteas, Theodosios; Mavrogenis, Andreas F

2016-10-01

Holistic ultrasound is a total body examination using an ultrasound device aiming to achieve immediate patient care and decision making. In the setting of trauma, it is one of the most fundamental components of care of the injured patients. Ground-breaking imaging software allows physicians to examine various organs thoroughly, recognize imaging signs early, and potentially foresee the onset or the possible outcome of certain types of injuries. Holistic ultrasound can be performed on a routine basis at the bedside of the patients, at admission and during the perioperative period. Trauma care physicians should be aware of the diagnostic and guidance benefits of ultrasound and should receive appropriate training for the optimal management of their patients. In this paper, the findings of holistic ultrasound in trauma patients are presented, with emphasis on the lungs, heart, cerebral circulation, abdomen, and airway. Additionally, the benefits of ultrasound imaging in interventional anaesthesia techniques such as ultrasound-guided peripheral nerve blocks and central vein catheterization are described. Copyright © 2016 Elsevier Ltd. All rights reserved.

Integrated Care in Prostate Cancer (ICARE-P): Nonrandomized Controlled Feasibility Study of Online Holistic Needs Assessment, Linking the Patient and the Health Care Team

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Dale, Jeremy; Roscoe, Julia; Hamborg, Thomas; Ahmedzai, Sam H; Arvanitis, Theodoros N; Badger, Douglas; James, Nicholas; Mendelsohn, Richard; Khan, Omar; Parashar, Deepak; Patel, Prashant

2017-01-01

Background The potential of technology to aid integration of care delivery systems is being explored in a range of contexts across a variety of conditions in the United Kingdom. Prostate cancer is the most common cancer in UK men. With a 10-year survival rate of 84%, there is a need to explore innovative methods of care that are integrated between primary health care providers and specialist teams in order to address long-term consequences of the disease and its treatment as well as to provide continued monitoring for recurrence. Objective Our aim was to test the feasibility of a randomized controlled trial to compare a model of prostate cancer continuing and follow-up care integration, underpinned by digital technology, with usual care in terms of clinical and cost-effectiveness, patient-reported outcomes, and experience. Methods A first phase of the study has included development of an online adaptive prostate specific Holistic Needs Assessment system (HNA), training for primary care-based nurses, training of an IT peer supporter, and interviews with health care professionals and men with prostate cancer to explore views of their care, experience of technology, and views of the proposed intervention. In Phase 2, men in the intervention arm will complete the HNA at home to help identify and articulate concerns and share them with their health care professionals, in both primary and specialist care. Participants in the control arm will receive usual care. Outcomes including quality of life and well-being, prostate-specific concerns, and patient enablement will be measured 3 times over a 9-month period. Results Findings from phase 1 indicated strong support for the intervention among men, including those who had had little experience of digital technology. Men expressed a range of views on ways that the online system might be used within a clinical pathway. Health care professionals gave valuable feedback on how the output of the assessment might be presented to

The perceived meaning of a (w)holistic view among general practitioners and district nurses in Swedish primary care: a qualitative study

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Strandberg, Eva Lena; Ovhed, Ingvar; Borgquist, Lars; Wilhelmsson, Susan

2007-01-01

Background The definition of primary care varies between countries. Swedish primary care has developed from a philosophic viewpoint based on quality, accessibility, continuity, co-operation and a holistic view. The meaning of holism in international literature differs between medicine and nursing. The question is, if the difference is due to different educational traditions. Due to the uncertainties in defining holism and a holistic view we wished to study, in depth, how holism is perceived by doctors and nurses in their clinical work. Thus, the aim was to explore the perceived meaning of a holistic view among general practitioners (GPs) and district nurses (DNs). Methods Seven focus group interviews with a purposive sample of 22 GPs and 20 nurses working in primary care in two Swedish county councils were conducted. The interviews were transcribed verbatim and analysed using qualitative content analysis. Results The analysis resulted in three categories, attitude, knowledge, and circumstances, with two, two and four subcategories respectively. A professional attitude involves recognising the whole person; not only fragments of a person with a disease. Factual knowledge is acquired through special training and long professional experience. Tacit knowledge is about feelings and social competence. Circumstances can either be barriers or facilitators. A holistic view is a strong motivator and as such it is a facilitator. The way primary care is organised can be either a barrier or a facilitator and could influence the use of a holistic approach. Defined geographical districts and care teams facilitate a holistic view with house calls being essential, particularly for nurses. In preventive work and palliative care, a holistic view was stated to be specifically important. Consultations and communication with the patient were seen as important tools. Conclusion 'Holistic view' is multidimensional, well implemented and very much alive among both GPs and DNs. The word

Integrative holistic medicine in Minnesota.

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Torkelson, Carolyn J; Manahan, Bill

2009-05-01

Minnesota has played a leading role in the integrative holistic medicine movement in the United States for more than 2 decades. This article defines integrative holistic medicine and describes how it is practiced. It also discusses the reasons why institutions and providers here and elsewhere in the country have embraced this approach to patient care.

A Pilot Randomized Controlled Trial of a Holistic Needs Assessment Questionnaire in a Supportive and Palliative Care Service.

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Ahmed, Nisar; Hughes, Philippa; Winslow, Michelle; Bath, Peter A; Collins, Karen; Noble, Bill

2015-11-01

At present, there is no widely used systematic evidence-based holistic approach to assessment of patients' supportive and palliative care needs. To determine whether the use of a holistic needs assessment questionnaire, Sheffield Profile for Assessment and Referral for Care (SPARC), will lead to improved health care outcomes for patients referred to a palliative care service. This was an open, pragmatic, randomized controlled trial. Patients (n = 182) referred to the palliative care service were randomized to receive SPARC at baseline (n = 87) or after a period of two weeks (waiting-list control n = 95). Primary outcome measure is the difference in score between Measure Yourself Concerns and Wellbeing (MYCAW) patient-nominated Concern 1 on the patient self-scoring visual analogue scale at baseline and the two-week follow-up. Secondary outcomes include difference in scores in the MYCAW, EuroQoL (EQ-5D), and Patient Enablement Instrument (PEI) scores at Weeks 2, 4, and 6. There was a significant association between change in MYCAW score and whether the patients were in the intervention or control group (χ(2)trend = 5.51; degrees of freedom = 1; P = 0.019). A higher proportion of patients in the control group had an improvement in MYCAW score from baseline to Week 2: control (34 of 70 [48.6%]) vs. intervention (19 of 66 [28.8%]). There were no significant differences (no detectable effect) between the control and intervention groups in the scores for EQ-5D and Patient Enablement Instrument at 2-, 4-, or 6-week follow-up. This trial result identifies a potential negative effect of SPARC in specialist palliative care services, raising questions that standardized holistic needs assessment questionnaires may be counterproductive if not integrated with a clinical assessment that informs the care plan. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Holistic Health Care: A Challenge to Podiatric Medical Practice.

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Levy, Leonard A.; Levine, Peter M.

1980-01-01

As the profession of podiatric medicine becomes more closely identified with the delivery of primary care, it is suggested that it is essential for practicing podiatrists and students to have more educational opportunities in the field of holistic health care, psychiatry, and the behavioral sciences. (Author/MLW)

Clinical Holistic Medicine: Mental Disorders in a Holistic Perspective

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2005-01-01

Full Text Available From a holistic perspective, psychiatric diseases are caused by the patient’s unwillingness to assume responsibility for his life, existence, and personal relations. The loss of responsibility arises from the repression of the fundamental existential dimensions of the patients. Repression of love and purpose causes depersonalization (i.e., a lack of responsibility for being yourself and for the contact with others, loss of direction and purpose in life. Repression of strength in mind and emotions leads to derealization (the breakdown of the reality testing, often with mental delusions and hallucinations. The repression of joy and gender leads to devitalization (emotional emptiness, loss of joy, personal energy, sexuality, and pleasure in life.The losses of existential dimensions are invariably connected to traumas with life-denying decisions. Healing the wounds of the soul by holding and processing will lead to the recovery of the person's character, purpose of life, and existential responsibility. It can be very difficult to help a psychotic patient. The physician must first love his patient unconditionally and then fully understand the patient in order to meet and support the patient to initiate the holistic process of healing. It takes motivation and willingness to suffer on behalf of the patients in order to heal, as the existential and emotional pain of the traumas resulting in insanity is often overwhelming. We believe that most psychiatric diseases can be alleviated or cured by the loving and caring physician who masters the holistic toolbox. Further research is needed to document the effect of holistic medicine in psychiatry.

Factors impacting on nurses' transference of theoretical knowledge of holistic care into clinical practice.

Science.gov (United States)

Henderson, Saras

2002-12-01

Since nurse education moved to universities, a reoccurring concern of health consumers, health administrators, and some practising nurses is that nurses are not able to transfer the theoretical knowledge of holistic care into practice. Much has been written about this concern usually under the heading of the theory-practice gap. A common reason that has been highlighted as the cause of this gap is that the theoretical knowledge that nurses learn in academia is predicated on concepts such as humanism and holistic caring. In contrast, the bureaucratic organisation where nurses provide care tends to be based on management concepts where cost containment and outcome measures are more acceptable. Hence nurses' learned values of holistic caring are pitted against the reality of the practice setting. So what is this practice reality? This paper attempts to provide an insider view of why the theoretical knowledge of holistic care may be difficult to enact in the clinical setting. In-depth taped interviews with nurses and participant observation were conducted in acute care hospitals in Western Australia. The interviews were transcribed verbatim and analysed using the constant comparative method. The findings indicated that utilitarian nursing and role models had impacted on the transference of theoretical knowledge of holistic care into practice. The paper outlines some measures that nurses themselves can undertake to ensure the narrowing of the theory-practice gap in this area.

Clinical holistic medicine: holistic adolescent medicine.

Science.gov (United States)

Ventegodt, Søren; Morad, Mohammed; Press, Joseph; Merrick, Joav; Shek, Daniel T L

2004-08-04

The holistic medical approach seems to be efficient and can also be used in adolescent medicine. Supporting the teenager to grow and develop is extremely important in order to prevent many of the problems they can carry into adulthood. The simple consciousness-based, holistic medicine--giving love, winning trust, giving holding, and getting permission to help the patient feel, understand, and let go of negative beliefs--is easy for the physician interested in this kind of practice and it requires little previous training for the physician to be able to care for his/her patient. A deeper insight into the principles of holistic treatment and a thorough understanding of our fellow human beings are making it work even better. Holistic medicine is not a miracle cure, but rather a means by which the empathic physician can support the patient in improving his/her future life in respect to quality of life, health, and functional capacity--through coaching the patient to work on him/herself in a hard and disciplined manner. When the patient is young, this work is so much easier. During our lifetime, we have several emotional traumas arranged in the subconscious mind with the smallest at the top, and it is normal for the person to work on a large number of traumatic events that have been processed to varying degrees. Some traumas have been acknowledged, some are still being explored by the person, and yet others are still preconscious, which can be seen for example in the form of muscle tension. Sometimes the young dysfunctional patient carries severe traumas of a violent or sexual nature, but the physician skilled in the holistic medical toolbox can help the patient on his/her way to an excellent quality of life, full self-expression, a love and sex life, and a realization of his/her talents--all that a young patient is typically dreaming about. Biomedicine is not necessary or even recommended when the physical or mental symptoms are caused by disturbances in the personal

Clinical Holistic Medicine: Holistic Adolescent Medicine

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2004-01-01

Full Text Available The holistic medical approach seems to be efficient and can also be used in adolescent medicine. Supporting the teenager to grow and develop is extremely important in order to prevent many of the problems they can carry into adulthood. The simple consciousness-based, holistic medicine — giving love, winning trust, giving holding, and getting permission to help the patient feel, understand, and let go of negative beliefs — is easy for the physician interested in this kind of practice and it requires little previous training for the physician to be able to care for his/her patient. A deeper insight into the principles of holistic treatment and a thorough understanding of our fellow human beings are making it work even better. Holistic medicine is not a miracle cure, but rather a means by which the empathic physician can support the patient in improving his/her future life in respect to quality of life, health, and functional capacity — through coaching the patient to work on him/herself in a hard and disciplined manner. When the patient is young, this work is so much easier. During our lifetime, we have several emotional traumas arranged in the subconscious mind with the smallest at the top, and it is normal for the person to work on a large number of traumatic events that have been processed to varying degrees. Some traumas have been acknowledged, some are still being explored by the person, and yet others are still preconscious, which can be seen for example in the form of muscle tension. Sometimes the young dysfunctional patient carries severe traumas of a violent or sexual nature, but the physician skilled in the holistic medical toolbox can help the patient on his/her way to an excellent quality of life, full self-expression, a love and sex life, and a realization of his/her talents — all that a young patient is typically dreaming about. Biomedicine is not necessary or even recommended when the physical or mental symptoms are caused

Integrated Care in Prostate Cancer (ICARE-P): Nonrandomized Controlled Feasibility Study of Online Holistic Needs Assessment, Linking the Patient and the Health Care Team.

Science.gov (United States)

Nanton, Veronica; Appleton, Rebecca; Dale, Jeremy; Roscoe, Julia; Hamborg, Thomas; Ahmedzai, Sam H; Arvanitis, Theodoros N; Badger, Douglas; James, Nicholas; Mendelsohn, Richard; Khan, Omar; Parashar, Deepak; Patel, Prashant

2017-07-28

The potential of technology to aid integration of care delivery systems is being explored in a range of contexts across a variety of conditions in the United Kingdom. Prostate cancer is the most common cancer in UK men. With a 10-year survival rate of 84%, there is a need to explore innovative methods of care that are integrated between primary health care providers and specialist teams in order to address long-term consequences of the disease and its treatment as well as to provide continued monitoring for recurrence. Our aim was to test the feasibility of a randomized controlled trial to compare a model of prostate cancer continuing and follow-up care integration, underpinned by digital technology, with usual care in terms of clinical and cost-effectiveness, patient-reported outcomes, and experience. A first phase of the study has included development of an online adaptive prostate specific Holistic Needs Assessment system (HNA), training for primary care-based nurses, training of an IT peer supporter, and interviews with health care professionals and men with prostate cancer to explore views of their care, experience of technology, and views of the proposed intervention. In Phase 2, men in the intervention arm will complete the HNA at home to help identify and articulate concerns and share them with their health care professionals, in both primary and specialist care. Participants in the control arm will receive usual care. Outcomes including quality of life and well-being, prostate-specific concerns, and patient enablement will be measured 3 times over a 9-month period. Findings from phase 1 indicated strong support for the intervention among men, including those who had had little experience of digital technology. Men expressed a range of views on ways that the online system might be used within a clinical pathway. Health care professionals gave valuable feedback on how the output of the assessment might be presented to encourage engagement and uptake by

Research paradigms and methods for investigating holistic nursing concerns.

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Hagedorn, Mary Enzman; Zahourek, Rothlyn P

2007-06-01

Holistic nursing is a discipline focused on healing the whole person and dedicated to understanding and supporting the premise of holistic health of the patient and promoting healing in practitioners, patients, families, social groups, and communities. An explication of knowledge related to caring and healing in the human health experience and in holistic nursing is informed by the individual nurse's paradigmatic stance. Holistic nursing research is complex and focuses on healing, particularly healing of self, others, systems, and communities at large. This article discusses the competing paradigmatic perspectives, theoretic perspectives supporting holistic research, fundamental patterns of knowing and knowledge generation, a framework for holistic research, and the challenges of conducting holistic research. Recommendations for future research agenda are presented.

Clinical Holistic Medicine: Chronic Pain in Internal Organs

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2005-01-01

Full Text Available Holistic medicine seems to be efficient in the treatment of chronic pain in internal organs, especially when the pain has no known cause. It is quite surprising that while chronic pain can be one of the toughest challenges in the biomedical clinic, it is often one of the simplest things to alleviate in the holistic clinic. These pains are regarded as being caused by repressed emotions and are explained as psychosomatic reactions. Using holistic medicine, the patients can often be cured of their suffering when they assume responsibility for the repressed feelings. The holistic process theory of healing states that the return to the natural (pain free state of being is possible whenever the person obtains the resources needed for existential healing. This shift is explained by the related quality of life and life mission theories. The resources needed are “holding” or genuine care in the dimensions of awareness, respect, care, acknowledgment, and acceptance with support and processing in the dimensions of feeling, understanding, and letting go of negative attitudes and beliefs. The preconditions for the holistic healing to take place are “love” and trust. Obtaining the full trust of the patient, therefore, seems to be the biggest challenge of holistic medicine, especially when dealing with a patient in pain.

Clinical Holistic Medicine: The Patient with Multiple Diseases

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Søren Ventegodt

2005-01-01

Full Text Available In clinical practice, patients can present with many different diseases, often both somatic and mental. Holistic medicine will try to see the diseases as a whole, as symptoms of a more fundamental imbalance in the state of being. The holistic physician must help the patient to recover existence and a good relationship with self. According to the life mission theory, theory of character, and holistic process theory of healing, recovering the purpose of life (the life mission is essential for the patient to regain life, love, and trust in order to find happiness and realize the true purpose of life. We illustrate the power of the holistic medical approach with a case study of an invalidated female artist, aged 42 years, who suffered from multiple severe health problems, many of which had been chronic for years. She had a combination of neurological disturbances (tinnitus, migraine, minor hallucinations, immunological disturbances (recurrent herpes simplex, phlegm in the throat, fungal infection in the crotch, hormonal disturbances (14 days of menstruation in each cycle, muscle disturbances (neck tensions, mental disturbances (tendency to cry, inferiority feeling, mild depression, desolation, anxiety, abdominal complaints, hemorrhoids, and more. The treatment was a combined strategy of improving the general quality of life, recovering her human character and purpose of life (“renewing the patients life energy”, “balancing her global information system”, and processing the local blockages, thus healing most of her many different diseases in a treatment using 30 h of intense holistic therapy over a period of 18 months.

Improvisation and the art of holistic nursing.

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Hanley, Mary Anne; Fenton, Mary V

2013-10-01

The art of improvisation is an essential component of responding on the front lines of caring. Improvisation expresses the nurse's capacity to perceive the changing patterns of patients and their environments in ways that foster creative and innovative approaches to meeting healthcare needs. Many holistic nurses across the country are working on the front lines of caring, improvising and implementing projects to create change within their communities. This article examines improvisation within the context of the art and science of nursing, and proposes that improvisation reflects qualities within holistic nursing that are essential in contemporary health care.

Improving allergy management in the primary care network--a holistic approach.

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Jutel, M; Angier, L; Palkonen, S; Ryan, D; Sheikh, A; Smith, H; Valovirta, E; Yusuf, O; van Wijk, R G; Agache, I

2013-11-01

The incidence, prevalence and costs of allergy have increased substantially in recent decades in many parts of Europe. The dominant model of allergy care within Europe is at the moment specialist-based. This model will become unsustainable and undeliverable with increasing disease prevalence. One solution to increase provision of allergy services is to diversify the providers. A new model for the provision of allergy care in the community with the general practitioner at the forefront is proposed. Pre- and postgraduate allergy education and training, implementation of pathways of care, allergy specialization and political will to generate resources and support are essential to achieve this new model. In parallel the holistic view of allergic diseases should be maintained, including assessment of severity and risk, psychological factors and health-care related costs in the context of the patient-centered decision making process. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

"I'm Not Trying to Be Cured, so There's Not Much He Can Do for Me": Hospice Patients' Constructions of Hospice's Holistic Care Approach in a Biomedical Culture

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Nebel Pederson, Sarah; Emmers-Sommer, Tara M.

2012-01-01

The hospice philosophy was founded on a mission to provide comprehensive and holistic services to individuals at the end of life. Hospice interdisciplinary teams work together to offer therapies such as spiritual services, comfort care, and massage therapy to meet patients' physical, psychological, emotional, and spiritual needs. Although the…

Advanced practice nursing students' knowledge, self-efficacy, and attitudes related to depression in older adults: teaching holistic depression care.

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Delaney, Colleen; Barrere, Cynthia

2012-01-01

The aim of this study was to examine the knowledge, attitudes, and self-efficacy of advanced practice nursing students toward depression in older adults. Findings suggest that advanced practice nursing students are interested in caring for the whole person and desired more information on the physical and emotional-spiritual needs of older patients with depression. Suggestions for holistic nursing depression care education are presented.

Breast Cancer: Exploring the Facts and Holistic Needs during and beyond Treatment.

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Ng, Zhi Xuan; Ong, Mei Shan; Jegadeesan, Tamilarasi; Deng, Shuo; Yap, Celestial T

2017-05-24

Breast cancer patients face challenges throughout the journey of diagnosis, treatment, post-treatment, and recovery. The breast cancer patient is exposed to a multidisciplinary team including doctors, nurses, therapists, counselors, and psychologists. While the team assembled together aims to address multiple facets in breast cancer care, the sub-specialized nature of individual professional practices may constrain the overview of patients' holistic needs and a comprehensive approach to cancer management. This paper aims to provide an overview of the holistic needs of breast cancer patients at each stage of their cancer journey, addressing their complex physical, psychological, and social needs. As every patient is different, cancer care has to be tailored to each patient based on a holistic needs assessment. This paper also explores how support can be provided from the perspectives of the healthcare providers, family members and caretakers. Examples of general practices at healthcare institutions worldwide as well as supportive care provided by support groups are discussed. The needs of breast cancer patients extend beyond the resolution of cancer as a disease, and the restoration of health as far as possible is a critical component of healing. Understanding the complex issues involved in the journey of breast cancer will aid healthcare providers to be better equipped to sensitively address their concerns and focus on healing the patient holistically. This paper provides a literature review of validated practices in different countries and elaborates on the holistic needs of patients at various stages of recovery. This review is based on more than a decade of publications sourced from multiple resources including PubMed journal articles; books and official websites of breast cancer organizations.

Breast Cancer: Exploring the Facts and Holistic Needs during and beyond Treatment

Science.gov (United States)

Ng, Zhi Xuan; Ong, Mei Shan; Jegadeesan, Tamilarasi; Deng, Shuo; Yap, Celestial T.

2017-01-01

Breast cancer patients face challenges throughout the journey of diagnosis, treatment, post-treatment, and recovery. The breast cancer patient is exposed to a multidisciplinary team including doctors, nurses, therapists, counselors, and psychologists. While the team assembled together aims to address multiple facets in breast cancer care, the sub-specialized nature of individual professional practices may constrain the overview of patients’ holistic needs and a comprehensive approach to cancer management. This paper aims to provide an overview of the holistic needs of breast cancer patients at each stage of their cancer journey, addressing their complex physical, psychological, and social needs. As every patient is different, cancer care has to be tailored to each patient based on a holistic needs assessment. This paper also explores how support can be provided from the perspectives of the healthcare providers, family members and caretakers. Examples of general practices at healthcare institutions worldwide as well as supportive care provided by support groups are discussed. The needs of breast cancer patients extend beyond the resolution of cancer as a disease, and the restoration of health as far as possible is a critical component of healing. Understanding the complex issues involved in the journey of breast cancer will aid healthcare providers to be better equipped to sensitively address their concerns and focus on healing the patient holistically. Methodology: This paper provides a literature review of validated practices in different countries and elaborates on the holistic needs of patients at various stages of recovery. This review is based on more than a decade of publications sourced from multiple resources including PubMed journal articles; books and official websites of breast cancer organizations. PMID:28538673

Biomedicine or Holistic Medicine for Treating Mentally Ill Patients? A Philosophical and Economical Analysis

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Søren Ventegodt

2007-01-01

Full Text Available Today we have two scientific medical traditions, two schools or treatment systems: holistic medicine and biomedicine. The two traditions are based on two very different philosophical positions: subjectivistic and objectivistic. The philosopher Buber taught us that you can say I-Thou or I-It, holding the other person as a subject or an object. These two fundamentally different attitudes seem to characterize the difference in world view and patient approach in the two schools, one coming from psychoanalysis and the old, holistic tradition of Hippocratic medicine. Holistic medicine during the last decade has developed its philosophical positions and is today an independent, medical system seemingly capable of curing mentally ill patients at the cost of a few thousand Euros with no side effects and with lasting value for the patient. The problem is that very few studies have tested the effect of holistic medicine on mentally ill patients. Another problem is that the effect of holistic medicine must be documented in a way that respects this school's philosophical integrity, allowing for subjective assessment of patient benefit and using the patient as his/her own control, as placebo control cannot be used in placebo-only treatment. As the existing data are strongly in favor of using holistic medicine, which seems to be safer, more efficient, and cheaper, it is recommended that clinical holistic medicine also be used as treatment for mental illness. More research and funding is needed to develop scientific holistic medicine.

Biomedicine or holistic medicine for treating mentally ill patients? A philosophical and economical analysis.

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Ventegodt, Søren; Kandel, Isack; Merrick, Joav

2007-12-18

Today we have two scientific medical traditions, two schools or treatment systems: holistic medicine and biomedicine. The two traditions are based on two very different philosophical positions: subjectivistic and objectivistic. The philosopher Buber taught us that you can say I-Thou or I-It, holding the other person as a subject or an object. These two fundamentally different attitudes seem to characterize the difference in world view and patient approach in the two schools, one coming from psychoanalysis and the old, holistic tradition of Hippocratic medicine. Holistic medicine during the last decade has developed its philosophical positions and is today an independent, medical system seemingly capable of curing mentally ill patients at the cost of a few thousand Euros with no side effects and with lasting value for the patient. The problem is that very few studies have tested the effect of holistic medicine on mentally ill patients. Another problem is that the effect of holistic medicine must be documented in a way that respects this school's philosophical integrity, allowing for subjective assessment of patient benefit and using the patient as his/her own control, as placebo control cannot be used in placebo-only treatment. As the existing data are strongly in favor of using holistic medicine, which seems to be safer, more efficient, and cheaper, it is recommended that clinical holistic medicine also be used as treatment for mental illness. More research and funding is needed to develop scientific holistic medicine.

Interdisciplinary care for adequate adherence totreatment in patients with lupus nephritis

Directory of Open Access Journals (Sweden)

Gladys Gaviria-García

2016-02-01

Full Text Available The review is based on the contribution that each discipline should provide the patient for a holistic care, which include medical assessment, monitoring and counselling as emotional support, assessment and nutritional monitoring as a key element in core requirements, physical activity that optimize the quality of life, social activities that can enter the individual in active groups, follow-up by nurses to the fulfillment of the ordered drug treatment, car care and orientation education to the family. The novelty of this proposal is to basically carry out care of the interdisciplinary team for treatment adherence. This review concluded that patients with lupus nephritis (NL treated after assessment and follow-up holistic, such as system monitoring and adherence to the treatment of comprehensive care, provides better quality of life, and minimizes the risks of complication of the patient, avoiding recurrent hospitalizations.

A Holistic Model of Care to Support Those Living with and beyond Cancer

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Cadet, Tamara; Davis, Cindy; Elks, Jacinta; Wilson, Patricia

2016-01-01

Background: Globally, the burden of cancer continues to increase and it is well-documented that while not a homogeneous population, cancer patients and cancer survivors face many physical, psychological, social, spiritual, and financial issues. Cancer care is shifting from a disease-focused to a patient-centered approach resulting in an increased need to address these concerns. Methods: Utilizing a quality improvement approach, this paper describes an integrated cancer care model at Bloomhill Cancer Center (BCC) in Queensland, Australia that demonstrates the ability to meet the holistic needs of patients living with and beyond cancer and to identify opportunities for better practice and service provision. Results: Survey results indicate that 67% and 77% of respondents were very satisfied and 27% and 17% were satisfied with their first contact and very satisfied with their first meeting with a nurse at BCC. Clients also reported being very satisfied (46%) or satisfied (30%) with the emotional support they received at BCC and over 90% were very satisfied or satisfied with the touch therapies that the received. Conclusion: Due to the early success of the interventions provided by BCC, the model potentially offers other states and countries a framework for supportive cancer care provision for people living with and beyond cancer. PMID:27869728

Effects of holistic nursing course: a paradigm shift for holistic health practices.

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Downey, Marty

2007-06-01

A study of an undergraduate course in holistic nursing was conducted to determine its impact on personal and professional health care practices. A mixed method design was used to examine responses on a sample of 200 participants. Results indicated a positive personal impact with continued application of concepts into professional health practices. Personal and professional nursing practices were influenced from 1 to 7 years after completing the holistic nursing course. After introduction of the concepts of self-care and holistic approaches to health, students and graduates experienced a shift in values and beliefs related to their own health practices. Continued exposure to holistic practices creates a pattern of awareness toward health that affects future personal and professional nursing practice, creating a paradigm shift for emerging nursing students and graduates from the course. This affects the manner in which nurses meet the needs of their clients in a variety of settings.

University Students' Perceptions of a Holistic Care Course through Cooperative Learning: Implications for Instructors and Researchers

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Pan, Peter Jen Der; Pan, Gloria Huey-Ming; Lee, Ching-Yieh; Chang, Shona Shih Hua

2010-01-01

The benefits of cooperative learning have been advocated in a wide range of educational contexts in higher education. There is, however, rare information on the contributions of holistic education courses on college students. Using grounded theory methods, this preliminary study was to explore participants' perceptions of a holistic care course…

Using holistic interpretive synthesis to create practice-relevant guidance for person-centred fundamental care delivered by nurses.

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Feo, Rebecca; Conroy, Tiffany; Marshall, Rhianon J; Rasmussen, Philippa; Wiechula, Richard; Kitson, Alison L

2017-04-01

Nursing policy and healthcare reform are focusing on two, interconnected areas: person-centred care and fundamental care. Each initiative emphasises a positive nurse-patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse-patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice-relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse-patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse-patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person-centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. © 2016 John Wiley & Sons Ltd.

Toward a Holistic Approach to Spiritual Health Care for People With Schizophrenia.

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Ho, Rainbow T H; Wan, Adrian H Y; Chan, Caitlin K P

2016-01-01

Medical and behavioral treatments are the predominant types of rehabilitation services for people with schizophrenia. Spirituality in people with schizophrenia remains poorly conceptualized, thereby limiting knowledge advancement in the area of spiritual health care services. To provide a framework for better clinical and research practices, we advocate a holistic approach to investigating spirituality and its application in spiritual health care services of people with schizophrenia.

Incorporating Peplau's Theory of Interpersonal Relations to Promote Holistic Communication Between Older Adults and Nursing Students.

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Deane, William H; Fain, James A

2016-03-01

With the increased life expectancy, older adults will interact with multiple health care providers to manage acute and chronic conditions. These interactions include nursing students who use various health care settings to meet the clinical practicum requirements of their programs. Nursing faculty are charged with facilitating students' learning throughout the program from basic human needs, to holistic communication, to advanced medical surgical concepts. Despite educating students on holistic communication, there remains a lack of a reliable framework to undertake the task of teaching holistic communication skills. Nursing students preparing to function as licensed practitioners need to develop appropriate knowledge to holistically care for older adults. The purpose of this article is to examine Hildegard Peplau's interpersonal relations theory as a framework to assist nursing students to understand holistic communication skills during their encounters with older adults. Peplau's theory provides nursing a useful set of three interlocking and oftentimes overlapping working phases for nurses' interaction with patients in the form of the nurse-patient relationship. Nursing education could adopt the three phases of Peplau's interpersonal relations theory to educate students on holistically communicating with older adults. © The Author(s) 2015.

Medical doctors and complementary and alternative medicine: the context of holistic practice.

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Winnick, Terri A

2006-04-01

Consumers, health care financing, external and internal competition are factors identified in the medical literature as prompting change within medicine. I test these factors to determine if they also prompt regular doctors to define themselves as 'holistic MDs' and align themselves with complementary and alternative medicine (CAM). State-level regression analyses on the number of MDs advertising in referral directories for CAM therapies find holistic practice a function of practice locale. The proportion of holistic MDs increases in states with an older population, where more patients survive despite serious disabilities, and where non-physician providers pose a competitive threat. Consumer demand, specialization and licensing do not significantly influence adoption of CAM treatments in these analyses. Health care financing has disparate effects. Indemnity insurance constrains holistic practice while HMO penetration enhances it. These results suggest that holistic practice may be an integral part of the regular profession's ongoing professionalization project.

Holistic Nursing in the Genetic/Genomic Era.

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Sharoff, Leighsa

2016-06-01

Holistic nursing practice is an ever-evolving transformative process with core values that require continued growth, professional leadership, and advocacy. Holistic nurses are required to stay current with all new required competencies, such as the Core Competencies in Genetics for Health Professional, and, as such, be adept at translating scientific evidence relating to genetics/genomics in the clinical setting. Knowledge of genetics/genomics in relation to nursing practice, policy, utilization, and research influence nurses' responsibilities. In addition to holistic nursing competencies, the holistic nurse must have basic knowledge and skills to integrate genetics/genomics aspects. It is important for holistic nurses to enhance their overall knowledge foundation, skills, and attitudes about genetics to prepare for the transformation in health care that is already underway. Holistic nurses can provide an important perspective to the application of genetics and genomics, focusing on health promotion, caring, and understanding the relationship between caring and families, community, and society. Yet there may be a lack of genetic and genomic knowledge to fully participate in the current genomic era. This article will explore the required core competencies for all health care professionals, share linkage of holistic nurses in practice with genetic/genomic conditions, and provide resources to further one's knowledge base. © The Author(s) 2015.

Mental health in young adults and adolescents - supporting general physicians to provide holistic care.

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Jurewicz, Izabela

2015-04-01

In the era of an ageing population, young adults on medical wards are quite rare, as only 12% of young adults report a long-term illness or disability. However, mental health problems remain prevalent in the younger population. In a recent report, mental health and obesity were listed as the most common problems in young adults. Teams set up specifically for the needs of younger adults, such as early intervention in psychosis services are shown to work better than traditional care and have also proven to be cost effective. On the medical wards, younger patients may elicit strong emotions in staff, who often feel protective and may identify strongly with the young patient's suffering. In order to provide holistic care for young adults, general physicians need to recognise common presentations of mental illness in young adults such as depression, deliberate self-harm, eating disorders and substance misuse. Apart from treating illness, health promotion is particularly important for young adults. © 2015 Royal College of Physicians.

Improving Quality of Care in Patients with Liver Cirrhosis.

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Saberifiroozi, Mehdi

2017-10-01

Liver cirrhosis is a major chronic disease in the field of digestive diseases. It causes more than one million deaths per year. Despite established evidence based guidelines, the adherence to standard of care or quality indicators are variable. Complete adherence to the recommendations of guidelines is less than 50%. To improve the quality of care in patients with cirrhosis, we need a more holistic view. Because of high rate of death due to cardiovascular disease and neoplasms, the care of comorbid conditions and risk factors such as smoking, hypertension, high blood sugar or cholesterol, would be important in addition to the management of primary liver disease. Despite a holistic multidisciplinary approach for this goal, the management of such patients should be patient centered and individualized. The diagnosis of underlying etiology and its appropriate treatment is the most important step. Definition and customizing the quality indicators for quality measure in patients are needed. Because most suggested quality indicators are designed for measuring the quality of care in decompensated liver cirrhosis, we need special quality indicators for compensated and milder forms of chronic liver disease as well. Training the patients for participation in their own management, design of special clinics with dedicated health professionals in a form of chronic disease model, is suggested for improvement of quality of care in this group of patients. Special day care centers by a dedicated gastroenterologist and a trained nurse may be a practical model for better management of such patients.

[Spiritual Care of Patients With Depression].

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Kao, Chia-Chan; Lin, Yu-Hua

2018-06-01

Spiritual care is a component of holistic care. Patients with depression often experience body-mind-spirit health problems and may suffer from spiritual crises, particularly during the acute stage of a diseases, due to low self-esteem, negative attitudes toward life goals, daily life issues, and beliefs caused by physical, psychological, and occupational dysfunctions. Nonetheless, psychical care is the main treatment for patients with depression. This paper focuses on patients with depression and addresses the concepts of spiritual needs and spiritual care, identifying the factors that influence spiritual needs, the essentials of spiritual intervention, and the health effects of spiritual intervention outcomes on patients with depression. Courses that teach practical spiritual interventions are recommended for nurses. These courses should address topics such as individual approaches, building trusting relationships, setting diverse goals for spiritual interventions based on disease stage, and spiritual interventions involving the body-mind-spiritual aspects for patients with depression.

Effects of holistic nursing on protection and control of nasopharyngeal carcinoma patient' oral mucosa damage during radiotherapy

International Nuclear Information System (INIS)

Chen Fenghua; Li Dongpo; Guo Ping; Liu Qiang; Fan Feiyue

2012-01-01

Objective: To explore if the overall care can effectively control nasopharyngeal carcinoma patients' oral mucosa damage during radiotherapy. Method: Forty-seven nasopharyngeal carcinoma patients were randomly divided into test group (24 cases) and control group (23 cases). Patients in test group received mental nursing,oral care and health guidance plus the routine nursing, and patients in control group just given routine nursing. Result: The damaged degree of oral mucosal was lighter in test group than that in control group, and the difference was statistically significant (χ 2 =5.181 and 4.449, both P<0.05). Conclusion: The damage of oral mucosa can controlled effectively by holistic nursing during radiotherapy. (authors)

Holistic Health Care for the Medically Uninsured: The Church Health Center of Memphis.

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Morris, G Scott

2015-11-05

The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry, optometry, counseling, social work, and nutrition and fitness education, to promote wellness in every dimension of life. A 2012 economic analysis estimated that a $1 contribution to the CHC provided roughly $8 in health services. The CHC has trained >1200 Congregational Health Promoters to be health leaders and is conducting research on the effectiveness of faith community nurses partnering with congregations to assist in home care for patients recently discharged from Memphis hospitals. The MEMPHIS Plan, CHC's employer-sponsored health care plan for small business and the self-employed, offers uninsured people in lower-wage jobs access to quality, affordable health care. The CHC also conducts replications workshops several times a year to share their model with leaders in other communities. The Institute for Healthcare Improvement (IHI) recently completed a case study that concluded: "The CHC is one of a very few organizations successfully embodying all three components of the IHI Triple Aim by improving population health outcomes, enhancing the individual's health care experience, and controlling costs. All three have been part of the Center's DNA since its inception, and as a transforming force in the community, the model is well worth national attention."

The holistic worldview in action: evolution of holistic nurses certification programs.

Science.gov (United States)

Erickson, Helen Lorraine; Erickson, Margaret Elizabeth; Sandor, M Kay; Brekke, Mary E

2013-12-01

The American Holistic Nurses Credentialing Corporation (AHNCC), the only national credentialing body for holistic nurses, has a responsibility to offer valid, reliable, and rigorous certification examinations and to grow and evolve as indicated by social and professional changes. This article describes four major changes in the work of AHNCC since 2004: a detection of an evolution in the domain of holistic nursing through review of the literature; clarification and specification of levels of practice by educational level; development of the nurse coach role in nursing, designed within the precepts of holistic nursing; and AHNCC's response to the social paradigm shift for health care, and nursing's advanced practice registered nurse consensus model. Each of these is discussed in detail describing the circumstances that perpetuated AHNCC's consideration and the actions taken by AHNCC.

Clinical holistic health: advanced tools for holistic medicine.

Science.gov (United States)

Ventegodt, Søren; Clausen, Birgitte; Nielsen, May Lyck; Merrick, Joav

2006-02-24

According to holistic medical theory, the patient will heal when old painful moments, the traumatic events of life that are often called "gestalts", are integrated in the present "now". The advanced holistic physician's expanded toolbox has many different tools to induce this healing, some that are more dangerous and potentially traumatic than others. The more intense the therapeutic technique, the more emotional energy will be released and contained in the session, but the higher also is the risk for the therapist to lose control of the session and lose the patient to his or her own dark side. To avoid harming the patient must be the highest priority in holistic existential therapy, making sufficient education and training an issue of highest importance. The concept of "stepping up" the therapy by using more and more "dramatic" methods to get access to repressed emotions and events has led us to a "therapeutic staircase" with ten steps: (1) establishing the relationship; (2) establishing intimacy, trust, and confidentiality; (3) giving support and holding; (4) taking the patient into the process of physical, emotional, and mental healing; (5) social healing of being in the family; (6) spiritual healing--returning to the abstract wholeness of the soul; (7) healing the informational layer of the body; (8) healing the three fundamental dimensions of existence: love, power, and sexuality in a direct way using, among other techniques, "controlled violence" and "acupressure through the vagina"; (9) mind-expanding and consciousness-transformative techniques like psychotropic drugs; and (10) techniques transgressing the patient's borders and, therefore, often traumatizing (for instance, the use of force against the will of the patient). We believe that the systematic use of the staircase will greatly improve the power and efficiency of holistic medicine for the patient and we invite a broad cooperation in scientifically testing the efficiency of the advanced holistic

Clinical Holistic Health: Advanced Tools for Holistic Medicine

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2006-01-01

Full Text Available According to holistic medical theory, the patient will heal when old painful moments, the traumatic events of life that are often called “gestalts”, are integrated in the present “now”. The advanced holistic physician’s expanded toolbox has many different tools to induce this healing, some that are more dangerous and potentially traumatic than others. The more intense the therapeutic technique, the more emotional energy will be released and contained in the session, but the higher also is the risk for the therapist to lose control of the session and lose the patient to his or her own dark side. To avoid harming the patient must be the highest priority in holistic existential therapy, making sufficient education and training an issue of highest importance. The concept of “stepping up” the therapy by using more and more “dramatic” methods to get access to repressed emotions and events has led us to a “therapeutic staircase” with ten steps: (1 establishing the relationship; (2 establishing intimacy, trust, and confidentiality; (3 giving support and holding; (4 taking the patient into the process of physical, emotional, and mental healing; (5 social healing of being in the family; (6 spiritual healing — returning to the abstract wholeness of the soul; (7 healing the informational layer of the body; (8 healing the three fundamental dimensions of existence: love, power, and sexuality in a direct way using, among other techniques, “controlled violence” and “acupressure through the vagina”; (9 mind-expanding and consciousness-transformative techniques like psychotropic drugs; and (10 techniques transgressing the patient's borders and, therefore, often traumatizing (for instance, the use of force against the will of the patient.We believe that the systematic use of the staircase will greatly improve the power and efficiency of holistic medicine for the patient and we invite a broad cooperation in scientifically testing the

Clinical Holistic Medicine: Holistic Sexology and Acupressure Through the Vagina (Hippocratic Pelvic Massage

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2006-01-01

Full Text Available Many gynecological and sexological problems (like urine incontinence, chronic pelvic pains, vulvodynia, and lack of lust, excitement, and orgasm are resistant to standard medical treatment. In our work at the Research Clinic for Holistic Medicine in Copenhagen, we have found that vaginal acupressure, or Hippocratic pelvic massage, can help some of these problems. Technically, it is a very simple procedure as it corresponds to the explorative phase of the standard pelvic examination, supplemented with the patient's report on the feelings it provokes and the processing and integration of these feelings. Sometimes it can be very difficult to control the emotions released by the technique, i.e., regression to earlier traumas from childhood sexual abuse. This review discusses the theory behind vaginal acupressure, ethical aspects, and presentation of a case story. This procedure helped the patient to become present in her pelvis and to integrate old traumas with painful emotions. Holistic gynecology and sexology can help the patient to identify and let go of negative feelings, beliefs, and attitudes related to sex, gender, sexual organs, body, and soul at large. Shame, guilt, helplessness, fear, disgust, anxiety, anger, hatred, and other strong feelings are almost always an important part of a sexual or functional problem as these feelings are “held” by the tissue of the pelvis and sexual organs. Acupressure through the vagina/pelvic massage must be done with great care by an experienced physician, with a third person present, after obtaining consent and the necessary trust of the patient. It must be followed by conversational therapy and further holistic existential processing.

Clinical holistic medicine: holistic sexology and treatment of vulvodynia through existential therapy and acceptance through touch.

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Ventegodt, Søren; Morad, Mohammed; Hyam, Eytan; Merrick, Joav

2004-08-04

Sexual problems are found in four major forms: lack of libido, lack of arousal and potency, pain and discomfort during intercourse, and lack of orgasm. It is possible to work with a holistic approach to sexology in the clinic in order to find and repair the negative beliefs, repressions of love, and lack of purpose of life, which are the core to problems like arousal, potency, and pain with repression of gender and sexuality. It is important not to focus only on the gender and genitals in understanding the patient"s sexual problems. It is of equal importance not to neglect the body, its parts, and the feelings and emotions connected to them. Shame, guilt, helplessness, fear, disgust, anger, hatred, and other strong feelings are almost always an important part of a sexual problem and these feelings are often "held" by the tissue of the pelvis and sexual organs. The patient with sexual problems can be helped both by healing existence in general and by discharging old painful emotions from the tissues. The later process of local healing is often facilitated by a simple technique: accepting contact via touch. This is a very simple technique, where the self-acceptance of the patient is to be promoted, for example, asking the female patient to put her hand on her stomach (uterus) or vulva, after which the holistic physician puts his hand supportively around hers. When done with care and after obtaining the necessary trust of the patient, this aspect of holding often releases the old negative emotions of shame bound to the touched areas. Afterwards, the emotional problems become a subject for conversational therapy and further holistic processing. Primary vulvodynia seems to be one of the diseases that can be cured after only a few successful sessions of working with acceptance through touch. The technique can be used as an isolated procedure or as a part of a pelvic examination. When touching the genitals with the intention of sexual healing, a written therapeutic

Clinical Holistic Medicine: Holistic Sexology and Treatment of Vulvodynia Through Existential Therapy and Acceptance Through Touch

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2004-01-01

Full Text Available Sexual problems are found in four major forms: lack of libido, lack of arousal and potency, pain and discomfort during intercourse, and lack of orgasm. It is possible to work with a holistic approach to sexology in the clinic in order to find and repair the negative beliefs, repressions of love, and lack of purpose of life, which are the core to problems like arousal, potency, and pain with repression of gender and sexuality. It is important not to focus only on the gender and genitals in understanding the patient's sexual problems. It is of equal importance not to neglect the body, its parts, and the feelings and emotions connected to them. Shame, guilt, helplessness, fear, disgust, anger, hatred, and other strong feelings are almost always an important part of a sexual problem and these feelings are often “held” by the tissue of the pelvis and sexual organs. The patient with sexual problems can be helped both by healing existence in general and by discharging old painful emotions from the tissues. The later process of local healing is often facilitated by a simple technique: accepting contact via touch. This is a very simple technique, where the self-acceptance of the patient is to be promoted, for example, asking the female patient to put her hand on her stomach (uterus or vulva, after which the holistic physician puts his hand supportively around hers. When done with care and after obtaining the necessary trust of the patient, this aspect of holding often releases the old negative emotions of shame bound to the touched areas. Afterwards, the emotional problems become a subject for conversational therapy and further holistic processing. Primary vulvodynia seems to be one of the diseases that can be cured after only a few successful sessions of working with acceptance through touch. The technique can be used as an isolated procedure or as a part of a pelvic examination. When touching the genitals with the intention of sexual healing, a

Managing pressures ulcers in a resource constrained situation: A holistic approach

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Abhijit Dam

2011-01-01

Full Text Available Managing pressure ulcers remain a challenge and call for a multidisciplinary team approach to care. Even more daunting is the management of such patients in remote locations and in resource constrained situations. The management of pressure sores in a patient with progressive muscular atrophy has been discussed using resources that were locally available, accessible, and affordable. Community participation was encouraged. A holistic approach to care was adopted.

Caring for cancer patients on non-specialist wards.

LENUS (Irish Health Repository)

Gill, Finola

2012-02-01

As cancer is the leading cause of death worldwide, every nurse will be required to care for patients with the condition at some point in his\\/her career. However, non-specialized oncology nurses are often ill-prepared to nurse patients suffering from cancer. This literature review aims to provide an overview of current trends and developments in cancer care nursing in an attempt to identify the range of previous research pertaining to caring for patients with cancer on non-specialist wards. The review finds that non-specialized cancer nurses report a lack of education and training with regard to cancer care and cancer treatments, which acts as a barrier to providing quality nursing care. Emotional and communication issues with patients and their families can also cause non-specialist nurses significant distress. International research has shown that specialist oncology nurses make a considerable difference to physical and psychosocial patient care. It is therefore paramount that non-speciality nurses\\' educational needs are met to develop clinical competence and to provide supportive holistic care for both patients and their families.

[Application of clinical nursing path integrated with holistic nursing in advanced schistosomiasis patients with ascites].

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Mei-Zhi, Yuan; Jing-Ru, Sun; Tao, Chen; Xiao-Yu, Zhang; Liang-Cai, He; Jia-Song, Wang

2016-05-12

To evaluate the effect of the clinical nursing path integrated with the holistic nursing on advanced schistosomiasis patients with ascites. A total of 226 advanced schistosomiasis patients with ascites were randomly divided into a control group and an experimental group (113 cases each group). The subjects in the experimental group were nursed by the clinical nursing path integrated with the holistic nursing, while those in the control group were nursed only by the holistic nursing. Then the clinical relevant indexes of the two groups were observed, and the quality of life of the patients before and after hospital discharge was assessed. The improvement rate, satisfaction degree, and awareness rate of health knowledge of the patients in the experiment group were 93.8%, 100% and 97.4%, respectively, which were significantly higher than those of the control group (all P holistic nursing can effectively improve the improvement rate and decrease the mortality of the advanced schistosomiasis patients with ascites; meanwhile, it can shorten the hospitalization time and save the hospitalization cost. Therefore, this nursing model is suitable for popularization and application in the treatment and nursing work of the advanced schistosomiasis assistance.

Clinical Holistic Medicine: Chronic Pain in the Locomotor System

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Søren Ventegodt

2005-01-01

Full Text Available Most pains from the locomotor system arise due to involuntary, chronic tensions in the muscles or other tissues. When the patient is motivated, the pain is easily cured in most of the cases by using the tools of consciousness-based medicine, primarily therapeutic touch, conversation, and coaching the patient in a positive philosophy of life. The pains are often caused by “blockages” that may cause problems other than just pain. Often it turns out that the blocked areas develop actual physical damage over time: a slipped disk in the back, articular degeneration, or osteoarthritis when the cartilage is affected, can often be explained in this way. Apparently, the exact areas where the blockage is situated cause cellular problems, disrupting cellular order. The holistic process theory of healing and the related quality of life theories state that return to the natural state of being is possible, whenever the person gets the resources needed for existential healing. The resources needed are “holding” in the dimensions of awareness, respect, care, acknowledgment, and acceptance with support and processing in the dimensions of feeling, understanding, and letting go of negative attitudes and beliefs. The preconditions for holistic healing are trust and the intention for the healing to take place. Case stories of holistic treatment of patients with chronic back pain, low back pain, muscle problems, knee pain, and symptoms of rheumatoid arthritis are discussed with exercises relevant for patients with these conditions in the holistic clinic.

The feasibility of a holistic wellness program for HIV/AIDS patients residing in a voluntary inpatient treatment program.

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Morgan, Vanessa

2014-03-01

The purpose of this project was to examine the feasibility of an ongoing holistic wellness program in a residential facility treating persons with HIV/AIDS. The goal was to create a voluntary, four week holistic wellness intensive within the established inpatient behavioral health treatment program. Participants were given practicable holistic self care tools to effectively manage HIV related symptoms, general medical issues, addiction, depression, stress and anxiety. The program incorporated evidence-based holistic activities including yoga, therapeutic dance, meditation, Reiki, and reflective journaling. Narrative survey results and post-program evaluation support that an ongoing holistic wellness program within the existing treatment model is feasible and could have numerous potential beneficial effects. This project clearly exemplified the ideal opportunity for holistic nurses to implement innovative holistic interventions within the current healthcare delivery system. It is the author's observation that future studies with a larger participant group to further examine measurable benefits can lend valuable information and insight into the future development of holistic wellness programs for residential treatment facilities.

USING BACH FLOWER IN HOLISTIC PSYCHOTHERAPY

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Vagner Ferreira do Nascimento

2017-05-01

Full Text Available This is a narrative review from scientific literature that aimed to describe concepts and approaches for indications of the therapeutic use of Bach flower remedies in holistic psychotherapy. The review was developed in February 2016 from books, official documents and articles indexed in Lilacs and Scielo databases. Bach flower remedies is a therapeutic method that aims to restore the balance of human being, restoring its vital energy through holistic care. Because the flower essences act on psychic and emotional dimension of individual, when employed in holistic psychotherapy can provide greater autonomy, self-care and effectiveness compared to other alternative methods. The literature indicated that flower essence therapy is a safe practice and can be used in a complementary to health care, but should be performed by qualified professionals. It has also shown to be a promising and important area for nursing professional, but it still requires greater investment in research in the area to support the practice.

Evaluating holistic needs assessment in outpatient cancer care--a randomised controlled trial: the study protocol.

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Snowden, Austyn; Young, Jenny; White, Craig; Murray, Esther; Richard, Claude; Lussier, Marie-Therese; MacArthur, Ewan; Storey, Dawn; Schipani, Stefano; Wheatley, Duncan; McMahon, Jeremy; Ross, Elaine

2015-05-11

People living with and beyond cancer are vulnerable to a number of physical, functional and psychological issues. Undertaking a holistic needs assessment (HNA) is one way to support a structured discussion of patients' needs within a clinical consultation. However, there is little evidence on how HNA impacts on the dynamics of the clinical consultation. This study aims to establish (1) how HNA affects the type of conversation that goes on during a clinical consultation and (2) how these putative changes impact on shared decision-making and self-efficacy. The study is hosted by 10 outpatient oncology clinics in the West of Scotland and South West England. Participants are patients with a diagnosis of head and neck, breast, urological, gynaecological and colorectal cancer who have received treatment for their cancer. Patients are randomised to an intervention or control group. The control group entails standard care--routine consultation between the patient and clinician. In the intervention group, the patient completes a holistic needs assessment prior to consultation. The completed assessment is then given to the clinician where it informs a discussion based on the patient's needs and concerns as identified by them. The primary outcome measure is patient participation, as determined by dialogue ratio (DR) and preponderance of initiative (PI) within the consultation. The secondary outcome measures are shared decision-making and self-efficacy. It is hypothesised that HNA will be associated with greater patient participation within the consultation, and that shared decision-making and feelings of self-efficacy will increase as a function of the intervention. This study has been given a favourable opinion by the West of Scotland Research Ethics Committee and NHS Research & Development. Study findings will be disseminated through peer-reviewed publications and conference attendance. Clinical Trials.gov NCT02274701. Published by the BMJ Publishing Group Limited. For

Is there a place for a holistic approach in surgical training?

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Atayoglu, Timucin; Buchholz, Noor; Atayoglu, Ayten Guner; Caliskan, Mujgan

2014-03-01

The holistic approach in medicine is a framework that considers and treats all aspects of a patient's needs, as it relates to their health. The goal of such an approach is to prevent illness, and to maximise the well-being of individuals and families. Holistic medicine is also referred to as integrative, which has been interpreted by some professionals as the combination of evidence-based medicine and complementary medicine. The speciality of Family Medicine (FM) is often referred to as General Practice (GP), a terminology which emphasises the holistic nature of that discipline. Furthermore, GP/FM professional bodies in some countries have incorporated the holistic and integrative approach into curricula and guidelines for doctors in training, which reflects its acceptance as a component of medical training. However, despite this validation, and despite research showing the effectiveness of such strategies in enhancing the outcomes of surgery, a holistic framework or integrative approach has not been equally integrated into speciality training for would-be surgeons. We argue that it would be advisable to include holistic approaches into surgical training and help surgeons to recognise their role in the continuum of care.

Social care informatics as an essential part of holistic health care: a call for action.

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Rigby, Michael; Hill, Penny; Koch, Sabine; Keeling, Debbie

2011-08-01

The authors identified the need for a cross-disciplinary research view of issues to ensure an integrated citizen-centric support to achieve optimal health of individual citizens and, in particular, the role of informatics to inform and coordinate support towards integrated and holistic care. An Exploratory Workshop was approved and sponsored by the European Science Foundation. Twenty-three participants from 15 countries attended, covering a full range of health, social care and informatics professions and disciplines. The participants found strong common ground in identifying key issues to be addressed if citizens with compromised health are to receive integrated and coordinated support to a common set of objectives, while also ensuring appropriate choice and support for citizen, family and other informal carers. At the same time, optimal health was identified as a fundamental human right, and that achieving this is a necessary priority of a caring society. Moreover, Europe has a commitment to researching and developing health informatics (e-health), though not yet giving a priority to this integration of health and social care. Specifically the following main informatics challenges to be addressed were identified: (1) to identify available information and communication needs related to different scenarios of use in the intersection between health and social care, (2) to develop and map shared ontologies, and standards for integration and/or brokerage, (3) to enable planned information access and sharing, shaping a system of trust where the patient is an active partner and policies are established considering all partners/interests, (4) to investigate the use of automatic/intelligent knowledge based and context-relevant services, and (5) empowering the citizen (or their selected agent) as co-producer through modern informatics tools, while carefully avoiding selective disempowerment of the most vulnerable. The Exploratory Workshop resulted in a unanimous

Challenges Encountered by Vietnamese Nurses When Caring for Patients With Cancer.

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Thuy Nguyen, Ly; Clemenceau Annoussamy, Lourdes; LeBaron, Virginia T

2017-03-01

Providing holistic care is acknowledged as central to providing quality care for patients with cancer, but providing competent nursing care consistent with these approaches remains a challenge for nurses in Vietnam. Obstacles for Vietnamese oncology nurses include their low status, the limited scope of nursing practice, work overload in a hierarchical system, and cultural beliefs that view death and dying as taboo. Additional research to support oncology nurses in Vietnam must acknowledge the merits of improving nursing education as an important strategy for enhancing nursing autonomy, quality of care, and outcomes for the increasing number of patients with cancer in low- and middle-income countries.

Holistic Medicine IV: Principles of Existential Holistic Group Therapy and the Holistic Process of Healing in a Group Setting

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Soren Ventegodt

2003-01-01

Full Text Available In existential holistic group therapy, the whole person heals in accordance with the holistic process theory and the life mission theory. Existential group psychotherapy addresses the emotional aspect of the human mind related to death, freedom, isolation, and meaninglessness, while existential holistic group therapy addresses the state of the person�s wholeness. This includes the body, the person�s philosophy of life, and often also love, purpose of life, and the spiritual dimension, to the same extent as it addresses the emotional psyche and sexuality, and it is thus much broader than traditional psychotherapy.Where existential psychotherapy is rather depressing concerning the fundamental human condition, existential holistic therapy conceives life to be basically good. The fundamentals in existential holistic therapy are that everybody has the potential for healing themselves to become loving, joyful, sexually attractive, strong, and gifted, which is a message that most patients welcome. While the patient is suffering and fighting to get through life, the most important job for the holistic therapist is to keep a positive perspective of life. In accordance with these fundamentals, many participants in holistic group therapy will have positive emotional experiences, often of an unknown intensity, and these experiences appear to transform their lives within only a few days or weeks of therapy.An important idea of the course is Bohm�s concept of �holo-movement� in the group, resulting from intense coherence between the group members. When the group comes together, the individual will be linked to the totality and the great movement forward towards love, consciousness, and happiness will happen collectively � if it happens at all. This gives the individual the feeling that everything that happens is right, important, and valuable for all the participants at the same time. Native Americans and other premodern people refer to this

Holistic medicine IV: principles of existential holistic group therapy and the holistic process of healing in a group setting.

Science.gov (United States)

Ventegodt, Søren; Andersen, Niels Jørgen; Merrick, Joav

2003-12-23

In existential holistic group therapy, the whole person heals in accordance with the holistic process theory and the life mission theory. Existential group psychotherapy addresses the emotional aspect of the human mind related to death, freedom, isolation, and meaninglessness, while existential holistic group therapy addresses the state of the person"s wholeness. This includes the body, the person's philosophy of life, and often also love, purpose of life, and the spiritual dimension, to the same extent as it addresses the emotional psyche and sexuality, and it is thus much broader than traditional psychotherapy. Where existential psychotherapy is rather depressing concerning the fundamental human condition, existential holistic therapy conceives life to be basically good. The fundamentals in existential holistic therapy are that everybody has the potential for healing themselves to become loving, joyful, sexually attractive, strong, and gifted, which is a message that most patients welcome. While the patient is suffering and fighting to get through life, the most important job for the holistic therapist is to keep a positive perspective of life. In accordance with these fundamentals, many participants in holistic group therapy will have positive emotional experiences, often of an unknown intensity, and these experiences appear to transform their lives within only a few days or weeks of therapy. An important idea of the course is Bohm's concept of "holo-movement" in the group, resulting from intense coherence between the group members. When the group comes together, the individual will be linked to the totality and the great movement forward towards love, consciousness, and happiness will happen collectively--if it happens at all. This gives the individual the feeling that everything that happens is right, important, and valuable for all the participants at the same time. Native Americans and other premodern people refer to this experience as "the spiritual design

Palliative Care in Cancer

Science.gov (United States)

... care is usually provided by palliative care specialists, health care practitioners who have received special training and/or certification in palliative care. They provide holistic care to the patient and family or caregiver ...

Interventions to Support Integrated Psychological Care and Holistic Health Outcomes in Paediatrics.

Science.gov (United States)

Shafran, Roz; Bennett, Sophie D; McKenzie Smith, Mhairi

2017-08-16

There are strong calls from many national and international bodies for there to be a 'holistic' and integrated approach to the understanding and management of psychological and physical health needs. Such holistic approaches are characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease. Holistic approaches can impact on mental and physical health and are cost-effective. Several psychological interventions have demonstrated efficacy in improving holistic health outcomes, for example Cognitive Behaviour Therapy, Behavioural Therapies and Problem Solving Therapies. They have shown to impact upon a wide range of outcomes, including psychological distress, pain, physical health, medication adherence, and family outcomes. There is increasing recognition that the holistic goals of the child and family should be prioritised, and that interventions and outcomes should reflect these goals. A focus on holistic goals in therapy can be achieved through a combination of personalised goal-based outcomes in addition to symptom-based measures.

Chiropractic care of a patient with vertebral subluxation and Bell's palsy.

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Alcantara, Joel; Plaugher, Gregory; Van Wyngarden, Darwin L

2003-05-01

To describe the chiropractic care of a patient medically diagnosed with Bell's palsy and discuss issues clinically relevant to this disorder, such as its epidemiology, etiology, diagnosis, care, and prognosis. A 49-year-old woman with a medical diagnosis of Bell's palsy sought chiropractic care. Her symptoms included right facial paralysis, extreme phonophobia, pain in the right temporomandibular joint (TMJ), and neck pain. Signs of cervical vertebral and TMJ subluxations included edema, tenderness, asymmetry of motion and posture, and malalignment detected from plain film radiographs. The patient was cared for with full spine contact-specific, high-velocity, low-amplitude adjustments (Gonstead Technique) to sites of vertebral and occipital subluxations. The patient's left TMJ was also adjusted. The initial symptomatic response to care was positive, and the patient made continued improvements during the 6 months of care. There are indications that patients suffering from Bell's palsy may benefit from a holistic chiropractic approach that not only includes a focus of examination and care of the primary regional areas of complaint (eg, face, TMJ) but also potentially from significant vertebral subluxation concomitants.

Developing a holistic approach to obesity management.

Science.gov (United States)

Brown, Jenny; Wimpenny, Peter

2011-02-01

The aim of this paper is to discuss the theoretical background and relevance of a holistic approach to obesity management by nurses. There is a global rise in the number of people with obesity, such that it now represents one of the major health challenges. However, nurses are often influenced by physical and dietetic focused approaches and could fail to acknowledge a range of other factors that can impact on weight management. As part of the development of a holistic approach to obesity a literature search was undertaken to establish relevant theoretical perspectives that underpin practice in physical, psychological and social aspects of care (focused on the period 1995-2005). In addition, experiences of working in a secondary care weight management clinic were also drawn upon. Psychobiological, attribution and social support theories were identified that could contribute to a better understanding of obesity. If these theoretical perspectives and supporting evidence can be integrated in a holistic approach to care and management it might be possible to promote better health and well-being in those with obesity. Creating a greater understanding of the range of theoretical perspectives and supporting evidence related to obesity could, it is argued, provide enhanced care and management. © 2011 Blackwell Publishing Asia Pty Ltd.

Social Media for the Promotion of Holistic Self-Participatory Care: An Evidence Based Approach. Contribution of the IMIA Social Media Working Group.

Science.gov (United States)

Miron-Shatz, T; Hansen, M M; Grajales, F J; Martin-Sanchez, F; Bamidis, P D

2013-01-01

As health information is becoming increasingly accessible, social media offers ample opportunities to track, be informed, share and promote health. These authors explore how social media and holistic care may work together; more specifically however, our objective is to document, from different perspectives, how social networks have impacted, supported and helped sustain holistic self-participatory care. A literature review was performed to investigate the use of social media for promoting health in general and complementary alternative care. We also explore a case study of an intervention for improving the health of Greek senior citizens through digital and other means. The Health Belief Model provides a framework for assessing the benefits of social media interventions in promoting comprehensive participatory self-care. Some interventions are particularly effective when integrating social media with real-world encounters. Yet not all social media tools are evidence-based and efficacious. Interestingly, social media is also used to elicit patient ratings of treatments (e.g., for depression), often demonstrating the effectiveness of complementary treatments, such as yoga and mindfulness meditation. To facilitate the use of social media for the promotion of complementary alternative medicine through self-quantification, social connectedness and sharing of experiences, exploration of concrete and abstract ideas are presented here within. The main mechanisms by which social support may help improve health - emotional support, an ability to share experiences, and non-hierarchal roles, emphasizing reciprocity in giving and receiving support - are integral to social media and provide great hope for its effective use.

Clinical Holistic Medicine: Holistic Rehabilitation

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2005-01-01

Full Text Available Quality of life, health, and ability are often lost at the same time and most often in one decaying existential movement over 5 or 10 years. This “lost life” is mostly too slow to be felt as life threatening, but once awakened to reality, it provokes the deepest of fears in patients: the fear of death itself and destruction of our mere existence. The horrible experience of having “lost life””, often without even noticing how it happened, can be turned into a strong motivation for improvement. Personal development is about finding the life deeply hidden within in order to induce revitalization and rehabilitation. Rehabilitation is about philosophy of life with the integration of the repressed painful feelings and emotions from the past and the letting go of the associated negative beliefs and decisions. The holistic medical toolbox builds on existential theories (the quality of life theories, the life mission theory, the theory of character, the theory of talent, and the holistic process theory and seems to have the power to rehabilitate the purpose of life, the character of the person, and fundamental existential dimensions of man: (1 love; (2 strength of mind, feelings, and body; and 3 joy, gender, and sexuality; allowing the person once again to express and realize his talents and full potential. The principles of rehabilitation are not very different from other healing, but the task is often more demanding for the holistic physician as the motivation and resources often are very low and the treatment can take many years.

Mode of treatment affects quality of life in head and neck cancer survivors: Implications for holistic care.

Science.gov (United States)

Bower, Wendy Fiona; Vlantis, Alexander Christopher; Chung, Tiffany M L; Van Hasselt, C Andrew

2010-10-01

As adverse effects of live-saving treatment are unavoidable surgeons have a duty to address physical changes and quality of life issues that matter to head and neck (H&N) cancer patients. We propose a tailored holistic care package. This study compared the quality of life of H&N cancer survivors managed with different approaches in the follow-up phase after initial treatment and identified factors adversely impacting quality of life parameters. H&N cancer patients studied: 1) surgery only, 2) radiotherapy only, 3) surgery and radiotherapy, and 4) any combination of surgery, chemotherapy or radiotherapy. Patients unable to communicate in Cantonese, with thyroid cancer or end-of-life disease were excluded. EORTC QLQ-H&N35 Cantonese version was administered at least 1 year after initial H&N cancer treatment. Quality of life impairment was worse in all of the domains for combination therapy versus monotherapy patients. Scores between surgery or radiotherapy-only patients were not significantly different. Radiotherapy preceding surgery impacted significantly more on speech than surgery before the radiotherapy. Patients with advanced disease had more impairment of quality of life in each domain than patients with early disease. Coughing, eating problems, sticky saliva, and difficulties with social contact were all significant predictors of problems associated with a dry mouth.

A case study from a nursing and occupational therapy perspective - Providing care for a patient with a traumatic brachial plexus injury.

Science.gov (United States)

Wellington, Beverley; McGeehan, Claire

2015-02-01

This paper presents a case study that demonstrates how collaborative working between professionals enhanced the holistic care for a patient following a traumatic brachial plexus injury. The paper will describe the patient's journey of care from initial presentation, diagnosis and assessment, acute care provision, discharge & rehabilitation to ongoing supportive counselling. The care encompasses input from both a nursing and occupational therapy perspective. Copyright © 2014 Elsevier Ltd. All rights reserved.

Outcomes of newly practicing nurses who applied principles of holistic comfort theory during the transition from school to practice: a qualitative study.

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Goodwin, Miki; Candela, Lori

2013-06-01

The aim of this qualitative study was to explore if newly practicing nurses benefited from learning holistic comfort theory during their baccalaureate education, and to provide a conceptual framework to support the transition from school to practice. The study was conducted among graduates of an accelerated baccalaureate nursing program where holistic comfort theory was embedded as a learner-centered philosophy across the curriculum. A phenomenological process using van Manen's qualitative methodology in education involving semi-structured interviews and thematic analysis was used. The nurses recalled what holistic comfort meant to them in school, and described the lived experience of assimilating holistic comfort into their attitudes and behaviors in practice. Themes were established and a conceptual framework was developed to better understand the nurses' lived experiences. Results showed that holistic comfort was experienced as a constructive approach to transcend unavoidable difficulties during the transition from school to practice. Participants described meaningful learning and acquisition of self-strengthening behaviors using holistic comfort theory. Holistic comfort principles were credited for easing nurses into the realities of work and advocating for best patient outcomes. Patient safety and pride in patient care were incidental positive outcomes. The study offers new insights about applying holistic comfort to prepare nurses for the realities of practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

A qualitative study of nurses' attitudes towards' and accommodations of patients' expressions of religiosity and faith in dementia care.

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Skomakerstuen Ødbehr, Liv; Kvigne, Kari; Hauge, Solveig; Danbolt, Lars Johan

2015-02-01

To investigate nurses' attitudes towards and accommodations of patients' expressions of religiosity and faith in dementia care. Holistic care for people with dementia addresses patients' religiosity and faith. Nurses' accommodations of patients' religiosity have not been studied extensively even though nurses report a lack of experience and knowledge regarding religious care. This study has a qualitative research design. Eight focus group interviews with 16 nurses and 15 care workers in four Norwegian nursing homes were conducted from June 2011-January 2012. The interview text was analysed using van Manen's hermeneutic-phenomenological approach and Lindseth and Nordberg's structural analysis. The following three main themes reflected the nurses' and care workers' attitudes towards and accommodations of patients' expressions of religiosity and faith: (i) embarrassment vs. comfort, described in the sub-themes 'feelings of embarrassment' and 'religiosity as a private matter'; (ii) unknown religious practice vs. known religious practice, described as 'religious practice that was scary' or 'religious practice that was recognizable'; and (iii) death vs. life, described as 'difficulty talking about death 'or 'focusing on life and the quality of life'. Nurses and care workers were uncertain and lacked knowledge of the patients' expressions of religiosity and faith in terms of both their substance and their function. Nurses struggled with ambivalent feelings about patients' religious expressions and with unclear understanding of the significance of religiosity. These challenges compromised person-centred and holistic care on several occasions. © 2014 John Wiley & Sons Ltd.

Clinical Holistic Medicine: The Case Story of Anna. II. Patient Diary as a Tool in Treatment

Directory of Open Access Journals (Sweden)

Sören Ventegodt

2006-01-01

Full Text Available In spite of extreme childhood sexual and violent abuse, a 22-year-old young woman, Anna, healed during holistic existential therapy. New and highly confrontational therapeutic tools were developed and used to help this patient (like acceptance through touch and acupressure through the vagina. Her vulva and introitus were scarred from repeated brutal rape, as was the interior of her mouth. During therapy, these scars were gently contacted and the negative emotional contents released. The healing was in accordance with the advanced holistic medical toolbox that uses (1 love, (2 trust, (3 holding, and (4 helping the patient to process and integrate old traumas.The case story clearly revealed the philosophical adjustments that Anna made during treatment in response to the severe childhood abuse. These adjustments are demonstrated by her diary, where sentences contain both the feelings and thoughts of the painful present (the gestalt at the time of the abuse, thus containing the essence of the traumas, making the repression of the painful emotions possible through the change in the patient’s philosophical perspective. Anna's case gives a unique insight into the process of traumatization (pathogenesis and the process of healing (salutogenesis. At the end of the healing, Anna reconnected her existence to the outer world in a deep existential, suicidal crisis and faced her choice of life or death. She decided to live and, in this process, assumed existential responsibility, which made her able to step out of her mental disease. The advanced holistic toolbox seems to help patients heal even from the worst childhood abuse. In spite of the depth of the existential crisis, holistic existential therapy seems to support existential responsibility well and thus safe for the patients.

The Holistic, Interactive and Persuasive Model to Facilitate Self-care of Patients with Diabetes

Science.gov (United States)

Vargas-Lombard, Miguel; Jipsion, Armando; Vejarano, Rafael; Camargo, Ismael; Álvarez, Humberto; Mora, Elena Villalba; Menasalva Ruíz, Ernestina

The patient, in his multiple facets of citizen and user of services of health, needs to acquire during, and later in his majority of age, favorable conditions of health to accentuate his quality of life and it is the responsibility of the health organizations to initiate the process of support for that patient during the process of mature life. The provision of services of health and the relation doctor-patient are undergoing important changes in the entire world, forced to a large extent by the indefensibility of the system itself. Nevertheless decision making requires previous information and, what more the necessity itself of being informed requires having a “culture” of health that generates pro activity and the capacity of searching for instruments that facilitate the awareness of the suffering and the self-care of the same. Therefore it is necessary to put into effect a ICT model (hiPAPD) that has the objective of causing Interaction, Motivation and Persuasion towards the surroundings of the diabetic Patient facilitating his self-care. As a result the patient himself individually manages his services through devices and AmI Systems (Ambient Intelligent).

Holistic care of complicated tuberculosis in healthcare settings with limited resources.

Science.gov (United States)

Duke, Trevor; Kasa Tom, Sharon; Poka, Harry; Welch, Henry

2017-12-01

In recent years, most of the focus on improving the quality of paediatric care in low-income countries has been on improving primary care using the Integrated Management of Childhood Illness, and improving triage and emergency treatment in hospitals aimed at reducing deaths in the first 24 hours. There has been little attention paid to improving the quality of care for children with chronic or complex diseases. Children with complicated forms of tuberculosis (TB), including central nervous system and chronic pulmonary TB, provide examples of acute and chronic multisystem paediatric illnesses that commonly present to district-level and second-level referral hospitals in low-income countries. The care of these children requires a holistic clinical and continuous quality improvement approach. This includes timely decisions on the commencement of treatment often when diagnoses are not certain, identification and management of acute respiratory, neurological and nutritional complications, identification and treatment of comorbidities, supportive care, systematic monitoring of treatment and progress, rehabilitation, psychological support, ensuring adherence, and safe transition to community care. New diagnostics and imaging can assist this, but meticulous attention to clinical detail at the bedside and having a clear plan for all aspects of care that is communicated well to staff and families are essential for good outcomes. The care is multidimensional: biomedical, rehabilitative, social and economic, and multidisciplinary: medical, nursing and allied health. In the era of the Sustainable Development Goals, approaches to these dimensions of healthcare are needed within the reach of the poorest people who access district hospitals in low-income countries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[EMOTIONAL MANAGEMENT AND CRITICAL THINKING IN THE AID RELATIONSHIP OF THE HOLISTIC CARE OF PALLIATIVE PATIENTS].

Science.gov (United States)

De Blas Gómez, Irene; Rodríguez García, Marta

2015-05-01

To care for palliative patients is essential that healthcare professionals develop emotional competencies. This means acquiring the habit of self reflection and be emphatic with other people, in order to be able to identify the personal emotions of patients, family and team. Reflection involves a continuing effort to reason about aspects of professional practice, especially on issues as complex as suffering and death. Both reflective reasoning and emotional management are vital in an Aid Relationship. For nursing healthcare professionals, to care the emotional aspects means becoming aware of their own and others feelings, and get to understand and accept to handle them properly. Nursing actions involves many qualities of social competence, such as empathy, understanding, communication skills, honesty, flexibility and adaptability to the individual needs of people cared. In the context of palliative care patients and their families all these aspects are fundamental and are part of the same philosophy. Emotional education still remains a challenge in our profession both in the initial and continuing training.

Exploring aspects of physiotherapy care valued by breast cancer patients.

Science.gov (United States)

Pidlyskyj, K; Roddam, H; Rawlinson, G; Selfe, J

2014-06-01

To explore the reported value of physiotherapy care received by patients who had accessed a Specialist Breast Care Physiotherapy Service. Exploratory qualitative study using in-depth interviews to explore aspects of physiotherapy care valued by breast cancer patients. Thematic network analysis was used to interpret the data and bring together the different experiences of the participants and identify common themes. Physiotherapy Department at a NHS Foundation Trust Teaching Hospital. Nineteen participants were recruited and three were selected to take part in the in-depth interviews. All participants had received physiotherapy care from a Specialist Breast Care Physiotherapy Service and had been discharged within the last six months. Participants valued a patient-centred holistic approach to care and access to a Specialist Service with an experienced clinician. In particular the importance of the therapeutic alliance and the value of psychological, emotional and educational support emerged, with the participants feeling empowered in their recovery. Participants reported an overall positive experience of their physiotherapy care. This study supports the need for service providers to evaluate their current physiotherapy provision and subsequently develop Specialised Services to meet the physiotherapy needs of breast cancer patients throughout all stages of their treatment pathway from the delivery of pre-operative care through to post-treatment follow-up. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Holistic Care in the US Military I-The Epidaurus Project: An Initiative in Holistic Medicine for the Military Health System, 2001-2012.

Science.gov (United States)

Foote, Frederick O; Bulger, Roger J; Frampton, Susan B; Pellegrino, Edmund D

2012-05-01

This article describes the history and findings of the Epidaurus Project, a Uniformed Services University-affiliated project to bring holistic care and evidence-based design into the Military Health System (MHS). A distinguished group of civilian thought leaders contributed. The 2005 Base Realignment and Closure process offered a chance to implement the Epidaurus agenda. A new integrated healthcare delivery system, centered around the Walter Reed National Military Medical Center at Bethesda, Maryland, was the result. These facilities will be templates for a new generation of MHS "healing environments" and a model for innovative systems of healthcare nationwide. The Epidaurus Project represents a significant collaboration between civilian medicine and the military in times of war.

Spirit-guided care: Christian nursing for the whole person.

Science.gov (United States)

Murphy, Lyn S; Walker, Mark S

2013-01-01

Healthcare today is challenged to provide care that goes beyond the medical model of meeting physical needs. Despite a strong historical foundation in spiritual whole person care, nurses struggle with holistic caring. We propose that for the Christian nurse, holistic nursing can be described as Spirit-guided care--removing oneself as the moiatiating force and allowing Christ, in the furm of the Holy Spirit, to flow through and guide the nurse in care of patients and families.

Moving toward holistic wellness, empowerment and self-determination for Indigenous peoples in Canada: Can traditional Indigenous health care practices increase ownership over health and health care decisions?

Science.gov (United States)

Auger, Monique; Howell, Teresa; Gomes, Tonya

2016-12-27

This study aimed to understand the role that traditional Indigenous health care practices can play in increasing individual-level self-determination over health care and improving health outcomes for urban Indigenous peoples in Canada. This project took place in Vancouver, British Columbia and included the creation and delivery of holistic workshops to engage community members (n = 35) in learning about aspects of traditional health care practices. Short-term and intermediate outcomes were discussed through two gatherings involving focus groups and surveys. Data were transcribed, reviewed, thematically analyzed, and presented to the working group for validation. When participants compared their experiences with traditional health care to western health care, they described barriers to care that they had experienced in accessing medical doctors (e.g., racism, mistrust), as well as the benefits of traditional healing (e.g., based on relationships, holistic approach). All participants also noted that they had increased ownership over their choices around, and access to, health care, inclusive of both western and traditional options. They stressed that increased access to traditional health care is crucial within urban settings. Self-determination within Indigenous urban communities, and on a smaller scale, ownership for individuals, is a key determinant of health for Indigenous individuals and communities; this was made clear through the analysis of the research findings and is also supported within the literature. This research also demonstrates that access to traditional healing can enhance ownership for community members. These findings emphasize that there is a continued and growing need for support to aid urban Indigenous peoples in accessing traditional health care supports.

Pengetahuan Dan Keterampilan Perawat Dalam Pelayanan Keperawatan Holistik Di Indonesian Holistic Tourist Hospital

OpenAIRE

Azizatunnisa, Nurul; Suhartini, Suhartini

2012-01-01

Health care nowadays provides holistic concept, which is focus on client's healing as the overall objectives including bio-psycho-socio-cultural-spiritual. This concept should be understood and applied by health practitioner, including nurses. Therefore, study about holistic nursing should be done, especially in Indonesian Holistic Tourist Hospital (IHTH) Purwakarta West Java as the first of health provider in Indonesia that used holistic approach. The objective of this research is to descri...

Attitudes towards holistic complementary and alternative medicine: a sample of healthy people in Turkey.

Science.gov (United States)

Erci, Behice

2007-04-01

This study aimed to investigate the attitude towards holistic complementary and alternative medicine of healthy people, and to evaluate the relationship between attitude towards holistic complementary and alternative medicine and the characteristics of the participants. Complementary and alternative medicines are becoming more accepted. This study used descriptive and correlational designs. The study included healthy individuals who attended or visited a primary care centre for healthcare services. The sample of the study consisted of 448 persons who responded to the questionnaire. The Attitude towards Holistic Complementary and Alternative Medicine scale consisted of 11 items on a six-point, and two subscales. The mean score of holistic complementary and alternative medicine was studied in relation to attributes and holistic complementary and alternative medicine. The mean score on the scale was 58.1 SD 4.1 point, and in terms of the mean score of the scale, the sample group showed a negative attitude towards holistic complementary and alternative medicine and one subscale. Demographic characteristics of the sample group affected attitudes towards holistic complementary and alternative medicine and both subscales. In light of these results, it is clear that healthy Turkish population have a tendency towards conventional medicine. Health professionals caring for healthy people should provide comprehensive care that addresses the physical, psychosocial and spiritual needs of the individual; they could provide the consultation regarding to different patterns of complementary therapies.

Achieving a holistic perspective in stroke rehabilitation

DEFF Research Database (Denmark)

Kristensen, Hanne Kaae; Lund, Hans; Jones, Dorrie

2015-01-01

Background/Aims: Holistic, multidisciplinary rehabilitation is often the most appropriate for stroke patients. The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) provides a comprehensive conceptual framework and systematic terminology used...... to a holistic approach in stroke rehabilitation, including an understanding of functioning and the ability to participate in everyday life. Using this approach to rehabilitation, disability is not only perceived as a consequence of stroke but also in the context of the individual person, where interactions...... the holistic approach....

Exploring Holistic Comfort in Children Who Experience a Clinical Venipuncture Procedure.

Science.gov (United States)

Bice, April A; Hall, Joanne; Devereaux, Matthew J

2018-06-01

Children often experience the uncomfortable effects of invasive procedures as a part of primary care and during times of illness. Holistic comfort has been well documented in adult literature but little research exists on the understanding of holistic procedural comfort from the child's perspective. In this study, holistic comfort related to an invasive venipuncture procedure was explored in children age 5 to 7 years and their caregivers of all ages. A qualitative descriptive design described by Sandelowski was used. The philosophical underpinnings of naturalistic inquiry of Guba and Lincoln were used. Semistructured interviews were conducted with 13 child and 15 caregiver participants. Children also drew pictures to help describe their perceptions. Traditional thematic content analysis described by Hsieh and Shannon yielded four overarching themes of holistic comfort related to venipuncture procedures in children: Body Comfort, Cognitive and Emotional Comfort, Comfort in the Procedure Surroundings, and Comfort Play. Numerous recommendations for future research are included. Implications for nursing and related health sciences, organizational and administrative policy, invasive procedures, theory, and methods were found and are discussed. Findings from this study will assist nurses in providing procedure management for children from a holistic care perspective.

Holism and embodiment in nursing: using Goethean science to join 2 perspectives on patient care.

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Mason, Deanna M

2014-01-01

Holism is a central concept in nursing theory, yet recently, embodiment has become prominent in the literature. Epistemological foundations from modern and contemporary philosophy are discussed and their relationship to nursing practice is explored to investigate the concepts of holism and embodiment. Nurses practice holistic care within the patient encounter while patients live an embodied experience. This creates inherent dissonance in the nurse-patient interaction. Goethean science is presented as a way to reconcile this discrepancy, to allow the nurse to better understand the patient's embodiment and, by default, his or her own embodiment. A new perspective of how nursing practice can use Goethean science and an embodied perspective are presented as a means to actualize Carper's fundamental pattern of knowing of personal knowledge within the nurse-patient interaction. With this approach, the nurse is able to examine the phenomenon of the patient with the patient to explore the essential nature that makes the patient who he or she is and what he or she is trying to become. During this exploration, the nurse uses the senses, language, and a critical mind to do what no machine or test could-to see the underlying meaningfulness and internal coherence of the patient. The intuitive revelation would expose nursing interventions simultaneously. Moving beyond the myopic perspective of how to keep "person" central to the nursing metaparadigm, nursing is beginning to see the embodiment of the patient as a means for understanding and providing care for patients. The challenge that remains is for nurses to see their own embodiment and reflect on if or how it is at odds with the necessity of providing holistic care to patients.

A holistic approach on the neurological benefits of music.

Science.gov (United States)

Jimenez-Dabdoub, Lily; Catterall, Jenn

2015-09-01

A holistic perspective on human beings allows health carers to achieve an understanding of all the physiological, psychological and social disturbances of the patient as a whole. Through this article we wish to focus on how music has holistic neurological benefits. Music-therapy interventions can be more accessible and even "self-managed" by the patient's relatives. They can reinforce social cohesion, family ties and patients' self-esteem and thus produce a better quality of life. Overall, it is important to consider the benefits that an evolutionary understanding of musical behaviour and a holistic clinical perspective of the role of music may bring for rehabilitation of a wide range of symptoms and conditions.

[Holistic Healthcare for the Aged: Concepts and Strategies].

Science.gov (United States)

Wang, Jing-Jy; Yang, Yueh-Ying; Liu, Mei-Yin

2018-04-01

Advancing medical technology continues to extend the average human life span, resulting in population aging globally as well as in Taiwan. The challenges posed by aging society increase not only medical and care costs but also the burden on pension funds and the social welfare system. In addition, there is currently a desperate need for many well-trained health providers as well as a friendly and comprehensive long-term care system. However, attention should not simply focus on medical payments and long-term care, as this may prolong the length of unhealthy living years for the aged and further strain national finances. Holistic healthcare for the aged should be introduced as early as possible in order to respond effectively to global aging by assisting the aged to maintain their health, to live independently, and to extend their social functions. The purposes of this report are to: 1. analyze the demographic characteristics of Taiwanese older adults; 2. introduce the concept of holistic healthcare as advocated by the World Health Organization (WHO); 3. discuss the promotion of physical-psychological health and the development of age-friendly environments; 4. strengthen the framework of long-term care policies; and 5. recommend the development of a holistic healthcare model for the aged based on the WHO Global Strategy and Action Plan on Aging and Health, announced in 2016. We hope to facilitate active aging, successful aging, self-esteem, and a high quality of life for the elderly in Taiwan.

Holistic Care in the US Military I—The Epidaurus Project: An Initiative in Holistic Medicine for the Military Health System, 2001–2012

Science.gov (United States)

Bulger, Roger J.; Frampton, Susan B.; Pellegrino, Edmund D.

2012-01-01

This article describes the history and findings of the Epidaurus Project, a Uniformed Services University–affiliated project to bring holistic care and evidence-based design into the Military Health System (MHS). A distinguished group of civilian thought leaders contributed. The 2005 Base Realignment and Closure process offered a chance to implement the Epidaurus agenda. A new integrated healthcare delivery system, centered around the Walter Reed National Military Medical Center at Bethesda, Maryland, was the result. These facilities will be templates for a new generation of MHS “healing environments” and a model for innovative systems of healthcare nationwide. The Epidaurus Project represents a significant collaboration between civilian medicine and the military in times of war. PMID:24278818

Patients' and Health Care Providers' Perception of Stressors in the Intensive Care Units.

Science.gov (United States)

Abuatiq, Alham

2015-01-01

The purposes of this study is first, to investigate intensive care patients' perceptions of stressors; second, to investigate the health care provider's perception of what constitutes a stressor from the patient's perspective; and third, to describe how health care providers manage their patients' stressors. This was a mixed-methods study; the quantitative section replicated Cornock's 1998 study of stress in the intensive care unit (ICU), with difference in sampling to include all health care providers in the ICU, in addition to nurses. The qualitative section added information to the current literature by describing how health care providers manage their patient's stressors. This article reports the quantitative findings of this study, as the qualitative section is presented in a separate article. It is important to describe ICU patients' stressful experiences to assess patient's stressors, provide holistic care to eliminate stressors, and provide feedback to health care providers. There is a need to describe the clinical practice related to stress perception and management of stressors in the critical care environment. A mixed-methods comparative descriptive design was used for the quantitative section, and a phenomenological approach guided the qualitative section. Lazarus and Folkman's theory formed the bases for integrating all variables investigated in this study. The sample included 70 ICU patients and 70 ICU health care providers. After consenting to participate in this study, subjects were given a demographic form and a paper-based tool, the Environmental Stressors graphic data form Questionnaire. Questionnaires were filled out by subjects anonymously in the ICU and returned to the researcher in the same setting. Descriptive statistics were analyzed using SPSS data analysis software. The top 3 most stressful items ranked by the patients included "being in pain," followed by "not being able to sleep" and "financial worries"; on the other hand, health care

Holistic Health: Does It Really Include Mental Health?

OpenAIRE

McClanahan, Kimberly K.; Huff, Marlene B.; Omar, Hatim A.

2006-01-01

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate publi...

Development and validation of the quality care questionnaire -palliative care (QCQ-PC): patient-reported assessment of quality of palliative care.

Science.gov (United States)

Yun, Young Ho; Kang, Eun Kyo; Lee, Jihye; Choo, Jiyeon; Ryu, Hyewon; Yun, Hye-Min; Kang, Jung Hun; Kim, Tae You; Sim, Jin-Ah; Kim, Yaeji

2018-03-05

In this study, we aimed to develop and validate an instrument that could be used by patients with cancer to evaluate their quality of palliative care. Development of the questionnaire followed the four-phase process: item generation and reduction, construction, pilot testing, and field testing. Based on the literature, we constructed a list of items for the quality of palliative care from 104 quality care issues divided into 14 subscales. We constructed scales of 43 items that only the cancer patients were asked to answer. Using relevance and feasibility criteria and pilot testing, we developed a 44-item questionnaire. To assess the sensitivity and validity of the questionnaire, we recruited 220 patients over 18 years of age from three Korean hospitals. Factor analysis of the data and fit statistics process resulted in the 4-factor, 32-item Quality Care Questionnaire-Palliative Care (QCQ-PC), which covers appropriate communication with health care professionals (ten items), discussing value of life and goals of care (nine items), support and counseling for needs of holistic care (seven items), and accessibility and sustainability of care (six items). All subscales and total scores showed a high internal consistency (Cronbach alpha range, 0.89 to 0.97). Multi-trait scaling analysis showed good convergent (0.568-0.995) and discriminant (0.472-0.869) validity. The correlation between the total and subscale scores of QCQ-PC and those of EORTC QLQ-C15-PAL, MQOL, SAT-SF, and DCS was obtained. This study demonstrates that the QCQ-PC can be adopted to assess the quality of care in patients with cancer.

Effect of a Multidisciplinary Outpatient Model of Care on Health Outcomes in Older Patients with Multimorbidity: A Retrospective Case Control Study.

Directory of Open Access Journals (Sweden)

Sepehr Shakib

Full Text Available To evaluate a holistic multidisciplinary outpatient model of care on hospital readmission, length of stay and mortality in older patients with multimorbidity following discharge from hospital.A pilot case-control study between March 2006 and June 2009 of patients referred on discharge to a multidisciplinary, integrated outpatient model of care that includes outpatient follow-up, timely GP communication and dial-in service compared with usual care following discharge, within a metropolitan, tertiary referral, public teaching hospital. Controls were matched in a 4:1 ratio with cases for age, gender, index admission diagnosis and length of stay.Non-elective readmission rates, total readmission length of stay and overall survival.A total of 252 cases and 1008 control patients were included in the study. Despite the patients referred to the multidisciplinary model of care had slightly more comorbid conditions, significantly higher total length of hospital stay in the previous 12 months and increased prevalence of diabetes and heart failure by comparison to those who received usual care, they had significantly improved survival (adjusted hazard ratio 0.70 95% CI 0.51-0.96, p = 0.029 and no excess in the number of hospitalisations observed.Following discharge from hospital, holistic multidisciplinary outpatient management is associated with improved survival in older patients with multimorbidity. The findings of this study warrant further examination in randomised and cost-effectiveness trials.

Israeli nurses' attitudes to the holistic approach to health and their use of complementary and alternative therapies.

Science.gov (United States)

Orkaby, Brurya; Greenberger, Chaya

2015-03-01

To examine nurses' attitudes to holistic and biomedical approaches to health care and the correlation between the two and to explore the extent of recommending and using complementary and alternative medicine (CAM) by nurses and its correlation with attitudes toward the holistic approach to care. In this cross-sectional correlational study, a structured questionnaire was completed anonymously by 213 Israeli hospital-based nurses from various departments. Nurses perceived both approaches as critical to optimal health care: a positive correlation emerged of attitudes to the two approaches. Nurses recommended and used CAM extensively; most therapies were recommended and/or used by 70% or more of the respondents. Nurses with more positive attitudes toward holistic care tended to recommend and use CAM to a greater extent. Biomedical and holistic approaches are perceived by nurses to coexist within nursing professional boundaries and form a broad basis for optimal health care. Nurses' attitudes to the holistic approach appear to promote recommendation and/or use of CAM in practice. More training in CAM should be offered in nursing educational frameworks and research should continue to establish evidence for CAM's effectiveness. © The Author(s) 2014.

[Strategies for improving care of oncologic patients: SHARE Project results].

Science.gov (United States)

Reñones Crego, María de la Concepción; Fernández Pérez, Dolores; Vena Fernández, Carmen; Zamudio Sánchez, Antonio

2016-01-01

Cancer treatment is a major burden for the patient and its family that requires an individualized management by healthcare professionals. Nurses are in charge of coordinating care and are the closest healthcare professionals to patient and family; however, in Spain, there are not standard protocols yet for the management of oncology patients. The Spanish Oncology Nursing Society developed between 2012 and 2014 the SHARE project, with the aim of establishing strategies to improve quality of life and nursing care in oncology patients. It was developed in 3 phases. First, a literature search and review was performed to identify nursing strategies, interventions and tools to improve cancer patients' care. At the second stage, these interventions were agreed within a group of oncology nursing experts; and at the third phase, a different group of experts in oncology care categorized the interventions to identify the ones with highest priority and most feasible to be implemented. As a result, 3 strategic actions were identified to improve nursing care during cancer treatment: To provide a named nurse to carry out the follow up process by attending to the clinic or telephonic consultation, develop therapeutic education with adapted protocols for each tumor type and treatment and ensure specific training for nurses on the management of the cancer patients. Strategic actions proposed in this paper aim to improve cancer patients' healthcare and quality of life through the development of advanced nursing roles based on a higher level of autonomy, situating nurses as care coordinators to assure an holistic care in oncology patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Clinical Holistic Medicine: Social Problems Disguised as Illness

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2004-01-01

Full Text Available Many of the diseases seen in the clinic are actually symptoms of social problems. It is often easier for the physician to treat the symptoms than to be a coach and help the patient to assume responsibility in order to improve quality of life, social situation, and relations. If the physician ignores the signs of the disease as a symptom of social problems, and treats the patient with pharmaceuticals, he can give the patient the best justification in the world not to do anything about the situation. It is very important that the physician is not tricked by the games the socially troubled patient, more or less unconsciously, is playing. A firm and wise attitude that confronts the patient with his or her lack of responsibility for solving social problems seems to be a constructive way out. The physician can give holding and support, but the responsibility must remain with the patient. Often it is better for the patient that the physician abstains from giving drugs that can remedy the symptoms and takes the role of a coach instead. Suffering is not necessarily bad, suffering is actually highly motivating and often the most efficient source of learning. Coaching can help the patient canalize his motivation into highly constructive considerations and behavior. A holistic approach thus gives the patient learning and helps him rehabilitate his social reality. Concerning children with recurrent or chronic pain, we have observed an overuse of painkillers, where we believe part is of a psychosomatic nature due to poor thriving in the family. Here the physician has an important job helping the parents to develop as persons, teaching them the basic holding of awareness, respect, care, acknowledgment and acceptance of their child. Most of the chronic pain and discomfort with children can be improved if the physician understands how to use the holistic medical toolbox.

Evaluating a dignity care intervention for palliative care in the community setting: community nurses' perspectives.

Science.gov (United States)

McIlfatrick, Sonja; Connolly, Michael; Collins, Rita; Murphy, Tara; Johnston, Bridget; Larkin, Philip

2017-12-01

To evaluate a dignity care intervention provided by community nurses seeking to address dignity concerns for people with advanced and life-limiting conditions. Evidence would suggest that dying people fear a loss of dignity and a central focus of palliative care is to assist people to die with dignity. Whilst community nurses have a key role to play in the delivery of palliative care, specific interventions for dignity are lacking. A mixed methods study using online survey and focus group interviews and thematic analysis to examine data. Twenty four community nurses implemented the dignity care intervention for people with advanced and life-limiting conditions were recruited from four pilot sites across Ireland. Four focus group interviews and on line survey were conducted between March-June 2015. The community nurses found the dignity care intervention useful. It helped the nurses to provide holistic end-of-life care and assisted in the overall assessment of palliative care patients, identifying areas that might not otherwise have been noted. Whilst it was a useful tool for communication, they noted that it stimulated some emotionally sensitive conversations for which they felt unprepared. Implementing the dignity care intervention in practice was challenging. However, the dignity care intervention facilitated holistic assessment and identified patient dignity-related concerns that may not have been otherwise identified. Further support is required to overcome barriers and enable dignity-conserving care. Ensuring dignity is a key aspect of palliative and end-of-life care; however, community nurses may not feel equipped to address this aspect of care. Implementing a dignity care intervention can assist in identifying patient dignity-related concerns and provision of holistic care. Community nurses need more training to assist in difficult conversations relating to dignity and end-of-life care. © 2017 John Wiley & Sons Ltd.

"Physician, Heal Thyself": How Teaching Holistic Medicine Differs from Teaching CAM.

Science.gov (United States)

Graham-Pole, John

2001-01-01

Describes the fundamental difference between complementary and alternative medicine (CAM) and holistic medicine, highlighting holistic medicine's emphasis on the promotion of healthy lifestyles for practitioners and patients alike. Asserts that offering physicians-to-be more course work in holistic medicine could lay the groundwork for future…

Trends in Contemporary Holistic Nursing Research: 2010-2015.

Science.gov (United States)

Delaney, Colleen; McCaffrey, Ruth G; Barrere, Cynthia; Kenefick Moore, Amy; Dunn, Dorothy J; Miller, Robin J; Molony, Sheila L; Thomas, Debra; Twomey, Teresa C; Susan Zhu, Xiaoyuan

2018-01-01

The purpose of this study was to describe and summarize the characteristics of contemporary holistic nursing research (HNR) published nationally. A descriptive research design was used for this study. Data for this study came from a consecutive sample of 579 studies published in six journals determined as most consistent with the scope of holistic nursing from 2010 to 2015. The Johns Hopkins level of evidence was used to identify evidence generated, and two criteria-power analysis for quantitative research and trustworthiness for qualitative research-were used to describe overall quality of HNR. Of the studies, 275 were considered HNR and included in the analysis. Caring, energy therapies, knowledge and attitudes, and spirituality were the most common foci, and caring/healing, symptom management, quality of life, and depression were the outcomes most often examined. Of the studies, 56% were quantitative, 39% qualitative, and 5% mixed-methods designs. Only 32% of studies were funded. Level III evidence (nonexperimental, qualitative) was the most common level of evidence generated. Findings from this study suggest ways in which holistic nurse researchers can strengthen study designs and thus improve the quality of scientific evidence available for application into practice and improve health outcomes.

Experiences of security and continuity of care: Patients' and families' narratives about the work of specialized palliative home care teams.

Science.gov (United States)

Klarare, Anna; Rasmussen, Birgit H; Fossum, Bjöörn; Fürst, Carl Johan; Hansson, Johan; Hagelin, Carina Lundh

2017-04-01

Those who are seriously ill and facing death are often living with physical, emotional, social, and spiritual suffering. Teamwork is considered to be necessary to holistically meet the diverse needs of patients in palliative care. Reviews of studies regarding palliative care team outcomes have concluded that teams provide benefits, especially regarding pain and symptom management. Much of the research concerning palliative care teams has been performed from the perspective of the service providers and has less often focused on patients' and families' experiences of care. Our aim was to investigate how the team's work is manifested in care episodes narrated by patients and families in specialized palliative home care (SPHC). A total of 13 interviews were conducted with patients and families receiving specialized home care. Six patients and seven family members were recruited through SPHC team leaders. Interviews were transcribed verbatim and the transcripts qualitatively analyzed into themes. Two themes were constructed through thematic analysis: (1) security ("They are always available," "I get the help I need quickly"); and (2) continuity of care ("They know me/us, our whole situation and they really care"). Of the 74 care episodes, 50 were descriptions of regularly scheduled visits, while 24 related to acute care visits and/or interventions. Patients' and family members' descriptions of the work of SPHC teams are conceptualized through experiences of security and continuity of care. Experiences of security are fostered through the 24/7 availability of the team, sensitivity and flexibility in meeting patients' and families' needs, and practical adjustments to enable care at home. Experiences of continuity of care are fostered through the team's collective approach, where the individual team member knows the patients and family members, including their whole situation, and cares about the little things in life as well as caring for the family unit.

Interventions to Support Integrated Psychological Care and Holistic Health Outcomes in Paediatrics

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Shafran, Roz; Bennett, Sophie D.; McKenzie Smith, Mhairi

2017-01-01

There are strong calls from many national and international bodies for there to be a ‘holistic’ and integrated approach to the understanding and management of psychological and physical health needs. Such holistic approaches are characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease. Holistic approaches can impact on mental and physical health and are cost-effective. Several psychological interventions have...

Effectiveness of holistic interventions for people with severe chronic obstructive pulmonary disease: systematic review of controlled clinical trials.

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Ulugbek Nurmatov

Full Text Available Despite a well-recognised burden of disabling physical symptoms compounded by co-morbidities, psychological distress and social isolation, the needs of people with severe chronic obstructive pulmonary disease (COPD are typically poorly addressed.To assess the effectiveness of interventions designed to deliver holistic care for people with severe COPD.We searched 11 biomedical databases, three trial repositories (January 1990-March 2012; no language restrictions and contacted international experts to locate published, unpublished and in-progress randomised controlled trials (RCTs, quasi-RCTs and controlled clinical trials (CCTs that investigated holistic interventions to support patients with severe COPD in any healthcare context. The primary outcome was health-related quality of life (HRQoL. Quality assessment and data extraction followed Cochrane Collaboration methodology. We used a piloted data extraction sheet and undertook narrative synthesis.From 2,866 potentially relevant papers, we identified three trials: two RCTs (from United States and Australia, and one CCT (from Thailand: total 216 patients. Risk of bias was assessed as moderate in two studies and high in the third. All the interventions were led by nurses acting in a co-ordinating role (e.g. facilitating community support in Thailand, providing case-management in the USA, or co-ordinating inpatient care in Australia. HRQoL improved significantly in the Thai CCT compared to the (very limited usual care (p<0.001, in two sub-domains in the American trial, but showed no significant changes in the Australian trial. Exercise tolerance, dyspnoea, and satisfaction with care also improved in the Thai trial.Some 15 years after reports first highlighted the unmet needs of people with severe COPD, we have been unable to find robust trial evidence about interventions that can address those needs. There is an urgent need to develop and evaluate holistic care interventions designed improve HRQo

Palliative care provision for patients with chronic obstructive pulmonary disease

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Yohannes Abebaw

2007-04-01

Full Text Available Abstract Chronic obstructive pulmonary disease (COPD is a major cause of disability, morbidity and mortality in old age. Patients with advanced stage COPD are most likely to be admitted three to four times per year with acute exacerbations of COPD (AECOPD which are costly to manage. The adverse events of AECOPD are associated with poor quality of life, severe physical disability, loneliness, and depression and anxiety symptoms. Currently there is a lack of palliative care provision for patients with advanced stage COPD compared with cancer patients despite having poor prognosis, intolerable dyspnoea, lower levels of self efficacy, greater disability, poor quality of life and higher levels of anxiety and depression. These symptoms affect patients' quality of life and can be a source of concern for family and carers as most patients are likely to be housebound and may be in need of continuous support and care. Evidence of palliative care provision for cancer patients indicate that it improves quality of life and reduces health care costs. The reasons why COPD patients do not receive palliative care are complex. This partly may relate to prognostic accuracy of patients' survival which poses a challenge for healthcare professionals, including general practitioners for patients with advanced stage COPD, as they are less likely to engage in end-of-life care planning in contrast with terminal disease like cancer. Furthermore there is a lack of resources which constraints for the wider availability of the palliative care programmes in the health care system. Potential barriers may include unwillingness of patients to discuss advance care planning and end-of-life care with their general practitioners, lack of time, increased workload, and fear of uncertainty of the information to provide about the prognosis of the disease and also lack of appropriate tools to guide general practitioners when to refer patients for palliative care. COPD is a chronic

SELF-DIRECTED LEARNING, TEAMWORK, HOLISTIC VIEW AND ORAL HEALTH.

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Leisnert, Leif

2014-01-01

The dental program at the Malmö Dental School, the so called Malmö-model, is guided by four linked principles: self-directed learning, teamwork, a holistic view of patient care, and oral health (Fig.1). Self-assessment ability is a critical competence for healthcare professionals, necessary for the successful adaptation to the modern life-long learning environment. Educational research seems to point out two critical factors for the development of such skills, continuous practice of self-assessment and constructive feedback. The first study presented in this thesis assessed students' self-assessment ability by means of the Interactive Examination in a cohort of senior dental students, who had gone through an identical assessment procedure during their second year of studies. The results indicated that self-assessment ability was not directly relevant to subject knowledge. Upon graduation, there were a number of students (10%) with significant self-assessment difficulties. Early detection of students with weak self-assessment abilities appears possible to achieve. The aim of the second study, concerning teamwork and holistic view, was to investigate if highlighting teamwork between dental and dental hygienist students could improve the students' holistic view on patients, as well as their knowledge of, and insight into, each other's future professions. This project showed that by initiating teamwork between dental and dental hygienist students, it was possible to increase students' knowledge on dental hygienists competence, develop students' perceived holistic view on patients, and prepare students for teamwork. The third study explored findings clinicians used when diagnosing chronic periodontitis. A questionnaire was distributed to students, dental teachers and clinical supervisors in the Public Dental Services. Within all categories of clinicians, the majority of the clinicians used deepened pocket, bone loss on x-rays, and bleeding as findings. There were

Patient's dignity in intensive care unit: A critical ethnography.

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Bidabadi, Farimah Shirani; Yazdannik, Ahmadreza; Zargham-Boroujeni, Ali

2017-01-01

Maintaining patient's dignity in intensive care units is difficult because of the unique conditions of both critically-ill patients and intensive care units. The aim of this study was to uncover the cultural factors that impeded maintaining patients' dignity in the cardiac surgery intensive care unit. The study was conducted using a critical ethnographic method proposed by Carspecken. Participants and research context: Participants included all physicians, nurses and staffs working in the study setting (two cardiac surgery intensive care units). Data collection methods included participant observations, formal and informal interviews, and documents assessment. In total, 200 hours of observation and 30 interviews were performed. Data were analyzed to uncover tacit cultural knowledge and to help healthcare providers to reconstruct the culture of their workplace. Ethical Consideration: Ethical approval for the study from Ethics committee of Isfahan University of Medical Sciences was obtained. The findings of the study fell into the following main themes: "Presence: the guarantee for giving enough attention to patients' self-esteem", "Instrumental and objectified attitudes", "Adherence to the human equality principle: value-action gap", "Paternalistic conduct", "Improper language", and "Non-interactive communication". The final assertion was "Reductionism as a major barrier to the maintaining of patient's dignity". The prevailing atmosphere in subculture of the CSICU was reductionism and paternalism. This key finding is part of the biomedical discourse. As a matter of fact, it is in contrast with dignified care because the latter necessitate holistic attitudes and approaches. Changing an ICU culture is not easy; but through increasing awareness and critical self-reflections, the nurses, physicians and other healthcare providers, may be able to reaffirm dignified care and cure in their therapeutic relationships.

Assessing the Readiness of Nursing Sectors in Low- and Middle-Income Countries to Adopt Holistic Practice: Rwanda as Exemplar.

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Rosa, William

Over the past several years, holistic nursing education has become more readily available to nurses working in high-income nations, and holistic practice has become better defined and promoted through countless organizational and governmental initiatives. However, global nursing community members, particularly those serving in low- and middle-income countries (LMICs) within resource-constrained health care systems, may not find holistic nursing easily accessible or applicable to practice. The purpose of this article is to assess the readiness of nursing sectors within these resource-constrained settings to access, understand, and apply holistic nursing principles and practices within the context of cultural norms, diverse definitions of the nursing role, and the current status of health care in these countries. The history, current status, and projected national goals of professional nursing in Rwanda is used as an exemplar to forward the discussion regarding the readiness of nurses to adopt holistic education into practice in LMICs. A background of holistic nursing practice in the United States is provided to illustrate the multifaceted aspects of support necessary in order that such a specialty continues to evolve and thrive within health care arenas and the communities it cares for.

Development and Validation of Quality Criteria for Providing Patient- and Family-centered Injury Care.

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Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T

2017-08-01

The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.

Bayreuth Productivity Analysis-a method for ascertaining and improving the holistic service productivity of acute care hospitals.

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Pfannstiel, Mario Alexander

2016-01-01

The healthcare sector is lacking a method with which hospitals can measure the extent to which they achieve their goals in terms of aggregate productivity from both patients' and employees' perspectives. The Bayreuth Productivity Analysis (BPA) provides a solution to this problem because it uses two standardized questionnaires-one for patients and one for employees-to ascertain productivity at hospitals. These questionnaires were developed in several steps according to the principles of classical test theory, and they consist of six dimensions (information, organization, climate, methods, infrastructure and equipment) of five items each. One item describes a factual situation relevant to productivity and services so that it makes a contribution to the overall productivity of a hospital. After individualized evaluation of these items, the dimensions are subjectively weighted in the two questionnaires. The productivity index thus ascertained can be considered "holistic" when all patients and employees in a hospital make a differentiated assessment and weigh off each of the dimensions. In conclusion, the BPA constitutes a simple yet practicable method to ascertain and improve the holistic service productivity of hospitals. Copyright © 2014 John Wiley & Sons, Ltd.

A holistic approach to factors affecting depression in haemodialysis patients.

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Gerogianni, Georgia; Kouzoupis, Anastasios; Grapsa, Eirini

2018-05-19

Depression in dialysis populations is affected by co-morbid diseases, such as cardiovascular disease, diabetes, and immune dysfunction, and it also includes high suicide risk and frequent hospitalizations. Depressive disorders have a close association with malnutrition and chronic inflammation, as well as with cognitive impairment. Impaired cognitive function may be manifested as low adherence to dialysis treatment, leading to malnutrition. Additionally, chronic pain and low quality of sleep lead to high rates of depressive symptoms in haemodialysis patients, while an untreated depression can cause sleep disturbances and increased mortality risk. Depression can also lead to sexual dysfunction and non-adherence, while unemployment can cause depressive disorders, due to patients' feelings of being a financial burden on their family. The present review provides a holistic approach to the factors affecting depression in haemodialysis, offering significant knowledge to renal professionals.

Nurses experiences in palliative care of terminally-ill HIV patients in a level 1 district hospital

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Nokwanda E. Bam

2014-07-01

Objectives: This study explored the respondents’ understanding of the concepts ‘caring’ and ‘terminal patient’ and described the experiences of nurses caring for terminally-ill patients with HIV and how these experiences influence the nature of care rendered. Methods: Qualitative research using Husserl’s approach of phenomenology design underpinned the study and Giorgi’s steps of analysis were used to make meaning of the data. Results: The concept ‘caring’ was experienced by the nurses as transforming the patients’ quality of life through supportive care and hope for life. Palliative care made the nurses conscious of their own mortality, enabling them to be more sensitive, compassionate and dedicated to caring for their patients. The findings described the social networking that enabled nurses to collaborate with colleagues in the interdisciplinary teams and shared knowledge, skills and support within the palliative care team in order to optimise patient outcomes. Conclusion: Nurses with prolonged involvement in caring for terminally-ill patients with HIV experienced helplessness and emotional stress. Recommendations based on the results are that training in psychological and holistic care of the patient, professional counselling and stress management services are needed to support the nurse in this context.

Impact of specialist palliative care on coping with Parkinson's disease: patients and carers.

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Badger, Nathan J; Frizelle, Dorothy; Adams, Debi; Johnson, Miriam J

2018-01-09

UK guidelines recommend palliative care access for people with Parkinson's disease; however, this remains sporadic, and it is unknown whether specialist palliative care helps patients and carers cope with this distressing condition. This study aimed to explore whether, and how, access to specialist palliative care services affected patients' and carers' coping with Parkinson's disease. Semistructured interviews were conducted, audio-recorded and verbatim transcribed. Data were analysed using interpretative phenomenological analysis. Participants were patients with advanced idiopathic Parkinson's disease (n=3), and carers of people with Parkinson's disease (n=5, however, one diagnosis was reviewed) receiving care from an integrated specialist palliative care and Parkinson's disease service in North East England. Access to specialist palliative care helped participants cope with some aspects of advanced Parkinson's disease. Three superordinate themes were developed:' managing uncertainty', 'impacts on the self' and 'specialist palliative care maintaining a positive outlook'. Specialist palliative care helped patients and carers cope with advanced Parkinson's disease. Specialist palliative care is a complex intervention that acknowledges the complex and holistic nature of Parkinson's disease, enabling health in some domains despite continued presence of pathology. These exploratory findings support the utility of this approach for people living with Parkinson's disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Future of Clinical Pharmacy: Developing a Holistic Model

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Patricia A. Shane

2013-11-01

Full Text Available This concept paper discusses the untapped promise of often overlooked humanistic skills to advance the practice of pharmacy. It highlights the seminal work that is, increasingly, integrated into medical and nursing education. The work of these educators and the growing empirical evidence that validates the importance of humanistic skills is raising questions for the future of pharmacy education and practice. To potentiate humanistic professional competencies, e.g., compassion, empathy, and emotional intelligence, how do we develop a more holistic model that integrates reflective and affective skills? There are many historical and current transitions in the profession and practice of pharmacy. If our education model is refocused with an emphasis on pharmacy’s therapeutic roots, the field has the opportunity to play a vital role in improving health outcomes and patient-centered care. Beyond the metrics of treatment effects, achieving greater patient-centeredness will require transformations that improve care processes and invest in patients’ experiences of the treatment and care they receive. Is layering on additional science sufficient to yield better health outcomes if we neglect the power of empathic interactions in the healing process?

Holistic Health: Does It Really Include Mental Health?

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Kimberly K. McClanahan

2006-01-01

Full Text Available Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S. over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

Holistic health: does it really include mental health?

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McClanahan, Kimberly K; Huff, Marlene B; Omar, Hatim A

2006-03-14

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

Feeling confident in burdensome yet enriching care: Community nurses describe the care of patients with hard-to-heal wounds

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Camilla Eskilsson

2010-10-01

Full Text Available Treating patients with hard-to-heal wounds is a complex task that requires a holistic view. Therefore this study focuses on the nurse's perspective with the aim on describing how community nurses experience the phenomenon the care of patients with hard-to-heal wounds. The method used was a reflective lifeworld approach. Seven qualitative interviews with community nurses were conducted. The findings show a tension between enriching and burdensome care. In this tension, the nurses try to find energy to reach harmony in their work through reflection, acceptance, and distance. This is further described by the constituents: “taking responsibility,” “showing respect for the whole person,” “being confident in order to offer confidence,” “seeing time and place as important.” The discussion highlights the importance for a nurse to find how to give ideal care in one's duty but not beyond it. As a consequence the concept “compliance” needs to be challenged in order to promote confidence and mutual trust between nurses and patients. Confidence can be seen as a key, both for nurses and patients, and is dependent on good inter-professional cooperation, competence, and closure.

A Holistic Framework to Improve the Uptake and Impact of eHealth Technologies

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van Limburg, Maarten; Ossebaard, Hans C; Kelders, Saskia M; Eysenbach, Gunther; Seydel, Erwin R

2011-01-01

Background Many eHealth technologies are not successful in realizing sustainable innovations in health care practices. One of the reasons for this is that the current development of eHealth technology often disregards the interdependencies between technology, human characteristics, and the socioeconomic environment, resulting in technology that has a low impact in health care practices. To overcome the hurdles with eHealth design and implementation, a new, holistic approach to the development of eHealth technologies is needed, one that takes into account the complexity of health care and the rituals and habits of patients and other stakeholders. Objective The aim of this viewpoint paper is to improve the uptake and impact of eHealth technologies by advocating a holistic approach toward their development and eventual integration in the health sector. Methods To identify the potential and limitations of current eHealth frameworks (1999–2009), we carried out a literature search in the following electronic databases: PubMed, ScienceDirect, Web of Knowledge, PiCarta, and Google Scholar. Of the 60 papers that were identified, 44 were selected for full review. We excluded those papers that did not describe hands-on guidelines or quality criteria for the design, implementation, and evaluation of eHealth technologies (28 papers). From the results retrieved, we identified 16 eHealth frameworks that matched the inclusion criteria. The outcomes were used to posit strategies and principles for a holistic approach toward the development of eHealth technologies; these principles underpin our holistic eHealth framework. Results A total of 16 frameworks qualified for a final analysis, based on their theoretical backgrounds and visions on eHealth, and the strategies and conditions for the research and development of eHealth technologies. Despite their potential, the relationship between the visions on eHealth, proposed strategies, and research methods is obscure, perhaps due to a

Exploration and Description of Faith-Based Health Resources: Findings Inform Advancing Holistic Health Care.

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Dyess, Susan MacLeod

2015-01-01

It is important to use all holistic resource opportunities in communities, such as integrative healing centers, and mind-body-spirit approaches to health. These holistic approaches may be realized through nontraditional avenues, such as faith-based resources. This article reports on an exploratory study that describes faith-based resources supporting holistic health in a southeastern region of the United States. A working definition for "faith-based health resources" was "ecumenical and interfaith community-based, open-access health resources that include in mission for service a reference to faith." Excluded from the definition were institutional services from hospitals, focused social services from area agencies, and federally funded services.

The effectiveness of holistic diabetic management between Siriraj Continuity of Care clinic and medical out-patient department.

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Chalermsri, Chalobol; Paisansudhi, Supalerg; Kantachuvesiri, Pitchaporn; Pramyothin, Pornpoj; Washirasaksiri, Chaiwat; Srivanichakorn, Weerachai; Nopmaneejumruslers, Cherdchai; Chouriyagune, Charoen; Pandejpong, Denla; Phisalprapa, Pochamana

2014-03-01

Diabetes mellitus is one of the most common diseases in the Thai population, and it is well known that diabetic complications could be prevented with appropriate management. Despite published guidelines, most Thai patients with diabetes do not achieve treatment goals. Siriraj Continuity of Care clinic (CC clinic) was recently established in order to provide training for medical students and internal medicine residents. It is possible that the training component in the CC clinic may contribute to better overall outcomes in type 2 diabetes mellitus (type 2 DM) patients when compared with usual care at the medical out-patient department (OPD). To compare the effectiveness of diabetic management in type 2 diabetes mellitus patients who attended the CC clinic and the medical OPD. Retrospective chart review was performed in type 2 diabetes mellitus patients who were treated at either clinic at Siriraj Hospital in 2007-2011. Baseline demographics, treatment strategies and outcomes, and participation in an appropriate health maintenance program were assessed in both groups. Seven hundred and fifty seven medical records were reviewed, including 383 patients in the CC clinic group and 374 in the OPD group. Mean HbA1c was significantly lower in the CC clinic group compared with the OPD group (7.3 +/- 0.9% and 7.8 +/- 1.3%, respectively, < 0.001). The number of patients who achieved goal HbA1c of less than 7% in CC clinic group was 123 (32.1%) compared with 91 (24.3%) in the OPD group (p = 0.039). More patients were screened for diabetic complications in the CC clinic group compared with the OPD group, including screening for diabetic neuropathy (57.4% vs. 2.1%, p < 0.001), diabetic retinopathy (56.7% vs. 36.6%, p < 0.001), and diabetic nephropathy (80.9% vs. 36.9%, p < 0.001). Patients in the CC clinic group had a higher rate of age-appropriate cancer screening than those in the OPD group (54.2% vs. 13.3%, p < 0.001 for breast cancer; 24.0% vs. 0.9%, p < 0.001 for cervical

Interprofessional teamwork in stroke care: Is it visible or important to patients and carers?

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Hewitt, Gillian; Sims, Sarah; Greenwood, Nan; Jones, Fiona; Ross, Fiona; Harris, Ruth

2015-01-01

Interprofessional teamwork is seen in healthcare policy and practice as a key strategy for providing safe, efficient and holistic healthcare and is an accepted part of evidence-based stroke care. The impact of interprofessional teamwork on patient and carer experience(s) of care is unknown, although some research suggests a relationship might exist. This study aimed to explore patient and carer perceptions of good and poor teamwork and its impact on experiences of care. Critical incident interviews were conducted with 50 patients and 33 carers in acute, inpatient rehabilitation and community phases of care within two UK stroke care pathways. An analytical framework, derived from a realist synthesis of 13 'mechanisms' (processes) of interprofessional teamwork, was used to identify positive and negative 'indicators' of teamwork. Participants identified several mechanisms of teamwork, but it was not a subject most talked about readily. This suggests that interprofessional teamwork is not a concept that is particularly important to stroke patients and carers; they do not readily perceive any impacts of teamwork on their experiences. These findings are a salient reminder that what might be expected by healthcare professionals to be important influences on experience may not be perceived to be so by patients and carers.

Obstetric Fistula “Disease” and Ensuing Care: Patients' Views in ...

African Journals Online (AJOL)

AJRH Managing Editor

views on obstetric fistula trauma and care in order to implement an effective holistic care ... problems despite surgical success has been .... Appendix 1: Participants socio-medical characteristics at the end of the study ..... pain during childbirth and post-surgery stories, but ... pain only when moving, and others no pain at all.

Nurses caring for the spirit: patients with cancer and family caregiver expectations.

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Taylor, Elizabeth Johnston

2003-01-01

To determine what patients with cancer and primary family caregivers expect from nurses with regard to having their spiritual needs addressed. Descriptive, cross-sectional, qualitative study using Miles and Huberman s approach to data reduction. Outpatient and inpatient settings in a county hospital and a comprehensive cancer center, both located in a large, southwestern, metropolitan area. 28 African American and Euro-American adult patients with cancer and primary family caregivers were purposively selected to provide variation of experiences (e.g., religious backgrounds). In-depth, semistructured, tape-recorded interviews conducted by the investigator. Analysis of transcribed interviews concurrently with data collection followed a process of data concentration, data display, and conclusion drawing. Spiritual needs, spiritual care. Informants identified nursing approaches for spiritual needs, including kindness and respect; talking and listening; prayer; connecting with symmetry, authenticity, and physical presence; quality temporal nursing care; and mobilizing religious or spiritual resources. To provide spiritual care, nurses must possess requisites of a personal, relational, or professional nature. Although some patients or caregivers do not want overt forms of spiritual care, others are eager for them. Many recognize nonreligious actions or attitudes that nurses can practice to care for spiritual needs. Nurses must consider how they can address patient preconceptions and requisites for spiritual caregiving. Nurses may need to educate the public regarding their role as holistic and spiritual healthcare providers.

Patient-Centred Multidisciplinary Inpatient Care-Have Diagnosis-Related Groups an Effect on the Doctor-Patient Relationship and Patients' Motivation for Behavioural Change?

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Romeyke, Tobias; Noehammer, Elisabeth; Ch Scheuer, Hans; Stummer, Harald

2016-10-01

The aim of this, the largest survey of patients performed to date, is to analyse the effects of diagnosis related groups (DRGs) on the doctor-patient relationship in the context of interdisciplinary patient-centered care. In addition, it is intended to investigate the possibility of motivating patients to change their behavioural patterns and lifestyle in the context of holistic therapy. Over a period of five years, a continuous survey was performed of hospitalised patients who were exercising their entitlement to interdisciplinary therapy in an acute, inpatient setting. The therapy was evaluated as good to very good both with and without the conditions of the case tariff fee system. Effects of the diagnosis related groups on the quality of the doctor-patient relationship could not be demonstrated (Mann-Whitney U test, p>0,05). A clear trend was evident in the influence on motivation to change behavioural patterns and lifestyle (Fisher's exact test, p=0,000). Studies of the effects of reimbursement systems in the context of interdisciplinary care are still in their infancy, despite the widespread use of diagnosis related groups. The mandatory character implicit in the case tariff fee system, which requires minimum qualitative standards for structural and procedural parameters in the context of providing interdisciplinary patient-centered care, can influence patients' behavioural patterns and lifestyle.

Concept Communication and Interpretation of Illness: A Holistic Model of Understanding in Nursing Practice.

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Nordby, Halvor

To ensure patient communication in nursing, certain conditions must be met that enable successful exchange of beliefs, thoughts, and other mental states. The conditions that have received most attention in the nursing literature are derived from general communication theories, psychology, and ethical frameworks of interpretation. This article focuses on a condition more directly related to an influential coherence model of concept possession from recent philosophy of mind and language. The basic ideas in this model are (i) that the primary source of understanding of illness experiences is communicative acts that express concepts of illness, and (ii) that the key to understanding patients' concepts of illness is to understand how they depend on patients' lifeworlds. The article argues that (i) and (ii) are especially relevant in caring practice since it has been extensively documented that patients' perspectives on disease and illness are shaped by their subjective horizons. According to coherentism, nurses need to focus holistically on patients' horizons in order to understand the meaning of patients' expressions of meaning. Furthermore, the coherence model implies that fundamental aims of understanding can be achieved only if nurses recognize the interdependence of patients' beliefs and experiences of ill health. The article uses case studies to elucidate how the holistic implications of coherentism can be used as conceptual tools in nursing.

Firstline treatment for chronic phase chronic myeloid leukemia patients should be based on a holistic approach.

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Breccia, Massimo; Alimena, Giuliana

2015-02-01

New selective and more potent drugs for the cure of chronic phase chronic myeloid leukemia patients are now available: physicians in some countries must decide the best option, selecting one of the drugs available. What the main prognostic factors are in order to make this selection remains a matter of discussion. Introducing a 'holistic approach' for the first time in chronic myeloid leukemia, as practiced in other diseases, and looking at the patient in a complete picture, considering several variables, such as comorbidities, age, concomitant drugs, lifestyle and patient expectations, may be of help to understand, patient by patient, the best therapeutic strategy.

The role of holistic care culture in mitigating burnout and enhancing engagement: a study among elderly service workers in Hong Kong.

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Ng, Siu-Man; Fong, Ted C T; Wang, Xiao-Lu

2011-08-01

Elderly service work is a labor intensive and emotion demanding occupation. Workers in this field are prone to burnout, a form of emotional exhaustion at work. While their job well-being is associated with a number of job demands, little research has been done in exploring job resources to promote their well-being. Holistic care culture (HCC) was proposed as an organizational culture of holistic caring. This study explored the role of HCC in predicting job well-being and moderating the impact of perceived stress on job well-being. A large-scale questionnaire survey was conducted among 992 elderly service workers of a major social service organization in Hong Kong, with a 93% response rate. Participants completed a standardized self-report questionnaire. Structural equation modeling found HCC negatively predicted burnout (β = -0.32, p stress and job well-being in expected directions. The model explained 53.7% and 35.8% of variance in burnout and engagement. Findings from this study provides supportive evidence for HCC as a moderator to ameliorate burnout and facilitate engagement among elderly service workers. Further studies of rigorous design on HCC are recommended. Implication of this study for organizational practice was discussed.

The development and evaluation of a holistic needs assessment and care planning learning package targeted at cancer nurses in the UK.

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Henry, R; Hartley, B; Simpson, M; Doyle, N

2014-01-01

A project team from the United Kingdom Oncology Nursing Society developed a blended e-learning website to facilitate nurses to further develop their confidence and competencies in a range of skills related to assessing the holistic needs of people with cancer. The project team identified three areas which were integral to an holistic needs assessment (HNA) implementation project. These were project support information, project management skills, and practical competencies delivered in a blended e-learning package containing a series of accessible video presentations, supporting documents, and practical activities. The team worked with internal and external partners to ensure that a robust and inspiring programme was created. www.hnaforcancer.com was launched in October 2012 as a blended learning programme that incorporates e-learning on core subjects. These subjects are packaged as videoed presentations with supporting learning material and can be accessed via the UKONS website. By the end of the programme participants were equipped to identify and explore the essential requirements for HNA and care planning, more able to recognise potential need, and initiate care to prevent or minimise the risk of complications. Participants had also developed confidence and competency in new skills, including basic project management.

Consumer views on a new holistic screening tool for supportive and palliative-care needs: Sheffield Profile for Assessment and Referral for Care (SPARC): a survey of self-help support groups in health care.

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Hughes, Philippa; Ahmed, Nisar; Winslow, Michelle; Walters, Stephen J; Collins, Karen; Noble, Bill

2015-08-01

Sheffield Profile for Assessment and Referral for Care (SPARC) was developed in response to concerns that palliative care may not be reaching all people who could benefit from it. Acceptability of the tool is an important step in developing its future use. To elicit the views of a wide variety of members of consumer and self-help support groups concerned with health care on the relevance, acceptability and the overall perception of using SPARC as an early holistic needs assessment tool in supportive and palliative care. This study was conducted in South Yorkshire and North Derbyshire (UK). Ninety-nine consumer and self-help groups were identified from information in the public domain. Thirty-eight groups participated. Packs containing study information and self-complete postal questionnaires were distributed to groups, and they were asked to circulate these to their members. Completed questionnaires were returned in pre-paid envelopes to the research team. 135 questionnaires and feedback forms were returned. The majority of respondents found SPARC easy to understand (93% (120/129; 95% Confidence Interval 87% to 96%) and complete (94% (125/133; 95% CI: 88% to 97%). A minority, 12.2% (16/131), of respondents found questions on SPARC 'too sensitive'. Overall, respondents considered SPARC an acceptable and relevant tool for clinical assessment of supportive and palliative-care needs. Whilst a small minority of people found SPARC difficult to understand (i.e. patients with cognitive impairments), most categories of service user found it relevant. Clinical studies are necessary to establish the clinical utility of SPARC. © 2013 John Wiley & Sons Ltd.

Holistic nurses' stories of personal healing.

Science.gov (United States)

Smith, Marlaine C; Zahourek, Rothlyn; Hines, Mary Enzman; Engebretson, Joan; Wardell, Diane Wind

2013-09-01

The purpose of this study was to uncover the nature, experiences, and meaning of personal healing for holistic nurses through their narrative accounts. The study employed a qualitative descriptive design with methods of narrative and story inquiry. Participants were nurse attendees at an American Holistic Nurses' Association conference who volunteered for the study. They were invited to share a story about healing self or another. Twenty-five stories were collected; seven were about personal healing, and these are the focus of this analysis. Data were analyzed using a hybrid approach from narrative and story inquiry methods. Eleven themes were clustered under three story segments. The themes within the Call to the Healing Encounter are the following: recognition of the need to resolve a personal or health crisis, knowledge of or engagement in self-care practices, and reliance on intuitive knowing. Themes under the Experience of Healing are the following: connections; profound sensations, perceptions, and events; awareness of the reciprocal nature of healing; inner resolution: forgiveness, awakening, and acceptance; use of multiple holistic approaches; and witnessing manifestations of healing. The themes for Insights are the following: gratitude and appreciation and ongoing journey. A metastory synthesizing the themes is presented, and findings are related to existing literature on healing.

Identifying primary care patient safety research priorities in the UK: a James Lind Alliance Priority Setting Partnership.

Science.gov (United States)

Morris, Rebecca Lauren; Stocks, Susan Jill; Alam, Rahul; Taylor, Sian; Rolfe, Carly; Glover, Steven William; Whitcombe, Joanne; Campbell, Stephen M

2018-02-28

To identify the top 10 unanswered research questions for primary care patient safety research. A modified nominal group technique. UK. Anyone with experience of primary care including: patients, carers and healthcare professionals. 341 patients and 86 healthcare professionals submitted questions. A top 10, and top 30, future research questions for primary care patient safety. 443 research questions were submitted by 341 patients and 86 healthcare professionals, through a national survey. After checking for relevance and rephrasing, a total of 173 questions were collated into themes. The themes were largely focused on communication, team and system working, interfaces across primary and secondary care, medication, self-management support and technology. The questions were then prioritised through a national survey, the top 30 questions were taken forward to the final prioritisation workshop. The top 10 research questions focused on the most vulnerable in society, holistic whole-person care, safer communication and coordination between care providers, work intensity, continuity of care, suicide risk, complex care at home and confidentiality. This study was the first national prioritisation exercise to identify patient and healthcare professional priorities for primary care patient safety research. The research priorities identified a range of important gaps in the existing evidence to inform everyday practice to address primary care patient safety. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Managing obesity in primary care.

Science.gov (United States)

Goldie, Christine; Brown, Jenny

Obesity is a complex problem and often difficult to tackle in primary care. A year-long pilot of a practice nurse-led scheme that used a holistic approach towards self-care in obesity management was set up to reduce the cardiovascular risk of patients who were obese and improve their quality of life. This person-centred approach may offer an important tool in the management of these patients in the GP surgery.

Biomedicine or Holistic Medicine for Treating Mentally Ill Patients? A Philosophical and Economical Analysis

OpenAIRE

Ventegodt, Søren; Kandel, Isack; Merrick, Joav

2007-01-01

Today we have two scientific medical traditions, two schools or treatment systems: holistic medicine and biomedicine. The two traditions are based on two very different philosophical positions: subjectivistic and objectivistic. The philosopher Buber taught us that you can say I-Thou or I-It, holding the other person as a subject or an object. These two fundamentally different attitudes seem to characterize the difference in world view and patient approach in the two schools, one coming from p...

Home-Based Palliative Care Program Relieves Chronic Pain in Kerala, India: Success Realized Through Patient, Family Narratives.

Science.gov (United States)

Ajjarapu, Aparna Sai; Broderick, Ann

2018-06-14

An estimated 1.5 billion people across the globe live with chronic pain, and an estimated 61 million people worldwide experience unrelieved serious health-related suffering. One-sixth of the global population lives in India, where approximately 10 million people endure unrelieved serious health-related suffering. The state of Kerala is home to Pallium India, one of the most sophisticated palliative care programs in the country. This private organization in Trivandrum provides palliative and hospice care to underresourced populations and emphasizes holistic pain treatment. The current project features the pain stories of six patients who received treatment from Pallium India. Basic patient demographic information was collected, and a Pallium India staff member who was fluent in Malayalam and English asked questions about each patient's pain experience. Pain narratives illustrate the substantial impact of Pallium India's home visit program and the role of total pain assessment in delivering high-quality palliative care.

Mobile technologies and the holistic management of chronic diseases.

Science.gov (United States)

Mirza, Farhaan; Norris, Tony; Stockdale, Rosemary

2008-12-01

Ageing populations and unhealthy lifestyles have led to some chronic conditions such as diabetes and heart disease reaching epidemic proportions in many developed nations. This paper explores the potential of mobile technologies to improve this situation. The pervasive nature of these technologies can contribute holistically across the whole spectrum of chronic care ranging from public information access and awareness, through monitoring and treatment of chronic disease, to support for patient carers. A related study to determine the perceptions of healthcare providers to m-health confirmed the view that attitudes were likely to be more important barriers to progress than technology. A key finding concerned the importance of seamless and integrated m-health processes across the spectrum of chronic disease management.

Differences between early and late involvement of palliative home care in oncology care: A focus group study with palliative home care teams.

Science.gov (United States)

Dhollander, Naomi; Deliens, Luc; Van Belle, Simon; De Vleminck, Aline; Pardon, Koen

2018-05-01

To date, no randomised controlled trials on the integration of specialised palliative home care into oncology care have been identified. Information on whether existing models of integrated care are applicable to the home care system and how working procedures and skills of the palliative care teams might require adaptation is missing. To gain insight into differences between early and late involvement and the effect on existing working procedures and skills as perceived by palliative home care teams. Qualitative study - focus group interviews. Six palliative home care teams in Flanders, Belgium. Participants included physicians, nurses and psychologists. Differences were found concerning (1) reasons for initiation, (2) planning of care process, (3) focus on future goals versus problems, (4) opportunity to provide holistic care, (5) empowerment of patients and (6) empowerment of professional caregivers. A shift from a medical approach to a more holistic approach is the most noticeable. Being involved earlier also results in a more structured follow-up and in empowering the patient to be part of the decision-making process. Early involvement creates the need for transmural collaboration, which leads to the teams taking on more supporting and coordinating tasks. Being involved earlier leads to different tasks and working procedures and to the need for transmural collaboration. Future research might focus on the development of an intervention model for the early integration of palliative home care into oncology care. To develop this model, components of existing models might need to be adapted or extended.

Creating a successful culturally sensitive home care program.

Science.gov (United States)

Blanter, R; Page, P M

1995-12-01

Providing quality home care services to immigrants requires an integrated, holistic approach that genuinely addresses language and cultural differences. One home care agency in Massachusetts developed a team-oriented, culturally sensitive outreach program that ensures non-English-speaking patients the same level of service that the general population receives.

Self-Care Motivation Among Patients With Heart Failure: A Qualitative Study Based on Orem's Theory.

Science.gov (United States)

Abotalebidariasari, Ghasem; Memarian, Robabe; Vanaki, Zohreh; Kazemnejad, Anoshirvan; Naderi, Nasim

2016-11-01

Initiating and adhering to self-care activities necessitate self-care motivation. This study was undertaken in Iran to explore self-care motivation among patients with heart failure (HF). This qualitative study was done in 2014 and 2015. Study participants were patients with HF and their family members who were purposively selected from Shaheed Rajaei Cardiovascular, Medical and Research Center, Tehran, Iran. The study data were collected from December 2014 to May 2015 by doing in-depth semistructured face-to-face interviews and were analyzed via the directed content analysis approach. Eleven primary codes were generated which reflected motivations for self-care among patients with HF in the Iranian sociocultural context. To enhance the clarity of the findings, these primarily codes were summarized and grouped into 7 subcategories including fear of death and love of life, returning to previous physical health status and preventing or alleviating symptoms, understanding the value of self-care behaviors and trusting them, having the desire for remaining independent, relying on God, reassuring and supporting family members, and preventing family members from feeling irritation. The findings of this study indicate that patients with HF have different motivations for doing self-care activities. Fear of death, love of life, wish to return to previous health status, and prevention or alleviation of HF symptoms were the participants' strongest motivations for self-care. Understanding the motivations for self-care among patients with HF, based a holistic approach and evidence-based practice, can help nurses and physicians develop motivational programs for promoting self-care behaviors.

Impact of holistic review on student interview pool diversity.

Science.gov (United States)

Grabowski, Christina J

2017-12-29

Diversity in the physician workforce lags behind the rapidly changing US population. Since the gateway to becoming a physician is medical school, diversity must be addressed in the admissions process. The Association of American Medical Colleges has implemented a Holistic Review Initiative aimed at assisting medical schools with broadening admission criteria to include relevant, mission-driven attributes and experiences in addition to academic preparation to identify applicants poised to meet the needs of a diverse patient population. More evidence is needed to determine whether holistic review results in a more diverse selection process. One of the keys to holistic review is to apply holistic principles in all stages of the selection process to ensure qualified applicants are not overlooked. This study examines whether the use of holistic review during application screening at a new medical school increased the diversity of applicants selected for interview. Using retrospective data from the first five application cycles at the Oakland University William Beaumont School of Medicine (OUWB), the author compared demographic and experiential differences between the applicants selected using holistic review, including experiences, attributes and academic metrics, to a test sample selected solely using academic metrics. The dataset consisted of the total group of applicants selected for interview in 2011 through 2015 using holistic review (n = 2773) and the same number of applicants who would have been selected for an interview using an academic-only selection model (n = 2773), which included 1204 applicants who were selected using both methods (final n = 4342). The author used a combination of cross-tabulation and analysis of variance to identify differences between applicants selected using holistic review and applicants in the test sample selected using only academics. The holistic review process yielded a significantly higher than expected percent of female

Somatic symptoms and holistic thinking as major dimensions behind modern health worries.

Science.gov (United States)

Köteles, Ferenc; Simor, Péter

2014-01-01

Modern health worries (MHWs) were related to somatic symptoms and to preference of holistic healing methods in previous studies. The study aimed to investigate the contribution of symptom-related and holism-related factors to MHWs. Participants (visitors of an Internet news portal; N = 16152; 64.1 % males) completed a questionnaire assessing MHWs, somatosensory amplification, somatic symptoms, positive and negative affect, spirituality, holistic health beliefs, and various aspects of health care utilization (both conventional and alternative). Exploratory factor analysis with oblique rotation revealed two independent dimensions ("Somatic symptom distress" and "Holism") MHWs were involved with factor loadings of 0.294 and 0.417, respectively. The existence of two factors was supported by the results of confirmatory factor analysis. No practically significant interaction between the two factors was found in binary logistic regression analysis. Positive and negative affect, somatosensory amplification, spirituality, and holistic health beliefs were positively connected, while self-rated health status was negatively connected to MHWs even after controlling for socio-demographic and treatment-related variables. Holistic thinking and symptom-related behavioral and psychological factors are independently associated with MHWs. Modern health worries can be conceptualized as symptom-related by-products of a holistic-spiritual worldview.

Holistic Management of Schizophrenia Symptoms Using Pharmacological and Non-pharmacological Treatment.

Science.gov (United States)

Ganguly, Pronab; Soliman, Abdrabo; Moustafa, Ahmed A

2018-01-01

Individuals with schizophrenia lead a poor quality of life, due to poor medical attention, homelessness, unemployment, financial constraints, lack of education, and poor social skills. Thus, a review of factors associated with the holistic management of schizophrenia is of paramount importance. The objective of this review is to improve the quality of life of individuals with schizophrenia, by addressing the factors related to the needs of the patients and present them in a unified manner. Although medications play a role, other factors that lead to a successful holistic management of schizophrenia include addressing the following: financial management, independent community living, independent living skill, relationship, friendship, entertainment, regular exercise for weight gained due to medication administration, co-morbid health issues, and day-care programmes for independent living. This review discusses the relationship between different symptoms and problems individuals with schizophrenia face (e.g., homelessness and unemployment), and how these can be managed using pharmacological and non-pharmacological methods. Thus, the target of this review is the carers of individuals with schizophrenia, public health managers, counselors, case workers, psychiatrists, and clinical psychologists aiming to enhance the quality of life of individuals with schizophrenia.

Quali-quantitative analysis (QQA): why it could open new frontiers for holistic health practice.

Science.gov (United States)

Bell, Erica

2006-12-15

Holistic health practice is often described as being about understanding the larger contexts of patients, their health services, and their communities. Yet do traditional quantitative and qualitative health research methods produce the best possible evidence for the holistic practices of doctors, nurses, and allied health professionals? This paper argues "no", and examines the potential of a cutting-edge, social science research method--Quali-Quantitative Research (QQA)--for providing better evidence for holistic practice, particularly in small-N populations, such as rural and remote communities. It does so with reference to the international literature on holistic medicine, as well as three holistic health projects conducted in Tasmania: about prevention of falls in older people, adolescent substance abuse, and interventions for children aged 0-5 exposed to domestic violence. The findings suggest that much health research fails to capture rigorously the contextual complexity of holistic health challenges: the multiple different needs of individual patients, and the interprofessional approaches needed to deliver multidisciplinary and multiservice health interventions tailored to meet those needs in particular community contexts. QQA offers a "configurational", case-based, diversity-oriented approach to analysing data that combines qualitative and quantitative techniques to overcome the limitations of both research traditions. The author concludes that QQA could open new frontiers for holistic health by helping doctors, nurses, and allied health professionals answer a fundamental question presented by complex health challenges: "Given this set of whole-of-patient needs, what elements of which interventions in what services would work best in this particular community?"

Introducing advance directives in the Nigerian health care Setting ...

African Journals Online (AJOL)

Patients and their families have rights to respect, compassion, attentive and skilled physical and psychosocial care, and spiritual support provided in a holistic manner by the health care team. The four bioethical principles of beneficence, autonomy, non-maleficence and justice should form the framework upon which ...

Holistic education and complexity thinking

NARCIS (Netherlands)

Jörg, T.

2007-01-01

Paper proposal for the SIG Holistic Education at AERA 2007 Title: Holistic Education and Complexity Thinking Ton Jörg IVLOS Institute of Education University of Utrecht The Netherlands A.G.D.Jorg@ivlos.uu.nl ABSTRACT In this paper I link complexity thinking with Holistic Education (HE). It is a

Successful engagement: CBM's holistic approach to the work in the area of ear care, deafness, hard of hearing and deafblindness.

Science.gov (United States)

Tesni, Sian; Santana-Hernández, Diego

2014-09-01

CBM is an international Christian development organisation, committed to improving the quality of life of persons with disabilities in disadvantaged societies. CBM aims at achieving this in partnership with local organisations and in cooperation with stakeholders at regional and international levels. This article aims at sharing CBM's holistic approach for successful engagement in the work area of ear care, deafness, hard of hearing and deafblindness. Review of CBM supporting documents, including strategies, position papers, technical guidelines, criteria of success and information related to partners, centres of excellence and model projects. Description of how partner programmes use participatory methods of planning and implementation, involving persons with disabilities and the community. Recommendations on how to develop national or sub-national strategies to impact the lives, and advocate with governments for the rights and inclusion, of persons with disabilities. CBM's holistic approach to work in the area of ear care; deafness; hard of hearing and deafblindness includes intervention at all levels of health care provision, Education, CBR and Audiological, Speech Therapy and other interdisciplinary services. This article presents CBM's core principles and shares specific strategic planning and results, together with lessons learnt while searching a sustainable engagement for field work. Rehabilitation, in its widest conception, should be approached as a multidisciplinary strategy, and developed in close cooperation with other local, national and international agencies. CBM is positioned in a strategic point from where it can play a key role in the facilitation of an international forum for agencies and stakeholders to reach a consensus to decrease the burden of ear disease and hearing loss, through early intervention and re/habilitation.

Creating a Holistic Extractables and Leachables (E&L) Program for Biotechnology Products.

Science.gov (United States)

Li, Kim; Rogers, Gary; Nashed-Samuel, Yasser; Lee, Hans; Mire-Sluis, Anthony; Cherney, Barry; Forster, Ronald; Yeh, Ping; Markovic, Ingrid

2015-01-01

The risk mitigation of extractables and leachables presents significant challenges to regulators and drug manufacturers with respect to the development, as well as the lifecycle management, of drug products. A holistic program is proposed, using a science- and risk-based strategy for testing extractables and leachables from primary containers, drug delivery devices, and single-use systems for the manufacture of biotechnology products. The strategy adopts the principles and concepts from ICH Q9 and ICH Q8(R2). The strategy is phase-appropriate, progressing from extractables testing for material screening/selection/qualification through leachables testing of final products. The strategy is designed primarily to ensure patient safety and product quality of biotechnology products. The holistic program requires robust extraction studies using model solvents, with careful consideration of solvation effect, pH, ionic strength, temperature, and product-contact surface and duration. From a wide variety of process- and product-contact materials, such extraction studies have identified and quantified over 200 organic extractable compounds. The most commonly observed compounds were siloxanes, fatty acid amides, and methacrylates. Toxicology assessments were conducted on these compounds using risk-based decision analysis. Parenteral permitted daily exposure limits were derived, as appropriate, for the majority of these compounds. Analysis of the derived parenteral permitted daily exposure limits helped to establish action thresholds to target high-risk leachables in drug products on stability until expiry. Action thresholds serve to trigger quality investigations to determine potential product impact. The holistic program also evaluates the potential risk for immunogenicity. This approach for primary drug containers and delivery devices is also applicable to single-use systems when justified with a historical knowledge base and understanding of the manufacturing processes of

[To see the future development of burn medicine from the view of holistic integrative medicine].

Science.gov (United States)

Hu, D H; Tao, K

2017-04-20

The therapeutic methods and effects have been improved greatly in the past few decades for burn care and management with several important advancements which have resulted in more effective patient stabilization and significantly decreased mortality in China. However, the challenges still exist, such as how to further improve the recovery of the patients' appearance and function, and how to advance the treatment of severe deep extensive burn injury, etc. The theory of holistic integrative medicine (HIM) provides a new opportunity for the development of clinical medicine. This article emphasizes the important roles of HIM in exploration of burn medicine, considering the advanced development of modern life sciences and relevant techniques.

A Holistic Approach to Manufacturing System Design in the Defense Aerospace Industry

National Research Council Canada - National Science Library

Vaughn, Amanda

2002-01-01

.... Also, manufacturing systems are complex systems that need to be carefully designed in a holistic manner and there are shortcomings with available tools and methods to assist in the design of these systems...

Clinical Holistic Medicine: Developing from Asthma, Allergy, and Eczema

Directory of Open Access Journals (Sweden)

Søren Ventegodt

2004-01-01

Full Text Available This paper shows how consciousness-based holistic medicine can be used in the case of asthma, allergy, and eczema. We have many fine drugs to relieve patients from the worst of these symptoms, where many children and adults suffer health problems related to hyper-reactivity of the immune system. Many symptoms remain throughout life because the drugs do not cure the allergy and allergy today is the sixth leading cause of chronic illness. The etiology of the immune disturbances is mostly unknown from a biomedical perspective. Consciousness-based holistic medicine could therefore be used to treat these diseases if the patient is willing to confront hidden existential pain, is motivated to work hard, and is dedicated to improve quality of life, quality of working life, and personal relationships. Improving quality of life is not always an easy job for the patient, but it can be done with coaching from the physician. An increased physical health is often observed after only a few sessions with a physician skilled in using holistic medical tools and able to coach the patient successfully through a few weeks of dedicated homework. Children with allergy and asthma can also be helped if their parents are able to do work on personal development, to improve the general quality of life in the family and their relationship with the child.

A Concept Analysis of Patient Participation in Intermediate Care.

Science.gov (United States)

Kvæl, Linda Aimée Hartford; Debesay, Jonas; Langaas, Anne; Bye, Asta; Bergland, Astrid

2018-03-05

Although the concept of patient participation has been discussed for a number of years, there is still no clear definition of what constitutes the multidimensional concept, and the application of the concept in an intermediate care (IC) context lacks clarity. Therefore this paper seeks to identify and explore the attributes of the concept, to elaborate ways of understanding the concept of patient participation for geriatric patients in the context of IC. Walker and Avant's model of Concept analysis [1] based on a literature review. Patient participation in the context of IC can be defined as a dynamic process emphasizing the person as a whole, focusing on the establishment of multiple alliances that facilitate individualized information and knowledge exchange, and ensuring a reciprocal engagement in activities within flexible and interactive/dynamic organizational structures. Patient participation in IC means involving patients and their relatives in holistic interdisciplinary collaborative decision-making. The results highlight the complexity of patient participation and contribute to a greater understanding of the influence of organizational structure and management. The present study may provide a practical framework for researchers, policy makers and health professionals to facilitate patient participation in IC services. Copyright © 2018 Elsevier B.V. All rights reserved.

Nurses experiences in palliative care of terminally-ill HIV patients in a level 1 district hospital

Directory of Open Access Journals (Sweden)

Nokwanda E. Bam

2014-02-01

Full Text Available Background: Whilst the discourse of palliative care in HIV management is largely documented and regarded as being an essential component, various authors have further argued that within the context of HIV care in sub-Saharan Africa, palliative care and exploration of the dimensions thereof is largely lacking. This article presents the lived experiences of nurses involved in palliative care, thus providing the perspective of nurses and the multi-faceted dimensions of the nature of caring inherent.Objectives: This study explored the respondents’ understanding of the concepts ‘caring’ and ‘terminal patient’ and described the experiences of nurses caring for terminally-ill patients with HIV and how these experiences influence the nature of care rendered.Methods: Qualitative research using Husserl’s approach of phenomenology design underpinned the study and Giorgi’s steps of analysis were used to make meaning of the data.Results: The concept ‘caring’ was experienced by the nurses as transforming the patients’ quality of life through supportive care and hope for life. Palliative care made the nurses conscious of their own mortality, enabling them to be more sensitive, compassionate and dedicated to caring for their patients. The findings described the social networking that enabled nurses to collaborate with colleagues in the interdisciplinary teams and shared knowledge, skills and support within the palliative care team in order to optimise patient outcomes.Conclusion: Nurses with prolonged involvement in caring for terminally-ill patients with HIV experienced helplessness and emotional stress. Recommendations based on the results are that training in psychological and holistic care of the patient, professional counselling and stress management services are needed to support the nurse in this context.

Organisational aspects of care.

Science.gov (United States)

Bloomfield, Jacqueline; Pegram, Anne

2015-03-04

Organisational aspects of care, the second essential skills cluster, identifies the need for registered nurses to systematically assess, plan and provide holistic patient care in accordance with individual needs. Safeguarding, supporting and protecting adults and children in vulnerable situations; leading, co-ordinating and managing care; functioning as an effective and confident member of the multidisciplinary team; and managing risk while maintaining a safe environment for patients and colleagues, are vital aspects of this cluster. This article discusses the roles and responsibilities of the newly registered graduate nurse. Throughout their education, nursing students work towards attaining this knowledge and these skills in preparation for their future roles as nurses.

Clinical holistic medicine: the Dean Ornish program ("opening the heart") in cardiovascular disease.

Science.gov (United States)

Ventegodt, Søren; Merrick, Efrat; Merrick, Joav

2006-02-02

Dean Ornish of the Preventive Medicine Research Institute in Sausalito, California has created an intensive holistic treatment for coronary heart patients with improved diet (low fat, whole foods, plant based), exercise, stress management, and social support that has proven to be efficient. In this paper, we analyze the rationale behind his cure in relation to contemporary holistic medical theory. In spite of a complex treatment program, the principles seem to be simple and in accordance with holistic medical theories, like the Antonovsky concept of rehabilitating the sense of coherence and the life mission theory for holistic medicine. We believe there is a need for the allocation of resources for further research into the aspects of holistic health and its methods, where positive and significant results have been proven and reproduced at several sites.

Poverty reduction in India through palliative care: A pilot project

Directory of Open Access Journals (Sweden)

Cathy Ratcliff

2017-01-01

Conclusions: Holistic palliative care can reduce the desperate poverty driven by life-limiting illness, and can do so systematically, on a large-scale, in-depth, especially if started early in the illness. Home-based care also frees up hospitals to serve more patients with treatable conditions.

Conflicts between healthcare professionals and families of a multi-ethnic patient population during critical care: an ethnographic study.

Science.gov (United States)

Van Keer, Rose-Lima; Deschepper, Reginald; Francke, Anneke L; Huyghens, Luc; Bilsen, Johan

2015-12-22

Conflicts during communication in multi-ethnic healthcare settings is an increasing point of concern as a result of societies' increased ethno-cultural diversity. We can expect that conflicts are even more likely to arise in situations where difficult medical decisions have to be made, such as critical medical situations in hospital. However, in-depth research on this topic is rather scarce. During critical care patients are often unable to communicate. We have therefore investigated factors contributing to conflicts between healthcare professionals and family members from ethnic minority groups in critical medical situations in hospital. Ethnographic fieldwork was done in one intensive care unit of a multi-ethnic urban hospital in Belgium over 6 months (January 2014 to June 2014). Data were collected through negotiated interactive observation, in-depth interviews with healthcare professionals, from patients' medical records, and by making notes in a logbook. Data were analysed by using grounded theory procedures. Conflicts were essentially related to differences in participants' views on what constitutes 'good care' based on different care approaches. Healthcare professionals' views on good care were based predominantly on a biomedical care model, whereas families' views on good care were mainly inspired by a holistic lifeworld-oriented approach. Giving good care, from the healthcare professionals' point of view, included great attention to regulations, structured communication, and central decision making. On the other hand, good care from the families' point of view included seeking exhaustive information, and participating in end-of-life decision making. Healthcare professionals' biomedical views on offering good care were strengthened by the features of the critical care context whereas families' holistic views on offering good care were reinforced by the specific characteristics of families' ethno-familial care context, including their different ethno

A holistic approach to managing a patient with heart failure.

Science.gov (United States)

Duncan, Alison; Cunnington, Colin

2013-03-01

Despite varied and complex therapeutic strategies for managing patients with heart failure, the prognosis may remain poor in certain groups. Recognition that patients with heart failure frequently require input from many care groups formed the basis of The British Society of Heart Failure Annual Autumn Meeting in London (UK), in November 2012, entitled: 'Heart failure: a multidisciplinary approach'. Experts in cardiology, cardiac surgery, general practice, care of the elderly, palliative care and cardiac imaging shared their knowledge and expertise. The 2-day symposium was attended by over 500 participants from the UK, Europe and North America, and hosted physicians, nurses, scientists, trainees and representatives from the industry, as well as patient and community groups. The symposium, accredited by the Royal College of Physicians and the Royal College of Nursing, focused on the multidisciplinary approach to heart failure, in particular, current therapeutic advances, cardiac remodeling, palliative care, atrial fibrillation, heart rate-lowering therapies, management of acute heart failure and the management of patients with mitral regurgitation and heart failure.

Palliative Care in Heart Failure

Directory of Open Access Journals (Sweden)

Hatice Mert

2012-04-01

Full Text Available Heart failure is an important health problem since its incidence and prevalence is increasing year by year. Since symptom burden and mortality are high in heart failure, supportive and palliative care should be provided. However, very few patients are referred to palliative care services. In comparison with cancer patients, it is difficult to identify end of life care for patients with heart failure, because these patients are hospitalized when the signs of acute decompensation appear, and their symptoms decrease and functional status improve before they are discharged. Therefore, palliative care, which is a holistic approach aiming to improve patients’ quality of life, to detect and treat the attacks of the disease before they become severe, and to deal with patients’ physical, psychological, social, and mental health altogether during their care, should be integrated into heart failure patients’ care. [TAF Prev Med Bull 2012; 11(2.000: 217-222

The perceived meaning of a (wholistic view among general practitioners and district nurses in Swedish primary care: a qualitative study

Directory of Open Access Journals (Sweden)

Borgquist Lars

2007-03-01

Full Text Available Abstract Background The definition of primary care varies between countries. Swedish primary care has developed from a philosophic viewpoint based on quality, accessibility, continuity, co-operation and a holistic view. The meaning of holism in international literature differs between medicine and nursing. The question is, if the difference is due to different educational traditions. Due to the uncertainties in defining holism and a holistic view we wished to study, in depth, how holism is perceived by doctors and nurses in their clinical work. Thus, the aim was to explore the perceived meaning of a holistic view among general practitioners (GPs and district nurses (DNs. Methods Seven focus group interviews with a purposive sample of 22 GPs and 20 nurses working in primary care in two Swedish county councils were conducted. The interviews were transcribed verbatim and analysed using qualitative content analysis. Results The analysis resulted in three categories, attitude, knowledge, and circumstances, with two, two and four subcategories respectively. A professional attitude involves recognising the whole person; not only fragments of a person with a disease. Factual knowledge is acquired through special training and long professional experience. Tacit knowledge is about feelings and social competence. Circumstances can either be barriers or facilitators. A holistic view is a strong motivator and as such it is a facilitator. The way primary care is organised can be either a barrier or a facilitator and could influence the use of a holistic approach. Defined geographical districts and care teams facilitate a holistic view with house calls being essential, particularly for nurses. In preventive work and palliative care, a holistic view was stated to be specifically important. Consultations and communication with the patient were seen as important tools. Conclusion 'Holistic view' is multidimensional, well implemented and very much alive among both

Partnering with patients to promote holistic diabetes management: changing paradigms.

Science.gov (United States)

Lorenzo, Lenora

2013-07-01

To provide a review of best practice for clinical management of diabetes mellitus (DM) for nurse practitioners (NPs) and accelerate incorporation of key findings into current practice. A search was conducted in Pub Med, Ovid, CINAHL, and Cochrane's Database of Systematic Reviews. There are many challenges for DM care identified in the current health system. There is a great need to change care paradigms to engage patients in partnership for enhanced management and self-management in DM. A review of the best practice evidence revealed numerous models of care, strategies, and tools available to enhance diabetes care and promote health and well-being. The primary focus of this article is to engage NP clinicians to incorporate new strategies to augment management and improve clinical outcomes. Incorporation of best practice for DM management may accelerate the paradigm shift to more patient-focused care. Engaged, informed, and activated patients along with clinicians working in partnerships may enhance clinical outcomes. ©2013 The Author ©2013 American Association of Nurse Practitioners.

The Holistic Health Movement.

Science.gov (United States)

Gross, Stanley J.

1980-01-01

Provides a conceptual framework for understanding the holistic health field so counselors may consider its implications in addressing a new service area. Holistic health has unique emphases on positive wellness, environmental concerns, self-responsibility, and such practices as meditation, fitness, nourishment, vitality, and spirituality. (Author)

Learning to care: medical students’ reported value and evaluation of palliative care teaching involving meeting patients and reflective writing

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Erica Borgstrom

2016-11-01

Full Text Available Abstract Background Over recent years there has been an increase in teaching of both palliative care and reflective practice in UK medical schools. The palliative care teaching at the University of Cambridge School of Clinical Medicine is multi-faceted and involves students writing reflective essays after individually meeting patients approaching the end of life during their final year general practice and hospital medicine placements. This paper draws on two studies examining this teaching element to analyse what the students found valuable about it and to comment on the practice of meeting patients and subsequent reflective writing. Methods Two studies have explored students’ perceptions of these course components. The first was a thematic analysis of 234 reflective essays from 123 students written in 2007-2008, including examining what students wrote about the exercise itself. The second project involved a semi-structured questionnaire that students completed anonymously; this paper reports on the free text elements of that study [sample size =107]. Since similar themes were found in both studies, the coding structures from each project were compared and combined, enabling triangulation of the findings around what the students found valuable from the palliative care teaching involving meeting patients and reflective writing. Results Overall, students reported that these components of the palliative care teaching are valuable. Four main themes were identified as aspects that students valued: (1 dedicated time with patients, (2 learning about wider elements of treatment and holistic care, (3 practicing communication skills, and (4 learning about themselves through reflective writing. Some students expressed a dislike for having to formally write a reflective essay. Conclusion It is possible to arrange for all of the medical students to individually meet at least two patients receiving palliative or end of life care. Students found these

Integration of naturopathic medicine into acute inpatient care: An approach for patient-centred medicine under diagnosis-related groups.

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Romeyke, Tobias; Nöhammer, Elisabeth; Scheuer, Hans Christoph; Stummer, Harald

2017-08-01

The integration of naturopathic methods into acute inpatient care has been the subject of very few scientific studies. Patient expectations of the service received in hospital are increasing, and the integration of naturopathy into clinical practice can serve as Unique Selling Proposition. The present study was conducted over a period of two years. In total, over 1700 patients were included in the study. The setting is an acute hospital specialising in a multimodal, patient-centred approach to treatment. Patient satisfaction with the use of holistic care, patient perception of adherence to treatment and the amount of time care staff spend with patients were all investigated. The patients' principal diagnoses were also recorded using the DRG classification system, as were the number of concomitant diseases and the length of their stay in hospital. The majority of patients rate the integration of complementary care in the acute hospital very positively. The effects on patient perception of adherence to treatment and the amount of time care staff spend with patients are also assessed positively. At the same time, we can see that patients who receive patient-centred care in this study predominantly suffer from diseases and disorders of the musculoskeletal system and connective tissue, diseases of the nervous system and mental diseases and disorders. They also have numerous concomitant diseases. It could be shown that patients are very satisfied with the combination of naturopathy and academic medicine and with approaches that take patient preferences into account. Integrating naturopathy can be considered for multimorbid patients, in particular. Moreover, patient-centred care can improve staff satisfaction levels. Copyright © 2017 Elsevier Ltd. All rights reserved.

Holistic self-management education and support: a proposed public health model for improving women's health in Zimbabwe.

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Kanchense, Jane Handina Murigwa

2006-08-01

The primary health care model of public health has been implemented in many countries around the globe since the Declaration of Alma Ata in 1978, without pilot testing the primary health care model. Therefore, many public health researchers have sought methods of improving primary health care by creating evidence-based models. Many of these researchers recognize the role of behavioral models in public health. These offshoots of primary health care include the ecological, care, central human capabilities, and the SPECIES models. Holistic self-management education and support is a capacity-building philosophy that ensures active involvement of consumers of health care in the planning and implementation and evaluation of health care services. It helps consumers of health care to achieve the desired improved quality of health and life in managing and sustaining their health at the grassroots level. The care model addresses disease management ideals of the in the original primary health care model. The SPECIES model addresses those aspects of the primary health care model that include the cultural and social factors, as well as individual health education and support in the original primary health care model. The ecological model offers an improvement of the socioeconomic ideal in the original primary health care model. Improving the health of individuals will prevent illness, thereby reducing health care costs and lessening the current strain on an overburdened health care system in Zimbabwe. Holistic self-management education and support links health care delivery systems with social processes. It is a best practices model that could better serve Zimbabwean girls and women by contributing positively to the national challenges in health care, thereby meeting the Zimbabwean primary health care and safe motherhood goals. It is here recommended that holistic self-management education and support must be pilot tested before being adopted as the most appropriate model for

The development of the nursing care system for patients with cleft lip-palate and craniofacial deformities at Tawanchai Cleft Center, Srinagarind Hospital, Khon Kaen, Thailand.

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Pradubwong, Suteera; Pongpagatip, Sumalee; Volrathongchai, Kanittha; Chowchuen, Bowornsilp

2012-11-01

The highest incidence of cleft lip-palate and craniofacial deformities in Thailand occur in the Northeastern Region. There is the necessity for an interdisciplinary care team as well as the specialized care center with systematic coordinated care, thus "Tawanchai Cleft Center" is becoming a superior medical center for patients with cleft lip-palate and craniofacial deformities. Therefore, the development of the nursing care system for patients with cleft lip-palate and craniofacial deformities at Tawanchai Cleft Center, Srinagarind Hospital is extremely important and necessary. To develop the nursing care system appropriate for a super tertiary hospital (Tawanchai Cleft Center). It is a participation study which has 3 steps as follows, 1) Analyzing the situations and collecting the opinions of the 22 Out-patient Surgery Department staff and Tawanchai Cleft Center staff by using 6 questions, 2) Summarizing of the situation analysis from the meetings and the questionnaires, then using such summary as the guidelines for developing the nursing care system from January 2011 onwards, 3) evaluating the satisfaction after the 4 month development period (May-August 2011) with 106 caregivers by using 8 questions and being analyzed by the average value, percentage and standard deviation. 1) The nursing care system consisted of psychosocial care, breast feeding, counseling and other assistance as required. This various assistance responded to the patient/family problems by following the treatment guideline of the multidisciplinary team which uses the continuous evaluation processes for the holistic patient/family care. 2) The patients with complete cleft lip-palate were the most common type, found in 44 cases or 41.53 percent. The highest number of caregivers were mothers which were 68 percent; the average age of those mothers was 36 years old. The highest number of them finished elementary school at 43 percent and 40 percent were farmers. The satisfaction for the services of

A case study exploring the ethical and policy dimensions of allocating acute care resources to a dying patient.

Science.gov (United States)

Cooke, Mary; Hurley, Ciarán

2008-05-01

We aimed to identify policy, process and ethical issues related to allocation of National Health Service resources when patients with end-of-life illness are referred to acute care services. Sharing healthcare decisions denotes a different partnership between professionals and patients when patients are empowered to define their needs. Implementation of a transition from professional to patient decision-making appears to be dependent upon its interpretation by personnel delivering care using the local trust policy. The outcome of this is a reformation of responsibility for budget allocation, choice of acute care provider and selecting services, currently in the realm of primary care; be it the general practitioner, community practitioners, or the patient. We used a 'lens' approach to case study analysis in which the lens is constructed of a model of policy analysis and four principles of biomedical ethics. A patient's decision to decline care proposed by an Accident and Emergency department nurse and the nurse's response to that decision expose a policy that restricts the use of ambulance transport and with that, flexibility in responses to patients' decisions. End-of-life care partnership decisions require sensitivity and flexibility from all healthcare practitioners. We found that policy-based systems currently used to deliver care across the primary care - hospital care border are far from seamless and can lead to foreseeable problems. Health professionals responsible for the care of a patient at the end of life should consider the holistic outcomes of resource allocation decisions for patients. Government and health professional agenda suggest that patients should be given a greater element of control over their healthcare than has historically been the case. When patients take responsibility for their decisions, healthcare personnel should recognize that this signals a shift in the nature of the professional-patient relationship to one of partnership.

Holistic Processing of Chinese Characters

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Alan Chun-Nang Wong

2011-05-01

Full Text Available Enhanced holistic processing (obligatory attention to all parts of an object has been associated with different types of perceptual expertise involving faces, cars, fingerprints, musical notes, English words, etc. Curiously Chinese characters are regarded as an exception, as indicated by the lack of holistic processing found for experts (Hsiao and Cottrell, 2009. The ceiling performance of experts, however, may have caused this null effect. We revisit this issue by adopting the often-used face-composite sequential-matching task to two-part Chinese characters. Participants matched the target halves (left or right of two characters while ignoring the irrelevant halves. Both Chinese readers (experts and non-Chinese readers (novices showed holistic processing. Follow-up experiments suggested different origins of the effects for the two groups. For experts, holistic processing was sensitive to the amount of experience with the characters, as it was larger for words than non-words (formed by swapping the two parts of a valid character. Novices, however, showed similar degree of holistic processing to words and non-words, suggesting that their effects were more related to their inefficient decomposition of a complex, character-like pattern into parts. Overall these findings suggest that holistic processing may be a marker of expertise with Chinese characters, contrary to previous claims.

Spirituality Intervention and Outcomes: Corner stone of Holistic Nursing Practice

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Mardiyono Mardiyono

2011-01-01

Full Text Available Background: Holistic nursing results in healing the whole person as human being that has interconnectedness of body mind social cultural spiritual aspect.Objective: The purpose of this paper is to examine the effects of Islamic spirituality interventions on health outcomes in nursing.Method: Databases searched for electronic journals and books that were published since 1994 to 2010 were included.Results: Spirituality intervention mainly composes of prayer, recitation of the holy Qur’an, remembrance of Allah, fasting, charity, prophets’ methods, and modified Islamic methods. Thirteen studies found that various outcomes have been highlighted when applied in several areas of nursing, such as stimulating baby’s cognitive ability in maternal nursing, promoting health during eating halal food, fasting, abstinence of alcohol and tobacco consumption, performing regular exercise, reducing anxiety, and pain in medical-surgical nursing. In mental health nursing, six studies explored effects of prayer and religious psychotherapy to enhance happiness and physical health and alleviate anxiety, and depression. Three studies reported Islamic cognitive therapy to alleviate the auditory hallucination, bereavement, and depression. In critical care nursing, three studies employed reciting the holy Qur’an and talqin in end of life care.Conclusion: Although the literature is limited in the amount and quality of spirituality interventions, some evidences have shown as integrative energy in nursing practice to promote health and minimize some symptoms. Spirituality interventions should be performed to acknowledge the high priority in holistic nursing and support interventions.Keywords: spirituality intervention, holistic nursing, Islam

Intuitive Face Judgments Rely on Holistic Eye Movement Pattern.

Science.gov (United States)

Mega, Laura F; Volz, Kirsten G

2017-01-01

Non-verbal signals such as facial expressions are of paramount importance for social encounters. Their perception predominantly occurs without conscious awareness and is effortlessly integrated into social interactions. In other words, face perception is intuitive. Contrary to classical intuition tasks, this work investigates intuitive processes in the realm of every-day type social judgments. Two differently instructed groups of participants judged the authenticity of emotional facial expressions, while their eye movements were recorded: an 'intuitive group,' instructed to rely on their "gut feeling" for the authenticity judgments, and a 'deliberative group,' instructed to make their judgments after careful analysis of the face. Pixel-wise statistical maps of the resulting eye movements revealed a differential viewing pattern, wherein the intuitive judgments relied on fewer, longer and more centrally located fixations. These markers have been associated with a global/holistic viewing strategy. The holistic pattern of intuitive face judgments is in line with evidence showing that intuition is related to processing the "gestalt" of an object, rather than focusing on details. Our work thereby provides further evidence that intuitive processes are characterized by holistic perception, in an understudied and real world domain of intuition research.

Meanings, mechanisms, and measures of holistic processing.

Science.gov (United States)

Richler, Jennifer J; Palmeri, Thomas J; Gauthier, Isabel

2012-01-01

Few concepts are more central to the study of face recognition than holistic processing. Progress toward understanding holistic processing is challenging because the term "holistic" has many meanings, with different researchers addressing different mechanisms and favoring different measures. While in principle the use of different measures should provide converging evidence for a common theoretical construct, convergence has been slow to emerge. We explore why this is the case. One challenge is that "holistic processing" is often used to describe both a theoretical construct and a measured effect, which may not have a one-to-one mapping. Progress requires more than greater precision in terminology regarding different measures of holistic processing or different hypothesized mechanisms of holistic processing. Researchers also need to be explicit about what meaning of holistic processing they are investigating so that it is clear whether different researchers are describing the same phenomenon or not. Face recognition differs from object recognition, and not all meanings of holistic processing are equally suited to help us understand that important difference.

A Short History of Clinical Holistic Medicine

OpenAIRE

Ventegodt, Søren; Kandel, Isack; Merrick, Joav

2007-01-01

Clinical holistic medicine has its roots in the medicine and tradition of Hippocrates. Modern epidemiological research in quality of life, the emerging science of complementary and alternative medicine, the tradition of psychodynamic therapy, and the tradition of bodywork are merging into a new scientific way of treating patients. This approach seems able to help every second patient with physical, mental, existential or sexual health problem in 20 sessions over one year. The paper discusses ...

Clinical Holistic Medicine: Treatment of Physical Health Problems Without a Known Cause, Exemplified by Hypertension and Tinnitus

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Søren Ventegodt

2004-01-01

Full Text Available In the medical clinic, we often face health problems that have no known cause, even after a thorough examination. Biomedicine is often unable to find a cure in these situations, leaving the problem unsolved or leaving the patient on a palliative pharmaceutical cure, which is often for a lifetime. In this case, consciousness-based, holistic medicine could be an alternative. Using the theories and tools of holistic medicine wisely, the physician can often provide treatment for the patient. The toolbox of holistic medicine makes it possible to work on everybody because there is always something related to the patients quality of life that can be improved: his love, his purpose of life, and the way he uses his talents, his mind, his feelings, his body, and his sexuality. For treatment in holistic medicine, it really does not matter as much that you cannot give the patient a precise medical diagnosis, because you can always work on the patient with the intention of healing his or her whole life and existence. It is quite a paradox that many of these diseases can be understood on the level of the individual patient at the same moment that the patient is cured; many of these diseases seem to be clearly related to the repression of the individual character, as stressed already by Hippocrates. So if you simply start working with the patient to help him confront old existential pain and coach him in his personal development of his life by intensifying its meaning and purpose, the symptoms very often simply disappear. The toolbox of holistic medicine also seems relevant to even difficult, neurotic, psychosomatic, and hypochondriac patients. Believing in the treatment and not giving up on your patient, and moving forward in the treatment with the patient himself is the ultimate goal, even when you yourself do not understand the mechanism fully. This will force you to develop your own competence and is, in essence, what makes an outstanding holistic

Holistic approach to treatment of intractable central neuropathic itch.

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Curtis, Ashley R; Tegeler, Charles; Burdette, Jonathan; Yosipovitch, Gil

2011-05-01

Central neuropathic itch can be a lifelong debilitating condition and treatment challenge. We report a patient with a traumatic brain injury with severe intractable pruritus who failed extensive pharmacologic and nonpharmacologic treatment but responded to a holistic approach using healing touch. We discuss the complexity of this type of neuropathic itch and present a holistic approach as an adjunct to therapy in reducing itch intensity. This case presentation along with the literature discussed suggests a therapeutic strategy for the management of complicated central neuropathic itch. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

A legacy building model for holistic nursing.

Science.gov (United States)

Lange, Bernadette; Zahourek, Rothlyn P; Mariano, Carla

2014-06-01

This pilot project was an effort to record the historical roots, development, and legacy of holistic nursing through the visionary spirit of four older American Holistic Nurses Association (AHNA) members. The aim was twofold: (a) to capture the holistic nursing career experiences of elder AHNA members and (b) to begin to create a Legacy Building Model for Holistic Nursing. The narratives will help initiate an ongoing, systematic method for the collection of historical data and serve as a perpetual archive of knowledge and inspiration for present and future holistic nurses. An aesthetic inquiry approach was used to conduct in-depth interviews with four older AHNA members who have made significant contributions to holistic nursing. The narratives provide a rich description of their personal and professional evolution as holistic nurses. The narratives are presented in an aesthetic format of the art forms of snapshot, pastiche, and collage rather than traditional presentations of research findings. A synopsis of the narratives is a dialogue between the three authors and provides insight for how a Legacy Model can guide our future. Considerations for practice, education, and research are discussed based on the words of wisdom from the four older holistic nurses.

Patient perspectives on care received at community acupuncture clinics: a qualitative thematic analysis.

Science.gov (United States)

Tippens, Kimberly M; Chao, Maria T; Connelly, Erin; Locke, Adrianna

2013-10-29

Community acupuncture is a recent innovation in acupuncture service delivery in the U.S. that aims to improve access to care through low-cost treatments in group-based settings. Patients at community acupuncture clinics represent a broader socioeconomic spectrum and receive more frequent treatments compared to acupuncture users nationwide. As a relatively new model of acupuncture in the U.S., little is known about the experiences of patients at community acupuncture clinics and whether quality of care is compromised through this high-volume model. The aim of this study was to assess patients' perspectives on the care received through community acupuncture clinics. The investigators conducted qualitative, thematic analysis of written comments from an observational, cross-sectional survey of clients of the Working Class Acupuncture clinics in Portland, Oregon. The survey included an open-ended question for respondents to share comments about their experiences with community acupuncture. Comments were received from 265 community acupuncture patients. Qualitative analysis of written comments identified two primary themes that elucidate patients' perspectives on quality of care: 1) aspects of health care delivery unique to community acupuncture, and 2) patient engagement in health care. Patients identified unique aspects of community acupuncture, including structures that facilitate access, processes that make treatments more comfortable and effective and holistic outcomes including physical improvements, enhanced quality of life, and empowerment. The group setting, community-based locations, and low cost were highlighted as aspects of this model that allow patients to access acupuncture. Patients' perspectives on the values and experiences unique to community acupuncture offer insights on the quality of care received in these settings. The group setting, community-based locations, and low cost of this model potentially reduce access barriers for those who might not

Defining a caring hospital by using currently implemented survey tools.

Science.gov (United States)

Jennings, Nancy

2010-09-01

Health care organizations are constantly striving to provide a more cost-effective and higher quality treatment within a caring environment. However, balancing the demands of regulatory agencies with the holistic needs of the patient is challenging. Further challenging is how to define those hospitals that provide an exceptional caring environment for their patients. By using survey tools that are already being administered in hospital settings, the opportunity exists to analyze the results obtained from these tools to define a hospital as a caring organization without the added burden of separate data collection.

Clinical Holistic Medicine: The Dean Ornish Program (“Opening the Heart” in Cardiovascular Disease

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Søren Ventegodt

2006-01-01

Full Text Available Dean Ornish of the Preventive Medicine Research Institute in Sausalito, California has created an intensive holistic treatment for coronary heart patients with improved diet (low fat, whole foods, plant based, exercise, stress management, and social support that has proven to be efficient. In this paper, we analyze the rationale behind his cure in relation to contemporary holistic medical theory. In spite of a complex treatment program, the principles seem to be simple and in accordance with holistic medical theories, like the Antonovsky concept of rehabilitating the sense of coherence and the life mission theory for holistic medicine. We believe there is a need for the allocation of resources for further research into the aspects of holistic health and its methods, where positive and significant results have been proven and reproduced at several sites.

Clinical Holistic Medicine: Whiplash, Fibromyalgia, and Chronic Fatigue

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Søren Ventegodt

2005-01-01

Full Text Available Holistic treatment of the highly complex, “new diseases” are often possible with the tools of consciousness-based medicine. The treatment is more complicated and the cure usually takes longer than for less-complex diseases. The problem with these patients is that they have less easily accessible resources than most patients, as they suffer from a combined socio-psycho-physical problem with depression, poor social standing, low confidence, and low self-esteem. Often, they have also already tried most of the specialist and alternative treatments on the market. To cure them, the most important thing is to coach them to improve their social life by changing their behavior to be of more value to others. Holding and processing must be especially careful and the contract with the patients must be extremely explicit in order to work on their personal development for 6—12 months. The new diseases can be cured with consciousness-based medicine if the patients are motivated and keep their appointments and agreements. Low responsibility, low personal energy, little joy of life, and limited insight into self and existence are some of the features of the new diseases that make them difficult to cure. The important thing is to keep a pace the patient can follow and give the patient a row of small successes and as few failures as possible. The new diseases are a challenge, a unique chance to improve communication, holding, and processing skills.

Holistic oral health care in India: A corporate perspective

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Manas Gupta

2015-01-01

Full Text Available People from many advanced countries are traveling to developing countries like India for medical and dental care along with their vacations, which is also known as medical tourism. Dental tourism means traveling abroad for affordable dental care, dental surgery, or dental procedures, which is generally expensive in their own country, while exploring the visiting country. Dental tourism forms 10% of the total Indian medical tourism, which is projected to grow to 30% by 2015. It has greatly developed overtime and it is likely to further expand more as international patients find it more and more advantageous due to affordable dental treatments in India from highly qualified and experienced professionals. The oral health professionals can arrange for travel and tours along with dental treatment at most competitive rates. The article focuses on the emergence of the dental tourism as a booming industry and the key management aspects that will help oral health professionals to establish India as a dental care destination.

Holistic processing of face configurations and components.

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Hayward, William G; Crookes, Kate; Chu, Ming Hon; Favelle, Simone K; Rhodes, Gillian

2016-10-01

Although many researchers agree that faces are processed holistically, we know relatively little about what information holistic processing captures from a face. Most studies that assess the nature of holistic processing do so with changes to the face affecting many different aspects of face information (e.g., different identities). Does holistic processing affect every aspect of a face? We used the composite task, a common means of examining the strength of holistic processing, with participants making same-different judgments about configuration changes or component changes to 1 portion of a face. Configuration changes involved changes in spatial position of the eyes, whereas component changes involved lightening or darkening the eyebrows. Composites were either aligned or misaligned, and were presented either upright or inverted. Both configuration judgments and component judgments showed evidence of holistic processing, and in both cases it was strongest for upright face composites. These results suggest that holistic processing captures a broad range of information about the face, including both configuration-based and component-based information. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Reflections on Palliative Care from the Jewish and Islamic Tradition

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Michael Schultz

2012-01-01

Full Text Available Spiritual care is a vital part of holistic patient care. Awareness of common patient beliefs will facilitate discussions about spirituality. Such conversations are inherently good for the patient, deepen the caring staff-patient-family relationship, and enhance understanding of how beliefs influence care decisions. All healthcare providers are likely to encounter Muslim patients, yet many lack basic knowledge of the Muslim faith and of the applications of Islamic teachings to palliative care. Similarly, some of the concepts underlying positive Jewish approaches to palliative care are not well known. We outline Jewish and Islamic attitudes toward suffering, treatment, and the end of life. We discuss our religions' approaches to treatments deemed unnecessary by medical staff, and consider some of the cultural reasons that patients and family members might object to palliative care, concluding with specific suggestions for the medical team.

Sygepleje til patienter med hepatisk encefalopati

DEFF Research Database (Denmark)

Ladegaard Grønkjær, Lea; Lænsø Baltzer, Rikke; Bjerg, Susanne Helle

2014-01-01

This article describes the nurse’s role in the treatment and care of patients with hepatic encephalopathy (HE). In order to provide a holistic care, a nurse should be aware of the triggering causes of HE and its treatment, differential diagnoses for HE and the degrees of HE severity. The article...

‘Holistic Mothers’ or ‘Bad Mothers’? Challenging Biomedical Models of the Body in Portugal

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Anna Fedele

2016-06-01

Full Text Available This paper is based on early fieldwork findings on ‘holistic mothering’ in contemporary Portugal. I use holistic mothering as an umbrella term to cover different mothering choices, which are rooted in the assumption that pregnancy, childbirth and early childhood are important spiritual occasions for both mother and child. Considering that little social scientific literature exists about the religious dimension of alternative mothering choices, I present here a first description of this phenomenon and offer some initial anthropological reflections, paying special attention to the influence of Goddess spirituality on holistic mothers. Drawing on Pamela Klassen’s ethnography about religion and home birth in America (2001, I argue that in Portugal holistic mothers are challenging biomedical models of the body, asking for a more woman-centred care, and contributing to the process, already widespread in certain other European countries, of ‘humanising’ pregnancy and childbirth.

Intuitive Face Judgments Rely on Holistic Eye Movement Pattern

Directory of Open Access Journals (Sweden)

Laura F. Mega

2017-06-01

Full Text Available Non-verbal signals such as facial expressions are of paramount importance for social encounters. Their perception predominantly occurs without conscious awareness and is effortlessly integrated into social interactions. In other words, face perception is intuitive. Contrary to classical intuition tasks, this work investigates intuitive processes in the realm of every-day type social judgments. Two differently instructed groups of participants judged the authenticity of emotional facial expressions, while their eye movements were recorded: an ‘intuitive group,’ instructed to rely on their “gut feeling” for the authenticity judgments, and a ‘deliberative group,’ instructed to make their judgments after careful analysis of the face. Pixel-wise statistical maps of the resulting eye movements revealed a differential viewing pattern, wherein the intuitive judgments relied on fewer, longer and more centrally located fixations. These markers have been associated with a global/holistic viewing strategy. The holistic pattern of intuitive face judgments is in line with evidence showing that intuition is related to processing the “gestalt” of an object, rather than focusing on details. Our work thereby provides further evidence that intuitive processes are characterized by holistic perception, in an understudied and real world domain of intuition research.

Proactive cancer care in primary care: a mixed-methods study.

Science.gov (United States)

Kendall, Marilyn; Mason, Bruce; Momen, Natalie; Barclay, Stephen; Munday, Dan; Lovick, Roberta; Macpherson, Stella; Paterson, Euan; Baughan, Paul; Cormie, Paul; Kiehlmann, Peter; Free, Amanda; Murray, Scott A

2013-06-01

Current models of post-treatment cancer care are based on traditional practices and clinician preference rather than evidence of benefit. To assess the feasibility of using a structured template to provide holistic follow-up of patients in primary care from cancer diagnosis onwards. A two-phase mixed methods action research project. An electronic cancer ongoing review document (CORD) was first developed with patients and general practitioners, and used with patients with a new diagnosis of cancer. This was evaluated through documentary analysis of the CORDs, qualitative interviews with patients, family carers and health professionals and record reviews. The records of 107 patients from 13 primary care teams were examined and 45 interviews conducted. The document was started in 54% of people with newly diagnosed cancer, and prompted clear documentation of multidimension needs and understanding. General practitioners found using the document helped to structure consultations and cover psychosocial areas, but they reported it needed to be better integrated in their medical records with computerized prompts in place. Few clinicians discussed the review openly with patients, and the template was often completed afterwards. Anticipatory cancer care from diagnosis to cure or death, 'in primary care', is feasible in the U.K. and acceptable to patients, although there are barriers. The process promoted continuity of care and holism. A reliable system for proactive cancer care in general practice supported by hospital specialists may allow more survivorship care to be delivered in primary care, as in other long-term conditions.

Holistic evaluations of learning materials

DEFF Research Database (Denmark)

Bundsgaard, Jeppe; Hansen, Thomas Illum

2011-01-01

The aim of this paper is to present a holistic framework for evaluating learning materials and designs for learning. A holistic evaluation of learning material comprises investigations of - the potential learning potential, i.e. the affordances and challenges of the learning material...

Behandling af kroniske sygdomme hos patienter med demens

DEFF Research Database (Denmark)

Pedersen, Hanne; Klinkby, Kristian Skikkild; Waldorff, Frans Borch

2017-01-01

, polypharmacy and chronic pain. Ongoing goal setting is important, and advance care planning is recommended. In general, comorbidity must be carefully and holistic assessed and managed according to each patient's general status of health and stage of dementia. As the dementia develops, focus should primarily...

Using patient acuity data to manage patient care outcomes and patient care costs.

Science.gov (United States)

Van Slyck, A; Johnson, K R

2001-01-01

This article describes actual reported uses for patient acuity data that go beyond historical uses in determining staffing allocations. These expanded uses include managing patient care outcomes and health care costs. The article offers the patient care executive examples of how objective, valid, and reliable data are used to drive approaches to effectively influence decision making in an increasingly competitive health care environment.

Mentor Service Themes Emergent in a Holistic, Undergraduate Peer-Mentoring Experience

Science.gov (United States)

Ward, Elijah G.; Thomas, Earl E.; Disch, William B.

2014-01-01

Little research has focused carefully on the means by which peer mentors foster development in undergraduate protégés. Two faculty members developed a holistic, peer-mentoring project in which 26 upperclassmen mentored 74 underclassmen at a midsize, 4-year institution. Mentor journal notes, open-ended protégé responses, and participant…

Adaptive practices in heart failure care teams: implications for patient-centered care in the context of complexity

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Tait GR

2015-08-01

Full Text Available Glendon R Tait,1 Joanna Bates,2 Kori A LaDonna,3 Valerie N Schulz,4 Patricia H Strachan,5 Allan McDougall,3 Lorelei Lingard3 1Department of Psychiatry and Division of Medical Education, Dalhousie University, Halifax, NS, 2Centre for Health Education Scholarship, Vancouver General Hospital, Vancouver, BC, 3Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, 4Palliative Care, London Health Sciences Centre, University Hospital, London; 5School of Nursing, McMaster University, Hamilton, ON, Canada Background: Heart failure (HF, one of the three leading causes of death, is a chronic, progressive, incurable disease. There is growing support for integration of palliative care’s holistic approach to suffering, but insufficient understanding of how this would happen in the complex team context of HF care. This study examined how HF care teams, as defined by patients, work together to provide care to patients with advanced disease. Methods: Team members were identified by each participating patient, generating team sampling units (TSUs for each patient. Drawn from five study sites in three Canadian provinces, our dataset consists of 209 interviews from 50 TSUs. Drawing on a theoretical framing of HF teams as complex adaptive systems (CAS, interviews were analyzed using the constant comparative method associated with constructivist grounded theory. Results: This paper centers on the dominant theme of system practices, how HF care delivery is reported to work organizationally, socially, and practically, and describes two subthemes: “the way things work around here”, which were commonplace, routine ways of doing things, and “the way we make things work around here”, which were more conscious, effortful adaptations to usual practice in response to emergent needs. An adaptive practice, often a small alteration to routine, could have amplified effects beyond those intended by the innovating team

Holistic processing of fingerprints by expert forensic examiners.

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Vogelsang, Macgregor D; Palmeri, Thomas J; Busey, Thomas A

2017-01-01

Holistic processing is often characterized as a process by which objects are perceived as a whole rather than a compilation of individual features. This mechanism may play an important role in the development of perceptual expertise because it allows for rapid integration across image regions. The present work explores whether holistic processing is present in latent fingerprint examiners, who compare fingerprints collected from crime scenes against a set of standards taken from a suspect. We adapted a composite task widely used in the face recognition and perceptual expertise literatures, in which participants were asked to match only a particular half of a fingerprint with a previous image while ignoring the other half. We tested both experts and novices, using both upright and inverted fingerprints. For upright fingerprints, we found weak evidence for holistic processing, but with no differences between experts and novices with respect to holistic processing. For inverted fingerprints, we found stronger evidence of holistic processing, with weak evidence for differences between experts and novices. These relatively weak holistic processing effects contrast with robust evidence for holistic processing with faces and with objects in other domains of perceptual expertise. The data constrain models of holistic processing by demonstrating that latent fingerprint experts and novices may not substantively differ in terms of the amount of holistic processing and that inverted stimuli actually produced more evidence for holistic processing than upright stimuli. Important differences between the present fingerprint stimuli and those in the literature include the lack of verbal labels for experts and the absence of strong vertical asymmetries, both of which might contribute to stronger holistic processing signatures in other stimulus domains.

Treatment of holistic suffering in cancer: A systematic literature review.

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Best, Megan; Aldridge, Lynley; Butow, Phyllis; Olver, Ian; Price, Melanie A; Webster, Fleur

2015-12-01

Holistic suffering is a debilitating problem for cancer patients. Although many treatments have been suggested for its alleviation, they have not been compared for effectiveness. This literature review seeks to identify what interventions are effective in treatment of holistic suffering of cancer patients. A systematic review was conducted to identify and evaluate studies of interventions for holistic suffering in adult cancer patients. Search terms were generated iteratively from the literature. MEDLINE, EMBASE, the Cochrane Library and PsycINFO databases were searched for the years 1992-2015. Included studies were peer-reviewed, English language reports of either a controlled trial or a randomised controlled trial focusing on therapies aimed at relieving suffering in adult cancer patients. Articles were excluded if focused predominantly on spiritual or existential issues or concerns not leading to suffering. Studies were graded for quality using the QualSyst quantitative checklist. Levels of evidence were ascertained by completing the National Health and Medical Research Council criteria. Results are reported according to AMSTAR guidelines. The studies represented seven intervention types. Meaning-centred, hope-centred and stress-reduction interventions were found to be effective. Results of both psycho-educational and spiritual interventions in improving spiritual well-being were mixed. Supportive-expressive interventions - with the exception of forgiveness therapy - were not efficacious. There was little or no evidence for the efficacy of creative and healing arts and other assessed interventions such as animal therapy and haptotherapy. This systematic review found that spiritual well-being, meaning, hope and benefit finding can be positively impacted by a variety of treatment modalities. © The Author(s) 2015.

'Targeting' sedation: the lived experience of the intensive care nurse.

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Everingham, Kirsty; Fawcett, Tonks; Walsh, Tim

2014-03-01

To discuss the findings from a phenomenological study that provides insights into the intensive care nurses' 'world' following changes in the sedation management of patients in an intensive care unit. Intensive care sedation practices have undergone significant changes. Patients, where possible, are now managed on lighter levels of sedation, often achieved through the performance of sedation holds (SHs). The performance of SHs is normally carried out by the bedside nurse but compliance is reported to be poor. There has been little exploration of the nurses' experiences of these changes and the implications of SHs and subsequent wakefulness on their delivery of care. Following ethical approval, 16 intensive care nurses, experienced and inexperienced, from within a general intensive care unit. A Heideggerian phenomenological approach was used. Data collection consisted of interviews guided by an aide memoir and a framework adapted from Van Manen informed the analysis. The findings reveal new insights into the world of the intensive care nurse in the light of the changes to sedation management. They demonstrate that there have been unforeseen outcomes from well-intentioned initiatives to improve the quality of patients' care. There were implications from the changes introduced for the nurses care delivery. The main themes that emerged were 'working priorities' and 'unintended consequences', in turn revealing embedded tensions between evidence-based targets and holistic care. Intensive care nurses find that the current approach to the changes in sedation management can threaten their professional obligation and personal desire to provide holistic care. The 'targeted' approach by healthcare organisations is perceived to militate against the patient-centred care they want to deliver. Sedation management is complex and needs further consideration particularly the potential constraints 'target-led' care has on nursing practice. © 2013 Blackwell Publishing Ltd.

Multidisciplinary family-centred psychosocial care for patients with CHD: consensus recommendations from the AEPC Psychosocial Working Group.

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Utens, Elisabeth M W J; Callus, Edward; Levert, Eveline M; Groote, Katya De; Casey, Frank

2018-02-01

Because of the enormous advances in the medical treatment of CHD, the long-term survival of patients suffering from this disease has increased significantly. Currently, about 90% of patients reach adulthood, which entails many new challenges both for patients and their families and for healthcare professionals. The main objective of family-centred psychosocial care is to strengthen the emotional resilience of chronically ill patients and their families by adopting a holistic approach. During the biannual meeting of the psychosocial working group in 2012, participants expressed the need for general European guidelines. The present recommendations were written to support medical staff and psychosocial healthcare professionals to provide the best care for children and adolescents with CHD as well as for their families. This article describes in detail how the integrated family-centred psychological care modules work, involving different healthcare specialists, including a paediatric/congenital cardiologist or a general paediatrician. The different clinical implications and specific needs have been taken into account and recommendations have been provided on the following: structured follow-up screening; identification of stressful periods related to cardiac surgery or invasive medical procedures; evidence-based, disease-specific, and family-oriented psychosocial interventions; and interactive media links to medical and psychosocial information.

Holistic Admissions in Nursing: We Can Do This.

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Glazer, Greer; Clark, Angela; Bankston, Karen; Danek, Jennifer; Fair, Malika; Michaels, Julia

2016-01-01

Research shows that holistic admissions review practices can increase diversity across students without decreasing the workforce preparedness and academic success of students. Therefore, many disciplines have readily adopted the widespread use of holistic admissions review. Despite its proven effectiveness in addressing student diversity, nursing has been slow to implement holistic admissions review. The purpose of this study was to gain a better understanding of the barriers to implementing holistic admissions review in nursing and the feasibility of adopting holistic admissions review across nursing programs. A biphasic qualitative research study was conducted with nursing deans from across the United States. Qualitative data collection consisted of two phases of focus group discussions conducted over a 3-month period. The qualitative data were analyzed using content analysis. The categories and subcategories identified in Phase 1 informed the discussion in Phase 2. One overarching category from Phase 1 was identified, which was the lack of nursing schools' knowledge regarding holistic admissions review. Four subcategories also identified in Phase 1 included the need for better dissemination of evidence, the need for additional support from university leaders and administrators, the need for legal guidance to facilitate implementation of holistic admissions review, and ensuring appropriate resources to support the holistic admissions review process. Three categories emerged in Phase 2, which included everyone's buy-in is required, the need for a model, and a need for training. The adoption of holistic admissions review in nursing may be feasible. However, certain barriers need to be overcome so that nursing schools can successfully take on this process. Therefore, five recommendations have been developed to assist nursing schools in the implementation of holistic admissions review. These recommendations include increasing knowledge and understanding of holistic

Holistic Admissions in Nursing: We Can Do This

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GLAZER, GREER; CLARK, ANGELA; BANKSTON, KAREN; DANEK, JENNIFER; FAIR, MALIKA; MICHAELS, JULIA

2016-01-01

Research shows that holistic admissions review practices can increase diversity across students without decreasing the workforce preparedness and academic success of students. Therefore, many disciplines have readily adopted the widespread use of holistic admissions review. Despite its proven effectiveness in addressing student diversity, nursing has been slow to implement holistic admissions review. The purpose of this study was to gain a better understanding of the barriers to implementing holistic admissions review in nursing and the feasibility of adopting holistic admissions review across nursing programs. A biphasic qualitative research study was conducted with nursing deans from across the United States. Qualitative data collection consisted of two phases of focus group discussions conducted over a 3-month period. The qualitative data were analyzed using content analysis. The categories and subcategories identified in Phase 1 informed the discussion in Phase 2. One overarching category from Phase 1 was identified, which was the lack of nursing schools’ knowledge regarding holistic admissions review. Four subcategories also identified in Phase 1 included the need for better dissemination of evidence, the need for additional support from university leaders and administrators, the need for legal guidance to facilitate implementation of holistic admissions review, and ensuring appropriate resources to support the holistic admissions review process. Three categories emerged in Phase 2, which included everyone’s buy-in is required, the need for a model, and a need for training. The adoption of holistic admissions review in nursing may be feasible. However, certain barriers need to be overcome so that nursing schools can successfully take on this process. Therefore, five recommendations have been developed to assist nursing schools in the implementation of holistic admissions review. These recommendations include increasing knowledge and understanding of

The effect of a holistic self-management plan on asthma control.

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Grammatopoulou, Eirini; Skordilis, Emmanouil K; Haniotou, Aikaterini; John, Zarotis; Athanasopoulos, Spyros

2017-08-01

The holistic self-management plan includes lifelong actions that enable patients to cope with their disease. The present study was designed to evaluate the effect of a holistic self-management plan on asthma control. A 12-month controlled study was conducted. Adult patients with mild-to-moderate asthma (n = 24) who attended the emergency asthma department were randomized to two groups: One group followed four educational sessions and three personal home sessions (n = 12), while a second group received a short manual with asthma information (n = 12). The main measure was the asthma control test (ACT), while secondary outcomes were self-efficacy (general self-efficacy scale, GSE), end-tidal carbon dioxide (ETCO 2 ), respiratory rate (RR), breathing hold time (BHT), the Nijmegen Questionnaire (NQ), and spirometry (FEV 1 % predicted (forced expiratory volume in 1 second % predicted)) scores. The 2 × 4 ANOVA showed a significant interaction effect between intervention and time in ACT (p = 0.001), GSE (p holistic self-management in asthma control. Behavioral changes, as indicated by the development of self-efficacy and the reduction of hyperventilation, contributed to the effectiveness of the intervention.

Holistic pediatric veterinary medicine.

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Pesch, Lisa

2014-03-01

Holistic veterinary medicine treats the whole patient including all physical and behavioral signs. The root cause of disease is treated at the same time as accompanying clinical signs. Herbal and nutritional supplements can help support tissue healing and proper organ functioning, thereby reducing the tendency of disease progression over time. Proper selection of homeopathic remedies is based on detailed evaluation of clinical signs. Herbal medicines are selected based on organ(s) affected and the physiologic nature of the imbalance. Many herbal and nutraceutical companies provide support for veterinarians, assisting with proper formula selection, dosing, drug interactions, and contraindications. Copyright © 2014 Elsevier Inc. All rights reserved.

Is routine holistic assessment with a prompt list feasible during consultations after treatment for oral cancer?

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Rogers, S N; Ahiaku, S; Lowe, D

2018-01-01

The head and neck cancer Patient Concerns Inventory (PCI-HN) is a holistic, self-reported list of items that can help patients to disclose their needs and concerns during routine follow-up consultations. The aim of this study was to report how often it was used during the first three years of follow up after treatment for oral cancer, and the range of issues that were raised. The sample comprised consecutive patients treated over a three-year period with curative intent. All clinic attendances were reviewed until October 2015 or until patients had a recurrence, a subsequent primary, metastases, or were discharged home or to follow up at a peripheral hospital, or started palliative care. We identified 92 patients and data were available for 88 of them. The median (IQR) age at the time of treatment was 65 (57-76) years, and 48 (55%) were men. Reviews alternated between the surgeon and oncologist, and typically there were 4.4 surgical reviews in year one, 2.8 in year two, and 1.6 in year three. The inventory was completed 157 times; at least once by 71% (55/77) during year one, 57% (29/51) during year two, and 37% (13/35) during year three. Of those who completed none, nearly half (7/17) died within 12 months, and another six were over 80 years of age. In conclusion, the diversity of concerns raised by patients highlights the need for holistic assessment during follow up, and integration of the inventory into routine consultations will mean that we can repeat it. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Transfer-of-Care Communication: Nursing Best Practices.

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Chard, Robin; Makary, Martin A

2015-10-01

The successful and safe transfer of the patient from one phase of care to another is contingent on optimal communication by all team members. Nurses are often in a natural leadership position to improve safe practices during hand overs. A holistic understanding of the patient allows the perioperative nurse the opportunity to identify issues and choose a nursing diagnosis based on key elements of a patient's needs and goals--information that should be relayed during patient transfers. This article reviews best practices in transfer-of-care communication to enable perioperative RNs to take an active, leading role in hand-over processes. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Better arthritis care: Patients' expectations and priorities, the competencies that community-based health professionals need to improve their care of people with arthritis?

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Erwin, J; Edwards, K; Woolf, A; Whitcombe, S; Kilty, S

2018-03-01

The aim of the present study was to identify the competencies that patients think non-specialist community-based nurses and allied health professionals (AHPs) need to enable them to assess, care for and manage arthritis appropriately. Four face-to-face focus groups were held with a total of 16 women and nine men with arthritis, to discuss the care they received from community-based health professionals, the skills and knowledge they expected from community-based health professionals and what they prioritized. People with arthritis wanted health providers to have an understanding of the difference between inflammatory arthritis (IA) and osteoarthritis (OA), of how serious OA can be, and of the unpredictability of IA and flares. They emphasized the need for nurses and AHPs to understand the psychosocial impact of arthritis on individuals, family and friends, and the psychological adjustment needed when diagnosed with IA. They wanted community-based health professionals to have some knowledge of the types of drug treatments that people with IA receive and the implications of taking immunosuppressive drugs. They also wanted them to understand the pain associated with arthritis, particularly OA, which participants felt was not taken seriously enough. They wanted nurses and AHPs in the community to be able to give basic advice on pacing and pain management, to make multidisciplinary referrals, to communicate effectively between referral points and to be able to signpost people to sources of help and good, reliable sources of education and information (especially for OA). They also wanted them to understand that patients who have had a diagnosis for a long time are the experts in their own disease. Other areas which were emphasized as being important were good communication skills and taking a holistic approach to caring for people with arthritis. OA and IA differ significantly, both in their nature and their management. However, patients with arthritis want health

Holistic processing from learned attention to parts.

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Chua, Kao-Wei; Richler, Jennifer J; Gauthier, Isabel

2015-08-01

Attention helps us focus on what is most relevant to our goals, and prior work has shown that aspects of attention can be learned. Learned inattention to parts can abolish holistic processing of faces, but it is unknown whether learned attention to parts is sufficient to cause a change from part-based to holistic processing with objects. We trained subjects to individuate nonface objects (Greebles) from 2 categories: Ploks and Glips. Diagnostic information was in complementary halves for the 2 categories. Holistic processing was then tested with Plok-Glip composites that combined the kind of part that was diagnostic or nondiagnostic during training. Exposure to Greeble parts resulted in general failures of selective attention for nondiagnostic composites, but face-like holistic processing was only observed for diagnostic composites. These results demonstrated a novel link between learned attentional control and the acquisition of holistic processing. (c) 2015 APA, all rights reserved).

Recurrent autoassociative networks and holistic computations

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Stoianov, [No Value; Amari, SI; Giles, CL; Gori, M; Piuri,

2000-01-01

The paper presents an experimental study of holistic computations over distributed representations (DRs) of sequences developed by the Recurrent Autoassociative Networks (KAN). Three groups of holistic operators are studied: extracting symbols at fixed position, extracting symbols at a variable

‘Reaching Out’: international models for transitional care for teenage and young adult cancer patients

Directory of Open Access Journals (Sweden)

Charlotte Weston

2018-05-01

Full Text Available Background: This article will give an overview of ‘Reaching Out’, a project to identify international models of transitional care for adolescent and young adult (AYA cancer patients. Aims: •\tExplore provision of AYA cancer care in a different cultural context •\tIdentify new models of care for supporting transition between paediatric, AYA and adult care, and between acute and primary care •\tIdentify relevant resources and service designs that could be adapted for use in AYA services in the UK Methods: Three-week observational visit in a range of international healthcare settings. Findings: Similarities and differences between Australian and UK healthcare systems were observed. Models of care using a range of resources, including structured health and wellbeing programmes, were identified to support transitional care. Models of collaborative working across organisations were observed. The implementation of innovative programmes to improve efficiency of services and limit unnecessary impact on patient time and finances were identified, including the use of Skype for collaborative consultations between acute and community healthcare providers. Conclusions: Recommendations to benefit AYA patients with an improved range of supportive, holistic services and improved person-centred care include: •\tJoint AYA nursing posts between AYA centres to support transition •\tStructured AYA post-treatment health and wellbeing programme •\tProgramme of creative wellbeing projects to support transition at the end of treatment Scope use of Skype appointments within the AYA service Implications for practice: Observing service provision and healthcare practice in an international setting provides the opportunity to improve cross-cultural competence, which is essential to culturally competent care. Cross-cultural competence supports the improvement of patient care through experiential learning, sharing of ideas and connecting with others. The

Ecological caring-Revisiting the original ideas of caring science.

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Dahlberg, Helena; Ranheim, Albertine; Dahlberg, Karin

2016-01-01

The aim of this empirically grounded philosophical paper is to explore the notion of holistic care with the intention to expand it into a notion of ecological care and in such a way revisit the original ideas of caring science. The philosophical analysis, driven by lifeworld theory and especially Merleau-Ponty's philosophy, is firmly rooted in contemporary clinical care. We used interview data from patients in a study at an anthroposophic clinic in Sweden, which forms part of an ecological community with, for example, ecological agriculture. The empirical study is analysed according to reflective lifeworld research. Starting from the fact that illness can be defined as a loss of homelikeness in the body and in the familiar world, our findings illustrate how ecological care helps the patient to once again find one's place in a world that is characterized by interconnectedness. The task of ecological care is thus not only to see the patient within a world of relationships but to help the patient find his/her place again, to understand himself/herself and the world anew . Ecological care is not only about fighting an illness, but also recognizes a patient from inside a world that s/he is affected by and affects, that s/he is understood and understands from. Such care tries to restore this connection by making possible the rhythmical movement as well as the space in-between activity and rest, between being cared for and actively involving oneself in one's recovery and between closing oneself off from the world and once again going out into it.

Patient's experience with comorbidity management in primary care: a qualitative study of comorbid pain and obesity.

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Janke, E Amy; Ramirez, Michelle L; Haltzman, Brittany; Fritz, Megan; Kozak, Andrea T

2016-01-01

The aim of this research is to examine perceptions of those with comorbid chronic pain and obesity regarding their experience of comorbidity management in primary care settings. Chronic pain and obesity are common comorbidities frequently managed in primary care settings. Evidence suggests individuals with this comorbidity may be at risk for suboptimal clinical interactions; however, treatment experiences and preferences of those with comorbid chronic pain and obesity have received little attention. Semi-structured interviews conducted with 30 primary care patients with mean body mass index=36.8 and comorbid persistent pain. The constant comparative method was used to analyze data. Participants discussed frustration with a perceived lack of information tailored to their needs and a desire for a personalized treatment experience. Participants found available medical approaches unsatisfying and sought a more holistic approach to management. Discussions also focused around the need for providers to initiate efforts at education and motivation enhancement and to show concern for and understanding of the unique difficulties associated with comorbidity. Findings suggest providers should engage in integrated communication regarding weight and pain, targeting this multimorbidity using methods aligned with priorities discussed by patients.

Emergency Nurses' Perspectives: Factors Affecting Caring.

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Enns, Carol L; Sawatzky, Jo-Ann V

2016-05-01

Caring is a universal phenomenon. However, as a result of higher patient acuity and staff shortages within the chaotic ED environment, caring behaviors may be in peril. The purpose of this study was to gain insight into the meaning of caring from the perspective of emergency nurses. Exploring nurses' perspectives of caring is central to improving staffing and retention issues in this unique work environment. As part of a larger study, a subsample of emergency nurses who work in public hospitals in Manitoba, Canada (n = 17) were interviewed. A qualitative descriptive design was used to gain insight into the caring perspectives of nurses by asking them, "What does caring meaning to you?" and "What affects caring in your practice in the emergency department?" Emerging themes were extracted through analysis of audio tapes and transcripts. Advocacy and holistic care emerged as major themes in the meaning of caring for emergency nurses. Caring was affected by a number of factors, including workload, lack of time, staffing issues, shift work, and lack of self-care. However, lack of management support was the most consistent hindrance to caring identified by study participants. Caring continues to be a unifying concept in nursing; however, influencing factors continue to undermine caring for emergency nurses. Caring is not subsidiary to nursing; it is the central core of nursing. Therefore, fostering a caring working environment is essential for nurses to practice holistic nursing care. It is also imperative to job satisfaction and the retention of emergency nurses. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

A pilot randomised controlled trial of personalised care after treatment for prostate cancer (TOPCAT-P): nurse-led holistic-needs assessment and individualised psychoeducational intervention: study protocol.

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Stanciu, Marian Andrei; Morris, Caroline; Makin, Matt; Watson, Eila; Bulger, Jenna; Evans, Richard; Hiscock, Julia; Hoare, Zoë; Edwards, Rhiannon Tudor; Neal, Richard David; Wilkinson, Clare

2015-06-25

Prostate cancer is common and the incidence is increasing, but more men are living longer after diagnosis, and die with their disease rather than of it. Nonetheless, specific and substantial physical, sexual, emotional and mental health problems often lead to a poor quality of life. Urology services increasingly struggle to cope with the demands of follow-up care, and primary care is likely to play the central role in long-term follow-up. The present phase II trial will evaluate the feasibility and acceptability of a nurse-led, person-centred psychoeducational intervention, delivered in community or primary care settings. Prostate cancer survivors diagnosed in the past 9-48 months and currently biochemically stable will be identified from hospital records by their treating clinician. Eligible men would have either completed radical treatment, or would be followed up with prostate specific antigen monitoring and symptom reporting. We will recruit 120 patients who will be randomised to receive either an augmented form of usual care, or an additional nurse-led intervention for a period of 36 weeks. Following the health policy in Wales, the intervention is offered by a key worker, is promoting prudent healthcare and is using a holistic needs assessment. Outcome measures will assess physical symptoms, psychological well-being, confidence in managing own health and quality of life. Healthcare service use will be measured over 36 weeks. Feedback interviews with patients and clinicians will further inform the acceptability of the intervention. Recruitment, attrition, questionnaire completion rates and outcome measures variability will be assessed, and results will inform the design of a future phase III trial and accompanying economic evaluation. Ethics approval was granted by Bangor University and North Wales REC (13/WA/0291). Results will be reported in peer-reviewed publications, at scientific conferences, and directly through national cancer and primary care networks

A pilot randomised controlled trial of personalised care after treatment for prostate cancer (TOPCAT-P): nurse-led holistic-needs assessment and individualised psychoeducational intervention: study protocol

Science.gov (United States)

Stanciu, Marian Andrei; Morris, Caroline; Makin, Matt; Watson, Eila; Bulger, Jenna; Evans, Richard; Hiscock, Julia; Hoare, Zoë; Edwards, Rhiannon Tudor; Neal, Richard David; Wilkinson, Clare

2015-01-01

Introduction Prostate cancer is common and the incidence is increasing, but more men are living longer after diagnosis, and die with their disease rather than of it. Nonetheless, specific and substantial physical, sexual, emotional and mental health problems often lead to a poor quality of life. Urology services increasingly struggle to cope with the demands of follow-up care, and primary care is likely to play the central role in long-term follow-up. The present phase II trial will evaluate the feasibility and acceptability of a nurse-led, person-centred psychoeducational intervention, delivered in community or primary care settings. Methods and analysis Prostate cancer survivors diagnosed in the past 9–48 months and currently biochemically stable will be identified from hospital records by their treating clinician. Eligible men would have either completed radical treatment, or would be followed up with prostate specific antigen monitoring and symptom reporting. We will recruit 120 patients who will be randomised to receive either an augmented form of usual care, or an additional nurse-led intervention for a period of 36 weeks. Following the health policy in Wales, the intervention is offered by a key worker, is promoting prudent healthcare and is using a holistic needs assessment. Outcome measures will assess physical symptoms, psychological well-being, confidence in managing own health and quality of life. Healthcare service use will be measured over 36 weeks. Feedback interviews with patients and clinicians will further inform the acceptability of the intervention. Recruitment, attrition, questionnaire completion rates and outcome measures variability will be assessed, and results will inform the design of a future phase III trial and accompanying economic evaluation. Ethics and dissemination Ethics approval was granted by Bangor University and North Wales REC (13/WA/0291). Results will be reported in peer-reviewed publications, at scientific

Contextual facilitators and maintaining of compassion-based care: An ethnographic study

Directory of Open Access Journals (Sweden)

Sima Babaei

2017-01-01

Full Text Available Background: Compassion is an important part of nursing. It fosters better relationships between nurses and their patients. Moreover, it gives patients more confidence in the care they receive. Determining facilitators of compassion are essential to holistic care. The purpose of this study was to explore these facilitators. Materials and Methods: This ethnographic study was conducted in 2014–2015 with 20 nurses, 12 patients, and 4 family members in the medical and surgical wards. Data collection was done through observations and in-depth semi-structured interviews with purposive sampling. The study was carried out in 15 months. Data analysis was performed using constant comparison based on Strauss and Corbin. Results: Data analysis defined three main themes and eight subthemes as the fundamentals of compassion-based care. Nurses' personal factors with subcategories of personality, attitudes, and values and holistic view; and socio-cultural factors with subcategories of kindness role model, religious, and cultural values are needed to elicit compassionate behaviors. Initiator factors, with subcategories of patient suffering, patient communication demands, and patient emotional and psychological necessity are also needed to start compassionate behaviors. Conclusions: The findings of this study showed that nurses' communication with patients is nurse's duty in order to understand and respect the needs of patients. Attention should be paid to issues relating to compassion in nursing and practice educational programs. Indeed, creating a care environment with compassion, regardless of any shortcomings in the work condition, would help in the development of effective nursing.

Assessing Online Discussions: A Holistic Approach

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Wang, Yu-mei; Chen, Der-Thanq

2017-01-01

This article reports a holistic approach to assessing online discussions. This holistic approach integrates three assessment methods: assessment of learning, assessment for learning, and assessment as learning. Assessment of learning directly examines students' learning products to decide whether they have achieved the expected learning through…

A Shape-Based Account for Holistic Face Processing

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Zhao, Mintao; Bülthoff, Heinrich H.; Bülthoff, Isabelle

2016-01-01

Faces are processed holistically, so selective attention to 1 face part without any influence of the others often fails. In this study, 3 experiments investigated what type of facial information (shape or surface) underlies holistic face processing and whether generalization of holistic processing to nonexperienced faces requires extensive…

Fast and Careless or Careful and Slow? Apparent Holistic Processing in Mental Rotation Is Explained by Speed-Accuracy Trade-Offs

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Liesefeld, Heinrich René; Fu, Xiaolan; Zimmer, Hubert D.

2015-01-01

A major debate in the mental-rotation literature concerns the question of whether objects are represented holistically during rotation. Effects of object complexity on rotational speed are considered strong evidence against such holistic representations. In Experiment 1, such an effect of object complexity was markedly present. A closer look on…

The effects of holistic health group interventions on improving the cognitive ability of persons with mild cognitive impairment: a randomized controlled trial

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Young, Kim-wan; Ng, Petrus; Kwok, Timothy; Cheng, Daphne

2017-01-01

Purpose Persons with mild cognitive impairment (PwMCI) are at a higher risk of developing dementia than those without cognitive impairment. This research study aims to evaluate the effectiveness of a holistic health group intervention, which is based on the holistic brain health approach as well as an Eastern approach to health care, on improving the cognitive ability of Chinese PwMCI. Research methods In a randomized controlled trial (RCT), 38 Chinese PwMCI were randomly assigned to either a 10-session holistic health intervention group or the control group. The holistic health treatment group attempted to promote the acceptance of their illness, enhance memory and coping skills, develop a positive lifestyle, maintain positive emotions, and facilitate emotional support among participants. The 10-session holistic health group intervention was structured, with each session conducted once per week and ~90 minutes in length. Control group patients and their family caregivers received standardized basic educational materials that provided basic information on cognitive decline for them to read at home. The Montreal Cognitive Assessment (MoCA) test was used to assess the cognitive ability of PwMCI in the pre- and posttreatment periods by a research assistant who was blind to the group assignment of the participants. Results The paired-samples t-test indicated that the treatment group (n=18) showed significant improvement in the MoCA score, whereas the control group (n=20) did not. Moreover, 2×2 (group × time) repeated-measures analysis of covariance (ANCOVA) demonstrated that the holistic health group treatment was significantly more effective than the control intervention in improving the MoCA score, with a moderate effect size, and improving the delayed recall (ie, short-term memory), with a strong effect size, after controlling for age, sex, education, and marital status. Conclusion This present RCT provides evidence to support the feasibility and effectiveness of

The effects of holistic health group interventions on improving the cognitive ability of persons with mild cognitive impairment: a randomized controlled trial.

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Young, Kim-Wan; Ng, Petrus; Kwok, Timothy; Cheng, Daphne

2017-01-01

Persons with mild cognitive impairment (PwMCI) are at a higher risk of developing dementia than those without cognitive impairment. This research study aims to evaluate the effectiveness of a holistic health group intervention, which is based on the holistic brain health approach as well as an Eastern approach to health care, on improving the cognitive ability of Chinese PwMCI. In a randomized controlled trial (RCT), 38 Chinese PwMCI were randomly assigned to either a 10-session holistic health intervention group or the control group. The holistic health treatment group attempted to promote the acceptance of their illness, enhance memory and coping skills, develop a positive lifestyle, maintain positive emotions, and facilitate emotional support among participants. The 10-session holistic health group intervention was structured, with each session conducted once per week and ~90 minutes in length. Control group patients and their family caregivers received standardized basic educational materials that provided basic information on cognitive decline for them to read at home. The Montreal Cognitive Assessment (MoCA) test was used to assess the cognitive ability of PwMCI in the pre- and posttreatment periods by a research assistant who was blind to the group assignment of the participants. The paired-samples t -test indicated that the treatment group (n=18) showed significant improvement in the MoCA score, whereas the control group (n=20) did not. Moreover, 2×2 (group × time) repeated-measures analysis of covariance (ANCOVA) demonstrated that the holistic health group treatment was significantly more effective than the control intervention in improving the MoCA score, with a moderate effect size, and improving the delayed recall (ie, short-term memory), with a strong effect size, after controlling for age, sex, education, and marital status. This present RCT provides evidence to support the feasibility and effectiveness of the holistic health group intervention in

Improving Electronic Resources through Holistic Budgeting

Science.gov (United States)

Kusik, James P.; Vargas, Mark A.

2009-01-01

To establish a more direct link between its collections and the educational goals of Saint Xavier University, the Byrne Memorial Library has adopted a "holistic" approach to collection development. This article examines how traditional budget practices influenced the library's selection of resources and describes how holistic collection…

Addressing holistic healthcare needs of oncology patients: Implementation and evaluation of a complementary and alternative medicine (CAM) course within an elective module designed for healthcare professionals.

Science.gov (United States)

Klafke, Nadja; Homberg, Angelika; Glassen, Katharina; Mahler, Cornelia

2016-12-01

Patients, and especially oncology patients, increasingly demand information and application of complementary therapies to supplement their conventional medical treatment and follow-up care. Due to the widespread interest in holistic treatment opportunities in oncology populations, healthcare professionals need to be prepared in differentiating evidence-based methods of the complementary and alternative medicine (CAM) spectrum and how to consult with patients about it. This paper reports on the implementation and evaluation of a newly designed module "Complementary and Alternative Medicine in oncological healthcare" in the bachelor degree program Interprofessional Health Care (B.Sc.). The study applied a developed evaluation questionnaire to capture students' perspectives on the CAM contents. This assessment instrument was administered pre and post the CAM teaching unit. Interprofessional medical education, University Hospital Heidelberg, Germany. The integration of the CAM elective module was possible and was met by positive response. Students' interest was reflected in an increase of their self-reported knowledge gain and positive CAM attitude. Comparison of pre and post evaluation data demonstrate that, particularly, students' expectations on developing their own opinion about CAM, and getting an overview of the evidence-base of different CAM methods have been met. Evaluation results indicate that the module content was in line with the students' expectations and may have positively impacted on their general CAM attitude. The results support us in continuing to offer this CAM course within the elective module to prepare today's healthcare professionals for patient-oriented healthcare delivery. Copyright © 2016 Elsevier Ltd. All rights reserved.

Meta-analysis of positive effects, side effects and adverse events of holistic mind-body medicine (clinical holistic medicine): experience from Denmark, Sweden, United Kingdom and Germany.

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Ventegodt, Søren; Merrick, Joav

2009-01-01

About 50% of the general population has a chronic disease not cured by biomedicine. Meta-analysis of holistic clinical medicine for which chronic patients were treated and outcomes were, 1) global quality of life, 2) self-rated physical/mental health, quality of life or ability of functioning, or 3) patients felt cured for a specific disease of dysfunction. MEDLINE and PsycLNFO and specific journals were searched in January 2009. Eleven clinical studies (18,500 participants) were identified. Positive effects: Quality of life Number Needed to Treat (NNT) = 2, physical health problems NNT = 3, mental health problems NNT = 2, sexual dysfunctions NNT = 2, self esteem NNT = 2, working/studying ability NNT = 2, anorgasmia NNT = 1, other specific sexual dysfunctions NNT = 2. Of 791 patients treated was 617, or 78.0% cured (NNT = 1). Side effects and adverse events: re-traumatization Number Needed to Harm (NNH) > 18,500; brief reactive psychosis (if mentally ill) NNH = 4,625; brief reactive psychosis (if not mentally ill) NNH > 9,250; brief reactive psychosis, all patients NNH = 9,250; depression NNH > 18,500; depersonalization and derealization NNH > 18,500; iatrogenic disturbances NNH > 18,500; minor bone fractures (ribs, hand) NNH = 4,625; serious bone fractures (spine, scull, pelvis) NNH > 18,500; suicides during or less than three month after therapy NNH > 18,500; suicide attempts during or less than three month after therapy NNH > 18,500. Suicide was prevented NNT = 1. Therapeutic value TV = NNH/NNT = 9,250. Holistic clinical medicine is an efficient complementary and alternative medicine (CAM) treatment for chronic illnesses and health related problems. Every second patient with physical and mental disorders, sexual dysfunctions, and existential problems were healed. Holistic clinical medicine had no significant side effects or adverse events.

Validation of the Vanderbilt Holistic Face Processing Test.

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Wang, Chao-Chih; Ross, David A; Gauthier, Isabel; Richler, Jennifer J

2016-01-01

The Vanderbilt Holistic Face Processing Test (VHPT-F) is a new measure of holistic face processing with better psychometric properties relative to prior measures developed for group studies (Richler et al., 2014). In fields where psychologists study individual differences, validation studies are commonplace and the concurrent validity of a new measure is established by comparing it to an older measure with established validity. We follow this approach and test whether the VHPT-F measures the same construct as the composite task, which is group-based measure at the center of the large literature on holistic face processing. In Experiment 1, we found a significant correlation between holistic processing measured in the VHPT-F and the composite task. Although this correlation was small, it was comparable to the correlation between holistic processing measured in the composite task with the same faces, but different target parts (top or bottom), which represents a reasonable upper limit for correlations between the composite task and another measure of holistic processing. These results confirm the validity of the VHPT-F by demonstrating shared variance with another measure of holistic processing based on the same operational definition. These results were replicated in Experiment 2, but only when the demographic profile of our sample matched that of Experiment 1.

Validation of the Vanderbilt Holistic Face Processing Test.

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Chao-Chih Wang

2016-11-01

Full Text Available The Vanderbilt Holistic Face Processing Test (VHPT-F is a new measure of holistic face processing with better psychometric properties relative to prior measures developed for group studies (Richler et al., 2014. In fields where psychologists study individual differences, validation studies are commonplace and the concurrent validity of a new measure is established by comparing it to an older measure with established validity. We follow this approach and test whether the VHPT-F measures the same construct as the composite task, which is group-based measure at the center of the large literature on holistic face processing. In Experiment 1, we found a significant correlation between holistic processing measured in the VHPT-F and the composite task. Although this correlation was small, it was comparable to the correlation between holistic processing measured in the composite task with the same faces, but different target parts (top or bottom, which represents a reasonable upper limit for correlations between the composite task and another measure of holistic processing. These results confirm the validity of the VHPT-F by demonstrating shared variance with another measure of holistic processing based on the same operational definition. These results were replicated in Experiment 2, but only when the demographic profile of our sample matched that of Experiment 1.

An Opportunity for Healing and Holistic Care: Exploring the Roles of Health Care Providers Working Within Northern Canadian Aboriginal Communities.

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Rahaman, Zaida; Holmes, Dave; Chartrand, Larry

2016-05-22

The purpose of this qualitative study was exploring what the roles and challenges of health care providers working within Northern Canadian Aboriginal communities are and what resources can help support or impede their efforts in working toward addressing health inequities within these communities. The qualitative research conducted was influenced by a postcolonial epistemology. The works of theorists Fanon on colonization and racial construction, Kristeva on semiotics and abjection, and Foucault on power/knowledge, governmentality, and biopower were used in providing a theoretical framework. Critical discourse analysis of 25 semistructured interviews with health care providers was used to gain a better understanding of their roles and challenges while working within Northern Canadian Aboriginal communities. Within this research study, three significant findings emerged from the data. First, the Aboriginal person's identity was constructed in relation to the health care provider's role of delivering essential health services. Second, health care providers were not treating the "ill" patient, but rather treating the patient for being "ill." Third, health care providers were treating the Aboriginal person for being "Aboriginal" by separating the patient from his or her identity. The treatment involved reforming the Aboriginal patient from the condition of being "Aboriginal." © The Author(s) 2016.

About-face on face recognition ability and holistic processing.

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Richler, Jennifer J; Floyd, R Jackie; Gauthier, Isabel

2015-01-01

Previous work found a small but significant relationship between holistic processing measured with the composite task and face recognition ability measured by the Cambridge Face Memory Test (CFMT; Duchaine & Nakayama, 2006). Surprisingly, recent work using a different measure of holistic processing (Vanderbilt Holistic Face Processing Test [VHPT-F]; Richler, Floyd, & Gauthier, 2014) and a larger sample found no evidence for such a relationship. In Experiment 1 we replicate this unexpected result, finding no relationship between holistic processing (VHPT-F) and face recognition ability (CFMT). A key difference between the VHPT-F and other holistic processing measures is that unique face parts are used on each trial in the VHPT-F, unlike in other tasks where a small set of face parts repeat across the experiment. In Experiment 2, we test the hypothesis that correlations between the CFMT and holistic processing tasks are driven by stimulus repetition that allows for learning during the composite task. Consistent with our predictions, CFMT performance was correlated with holistic processing in the composite task when a small set of face parts repeated over trials, but not when face parts did not repeat. A meta-analysis confirms that relationships between the CFMT and holistic processing depend on stimulus repetition. These results raise important questions about what is being measured by the CFMT, and challenge current assumptions about why faces are processed holistically.

Holistic concept of marketing performance

OpenAIRE

Yu.V. Robul

2011-01-01

The scope of the article is to provide a critical analysis of ROMI as a metric of marketing performance, and to propose a more comprehensive construct of marketing efficiency, which considers a holistic nature of the concept of modern marketing. It is argued that ROMI be crucial insufficient as a marketing performanceindicator. In the holistic framework, a complex set of marketing performance metrics to be developed is outlined.

Hemispheric asymmetry in holistic processing of words.

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Ventura, Paulo; Delgado, João; Ferreira, Miguel; Farinha-Fernandes, António; Guerreiro, José C; Faustino, Bruno; Leite, Isabel; Wong, Alan C-N

2018-05-13

Holistic processing has been regarded as a hallmark of face perception, indicating the automatic and obligatory tendency of the visual system to process all face parts as a perceptual unit rather than in isolation. Studies involving lateralized stimulus presentation suggest that the right hemisphere dominates holistic face processing. Holistic processing can also be shown with other categories such as words and thus it is not specific to faces or face-like expertize. Here, we used divided visual field presentation to investigate the possibly different contributions of the two hemispheres for holistic word processing. Observers performed same/different judgment on the cued parts of two sequentially presented words in the complete composite paradigm. Our data indicate a right hemisphere specialization for holistic word processing. Thus, these markers of expert object recognition are domain general.

Rationality and Irrationality in Ryke Geerd Hamer's System for Holistic Treatment of Metastatic Cancer

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Søren Ventegodt

2005-01-01

Full Text Available The aim of this paper is to examine if the “medical laws” found by the German physician Ryke Geerd Hamer are substantiated by contemporary holistic medical theory. He developed a psychosomatic theory after a personal emotional trauma that he believed resulted in his subsequent development of a testicular cancer. From our analysis, it is clear that the two most fundamental principles of Hamer's work, the psychosomatic “iron law of cancer” (Hamer's first “law” and the principle of pathogenesis being reversed into salutogenesis (Hamer's second “law”, are well-established principles of holistic medicine today. Hamer's understanding of symbols in medicine, virus and bacteria, and the evolutionary process itself (Hamer's third, fourth, and fifth “law” differs a great deal from both traditional and contemporary holistic medical theory and we did not find them substantiated. Hamer's understanding of cancer metastasis was built on these failing principles and therefore not substantiated either. Altogether, it seems that Hamer's thinking was basically sound as the most fundamental principles of his work were built on an understanding very similar to holistic medical thinkers of today. We found his postulate that metastatic cancer patients can be healed or their health improved by using his system of holistic medicine likely to be true, at least for some motivated patients. This must be tested scientifically, however, before being accepted. His presentation of his system and work has been idiosyncratic and highly provocative, which has alienated him from the whole medical community.

Palliative care for Parkinson's disease: Patient and carer's perspectives explored through qualitative interview.

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Fox, Siobhan; Cashell, Alison; Kernohan, W George; Lynch, Marie; McGlade, Ciara; O'Brien, Tony; O'Sullivan, Sean S; Foley, Mary J; Timmons, Suzanne

2017-07-01

Palliative care is recommended for non-malignant illnesses, including Parkinson's disease. However, past research with healthcare workers highlights unmet palliative needs in this population and referral rates to Specialist Palliative Care are low. Some healthcare workers perceive a 'fear' in their patients about introducing palliative care. However, less is known about the views of people with Parkinson's disease and their carers about palliative care. (1) To explore the palliative care and related issues most affecting people with Parkinson's disease and their families and (2) to examine perceptions about/understanding of palliative care. This was a qualitative study; semi-structured interviews were conducted, transcribed and analysed using thematic analysis. A total of 31 people participated, both people with Parkinson's disease ( n = 19) and carers ( n = 12), across three Movement Disorder Clinics in the Republic of Ireland. People with Parkinson's disease and their carers were unfamiliar with the term palliative care. When informed of the role of palliative care, most felt that they would benefit from this input. People with Parkinson's disease and carers experienced a high illness burden and wanted extra support. Crises requiring Specialist Palliative Care involvement may occur at diagnosis and later, with advancing illness. Participants wanted more information about palliative care and especially further supports to address their psychosocial needs. A holistic palliative care approach could address the complex physical and psychosocial symptoms experienced by people with Parkinson's disease and their carers, and people with Parkinson's disease and their carers are open to palliative care. Further research needs to explore how palliative care can be introduced into the routine care for people with Parkinson's disease.

Psychiatric and addiction consultation for patients in critical care.

Science.gov (United States)

Kaiser, Susan

2012-03-01

Practicing within the paradigm of compartmentalized specially treatment without a collaborative practice is ineffective for the chemical dependency and dual diagnosis population. Chemical dependency is not well understood as a disease, evidenced by barriers cited from the 2005 Survey on Drug Use and Health. Recovery from addiction and dual diagnosis logically demands an integrated and science-based treatment approach with unified standards for care and improved educational standards for preparation of care providers. Consultation and collaboration with addiction and psychiatric specialists is needed to establish consistency in standards for treatment and holistic care, essential for comorbidity. Continued learning and research about the complexity of the addiction process and comorbidity will provide continued accurate information about the harmful effects of alcoholism and drug abuse which in turn will empower individuals to make informed choices and result in better treatment and social policies.

A Practice-Based Theory of Healing Through Therapeutic Touch: Advancing Holistic Nursing Practice.

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Hanley, Mary Anne; Coppa, Denise; Shields, Deborah

2017-08-01

For nearly 50 years, Therapeutic Touch (TT) has contributed to advancing holistic nursing practice and has been recognized as a uniquely human approach to healing. This narrative explores the development of a practice-based theory of healing through TT, which occurred between 2010 and 2016. Through the in-depth self-inquiry of participatory reflective dialogue in concert with constant narrative analysis, TT practitioners revealed the meaning of healing within the context of their TT practice. As the community of TT experts participated in an iterative process of small group and community dialogues with analysis and synthesis of emerging themes, the assumptions and concepts central to a theory of healing emerged, were clarified and verified. Exemplars of practice illustrate the concepts. A model of the theory of healing illuminates the movement and relationship among concepts and evolved over time. Feedback from nursing and inter-professional practitioners indicate that the theory of healing, while situated within the context of TT, may be useful in advancing holistic nursing practice, informing healing and caring approaches, stimulating research and education, and contributing to future transformations in health care.

Holistic Marketing 3.0: Menuju Organisasi Spiritual

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Gancar Candra Premananto

2015-12-01

Full Text Available Holistic Marketing is become new mantra for marketer in this 21 century. The concept builds on 4 pillars which are integrated marketing, internal marketing, performance marketing and relationship marketing. The point of that concept is about the important things is to make relationship to everybody and to every stakeholders. The concepts still on development process by Kotler & Keller. This conceptual article proposed that Holistic Marketing proposed by Kotler & Keller still discuss about horizontal relationship. It is not include the important relationship that should be building by human, which is relationship to God. Those relationship can make organization can apply the concept of HabluminaLLAH, habluminannas dan rahmatan lil ’alamin. The concept proposed as Holistic Marketing 3.0, to make more complete and holistic relationship.

Validation of holistic nursing competencies: role-delineation study, 2012.

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Erickson, Helen Lorraine; Erickson, Margaret Elizabeth; Campbell, Joan A; Brekke, Mary E; Sandor, M Kay

2013-12-01

The American Holistic Nurses Credentialing Corporation (AHNCC), certifying body for nurses practicing within the precepts of holistic nursing, uses a systematic process to guide program development. A previous publication described their early work that distinguished basic and advanced holistic nursing and development of related examinations. A more recent publication described the work of AHNCC from 2004 to 2012, including a role-delineation study (RDS) that was undertaken to identify and validate competencies currently used by holistic nurses. A final report describes the RDS design, methods, and raw data information. This article discusses AHNCC's goals for undertaking the 2012 Holistic Nursing RDS and the implications for the certification programs.

Clinical Holistic Medicine: The Dean Ornish Program (“Opening the Heart”) in Cardiovascular Disease

OpenAIRE

Ventegodt, Søren; Merrick, Efrat; Merrick, Joav

2006-01-01

Dean Ornish of the Preventive Medicine Research Institute in Sausalito, California has created an intensive holistic treatment for coronary heart patients with improved diet (low fat, whole foods, plant based), exercise, stress management, and social support that has proven to be efficient. In this paper, we analyze the rationale behind his cure in relation to contemporary holistic medical theory. In spite of a complex treatment program, the principles seem to be simple and in accordance with...

Reiki therapy: a nursing intervention for critical care.

Science.gov (United States)

Toms, Robin

2011-01-01

Complementary and alternative medicine (CAM) is not generally associated with the complexity and intensity of critical care. Most CAM therapies involve slow, calming techniques that seem to be in direct contrast with the fast-paced, highly technical nature of critical care. However, patients in critical care often find themselves coping with the pain and stress of their illness exacerbated by the stress of the critical care environment. Complementary and alternative medicine-related research reveals that complementary therapies, such as Reiki, relieve pain and anxiety and reduce symptoms of stress such as elevated blood pressure and pulse rates. Patients and health care professionals alike have become increasingly interested in complementary and alternative therapies that do not rely on expensive, invasive technology, and are holistic in focus. Reiki is cost-effective, noninvasive, and can easily be incorporated into patient care. The purpose of this article is to examine the science of Reiki therapy and to explore Reiki as a valuable nursing intervention.

Transforming doctor-patient relationships to promote patient-centered care: lessons from palliative care.

Science.gov (United States)

Yedidia, Michael J

2007-01-01

Palliative care was studied for its potential to yield lessons for transforming doctor-patient relationships to promote patient-centered care. Examination of patient and provider experiences of the transition from curative to palliative care promises valuable insights about establishing and maintaining trust as the goals of care shift and about addressing a broad spectrum of patient needs. The study was guided by a conceptual framework grounded in existing models to address five dimensions of doctor-patient relationships: range of needs addressed, source of authority, maintenance of trust, emotional involvement, and expression of authenticity. Data collection included observation of the care of 40 patients in the inpatient hospice unit and at home, interviews with patients and family members, and in-depth interviews with 22 physicians and two nurses providing end-of-life care. Standard qualitative procedures were used to analyze the data, incorporating techniques for maximizing the validity of the results and broadening their relevance to other contexts. Findings provide evidence for challenging prominent assumptions about possibilities for doctor-patient relationships: questioning the merits of the prohibition on emotional involvement, dependence on protocols for handling difficult communication issues, unqualified reliance on consumer empowerment to assure that care is responsive to patients' needs, and adoption of narrowly defined boundaries between medical and social service systems in caring for patients. Medical education can play a role in preparing doctors to assume new roles by openly addressing management of emotions in routine clinical work, incorporating personal awareness training, facilitating reflection on interactions with patients through use of standardized patients and videotapes, and expanding capacity to effectively address a broad range of needs through teamwork training.

A holistic approach to the mycetoma management.

Science.gov (United States)

Bakhiet, Sahar Mubarak; Fahal, Ahmed Hassan; Musa, Ahmed Mudawi; Mohamed, El Samani Wadaa; Omer, Rowa Fathelrahman; Ahmed, Eiman Siddig; El Nour, Mustafa; Mustafa, El Rayah Mohamed; Sheikh A Rahman, Manar El; Suliman, Suliman Hussein; El Mamoun, Mohamed A Gadir; El Amin, Hajo Mohamed

2018-05-01

Mycetoma, one of the badly neglected tropical diseases, it is a localised chronic granulomatous inflammatory disease characterised by painless subcutaneous mass and formation of multiple sinuses that produce purulent discharge and grains. If untreated early and appropriately, it usually spread to affect the deep structures and bone resulting in massive damage, deformities and disabilities. It can also spread via the lymphatics and blood leading to distant secondary satellites associated with high morbidity and mortality. To date and despite progress in mycetoma research, a huge knowledge gap remains in mycetoma pathogenesis and epidemiology resulting in the lack of objective and effective control programmes. Currently, the available disease control method is early case detection and proper management. However, the majority of patients present late with immense disease and for many of them, heroic substantial deforming surgical excisions or amputation are the only prevailing treatment options. In this communication, the Mycetoma Research Center (MRC), Sudan shares its experience in implementing a new holistic approach to manage mycetoma patients locally at the village level. The MRC in collaboration with Sennar State Ministry of Health, Sudan had established a region mycetoma centre in one of the endemic mycetoma villages in the state. The patients were treated locally in that centre, the local medical and health personals were trained on early case detection and management, the local community was trained on mycetoma advocacy, and environmental conditions improvement. This comprehensive approach had also addressed the patients' socioeconomic constraints that hinder early presentation and treatment. This approach has also included the active local health authorities, community and civil society participation and contributions to deliver the best management. This holistic approach for mycetoma patients' management proved to be effective for early case detection and

Evaluation of the Dignity Care Pathway for community nurses caring for people at the end of life.

Science.gov (United States)

Johnston, Bridget; Östlund, Ulrika; Brown, Hilary

2012-10-01

People nearing the end of life fear loss of dignity, and a central tenet of palliative care is to help people die with dignity. The Dignity Care Pathway (DCP) is an intervention based on the Chochinov theoretical model of dignity care. It has four sections: a manual, a Patient Dignity Inventory, reflective questions, and care actions. The feasibility and acceptability of the DCP were evaluated using a qualitative design with a purposive sample of community nurses. Data was collected from April to October 2010 using in-depth interviews, reflective diaries, and case studies and then analysed using framework analysis. The DCP was acceptable to the community nurses, helped them identify when patients were at the end of life, identified patients' key concerns, and aided nurses in providing holistic end-of-life care. It requires the nurse to have excellent communication skills. Some of the nurses found it hard to initiate a conversation on dignity-conserving care. The DCP helps nurses to deliver individualised care and psychological care, which has previously been identified as a difficult area for community nurses. All of the nurses wished to continue to use the DCP and would recommend it to others.

Spirituality and spiritual care in in the context of nursing education in South Africa

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Sandhya Chandramohan

2015-12-01

Full Text Available Background: In order for nursing education to prepare nurses for holistic patient care, it is critical that educators become more aware of the religious and spiritual dimensions in patien tcare and be able to provide adequate knowledge and skills for nurses to offer spiritually-basedc are in an ethical way. Furthermore, spiritual care is an essential component in the nursing context, as nurses have to care for patients who may often turn to the spiritual dimension to cope and heal. These aspects are important issues to be considered in planning what should be taught as part of spiritual care. Objectives: This paper presents findings from a study on nursing practitioners’ views on the role of spiritual care in nursing practice and whether current nursing education has integrated this dimension into teaching. Method: A descriptive survey using a cross-sectional design with 385 nurses was conducted between December 2012 and February 2013. Participants were recruited through multistage random sampling. Data analysis was undertaken using SSPS 0.20. Results: All the participants (n = 385 concurred that spiritual care was a salient component of holistic patient care. They however stated that the primary barriers to providing spiritual care related to uncertainty on how to provide this type of care, and a lack of educational preparedness for this role. Conclusion: The study found that nurses were very accepting of the need for spiritual care as part of their nursing role but that nursing education had not paid adequate attention to integrating this dimension into the nursing curriculum.

Views and experiences of using integrated care pathways (ICPs) for caring for people in the last days to hours of life: results from a cross-sectional survey of UK professionals.

Science.gov (United States)

Collins, K A; Hughes, P M; Ibbotson, R; Foy, G; Brooks, D

2016-09-01

To determine the views and experiences of health and social care professionals on using integrated care pathways (ICPs)for caring for people in the last days to hours of life. Online cross-sectional questionnaire survey of UK professionals working in UK primary and secondary care settings. 1331 professionals returned completed questionnaires. Ninety-three per cent (1138/1228) of respondents used the Liverpool Care Pathway (LCP) or local variant. Eighty-eight (1089/1234) felt ICPs enabled professionals to provide better care for individuals and their families/carers. ICPs were viewed as promoting patient-centred holistic care, improving pain and symptom control, providing guidance and standards and improving communication with patients/families. Sixty-two per cent (770/1234) had no concerns regarding the use of ICPs. Areas of concern included incorrect use and implementation of the ICP, poor communication with families, junior level staff making decisions and insufficient education and support. There was strong support for using ICPs for caring for people in the last days to hours of life. ICPs were viewed as supporting high-quality patient-centred holistic care. Given the recommendations of the More Care Less Pathway report, those that develop the guidance and support that replace the LCP need to incorporate the aspects of this that have resulted in the benefits seen by professionals within this survey, but also learn from the instances where ICPs have failed to prevent poor care, or worse, have contributed to it. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Health care employee perceptions of patient-centered care.

Science.gov (United States)

Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L

2015-03-01

Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. © The Author(s) 2014.

Holistic Energy Renovation of Pre- and Postwar Apartment Blocks in Denmark

DEFF Research Database (Denmark)

Eriksen, Marlene Stenberg Hagen; Rode, Carsten; Bjarløv, Søren Peter

of today. This paper presents the Danish research project Holistic Energy Renovation, which aims at performing a holistic energy renovation of two case buildings. As part of the project nine parameters for a holistic renovation have been defined, a method for developing and assessing a holistic building...... of the assessment method and an evaluation of how the holistic perspective has influenced the project process and product development....

The application of holistic risk management in the banking industry

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J. Chibayambuya

2007-12-01

Full Text Available Purpose: The application of holistic risk management is fast becoming a standard measure of good governance in the business arena. What role can holistic risk management play in the management of risk in the financial services industry? The aim of this paper is to propose a holistic risk management framework for the management of risk. Design/Methodology/Approach: A comprehensive framework that covers the holistic view risk management is proposed/developed out of an extensive literature review. Findings: Given the deliberations of various frameworks, a holistic risk management is proposed. The proposed framework ensures that all components of risk management are taken into account when strategizing for risk management in general and holistic risk management in particular; thereby improving the management of risk in the banking industry. Implications: The article proposes a holistic approach to risk management which takes into account all the facets of risk management, e.g. analyzing, planning, strategy, communication, implementation, motivation, systems review and plan modification. This holistic approach, when implemented in the banking industry, can have a significant impact on the improved management of risk. Originality/Value: The new proposed holistic risk management framework offers a fresh perspective of strategizing for risk management in terms of risk analysis, risk planning, risk strategy, risk communication, risk implementation, risk motivation, risk review and risk plan modification.

Characteristics of patients consulting their regular primary care physician according to their prescribing preferences for homeopathy and complementary medicine.

Science.gov (United States)

Lert, France; Grimaldi-Bensouda, Lamiae; Rouillon, Frederic; Massol, Jacques; Guillemot, Didier; Avouac, Bernard; Duru, Gerard; Magnier, Anne-Marie; Rossignol, Michel; Abenhaim, Lucien; Begaud, Bernard

2014-01-01

Homeopathic care has not been well documented in terms of its impact on patients' utilization of drugs or other complementary and alternative medicines (CAM). The objective of this study was to describe and compare patients who visit physicians in general practice (GPs) who prescribe only conventional medicines (GP-CM), regularly prescribe homeopathy within a mixed practice (GP-Mx), or are certified homeopathic GPs (GP-Ho). The EPI3-LASER study was a nationwide observational survey of a representative sample of GPs and their patients from across France. Physicians recorded their diagnoses and prescriptions on participating patients who completed a self-questionnaire on socio-demographics, lifestyle, quality of life Short Form 12 (SF-12) and the complementary and alternative medicine beliefs inventory (CAMBI). A total of 6379 patients (participation rate 73.1%) recruited from 804 GP practices participated in this survey. Patients attending a GP-Ho were slightly more often female with higher education than in the GP-CM group and had markedly healthier lifestyle. They did not differ greatly in their comorbidities or quality of life but exhibited large differences in their beliefs in holistic medicine and natural treatments, and in their attitude toward participating to their own care. Similar but less striking observations were made in patients of the GP-Mx group. Patients seeking care with a homeopathic GP did not differ greatly in their socio-demographic characteristics but more so by their healthier lifestyle and positive attitude toward CAM. Further research is needed to explore the directionality of those associations and to assess the potential economic benefits of homeopathic management in primary care. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

Cardiac patients' perception of patient-centred care: a qualitative study.

Science.gov (United States)

Esmaeili, Maryam; Cheraghi, Mohammad A; Salsali, Mahvash

2016-03-01

The aim of this study was to explore cardiac patients' perception of patient-centred care. Despite patient's importance in the process of care, less attention has been paid to experiences and expectations of patients in definitions of patient-centred care. As patients are an important element in process of patient-centred care, organizing care programs according to their perceptions and expectations will lead to enhanced quality of care and greater patient satisfaction. This study is a descriptive qualitative study. Content analysis approach was performed for data analysis. Participants were 18 cardiac patients (10 women and 8 men) hospitalized in coronary care units of teaching hospitals affiliated to Tehran University of Medical Sciences. We collected the study data through conducting personal face-to-face semi-structured interviews. The participants' perceptions of patient-centred care fell into three main themes including managing patients uncertainty, providing care with more flexibility and establishing a therapeutic communication. The second theme consisted of two sub-themes: empathizing with patients and having the right to make independent decisions. Receiving patient-centred care is essential for cardiac patients. Attention to priorities and preferences of cardiac patients and making decisions accordingly is among effective strategies for achieving patient-centred care. Cardiac care unit nurses ought to be aware that in spite of technological developments and advances, it is still important to pay attention to patients' needs and expectations in order to achieve patient satisfaction. In planning care programs, they should consider accountability towards patients' needs, flexibility in process of care and establishing medical interactions as an effective strategy for improving quality of care. © 2014 British Association of Critical Care Nurses.

'I try to make a net around each patient': home care nursing as relational practice.

Science.gov (United States)

Bjornsdottir, Kristin

2018-03-01

As a result of restructuring, home care is increasingly defined in a narrow, task-based way, undermining the holistic nature of practice. Recent practice theories can aid us in articulating the nature of this important, yet often invisible practice. My aim in this article was to enhance our knowledge and understanding of the nature of home care nursing practice. The approach was ethnographic, involving extensive fieldwork and formal interviews with members of five home care nursing teams and 15 older persons receiving care at home in a metropolitan area of Iceland. The study was approved by the National Bioethics Committee. As a net of services, home care was enacted through relational, but often invisible care practices, relating different actors - patient, family and health-care and social-care workers - in doing the work needed for the older persons to live comfortably at home. The work was collective in that it was shared by different actors and motivated by a common understanding that had developed and was preserved in conversations in the teams. Although the findings are limited in that they only reflect home care as practiced in one neighbourhood, they can be seen as providing important insights into what is needed for home care services to work. Home care practice can be understood as relational, aimed at creating a net of needed assistance. This work is a collective accomplishment of the teams and shaped by ideals and values shared among team members. © 2017 Nordic College of Caring Science.

Evaluation of Learning Materials: A Holistic Framework

Science.gov (United States)

Bundsgaard, Jeppe; Hansen, Thomas Illum

2011-01-01

This paper presents a holistic framework for evaluating learning materials and designs for learning. A holistic evaluation comprises investigations of the potential learning potential, the actualised learning potential, and the actual learning. Each aspect is explained and exemplified through theoretical models and definitions. (Contains 3 figures…

Spirituality and spiritual care in Iran: nurses' perceptions and barriers.

Science.gov (United States)

Zakaria Kiaei, M; Salehi, A; Moosazadeh Nasrabadi, A; Whitehead, D; Azmal, M; Kalhor, R; Shah Bahrami, E

2015-12-01

This study aimed to explore the perception of Iranian nurses concerning spiritual care and to reveal any confronted barriers. Although the context of spiritual care is a substantial aspect of holistic care, the delivery of spiritual care has been problematic due to lack of nurses' understanding of this concept. Nurses' perceptions of spirituality and spiritual care directly influence their performance as well as their relationships with patients. This cross-sectional survey was conducted in 2013 with 259 nurses working in hospitals affiliated with Qazvin University of Medical Sciences, Iran. Data were collected using the Spirituality and Spiritual Care Rating Scale alongside qualitative open-ended questions. Descriptive and inferential statistics were used for the quantitative data and content analysis for the qualitative data. The overall average for spirituality and spiritual care was 2.84 (score range: 1-4), indicating a moderate mean score. A significant relationship was found between education level and spiritual care. The majority of participants believed that they did not receive enough training in this aspect of care. The main obstacles regarding delivering spiritual care included busy working schedules, insufficient knowledge regarding spiritual care, low motivation, diversity of patients' spiritual needs and feeling 'unqualified' to provide spiritual cares. Consistent with the previous studies, this study has demonstrated that nurses had low confidence to meet the spiritual needs of patients due to lack of knowledge and training in this regard. Iranian nurses' perception of spirituality and spiritual care is moderate, reflecting that they do not receive sufficient training regarding spiritual care. Despite the attention focused on spiritual care in clinical settings in Iran, there remains a significant gap in terms of meeting the spiritual needs of patients in nursing practice. This finding assists nursing clinicians, educators and policy makers to more

Patient Care Planning: An Interdisciplinary Approach

OpenAIRE

Prophet, Colleen M.

1989-01-01

The INFORMM Patient Care Planning System provides interdepartmental communication and individualized patient care plans based upon current standards of care. This interdisciplinary system facilitates the identification of patient problems and nursing diagnoses as well as patient care orders. The selected nurses' and physicians' orders are integrated and organized by care plan categories in printouts. As a system by-product, Patient Care Planning automatically generates and calculates patient ...

Nursing Practice in Primary Care and Patients' Experience of Care.

Science.gov (United States)

Borgès Da Silva, Roxane; Brault, Isabelle; Pineault, Raynald; Chouinard, Maud-Christine; Prud'homme, Alexandre; D'Amour, Danielle

2018-01-01

Nurses are identified as a key provider in the management of patients in primary care. The objective of this study was to evaluate patients' experience of care in primary care as it pertained to the nursing role. The aim was to test the hypothesis that, in primary health care organizations (PHCOs) where patients are systematically followed by a nurse, and where nursing competencies are therefore optimally used, patients' experience of care is better. Based on a cross-sectional analysis combining organizational and experience of care surveys, we built 2 groups of PHCOs. The first group of PHCOs reported having a nurse who systematically followed patients. The second group had a nurse who performed a variety of activities but did not systematically follow patients. Five indicators of care were constructed based on patient questionnaires. Bivariate and multivariate linear mixed models with random intercepts and with patients nested within were used to analyze the experience of care indicators in both groups. Bivariate analyses revealed a better patient experience of care in PHCOs where a nurse systematically followed patients than in those where a nurse performed other activities. In multivariate analyses that included adjustment variables related to PHCOs and patients, the accessibility indicator was found to be higher. Results indicated that systematic follow-up of patients by nurses improved patients' experience of care in terms of accessibility. Using nurses' scope of practice to its full potential is a promising avenue for enhancing both patients' experience of care and health services efficiency.

Primary care patients with anxiety and depression: need for care from the patient's perspective.

NARCIS (Netherlands)

Prins, M.A.; Verhaak, P.F.M.; Meer, K. van der; Penninx, B.W.J.H.; Bensing, J.M.

2009-01-01

Many anxiety and depression patients receive no care, resulting in unnecessary suffering and high costs. Specific beliefs and the absence of a perceived need for care are major reasons for not receiving care. This study aims to determine the specific perceived need for care in primary care patients

Individual care plans for chronically ill patients within primary care in the Netherlands: Dissemination and associations with patient characteristics and patient-perceived quality of care.

Science.gov (United States)

Jansen, Daphne L; Heijmans, Monique; Rijken, Mieke

2015-06-01

To examine the use of individual care plans (ICPs) within primary chronic illness care in the Netherlands, and to explore the relationships between ICP use, patient characteristics, and patient-perceived quality of care. Cross-sectional study using survey data from a panel of chronically ill patients and medical registration data provided by their general practices. A sample of 1377 patients with somatic chronic disease(s) randomly selected in general practices throughout the Netherlands, supplemented with a sample of 225 COPD patients, also recruited from general practices. (i) Percentage of ICP use based on self-report by chronically ill patients, and (ii) patient-perceived quality of care as assessed using the Patient Assessment of Chronic Illness Care (PACIC). ICP use among the total generic sample was low (9%), but slightly higher (13%) among patients diagnosed with diabetes or COPD, diseases for which disease management programmes have been set up in the Netherlands. Patients with a low educational level and patients with poor(er) self-rated health were more likely to have an ICP. Compared with patients without an ICP, patients with an ICP more often reported that the care they received was patient-centred, proactive, planned, and included collaborative goal setting, problem-solving, and follow-up support. Findings reveal a discrepancy between practice and policy aspirations regarding ICP use in primary chronic illness care. More research is needed to gain insight into the effectiveness of ICPs to improve the quality of chronic illness care in various patient populations.

A critical appraisal of holistic teaching and its effects on dental student learning at University of Bergen, Norway.

Science.gov (United States)

Berge, Morten E; Berg, Einar; Ingebrigtsen, Jana

2013-05-01

The curriculum of the dental faculty at the University of Bergen, Norway, was revised and a new curriculum implemented in 1998 based on the principles of holistic teaching and patient-centered treatment. The first candidates graduated in 2003. The change of curricula, experience gained, and lack of an evidence base for holistic teaching justify a general discussion of all relevant aspects associated with this approach. The purpose of this article was to make a contribution towards such a discussion. A PubMed search regarding holistic teaching in dentistry was performed. Of the 211 entries on holistic teaching, few discussed holism in depth; none reported outcome measures comparing old and new curricula. Data collected from students graduating in 2003 (new curriculum) and 2000 (old curriculum) on their satisfaction with the teaching comprise a possible outcome measure. In most respects, using prosthodontics as an example, no differences between the two groups of students were found. Students studying under the new holistic curriculum were less satisfied than those studying under the old one regarding the number of available teachers and teachers' feedback on student performance. Both holistic teaching/patient-centered treatment and a more traditional subject-specific approach have advantages and disadvantages, and neither can be practiced in its pure form for ethical and practical reasons. The quantitative results of this study did not support the hypothesis that holism improved students' satisfaction with the teaching. A wide discussion of holism in dental education is needed, along with outcome measures when curricula are changed.

Value Based Care and Patient-Centered Care: Divergent or Complementary?

Science.gov (United States)

Tseng, Eric K; Hicks, Lisa K

2016-08-01

Two distinct but overlapping care philosophies have emerged in cancer care: patient-centered care (PCC) and value-based care (VBC). Value in healthcare has been defined as the quality of care (measured typically by healthcare outcomes) modified by cost. In this conception of value, patient-centeredness is one important but not necessarily dominant quality measure. In contrast, PCC includes multiple domains of patient-centeredness and places the patient and family central to all decisions and evaluations of quality. The alignment of PCC and VBC is complicated by several tensions, including a relative lack of patient experience and preference measures, and conceptions of cost that are payer-focused instead of patient-focused. Several strategies may help to align these two philosophies, including the use of patient-reported outcomes in clinical trials and value determinations, and the purposeful integration of patient preference in clinical decisions and guidelines. Innovative models of care, including accountable care organizations and oncology patient-centered medical homes, may also facilitate alignment through improved care coordination and quality-based payment incentives. Ultimately, VBC and PCC will only be aligned if patient-centered outcomes, perspectives, and preferences are explicitly incorporated into the definitions and metrics of quality, cost, and value that will increasingly influence the delivery of cancer care.

Holistic Processing of Static and Moving Faces

Science.gov (United States)

Zhao, Mintao; Bülthoff, Isabelle

2017-01-01

Humans' face ability develops and matures with extensive experience in perceiving, recognizing, and interacting with faces that move most of the time. However, how facial movements affect 1 core aspect of face ability--holistic face processing--remains unclear. Here we investigated the influence of rigid facial motion on holistic and part-based…

Holistic Processing in the Composite Task Depends on Face Size.

Science.gov (United States)

Ross, David A; Gauthier, Isabel

Holistic processing is a hallmark of face processing. There is evidence that holistic processing is strongest for faces at identification distance, 2 - 10 meters from the observer. However, this evidence is based on tasks that have been little used in the literature and that are indirect measures of holistic processing. We use the composite task- a well validated and frequently used paradigm - to measure the effect of viewing distance on holistic processing. In line with previous work, we find a congruency x alignment effect that is strongest for faces that are close (2m equivalent distance) than for faces that are further away (24m equivalent distance). In contrast, the alignment effect for same trials, used by several authors to measure holistic processing, produced results that are difficult to interpret. We conclude that our results converge with previous findings providing more direct evidence for an effect of size on holistic processing.

Book review. Design for Care: Innovating Healthcare Experience

Directory of Open Access Journals (Sweden)

Manuela Aguirre Ulloa

2014-12-01

Full Text Available Adapted from a review on the same book published by The Design Observer Group on April 4th, 2014. You can access the original publication online at http://designobserver.com/feature/design-for-care/38382/ Peter Jones´ recently published book represents a timely and comprehensive view of the value design brings to healthcare innovation. The book uses an empathic user story that conveys emotions and life to a structure that embraces the different meanings of Design for Care: Spanning from caring at the personal level to large-scale caring systems. The author has a main objective for each of its three main target audiences: Designers, companies and healthcare teams. Firstly, it allows designers to understand healthcare in a holistic and patient-centered way, breaking down specialized silos. Secondly, it shows how to design better care experiences across care continuums. Consequently, for companies serving the healthcare sector, the book presents how to humanize information technology (IT and services and meet the needs of health seekers. Finally, the book aims to inform healthcare teams (clinical practitioners and administrators the value design brings in research, co-creation and implementation of user and organizational experiences. It also proposes that healthcare teams learn and adopt design and systems thinking techniques so their innovation processes can be more participatory, holistic and user-centered.

Palliative care - managing pain

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... page, please enable JavaScript. Palliative care is a holistic approach to care that focuses on treating pain ... stressful for you and your family. But with treatment, pain can be managed. How Pain is Measured ...

"Patient care in radiology"

DEFF Research Database (Denmark)

Bro Brask, Kirsten; Birkelund, Regner

2014-01-01

The aim of this study was to research how the staff experience care expressed during the brief encounter with the patients in a diagnostic imaging department. This was a qualitative study with a phenomenological and hermeneutical frame of reference. The data were collected using field observation...... was electronically forwarded. And, care expressed in between was perceived as care in the traditional sense and termed as “patient care in radiology.”...

Clinical Holistic Medicine: Teaching Orgasm for Females with Chronic Anorgasmia using the Betty Dodson Method

Science.gov (United States)

Struck, Pia; Ventegodt, Søren

2008-01-01

The objective of this study was to test the Betty Dodson method of breaking the female orgasm barrier in chronic anorgasmic women. The aim was sexual and existential healing (salutogenesis) through direct confrontation and integration of both the repressed shame, guilt, and other negative feelings associated with body, genitals, and sexuality, and the repressed sexual pleasure and desire. We conducted a retrospective analysis of clinic data from holistic sexological manual therapeutic intervention, an intensive subtype of clinical holistic medicine (CHM). The patients received 3 × 5 h of group therapy, integrating short-term psychodynamic psychotherapy (STPP) and complementary medicine (CAM bodywork, manual sexology similar to the “sexological examination”). The therapy used the advanced tools of reparenting, genital acceptance, acceptance through touch, and direct sexual clitoral stimulation. A clitoral vibrator was used. Participants were 500 female patients between 18 and 88 years of age (mean of 35 years) with chronic anorgasmia (for 12 years on average) who were participating in the “orgasm course for anorgasmic women”; 25% of the patients had never experienced an orgasm. Our results show that 465 patients (93%) had an orgasm during therapy, witnessed by the therapist, and 35 patients (7%) did not. Postmenopausal women were as able to achieve orgasm as fertile women, as were women who never had an orgasm. No patients had detectable negative side effects or adverse effects. NNT: 1.04 500. Therapeutic value: TV = NNH/NNT > 446. Our conclusions are that holistic sexological manual therapy may be rational, safe, ethical, and efficient. PMID:18836654

Clinical Holistic Medicine: Teaching Orgasm for Females with Chronic Anorgasmia using the Betty Dodson Method

Directory of Open Access Journals (Sweden)

Pia Struck

2008-01-01

Full Text Available The objective of this study was to test the Betty Dodson method of breaking the female orgasm barrier in chronic anorgasmic women. The aim was sexual and existential healing (salutogenesis through direct confrontation and integration of both the repressed shame, guilt, and other negative feelings associated with body, genitals, and sexuality, and the repressed sexual pleasure and desire. We conducted a retrospective analysis of clinic data from holistic sexological manual therapeutic intervention, an intensive subtype of clinical holistic medicine (CHM. The patients received 3 × 5 h of group therapy, integrating short-term psychodynamic psychotherapy (STPP and complementary medicine (CAM bodywork, manual sexology similar to the “sexological examination”. The therapy used the advanced tools of reparenting, genital acceptance, acceptance through touch, and direct sexual clitoral stimulation. A clitoral vibrator was used. Participants were 500 female patients between 18 and 88 years of age (mean of 35 years with chronic anorgasmia (for 12 years on average who were participating in the “orgasm course for anorgasmic women”; 25% of the patients had never experienced an orgasm. Our results show that 465 patients (93% had an orgasm during therapy, witnessed by the therapist, and 35 patients (7% did not. Postmenopausal women were as able to achieve orgasm as fertile women, as were women who never had an orgasm. No patients had detectable negative side effects or adverse effects. NNT: 1.04 500. Therapeutic value: TV = NNH/NNT > 446. Our conclusions are that holistic sexological manual therapy may be rational, safe, ethical, and efficient.

Exploring the psychosocial needs and satisfaction of the family of patients hospitalized in the Intensive Care Unit

Directory of Open Access Journals (Sweden)

Efthymia Chalkidi

2016-09-01

Full Text Available Introduction: The sudden admission of patients in the Intensive Care Unit (ICU is considered an extremely stressful and painful experience for the whole family. In recent years, family has been recognized to have an important role to the outcome and particular emphasis has been given to the oriented approach of the patient’s family. Aims: To investigate the needs and the degree of satisfaction of relatives whose patients are hospitalized in ICU. Methodology: This cross-sectional analytical study was conducted in a Greek ICU of a public hospital from November 2015 to – February 2016. The sample consisted of 47 relatives of patients who had been hospitalized for more than 48 hours. They were administered a questionnaire including socio- demographic data and the following psychometric tools: Family Satisfaction in Intensive Care Unit (FS- ICU 24 and Critical Care Family Needs Inventory (CCFNI. Data were analyzed with the program SPSS version 23.0 . Results: A 72% and 80% of patients companions, expressed a great satisfaction in the caring and satisfaction with the decision making process scales of the FS-ICU 24. Basics are considered the need of reassurance for the better delivered care the knowledge of their patients’ outcome and the administration of sincere and understandable information. Statistically significant differences have been found on the relationship with the patient, in the approach subscale of the CCFNI (p=0,024. Concerning the ages of the participants, statistically differences have been found at a group of 26-40 years old, in reassurance subscales (p=0,049, information (p=0,006, approach (p=0,009, support (p=0,004 and the offer of comfort (p=0,005 of the CCFNI. Conclusions: The cooperation of ICU professionals with relatives, the training of personnel in the provision of holistic care and the family’s integration in the therapeutic process, may be beneficial in reducing stress and adequate and effectively fulfillment of

Holistic Treatment Approaches to ADHD: Nutrition, Sleep,and Exercise, Part 7

Science.gov (United States)

Lavoie, Theresa

2009-01-01

This article is part of a series exploring Attention Deficit Hyperactivity Disorder (ADHD). In this seventh installment, the author discusses three holistic treatments for children and adults with ADHD: diet and nutrition, sleep, and exercise. These approaches focus and improve the overall health of ADHD patients. (For Part 6 of this series, see…

Factors affecting experiences of intensive care patients in Turkey: patient outcomes in critical care setting.

Science.gov (United States)

Demir, Yurdanur; Korhan, Esra Akin; Eser, Ismet; Khorshid, Leyla

2013-07-01

To determine the factors affecting a patient's intensive care experience. The descriptive study was conducted at an intensive care unit in the Aegean Region of Turkey, and comprised 158 patients who spent at least 48 hours at the unit between June and November 2009. A questionnaire form and the Intensive Care Experience Scale were used as data collection tools. SPSS 11.5 was used for statistical analysis of the data. Of the total, 86 (54.4%) patients related to the surgical unit, while 72 (45.5%) spent time at the intensive care unit. Most of the subjects (n=113; 71.5%) reported that they constantly experienced pain during hospitalisation. Patients receiving mechanical ventilation support and patients reporting no pain had significantly higher scores on the intensive care experience scale. Patients who reported pain remembered their experiences less than those having no pain. Interventions are needed to make the experiences of patients in intensive care more positive.

Holistic Education from a Humanist Perspective

OpenAIRE

López Arrillaga, César Enrique

2018-01-01

This essay intends to approach the basic concepts of Holistic Education (Barrera, 2013) and a brief conceptual journey and main postulates of the humanist theory considered by the author on personality, (Carl, 1961), to establish the possible link of holistic education from a humanist perspective in the meeting of the postulates of Humanism in the teaching practice that allows the humanization of education, centered on human beings taking into account their abilities, abilities and skills, in...

A Holistic Approach to Bit Preservation

DEFF Research Database (Denmark)

Zierau, Eld Maj-Britt Olmütz

2011-01-01

This thesis presents three main results for a holistic approach to bit preservation, where the ultimate goal is to find the optimal bit preservation strategy for specific digital material that must be digitally preserved. Digital material consists of sequences of bits, where a bit is a binary digit...... which can have the value 0 or 1. Bit preservation must ensure that the bits remain intact and readable in the future, but bit preservation is not concerned with how bits can be interpreted as e.g. an image. A holistic approach to bit preservation includes aspects that influence the final choice of a bit...... a holistic approach and include aspects of digital representation, confidentiality, availability, bit safety and costs when defining requirements for the bit preservation. Analysis of such requirements and choice of the final bit preservation solution can be supported by the three main results presented...

Developmental changes in analytic and holistic processes in face perception.

Science.gov (United States)

Joseph, Jane E; DiBartolo, Michelle D; Bhatt, Ramesh S

2015-01-01

Although infants demonstrate sensitivity to some kinds of perceptual information in faces, many face capacities continue to develop throughout childhood. One debate is the degree to which children perceive faces analytically versus holistically and how these processes undergo developmental change. In the present study, school-aged children and adults performed a perceptual matching task with upright and inverted face and house pairs that varied in similarity of featural or 2(nd) order configural information. Holistic processing was operationalized as the degree of serial processing when discriminating faces and houses [i.e., increased reaction time (RT), as more features or spacing relations were shared between stimuli]. Analytical processing was operationalized as the degree of parallel processing (or no change in RT as a function of greater similarity of features or spatial relations). Adults showed the most evidence for holistic processing (most strongly for 2(nd) order faces) and holistic processing was weaker for inverted faces and houses. Younger children (6-8 years), in contrast, showed analytical processing across all experimental manipulations. Older children (9-11 years) showed an intermediate pattern with a trend toward holistic processing of 2(nd) order faces like adults, but parallel processing in other experimental conditions like younger children. These findings indicate that holistic face representations emerge around 10 years of age. In adults both 2(nd) order and featural information are incorporated into holistic representations, whereas older children only incorporate 2(nd) order information. Holistic processing was not evident in younger children. Hence, the development of holistic face representations relies on 2(nd) order processing initially then incorporates featural information by adulthood.

Developmental changes in analytic and holistic processes in face perception

Directory of Open Access Journals (Sweden)

Jane Elizabeth Joseph

2015-08-01

Full Text Available Although infants demonstrate sensitivity to some kinds of perceptual information in faces, many face capacities continue to develop throughout childhood. One debate is the degree to which children perceive faces analytically versus holistically and how these processes undergo developmental change. In the present study, school-aged children and adults performed a perceptual matching task with upright and inverted face and house pairs that varied in similarity of featural or 2nd order configural information. Holistic processing was operationalized as the degree of serial processing when discriminating faces and houses (i.e., increased reaction time, RT, as more features or spacing relations were shared between stimuli. Analytical processing was operationalized as the degree of parallel processing (or no change in reaction time as a function of greater similarity of features or spatial relations. Adults showed the most evidence for holistic processing (most strongly for 2nd order faces and holistic processing was weaker for inverted faces and houses. Younger children (6-8 years, in contrast, showed analytical processing across all experimental manipulations. Older children (9-11 years showed an intermediate pattern with a trend toward holistic processing of 2nd order faces like adults, but parallel processing in other experimental conditions like younger children. These findings indicate that holistic face representations emerge around 10 years of age. In adults both 2nd order and featural information are incorporated into holistic representations, whereas older children only incorporate 2nd order information. Holistic processing was not evident in younger children. Hence, the development of holistic face representations relies on 2nd order processing initially then incorporates featural information by adulthood.

Developmental changes in analytic and holistic processes in face perception

Science.gov (United States)

Joseph, Jane E.; DiBartolo, Michelle D.; Bhatt, Ramesh S.

2015-01-01

Although infants demonstrate sensitivity to some kinds of perceptual information in faces, many face capacities continue to develop throughout childhood. One debate is the degree to which children perceive faces analytically versus holistically and how these processes undergo developmental change. In the present study, school-aged children and adults performed a perceptual matching task with upright and inverted face and house pairs that varied in similarity of featural or 2nd order configural information. Holistic processing was operationalized as the degree of serial processing when discriminating faces and houses [i.e., increased reaction time (RT), as more features or spacing relations were shared between stimuli]. Analytical processing was operationalized as the degree of parallel processing (or no change in RT as a function of greater similarity of features or spatial relations). Adults showed the most evidence for holistic processing (most strongly for 2nd order faces) and holistic processing was weaker for inverted faces and houses. Younger children (6–8 years), in contrast, showed analytical processing across all experimental manipulations. Older children (9–11 years) showed an intermediate pattern with a trend toward holistic processing of 2nd order faces like adults, but parallel processing in other experimental conditions like younger children. These findings indicate that holistic face representations emerge around 10 years of age. In adults both 2nd order and featural information are incorporated into holistic representations, whereas older children only incorporate 2nd order information. Holistic processing was not evident in younger children. Hence, the development of holistic face representations relies on 2nd order processing initially then incorporates featural information by adulthood. PMID:26300838

A team approach in palliative care: enhancing outcomes.

Science.gov (United States)

Schrader, Susan L; Horner, Arlene; Eidsness, LuAnn; Young, Sandy; Wright, Chris; Robinson, Michael

2002-07-01

While most Americans envision a "good death" as one occurring quickly and painlessly at home surrounded by loved ones, many people do not die in this fashion. Palliative care focuses on holistic treatment of patients whose disease is not responsive to curative treatment, and strives to improve quality of life for patients and families at end-of-life (EOL). This hospital-based study examines the extent to which a palliative care consultant team makes a difference in EOL for patients and families. Data were collected from a convenience sample of 50 hospitalized patients referred to an interdisciplinary palliative care consulting team at a South Dakota tertiary hospital during 2001. Various palliative care interventions were introduced during the course of hospitalization, and data were collected two days later to see if quality of life had improved. Statistically significant improvements were found in pain levels, non-pain symptom management, numerous psychosocial measures of quality of life, change in code status, and perceptions of communication and treatment during hospitalization. The study demonstrates that consultations with a palliative care team are beneficial and enhance the EOL experience for patients and families.

Person-centred pain management for the patient with acute abdominal pain: an ethnography informed by the Fundamentals of Care framework.

Science.gov (United States)

Avallin, Therese; Muntlin Athlin, Åsa; Sorensen, Erik Elgaard; Kitson, Alison; Björck, Martin; Jangland, Eva

2018-06-12

To explore and describe the impact of the organizational culture on and the patient-practitioner patterns of actions that contribute to or detract from successful pain management for the patient with acute abdominal pain across the acute care pathway. Although pain management is a recognised human right, unmanaged pain continues to cause suffering and prolong hospital care. Unanswered questions about how to successfully manage pain relate to both organizational culture and individual practitioners' performance. Focused ethnography, applying the Developmental Research Sequence and the Fundamentals of Care framework. Participant observation and informal interviews (92 hours) were performed at one emergency department and two surgical wards at a University Hospital during April - November 2015. Data includes 261 interactions between patients, aged ≥18 years seeking care for acute abdominal pain at the emergency department and admitted to a surgical ward (N = 31; aged 20-90 years; 14 men, 17 women; 9 with communicative disabilities) and healthcare practitioners (N =198). The observations revealed an organizational culture with considerable impact on how well pain was managed. Well managed pain presupposed the patient and practitioners to connect in a holistic pain management including a trustful relationship, communication to share knowledge and individualized analgesics. Person-centred pain management requires an organization where patients and practitioners share their knowledge of pain and pain management as true partners. Leaders and practitioners should make small behavioural changes to enable the crucial positive experience of pain management. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

An innovative outcome-based care and procurement model of hemophilia management.

Science.gov (United States)

Gringeri, Alessandro; Doralt, Jennifer; Valentino, Leonard A; Crea, Roberto; Reininger, Armin J

2016-06-01

Hemophilia is a rare bleeding disorder associated with spontaneous and post-traumatic bleeding. Each hemophilia patient requires a personalized approach to episodic or prophylactic treatment, but self-management can be challenging for patients, and avoidable bleeding may occur. Patient-tailored care may provide more effective prevention of bleeding, which in turn, may decrease the likelihood of arthropathy and associated chronic pain, missed time from school or work, and progressive loss of mobility. A strategy is presented here aiming to reduce or eliminate bleeding altogether through a holistic approach based on individual patient characteristics. In an environment of budget constraints, this approach would link procurement to patient outcome, adding incentives for all stakeholders to strive for optimal care and, ultimately, a bleed-free world.

Creation of an American Holistic Nurses Association research consultation program.

Science.gov (United States)

Robertson, Sue; Clingerman, Evelyn; Zahourek, Rothlyn P; Mariano, Carla; Lange, Bernadette

2012-12-01

A goal of the American Holistic Nurses Association (AHNA) Research Committee is to prepare holistic nurses to conduct holistic nursing research. This article describes the creation of a Research Consultation Program and how the knowledge gained from the program will contribute to the development of a formal research mentor program.

Caregivers as the fulcrum of care for mentally ill in the community: The urban rural divide among caregivers and care giving facilities

Directory of Open Access Journals (Sweden)

R C Jiloha

2016-01-01

Full Text Available Illness trends, health beliefs, healthcare pathways, level of awareness, access to health care resources, level of social support, perceived stigma, burden, coping strategies, care giving appraisal, and cultural acceptance of modes of treatment are different in urban and rural settings along with different caregivers profile. This review will highlight these differences in light of their overall characteristics, and health seeking behavior. This further calls for empowering caregivers, understanding and exploring new dimensions of caregiving, and implementing holistic intervention for patients as well as caregiver′s well-being.

Self-care essential extras: an integration of holistic nursing, functional medicine, and health coaching to promote therapeutic lifestyle change and decrease chronic disease.

Science.gov (United States)

Scattergood, Donna M

2010-01-01

The Essential Vitality Program blends holistic nursing, functional medicine, and health coaching to promote lifestyle changes that modify risk factors of costly chronic disease. Karl is a client who experienced enhanced vitality, decreased chronic pain and medications use, and improved meaningful functioning, by partnering with a holistic nurse coach.

Holistic face perception is modulated by experience-dependent perceptual grouping.

Science.gov (United States)

Curby, Kim M; Entenman, Robert J; Fleming, Justin T

2016-07-01

What role do general-purpose, experience-sensitive perceptual mechanisms play in producing characteristic features of face perception? We previously demonstrated that different-colored, misaligned framing backgrounds, designed to disrupt perceptual grouping of face parts appearing upon them, disrupt holistic face perception. In the current experiments, a similar part-judgment task with composite faces was performed: face parts appeared in either misaligned, different-colored rectangles or aligned, same-colored rectangles. To investigate whether experience can shape impacts of perceptual grouping on holistic face perception, a pre-task fostered the perception of either (a) the misaligned, differently colored rectangle frames as parts of a single, multicolored polygon or (b) the aligned, same-colored rectangle frames as a single square shape. Faces appearing in the misaligned, differently colored rectangles were processed more holistically by those in the polygon-, compared with the square-, pre-task group. Holistic effects for faces appearing in aligned, same-colored rectangles showed the opposite pattern. Experiment 2, which included a pre-task condition fostering the perception of the aligned, same-colored frames as pairs of independent rectangles, provided converging evidence that experience can modulate impacts of perceptual grouping on holistic face perception. These results are surprising given the proposed impenetrability of holistic face perception and provide insights into the elusive mechanisms underlying holistic perception.

Holistic Practice in Traumatic Brain Injury Rehabilitation: Perspectives of Health Practitioners

Science.gov (United States)

Wright, Courtney J.; Zeeman, Heidi; Biezaitis, Valda

2016-01-01

Given that the literature suggests there are various (and often contradictory) interpretations of holistic practice in brain injury rehabilitation and multiple complexities in its implementation (including complex setting, discipline, and client-base factors), this study aimed to examine the experiences of practitioners in their conceptualization and delivery of holistic practice in their respective settings. Nineteen health practitioners purposively sampled from an extensive Brain Injury Network in Queensland, Australia participated in individual interviews. A systematic text analysis process using Leximancer qualitative analysis program was undertaken, followed by manual thematic analysis to develop overarching themes. The findings from this study have identified several items for future inter-professional development that will not only benefit the practitioners working in brain injury rehabilitation settings, but the patients and their families as well. PMID:27270604

Holistic Practice in Traumatic Brain Injury Rehabilitation: Perspectives of Health Practitioners.

Science.gov (United States)

Wright, Courtney J; Zeeman, Heidi; Biezaitis, Valda

2016-01-01

Given that the literature suggests there are various (and often contradictory) interpretations of holistic practice in brain injury rehabilitation and multiple complexities in its implementation (including complex setting, discipline, and client-base factors), this study aimed to examine the experiences of practitioners in their conceptualization and delivery of holistic practice in their respective settings. Nineteen health practitioners purposively sampled from an extensive Brain Injury Network in Queensland, Australia participated in individual interviews. A systematic text analysis process using Leximancer qualitative analysis program was undertaken, followed by manual thematic analysis to develop overarching themes. The findings from this study have identified several items for future inter-professional development that will not only benefit the practitioners working in brain injury rehabilitation settings, but the patients and their families as well.

Older patients' experiences during care transition

Directory of Open Access Journals (Sweden)

Rustad EC

2016-05-01

Full Text Available Else Cathrine Rustad,1–4 Bodil Furnes,1 Berit Seiger Cronfalk,2,5,6 Elin Dysvik1 1Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway; 2Faculty of Health and Caring Sciences, Stord Haugesund University College, Stord, Norway; 3Research Network on Integrated Health Care in Western Norway, Helse Fonna Local Health Authority, Haugesund, Norway; 4Department of Clinical Medicine, Helse Fonna Local Health Authority, Haugesund, Norway; 5Palliative Research Center, Ersta Sköndal University College, Stockholm, Sweden; 6Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Background: A fragmented health care system leads to an increased demand for continuity of care across health care levels. Research indicates age-related differences during care transition, with the oldest patients having experiences and needs that differ from those of other patients. To meet the older patients’ needs and preferences during care transition, professionals must understand their experiences.Objective: The purpose of the study was to explore how patients ≥80 years of age experienced the care transition from hospital to municipal health care services.Methods: The study has a descriptive, explorative design, using semistructured interviews. Fourteen patients aged ≥80 participated in the study. Qualitative content analysis was used to describe the individuals’ experiences during care transition.Results: Two complementary themes emerged during the analysis: “Participation depends on being invited to plan the care transition” and “Managing continuity of care represents a complex and challenging process”.Discussion: Lack of participation, insufficient information, and vague responsibilities among staff during care transition seemed to limit the continuity of care. The patients are the vulnerable part of the care transition process, although they possess important

Balancing performance-based expectations with a holistic perspective on coaching: a qualitative study of Swedish women's national football team coaches' practice experiences.

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Lindgren, Eva-Carin; Barker-Ruchti, Natalie

2017-12-01

The purpose of this study was to explore how an exclusive sample of women's national football team coaches described how they implement careful coaching while facing social and organizational pressure to win medals. To consider coaches' negotiations, we drew on Noddings' concept of caring. Using an interpretive research paradigm, we conducted in-depth interviews with five Swedish women's national football team coaches. An abductive approach was used to simultaneously process the theoretical framework of "ethics of care" and the empirical data. The coaches unanimously adopted a holistic perspective to coaching. The coaching strategies they described included promoting players' development, well-being, and sustainable elite performance; listening to the players' voices and engaging in dialogue; and creating a positive environment and promoting fair play. These findings demonstrate that the women coaches, despite performance pressure, adopt caring coaching in the form of Noddings' pedagogical modelling, dialogue, and confirmation strategies, and provide an example of how coaches can adopt caring, holistic, and athlete-centred coaching while working at the highest level of competitive sport and achieving competitive success.

Towards a Holistic Approach in EU Biomass Regulation

NARCIS (Netherlands)

Giljam, Renske

The energy transition requires a legal system that promotes the most sustainable forms of energy. This requires a holistic approach that accounts for all effects of energy production throughout the energy chain. This article analyses the presence of holistic elements in the current legal framework

Giuseppe Moscati (1880-1927): a holistic approach to medicine.

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Ponti, Giovanni; Tomasi, Aldo

2014-05-01

Giuseppe Moscati was a physician, medical school professor and a pioneer in the field of biochemistry and Italian studies on diabetes. He was declared a Catholic saint in 1987. In order to respond better to both the physical and spiritual needs of his patients, he developed his own holistic approach to healthcare involving meticulous drug regimens, meditation and discipline. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Acute care patients discuss the patient role in patient safety.

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Rathert, Cheryl; Huddleston, Nicole; Pak, Youngju

2011-01-01

Patient safety has been a highly researched topic in health care since the year 2000. One strategy for improving patient safety has been to encourage patients to take an active role in their safety during their health care experiences. However, little research has shed light on how patients view their roles. This study attempted to address this deficit by inductively exploring the results of a qualitative study in which patients reported their ideas about what they believe their roles should be. Patients with an overnight stay in the previous 90 days at one of three hospitals were surveyed using a mailing methodology. Of 1,040 respondents, 491 provided an open-ended response regarding what they believe the patient role should be. Qualitative analysis found several prominent themes. The largest proportion of responses (23%) suggested that patients should follow instructions given by care providers. Other prominent themes were that patients should ask questions and become informed about their conditions and treatments, and many implied that they should expect competent care. Our results suggest that patients believe they should be able to trust that they are being provided competent care, as opposed to assuming a leadership role in their safety. Our results suggest that engaging patients in safety efforts may be complex, requiring a variety of strategies. Managers must provide environments conducive to staff and patient interactions to support patients in this effort. Different types of patients may require different engagement strategies.

Principle-based concept analysis: intentionality in holistic nursing theories.

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Aghebati, Nahid; Mohammadi, Eesa; Ahmadi, Fazlollah; Noaparast, Khosrow Bagheri

2015-03-01

This is a report of a principle-based concept analysis of intentionality in holistic nursing theories. A principle-based concept analysis method was used to analyze seven holistic theories. The data included eight books and 31 articles (1998-2011), which were retrieved through MEDLINE and CINAHL. Erickson, Kriger, Parse, Watson, and Zahourek define intentionality as a capacity, a focused consciousness, and a pattern of human being. Rogers and Newman do not explicitly mention intentionality; however, they do explain pattern and consciousness (epistemology). Intentionality has been operationalized as a core concept of nurse-client relationships (pragmatic). The theories are consistent on intentionality as a noun and as an attribute of the person-intentionality is different from intent and intention (linguistic). There is ambiguity concerning the boundaries between intentionality and consciousness (logic). Theoretically, intentionality is an evolutionary capacity to integrate human awareness and experience. Because intentionality is an individualized concept, we introduced it as "a matrix of continuous known changes" that emerges in two forms: as a capacity of human being and as a capacity of transpersonal caring. This study has produced a theoretical definition of intentionality and provides a foundation for future research to further investigate intentionality to better delineate its boundaries. © The Author(s) 2014.

A holistic approach to marketing in Montenegrin banks

Directory of Open Access Journals (Sweden)

Žugić Jelena

2016-01-01

Full Text Available In modern conditions of market globalization and strong competition, it is necessary to improve a holistic approach to marketing in banks. This paper is based on the research conducted in the banks in Montenegro. The goal of this study was to determine whether the Montenegrin banks have clearly redefined the concept of marketing, recognized the specific nature of marketing in banking and adopted a holistic marketing concept in modern banking. The main purpose of marketing in banking is to attract, retain and develop long-term relationships with customers and other stakeholders. Also, the marketing concept in banking includes the achievement of full cooperation with customers through relationship marketing, customer relationship management (CRM, alternative distribution channels in modern banking and, in general, a holistic approach to marketing. Holistic marketing analysis will help identify the strengths and weaknesses in marketing in the banking sector of Montenegro and give platform for strategic planning for its further development.

Developmental differences in holistic interference of facial part recognition.

Directory of Open Access Journals (Sweden)

Kazuyo Nakabayashi

Full Text Available Research has shown that adults' recognition of a facial part can be disrupted if the part is learnt without a face context but tested in a whole face. This has been interpreted as the holistic interference effect. The present study investigated whether children of 6- and 9-10-year-olds would show a similar effect. Participants were asked to judge whether a probe part was the same as or different from a test part whereby the part was presented either in isolation or in a whole face. The results showed that while all the groups were susceptible to a holistic interference, the youngest group was most severely affected. Contrary to the view that piecemeal processing precedes holistic processing in the cognitive development, our findings demonstrate that holistic processing is already present at 6 years of age. It is the ability to inhibit the influence of holistic information on piecemeal processing that seems to require a longer period of development into at an older and adult age.

Developmental Differences in Holistic Interference of Facial Part Recognition

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Nakabayashi, Kazuyo; Liu, Chang Hong

2013-01-01

Research has shown that adults’ recognition of a facial part can be disrupted if the part is learnt without a face context but tested in a whole face. This has been interpreted as the holistic interference effect. The present study investigated whether children of 6- and 9–10-year-olds would show a similar effect. Participants were asked to judge whether a probe part was the same as or different from a test part whereby the part was presented either in isolation or in a whole face. The results showed that while all the groups were susceptible to a holistic interference, the youngest group was most severely affected. Contrary to the view that piecemeal processing precedes holistic processing in the cognitive development, our findings demonstrate that holistic processing is already present at 6 years of age. It is the ability to inhibit the influence of holistic information on piecemeal processing that seems to require a longer period of development into at an older and adult age. PMID:24204847

The Design of Holistic Innovation Policy

DEFF Research Database (Denmark)

Borrás, Susana; Edquist, Charles

looks into a series of issues related to the design of holistic innovation policy. With this purpose in mind, this chapter summarizes previous chapters’ identification of the problems, bottlenecks and deficiencies that can afflict innovation systems. Taken together, they provide the theoretical...... foundations for the design of holistic innovation policy, which includes not only framing the problems in the innovation system, but also considerations about policy instruments for the tasks at hand, as well as the problems generated by policy itself (unintended consequences of inefficient of incomplete...

Patient care in radiography

International Nuclear Information System (INIS)

Ehrlich, R.A.; McCloskey, E.D.

1989-01-01

This book focuses on patient care procedures for radiographers. The authors focus on the role of the radiographer as a member of the health care team. The authors report on such topics as communication in patient care: safety, medico-legal considerations, transfer and positioning; physical needs; infection control; medication; CPR standards, acute situations; examination of the GI tract; contrast media; special imaging techniques and bedside radiography

Patients' perceptions of palliative care: adaptation of the Quality from the Patient's Perspective instrument for use in palliative care, and description of patients' perceptions of care received.

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Sandsdalen, Tuva; Rystedt, Ingrid; Grøndahl, Vigdis Abrahamsen; Hov, Reidun; Høye, Sevald; Wilde-Larsson, Bodil

2015-11-02

Instruments specific to palliative care tend to measure care quality from relative perspectives or have insufficient theoretical foundation. The instrument Quality from the Patient's Perspective (QPP) is based on a model for care quality derived from patients' perceptions of care, although it has not been psychometrically evaluated for use in palliative care. The aim of this study was to adapt the QPP for use in palliative care contexts, and to describe patients' perceptions of the care quality in terms of the subjective importance of the care aspects and the perceptions of the care received. A cross-sectional study was conducted between November 2013 and December 2014 which included 191 patients (73% response rate) in late palliative phase at hospice inpatient units, hospice day-care units, wards in nursing homes that specialized in palliative care and homecare districts, all in Norway. An explorative factor analysis using principal component analysis, including data from 184 patients, was performed for psychometric evaluation. Internal consistency was assessed by Cronbach's alpha and paired t-tests were used to describe patients' perceptions of their care. The QPP instrument was adapted for palliative care in four steps: (1) selecting items from the QPP, (2) modifying items and (3) constructing new items to the palliative care setting, and (4) a pilot evaluation. QPP instrument specific to palliative care (QPP-PC) consists of 51 items and 12 factors with an eigenvalue ≥1.0, and showed a stable factor solution that explained 68.25% of the total variance. The reliability coefficients were acceptable for most factors (0.79-0.96). Patients scored most aspects of care related to both subjective importance and actual care received as high. Areas for improvement were symptom relief, participation, continuity, and planning and cooperation. The QPP-PC is based on a theoretical model of quality of care, and has its roots in patients' perspectives. The instrument was

The Happy Antics programme: Holistic exercise for people with dementia.

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Khoo, Yvonne J-Lyn; van Schaik, Paul; McKenna, Jackie

2014-10-01

Holistic exercise for people with dementia could have psychological and physical benefits, but there is a lack of research on the experience of this type of exercise. Therefore, the objective of this study was to determine the feasibility and acceptance of holistic exercise among people with dementia. A holistic exercise programme for people with dementia was designed and implemented. Semi-structured interviews were undertaken to explore participants' experience of holistic exercise, transcribed verbatim and analyzed. Seven themes were generated from the data. They were enjoyment, relaxation, keeping active, social interaction, pain relief, learning something new and intention to continue, respectively. The results of the current small-scale study provide evidence for the feasibility and acceptance of holistic exercise for people with dementia. In addition, participants appeared to benefit in terms of psychological and physical wellbeing. Copyright © 2014 Elsevier Ltd. All rights reserved.

Palliative care - shortness of breath

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... page, please enable JavaScript. Palliative care is a holistic approach to care that focuses on treating pain ... the cause will help the team decide the treatment. The nurse may check how much oxygen is ...

Clinical holistic medicine: teaching orgasm for females with chronic anorgasmia using the Betty Dodson method.

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Struck, Pia; Ventegodt, Søren

2008-09-21

The objective of this study was to test the Betty Dodson method of breaking the female orgasm barrier in chronic anorgasmic women. The aim was sexual and existential healing (salutogenesis) through direct confrontation and integration of both the repressed shame, guilt, and other negative feelings associated with body, genitals, and sexuality, and the repressed sexual pleasure and desire. We conducted a retrospective analysis of clinic data from holistic sexological manual therapeutic intervention, an intensive subtype of clinical holistic medicine (CHM). The patients received 3 "e 5 h of group therapy, integrating short-term psychodynamic psychotherapy (STPP) and complementary medicine (CAM bodywork, manual sexology similar to the inverted exclamation mark section signsexological examination inverted exclamation mark ). The therapy used the advanced tools of reparenting, genital acceptance, acceptance through touch, and direct sexual clitoral stimulation. A clitoral vibrator was used. Participants were 500 female patients between 18 and 88 years of age (mean of 35 years) with chronic anorgasmia (for 12 years on average) who were participating in the inverted exclamation mark section signorgasm course for anorgasmic women inverted exclamation mark ; 25% of the patients had never experienced an orgasm. Our results show that 465 patients (93%) had an orgasm during therapy, witnessed by the therapist, and 35 patients (7%) did not. Postmenopausal women were as able to achieve orgasm as fertile women, as were women who never had an orgasm. No patients had detectable negative side effects or adverse effects. NNT: 1.04 500. Therapeutic value: TV = NNH/NNT > 446. Our conclusions are that holistic sexological manual therapy may be rational, safe, ethical, and efficient.

Face-specific impairment in holistic perception following focal lesion of the right anterior temporal lobe.

Science.gov (United States)

Busigny, Thomas; Van Belle, Goedele; Jemel, Boutheina; Hosein, Anthony; Joubert, Sven; Rossion, Bruno

2014-04-01

Recent studies have provided solid evidence for pure cases of prosopagnosia following brain damage. The patients reported so far have posterior lesions encompassing either or both the right inferior occipital cortex and fusiform gyrus, and exhibit a critical impairment in generating a sufficiently detailed holistic percept to individualize faces. Here, we extended these observations to include the prosopagnosic patient LR (Bukach, Bub, Gauthier, & Tarr, 2006), whose damage is restricted to the anterior region of the right temporal lobe. First, we report that LR is able to discriminate parametrically defined individual exemplars of nonface object categories as accurately and quickly as typical observers, which suggests that the visual similarity account of prosopagnosia does not explain his impairments. Then, we show that LR does not present with the typical face inversion effect, whole-part advantage, or composite face effect and, therefore, has impaired holistic perception of individual faces. Moreover, the patient is more impaired at matching faces when the facial part he fixates is masked than when it is selectively revealed by means of gaze contingency. Altogether these observations support the view that the nature of the critical face impairment does not differ qualitatively across patients with acquired prosopagnosia, regardless of the localization of brain damage: all these patients appear to be impaired to some extent at what constitutes the heart of our visual expertise with faces, namely holistic perception at a sufficiently fine-grained level of resolution to discriminate exemplars of the face class efficiently. This conclusion raises issues regarding the existing criteria for diagnosis/classification of patients as cases of apperceptive or associative prosopagnosia. Copyright © 2014 Elsevier Ltd. All rights reserved.

Towards non-reductionistic medical anthropology, medical education and practitioner-patient-interaction: the example of Anthroposophic Medicine.

Science.gov (United States)

Heusser, Peter; Scheffer, Christian; Neumann, Melanie; Tauschel, Diethart; Edelhäuser, Friedrich

2012-12-01

To develop the hypothesis that reductionism in medical anthropology, professional education and health care influences empathy development, communication and patient satisfaction. We identified relevant literature and reviewed the material in a structured essay. We reflected our hypothesis by applying it to Anthroposophic Medicine (AM), an example of holistic theory and practice. Reductionism in medical anthropology such as in conventional medicine seems to lead to a less empathetic and less communicative health care culture than holism such as in CAM disciplines. However, reductionism can be transformed into a systemic, multi-perspective holistic view, when the emergent properties of the physical, living, psychic, spiritual and social levels of human existence and the causal relations between them are more carefully accounted for in epistemology, medical anthropology and professional education. This is shown by the example of AM and its possible benefits for communication with and satisfaction of patients. A non-reductionistic understanding of the human being may improve communication with patients and enhance patient benefit and satisfaction. Interdisciplinary qualitative and quantitative studies are warranted to test this hypothesis and to understand the complex relations between epistemology, medical anthropology, education, health care delivery and benefit for patients. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Psychometric testing of the modified Care Dependency Scale (Neuro-CDS).

Science.gov (United States)

Piredda, Michela; Biagioli, Valentina; Gambale, Giulia; Porcelli, Elisa; Barbaranelli, Claudio; Palese, Alvisa; De Marinis, Maria Grazia

2016-01-01

Effective measures of nursing care dependency in neurorehabilitation are warranted to plan nursing interventions to help patients avoid increasing dependency. The Care Dependency Scale (CDS) is a theory-based, comprehensive tool to evaluate functional disability. This study aimed to modify the CDS for neurological and neurorehabilitation patients (Neuro-CDS) and to test its psychometric properties in adult neurorehabilitation inpatients. Exploratory factor analysis (EFA) was performed using a Maximum Likelihood robust (MLR) estimator. The Barthel Index (BI) was used to evaluate concurrent validity. Stability was measured using the Intra-class Correlation Coefficient (ICC). The sample included 124 patients (mean age = 69.7 years, 54% male). The EFA revealed a two-factor structure with good fit indexes, Factor 1 (Physical care dependence) loaded by 11 items and Factor 2 (Psycho-social care dependence) loaded by 4 items. The correlation between factors was 0.61. Correlations between Factor 1 and the BI and between Factor 2 and the BI were r = 0.843 and r = 0.677, respectively (p dependence in neurorehabilitation patients as a basis for individualized and holistic care.

Older Patients' Perspectives on Quality of Serious Illness Care in Primary Care.

Science.gov (United States)

Abu Al Hamayel, Nebras; Isenberg, Sarina R; Hannum, Susan M; Sixon, Joshua; Smith, Katherine Clegg; Dy, Sydney M

2018-01-01

Despite increased focus on measuring and improving quality of serious illness care, there has been little emphasis on the primary care context or incorporation of the patient perspective. To explore older patients' perspectives on the quality of serious illness care in primary care. Qualitative interview study. Twenty patients aged 60 or older who were at risk for or living with serious illness and who had participated in the clinic's quality improvement initiative. We used a semistructured, open-ended guide focusing on how older patients perceived quality of serious illness care, particularly in primary care. We transcribed interviews verbatim and inductively identified codes. We identified emergent themes using a thematic and constant comparative method. We identified 5 key themes: (1) the importance of patient-centered communication, (2) coordination of care, (3) the shared decision-making process, (4) clinician competence, and (5) access to care. Communication was an overarching theme that facilitated coordination of care between patients and their clinicians, empowered patients for shared decision-making, related to clinicians' perceived competence, and enabled access to primary and specialty care. Although access to care is not traditionally considered an aspect of quality, patients considered this integral to the quality of care they received. Patients perceived serious illness care as a key aspect of quality in primary care. Efforts to improve quality measurement and implementation of quality improvement initiatives in serious illness care should consider these aspects of care that patients deem important, particularly communication as an overarching priority.

Seeking Humanizing Care in Patient-Centered Care Process: A Grounded Theory Study.

Science.gov (United States)

Cheraghi, Mohammad Ali; Esmaeili, Maryam; Salsali, Mahvash

Patient-centered care is both a goal in itself and a tool for enhancing health outcomes. The application of patient-centered care in health care services globally however is diverse. This article reports on a study that sought to introduce patient-centered care. The aim of this study is to explore the process of providing patient-centered care in critical care units. The study used a grounded theory method. Data were collected on 5 critical care units in Tehran University of Medical Sciences. Purposive and theoretical sampling directed the collection of data using 29 semistructured interviews with 27 participants (nurses, patients, and physician). Data obtained were analyzed according to the analysis stages of grounded theory and constant comparison to identify the concepts, context, and process of the study. The core category of this grounded theory is "humanizing care," which consisted of 4 interrelated phases, including patient acceptance, purposeful patient assessment and identification, understanding patients, and patient empowerment. A core category of humanizing care integrated the theory. Humanizing care was an outcome and process. Patient-centered care is a dynamic and multifaceted process provided according to the nurses' understanding of the concept. Patient-centered care does not involve repeating routine tasks; rather, it requires an all-embracing understanding of the patients and showing respect for their values, needs, and preferences.

Palliative care for patients with cancer: do patients receive the care they consider important? A survey study.

Science.gov (United States)

Heins, Marianne; Hofstede, Jolien; Rijken, Mieke; Korevaar, Joke; Donker, Gé; Francke, Anneke

2018-04-17

In many countries, GPs and home care nurses are involved in care for patients with advanced cancer. Given the varied and complex needs of these patients, providing satisfactory care is a major challenge for them. We therefore aimed to study which aspects of care patients, GPs and home care nurses consider important and whether patients receive these aspects. Seventy-two Dutch patients with advanced cancer, 87 GPs and 26 home care nurses rated the importance of support when experiencing symptoms, respect for patients' autonomy and information provision. Patients also rated whether they received these aspects. Questionnaires were based on the CQ index palliative care. Almost all patients rated information provision and respect for their autonomy as important. The majority also rated support when suffering from specific symptoms as important, especially support when in pain. In general, patients received the care they considered important. However, 49% of those who considered it important to receive support when suffering from fatigue and 23% of those who wanted to receive information on the expected course of their illness did not receive this or only did so sometimes. For most patients with advanced cancer, the palliative care that they receive matches what they consider important. Support for patients experiencing fatigue may need more attention. When symptoms are difficult to control, GPs and nurses may still provide emotional support and practical advice. Furthermore, we recommend that GPs discuss patients' need for information about the expected course of their illness.

The impact of current alternative herbal remedies on dental patient management.

Science.gov (United States)

Karimi, K

1999-01-01

With the recent boom in holistic and herbal medicine and an ever-growing trend among the general population to refer to herbal remedies as an alternative to traditional pharmaceutical therapies, dental health care providers must be aware of the wide consumption of such products and understand their nature. It becomes imperative, therefore, to include questions regarding the use of herbal preparations as a matter of routine in the patient's drug history, since this may impact a safe dental patient care delivery.

Primary care providers' experiences caring for complex patients in primary care: a qualitative study.

Science.gov (United States)

Loeb, Danielle F; Bayliss, Elizabeth A; Candrian, Carey; deGruy, Frank V; Binswanger, Ingrid A

2016-03-22

Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care. Using a general inductive approach, our qualitative research study was guided by an interpretive epistemology, or way of knowing. Our method for understanding included semi-structured in-depth interviews with internal medicine PCPs from two university-based and three community health clinics. We developed an interview guide, which included questions on PCPs' experiences, perceived system barriers and facilitators, and strategies to improve their ability to effectively treat complex patients. To focus interviews on real cases, providers were asked to bring de-identified clinical notes from patients they considered complex to the interview. Interview transcripts were coded and analyzed to develop categories from the raw data, which were then conceptualized into broad themes after team-based discussion. PCPs (N = 15) described complex patients with multidimensional needs, such as socio-economic, medical, and mental health. A vision of optimal care emerged from the data, which included coordinating care, preventing hospitalizations, and developing patient trust. PCPs relied on professional values and individual care strategies to overcome local and system barriers. Team based approaches were endorsed to improve the management of complex patients. Given the barriers to effective care described by PCPs, individual PCP efforts alone are unlikely to meet the needs of complex patients. To fulfill PCP's expressed concepts of

Does patient-provider gender concordance affect mental health care received by primary care patients with major depression?

Science.gov (United States)

Chan, Kitty S; Bird, Chloe E; Weiss, Robert; Duan, Naihua; Meredith, Lisa S; Sherbourne, Cathy D

2006-01-01

We sought to determine whether patient-provider gender concordance influences the detection and care of depression and comorbid anxiety and substance use in patients with major depression Cross-sectional analyses of baseline patient survey data linked with provider data were performed. Data based on routine primary care visits in clinics from a variety of health systems serving diverse patient populations across the United States. Participants all had major depression. Depression care was examined in the Quality Improvement for Depression (QID) Collaboration sample (n patients = 1,428, n providers = 389). In a subanalysis of data solely from 714 patients and 157 providers from Partners-In-Care, one of the projects participating in QID, we also examined detection of anxiety disorder and alcohol or drug problems. Rates of detection and care of mental health problems in primary care were low even among patients with major depression. Except for anxiety counseling in female patients, patient-provider gender concordance did not improve care as hypothesized. However, female providers were more likely to counsel on anxiety and less likely to counsel on alcohol or drug use than male providers. Female patients were less likely to be counseled on alcohol or drug use compared with male patients. Detection and care of mental health and substance use problems for patients with major depression is not influenced by patient-provider gender concordance. However, depressed female patients may have greater unmet needs for alcohol and drug use counseling than their male counterparts.

Palliative and end-of-life care for adults with advanced chronic obstructive pulmonary disease: a rapid review focusing on patient and family caregiver perspectives.

Science.gov (United States)

Mathews, Gillian; Johnston, Bridget

2017-12-01

The aim of the review was to explore patient and family caregiver perspectives on key issues for ensuring quality of end-of-life care for people with chronic obstructive pulmonary disease (COPD). The growing evidence on the value of specialist palliative care services demonstrates significant improvements in treatments and provisions; however, much of the literature is generic in nature or centred on people with a cancer diagnosis. In this review, we examine the literature to ascertain the views and needs of patients and carers affected by advanced COPD, a highly debilitating condition that can have a profoundly negative impact on the quality of end-of-life experience. A total of 19 papers were included in the review. The main themes in the literature were Holistic Care, Illness Trajectory and Technology. Areas of unmet need emphasized across physical, psychosocial and spiritual domains were identified, particularly in relation to appropriate and timely conversations. Positive developments in the care and treatment of advanced COPD include the use of the STIOLTO Respimat inhaler, a brief educative and psychosocial intervention based on cognitive-behavioural therapy, and high-intensity exercise training. There is some evidence regarding the use of technology in end-stage COPD.

A historical review of the concept of labor support in technocratic, humanistic and holistic paradigms of childbirth.

Science.gov (United States)

Najafi, Tahereh Fathi; Roudsari, Robab Latifnejad; Ebrahimipour, Hossein

2017-10-01

In the past century, maternal support during childbirth has been changed according to the different approaches suggested by various health care paradigms. The aim of this review was to argue the maternity supportive care paradigms of the past century and to closely analyze each paradigm. This is a historical review, in which published articles were retrieved from databases including Scopus, Science Direct, PubMed and Google Scholar. Sage Journals and Springer's publications were also searched due to the high citation rate of their articles. The keywords entered were "Labor support", "Normal delivery", "Birth attendance", "Supportive approaches", "Health care paradigms", and "Midwifery models of care". They were entered alone or in combinations using "AND". Also, Persian articles were searched in local databases including Irandoc, SID, IranMedex, and Magiran using the above-mentioned keywords in Persian. Sixty articles met inclusion criteria. The review revealed four main themes including the definitions of continuous labor support, the technocratic paradigm, the humanistic paradigm and the naturalistic paradigm as models of labor support. According to the evidence, labor support has changed from technocratic to humanistic and holistic approaches, which in turn, caused some changes in midwifery models of care used by midwives in the practice. Labor support based on the holistic approaches and the naturalistic paradigms could bring about remarkable outcomes, the most important being satisfied with the birth experience, increased mother's self-confidence, enhanced mother's ability in childbirth and better completion of the childbirth process.

Holistic face representation is highly orientation-specific.

Science.gov (United States)

Rosenthal, Gideon; Levakov, Gidon; Avidan, Galia

2017-09-29

It has long been argued that face processing requires disproportionate reliance on holistic processing (HP), relative to that required for nonface object recognition. Nevertheless, whether the holistic nature of face perception is achieved via a unique internal representation or by the employment of an automated attention mechanism is still debated. Previous studies had used the face inversion effect (FIE), a unique face-processing marker, or the face composite task, a gold standard paradigm measuring holistic processing, to examine the validity of these two different hypotheses, with some studies combining the two paradigms. However, the results of such studies remain inconclusive, particularly pertaining to the issue of the two proposed HP mechanisms-an internal representation as opposed to an automated attention mechanism. Here, using the complete composite paradigm design, we aimed to examine whether face rotation yields a nonlinear or a linear drop in HP, thus supporting an account that face processing is based either on an orientation-dependent internal representation or on automated attention. Our results reveal that even a relatively small perturbation in face orientation (30 deg away from upright) already causes a sharp decline in HP. These findings support the face internal representation hypothesis and the notion that the holistic processing of faces is highly orientation-specific.

Paradigm shifts in critical care medicine: the progress we have made.

Science.gov (United States)

Vincent, Jean-Louis; Creteur, Jacques

2015-01-01

There have really been no single, major, advances in critical care medicine since the specialty came into existence. There has, however, been a gradual, continuous improvement in the process of care over the years, which has resulted in improved patient outcomes. Here, we will highlight just a few of the paradigm shifts we have seen in processes of critical care, including the move from small, closed units to larger, more open ICUs; from a paternal "dictatorship" to more "democratic" team-work; from intermittent to continuous, invasive to less-invasive monitoring; from "more" interventions to "less" thus reducing iatrogenicity; from consideration of critical illness as a single event to realization that it is just one part of a trajectory; and from "four walls" to "no walls" as we take intensive care outside the physical ICU. These and other paradigm shifts have resulted in improvements in the whole approach to patient management, leading to more holistic, humane care for patients and their families. As critical care medicine continues to develop, further paradigm shifts in processes of care are inevitable and must be embraced if we are to continue to provide the best possible care for all critically ill patients.

Paradigm shifts in critical care medicine: the progress we have made

Science.gov (United States)

2015-01-01

There have really been no single, major, advances in critical care medicine since the specialty came into existence. There has, however, been a gradual, continuous improvement in the process of care over the years, which has resulted in improved patient outcomes. Here, we will highlight just a few of the paradigm shifts we have seen in processes of critical care, including the move from small, closed units to larger, more open ICUs; from a paternal "dictatorship" to more "democratic" team-work; from intermittent to continuous, invasive to less-invasive monitoring; from "more" interventions to "less" thus reducing iatrogenicity; from consideration of critical illness as a single event to realization that it is just one part of a trajectory; and from "four walls" to "no walls" as we take intensive care outside the physical ICU. These and other paradigm shifts have resulted in improvements in the whole approach to patient management, leading to more holistic, humane care for patients and their families. As critical care medicine continues to develop, further paradigm shifts in processes of care are inevitable and must be embraced if we are to continue to provide the best possible care for all critically ill patients. PMID:26728199

Nursing care in fast-track surgery strategy

Directory of Open Access Journals (Sweden)

Dorota Kozieł

2015-10-01

Full Text Available In recent years, many study results have been published confirming an improvement in the outcomes of treatment related with management of patients within the fast-track surgery programme. Early postoperative rehabilitation is possible provided there is engagement of a multi-disciplinary team, including well-educated nurses. Today, a diversion can be observed from traditional nursing on behalf of a coordinated, holistic approach, while more attention is paid to the, thus far marginalised, psychosocial aspects of care. The objective of the study is to discuss the basic assumptions of fast track surgery with respect to nursing care, with particular emphasis placed on the educational function. Modern nursing within the short-track surgery programme should focus on the provision of patients with care consisting of preliminary information concerning the perioperative period, social and psychological support, counselling in the area of home convalescence, and procedures in the case of complications.

PALLIATIVE CARE IN SLOVENIA AND FUTURE CHALLENGES

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Urška Lunder

2003-11-01

Full Text Available Background. Palliative care in Slovene health care system isn’t developed. Comparison with other countries is not possible in many aspects. There is no complete or appropriately educated palliative care team in hospitals or in primary care. Palliative care departments in hospitals and nursing homes do not exist. Holistic palliative home care is offered only by Slovene association of hospice. The pressure on nursing homes and nursing service departments is getting stronger. Standards and norms for staff, for living conditions and medical equipment do not allow any more admittances of patients with the needs of high category of care in these institutions.Conclusions. Indirect indicators of level of palliative care (e.g. morphine consumption, palliative care departments, home care network, undergraduate education, specialisation and research put Slovenia at the bade of the Europe. Statistics predict aging of population and more patients are also living with consequences of progressive chronic diseases and cancer.In the new healthcare reform there is an opportunity for palliative care to get an equal place in healthcare system. With coordinated implementation of palliative care departments, consultant teams and mobile specialistic teams, palliative care could reach a better level of quality. At the same time, quality permanent education is essential.

Bet You Would Not Call a Holistic Plumber

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Mahon, Robert Lee

2007-01-01

In this article, the author examines the misuse of the idea of holistic education. Western culture--and not just science and technology, but finance, politics, arts, crafts, and professions too--is not built on holistic insight or understanding, but on analytic thinking. Therefore, logically, successful teaching in all of the above must be created…

Holistic Marketing 3.0: Menuju Organisasi Spiritual

OpenAIRE

Gancar Candra Premananto

2015-01-01

Holistic Marketing is become new mantra for marketer in this 21 century. The concept builds on 4 pillars which are integrated marketing, internal marketing, performance marketing and relationship marketing. The point of that concept is about the important things is to make relationship to everybody and to every stakeholders. The concepts still on development process by Kotler & Keller. This conceptual article proposed that Holistic Marketing proposed by Kotler & Keller still discuss about hor...

Systems Pharmacology Dissecting Holistic Medicine for Treatment of Complex Diseases: An Example Using Cardiocerebrovascular Diseases Treated by TCM.

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Wang, Yonghua; Zheng, Chunli; Huang, Chao; Li, Yan; Chen, Xuetong; Wu, Ziyin; Wang, Zhenzhong; Xiao, Wei; Zhang, Boli

2015-01-01

Holistic medicine is an interdisciplinary field of study that integrates all types of biological information (protein, small molecules, tissues, organs, external environmental signals, etc.) to lead to predictive and actionable models for health care and disease treatment. Despite the global and integrative character of this discipline, a comprehensive picture of holistic medicine for the treatment of complex diseases is still lacking. In this study, we develop a novel systems pharmacology approach to dissect holistic medicine in treating cardiocerebrovascular diseases (CCDs) by TCM (traditional Chinese medicine). Firstly, by applying the TCM active ingredients screened out by a systems-ADME process, we explored and experimentalized the signed drug-target interactions for revealing the pharmacological actions of drugs at a molecule level. Then, at a/an tissue/organ level, the drug therapeutic mechanisms were further investigated by a target-organ location method. Finally, a translational integrating pathway approach was applied to extract the diseases-therapeutic modules for understanding the complex disease and its therapy at systems level. For the first time, the feature of the drug-target-pathway-organ-cooperations for treatment of multiple organ diseases in holistic medicine was revealed, facilitating the development of novel treatment paradigm for complex diseases in the future.

Palliative care and end-of-life care for polypathological patients.

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Martinez-Litago, E; Martínez-Velasco, M C; Muniesa-Zaragozano, M P

2017-12-01

Patients with advanced chronic diseases receive fragmented care, which entails high resource consumption and a poor quality of life. Uncertainty in the prognosis and scarce investigation into the importance of symptomatic control in this patient group hinders a proper therapeutic approach. Palliative care teams optimise the use of resources through comprehensive patient care, the optimization of the patient's environment, communication, the preparation of early care plans and the creation of coordinated healthcare circuits, which improve the quality of the patient's care in advanced stages of the disease. In the end-of-life phase, the therapeutic approach is focused on symptomatic control, selecting treatments according to the cause, comorbidities and the patient's wishes. To control refractory symptoms, palliative sedation is considered an indispensable option. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Evaluating the Needs of Patients Living With Solid Tumor Cancer: A Survey Design.

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Schmidt, April L; Lorenz, Rebecca A; Buchanan, Paula M; McLaughlin, Laura

2018-03-01

To describe the unmet needs of adult patients living with solid tumor cancer. Survey design. Adult patients living with solid tumor cancer from two outpatient clinics were mailed the Sheffield Profile for Assessment and Referral to Care, a holistic screening questionnaire for assessing palliative care needs, and a demographics questionnaire. One hundred fifteen patients returned the instruments, corresponding to a 62% response rate. There were no significant differences by cancer type (breast, non-breast) or gender. However, Caucasians reported significantly more psychological issues, such as anxiety, than non-Caucasians ([ n = 101 (87.8%)] and [ n = 14 (12.2%)], respectively, p = .032). Older patients reported more concerns about loss of independence/activity ( p = .012) compared with younger age groups. Patients living with Stage III/IV cancer reported more distressed about independence/activity ( p = .034), family/social issues ( p = .007), and treatment side effects ( p = .027) than patients living with Stage I/II cancer. Patients living with solid tumor cancer have a myriad of unmet needs regardless of age, gender, cancer type, or cancer stage. There appears to be important differences by cancer stage. The Sheffield Profile for Assessment and Referral to Care questionnaire provides a holistic approach for nurses to identify unmet needs and concerns. Future research should explore the preferred methods of receiving support and information.

Clinical Holistic Medicine: Holistic Treatment of Rape and Incest Trauma

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Søren Ventegodt

2005-01-01

Full Text Available Studies indicate that at least 15% of the female population in western countries has experienced sexual abuse and severe sexual traumas. This paper explains how even serious sexual abuse and trauma can be healed when care and resources encourage the patient to return to the painful life events. When the physician cares and receives the trust of the patient, emotional holding and processing will follow quite naturally. Spontaneous regression seems to be an almost pain-free way of integrating the severe traumas from earlier experiences of rape and incest. This technique is a recommended alternative to classical timeline therapy using therapeutic commands. When traumatized patients distance themselves from their soul (feelings, sexuality, and existential depth, they often lose their energy and enjoyment of life. However, this does not mean that they are lost to life. Although it may seem paradoxical, a severe trauma may be a unique opportunity to regain enjoyment of life. The patient will often be richly rewarded for the extensive work of clearing and sorting out in order to experience a new depth in his or her existence and emotional life, with a new ability to understand life in general and other people in particular. So what may look like a tragedy can be transformed into a unique gift; if the patient gets sufficient support, there is the possibility of healing and learning. Consciousness-based medicine seems to provide severely traumatized patients with the quality of support and care needed for their soul to heal.

Holistic energy retrofitting of multi-storey building to low energy level

DEFF Research Database (Denmark)

Morelli, Martin; Tommerup, Henrik M.; Tafdrup, Morten K.

2011-01-01

a holistic energy retrofitting of a multi-storey building from 1930 with facades worth preserving. Different single measures, e.g. windows and wall insulation, are assessed with regard to energy saving and economy. The best performing single measures are combined in a holistic retrofitting. The total energy...... consumption of the holistic solution is theoretically calculated, and the economy is documented based on calculations of cost of conserved energy. The results show that many single measures are cost-effective. However, when they are combined, the holistic retrofitting solution turns out not to be cost...

Examining chronic care patient preferences for involvement in health-care decision making: the case of Parkinson's disease patients in a patient-centred clinic.

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Zizzo, Natalie; Bell, Emily; Lafontaine, Anne-Louise; Racine, Eric

2017-08-01

Patient-centred care is a recommended model of care for Parkinson's disease (PD). It aims to provide care that is respectful and responsive to patient preferences, values and perspectives. Provision of patient-centred care should entail considering how patients want to be involved in their care. To understand the participation preferences of patients with PD from a patient-centred care clinic in health-care decision-making processes. Mixed-methods study with early-stage Parkinson's disease patients from a patient-centred care clinic. Study involved a modified Autonomy Preference Index survey (N=65) and qualitative, semi-structured in-depth interviews, analysed using thematic qualitative content analysis (N=20, purposefully selected from survey participants). Interviews examined (i) the patient preferences for involvement in health-care decision making; (ii) patient perspectives on the patient-physician relationship; and (iii) patient preferences for communication of information relevant to decision making. Preferences for participation in decision making varied between individuals and also within individuals depending on decision type, relational and contextual factors. Patients had high preferences for communication of information, but with acknowledged limits. The importance of communication in the patient-physician relationship was emphasized. Patient preferences for involvement in decision making are dynamic and support shared decision making. Relational autonomy corresponds to how patients envision their participation in decision making. Clinicians may need to assess patient preferences on an on-going basis. Our results highlight the complexities of decision-making processes. Improved understanding of individual preferences could enhance respect for persons and make for patient-centred care that is truly respectful of individual patients' wants, needs and values. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Nursing Students' Attitudes and Use of Holistic Therapies for Stress Relief.

Science.gov (United States)

Kinchen, Elizabeth V; Loerzel, Victoria

2018-03-01

The purpose of this study was to explore student nurses' openness to using or recommending holistic therapies, the strategies they use to manage stress from school or work, and their perceptions of the impact of holistic therapies on personal health. Qualitative component of a quasi-experimental, mixed-methods study. A convenience sample of undergraduate nursing students in a southeastern U.S. university completed baseline surveys, including demographics and three open-ended questions regarding attitudes toward holistic therapies and strategies used for stress management. Qualitative thematic analysis was undertaken to identify recurring themes in textual data. Students are open to using or recommending holistic therapies but identify lack of knowledge and lack of time as barriers to their practice. Among strategies used by student nurses to manage stress from school or work were physical activity, prayer and meditation, time management, distraction, socialization, artistic pursuits, animal interactions, and other activities. Themes describing holistic therapies' impact on personal health were wholeness, self-empowerment, relaxation/restoration, and alternative/complement to traditional medicine. Findings indicate receptiveness by student nurses to the use of holistic therapies but point to the need for the inclusion of informational as well as experiential education on holistic therapies within nursing curricula.

Advancing a holistic approach to openness

DEFF Research Database (Denmark)

Søndergaard, Helle Alsted; Araújo, Ana Luiza Lara de

Open innovation has emerged as a new and interesting research area, and with this paper we wish to contribute to the research on open innovation by proposing a more holistic approach to openness that includes the internal sphere of openness. We use data from 170 Danish SMEs in the high-tech and m......Open innovation has emerged as a new and interesting research area, and with this paper we wish to contribute to the research on open innovation by proposing a more holistic approach to openness that includes the internal sphere of openness. We use data from 170 Danish SMEs in the high...

Holistic Education from a Humanist Perspective

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César Enrique López Arrillaga

2018-05-01

Full Text Available This essay intends to approach the basic concepts of Holistic Education (Barrera, 2013 and a brief conceptual journey and main postulates of the humanist theory considered by the author on personality, (Carl, 1961, to establish the possible link of holistic education from a humanist perspective in the meeting of the postulates of Humanism in the teaching practice that allows the humanization of education, centered on human beings taking into account their abilities, abilities and skills, in a few words a tour of some important theoretical topics that will help build a vision of Hologogy in teachers.

An exploration of the extent of inclusion of spirituality and spiritual care concepts in core nursing textbooks.

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Timmins, Fiona; Murphy, Maryanne; Neill, Freda; Begley, Thelma; Sheaf, Greg

2015-01-01

Holistic care that encompasses a spiritual dimension is an expectation in modern healthcare (Rothman, 2009). Increasing attention is being paid to the role of nurses in providing spiritual care to patients. However nurses lack specific skills and expertise in this area (Lundmark, 2006; Timmins, 2010; RCN, 2011), and the extent to which their undergraduate education prepares them for this role is unclear. There is often an absence of clear direction about what to teach undergraduate nursing students. The extent to which core textbooks direct student studies in this area is not known. There is some evidence that some of these fundamental core textbooks provide insufficient direction (Pesut, 2008), thus gaps in knowledge and care provision in this field could be exacerbated. The aim of this study is to examine the extent to which spiritual care concepts are addressed in core nursing textbooks. Five hundred and forty three books were sampled from the Nursing and Midwifery Core Collection list (UK) (Tomlinsons, 2010) representing 94% of the total (n=580). A survey, the Spirituality Textbook Analysis Tool (STAT), was developed and used to collect data. One hundred and thirty of the books included content related to spirituality and religion. However there was little consistency in the core nursing textbooks with regard to direction for providing spiritual care. Thirty eight percent of the books defined spiritual care and 36% provided an outline of the role of the nurse in providing this. While some books advocated the assessment of patients' spiritual needs (32%) few referred specifically to assessment tools. It is essential that nurses are adequately prepared to address the spiritual needs of patients. While there are numerous spiritual care texts that deal solely with this issue for nurses, there is an argument emerging that core nursing texts used by nursing students ought to encompass spiritual care elements. Lack of specific focus on this field, by these key

A retrospective non-comparative analysis of the quality of care for osteoarthritis at the general out-patient department of Jos University Teaching Hospital, Nigeria

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Festus E Osajie

2015-01-01

Full Text Available Background: Osteoarthritis is a common condition in primary care and is often associated with disability and limitation of function requiring holistic care. Aim: The aim of this audit was to assess the quality of care provided by family physicians in the management of osteoarthritis at the General Out-patient Department (GOPD of Jos University Teaching Hospital (JUTH as well as ascertain if such care was in line with evidence-based medicine. Methods: This was a retrospective noncomparative study. The recommendations of the Nigerian Standard Treatment Guidelines 2008 and the National Institute for Health and Care Excellence 2014 guidelines were used to form standard targets for each of the structural, process and outcome components of the care process. Each of the consultation rooms was inspected for the structure components of the care process. For the process and outcome components of care, the medical records of all patients being managed for osteoarthritis at the GOPD of JUTH over a 1-year period were retrieved and studied. Results: For one aspect of the structural component (i.e. availability of weighing scale for each consultation room, 80% of the standard target was met which was below the standard target of 100%. The highest performance under the process component was for the documentation of risk associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs and documentation for NSAID/cyclooxygenase-2 inhibitors use with a gastro-protective agent. For both of these, 22.4% of the standard target was met; less than the standard target of 100% and 80% respectively. None of the standard targets for the outcome component were met. Conclusion: The quality of care for patients with osteoarthritis in this practice setting was sub-optimal. More can be done by family physicians with regards provision of comprehensive care for patients suffering from osteoarthritis.

Reflection on care in recurrent sexually transmitted co-infections.

Science.gov (United States)

Paparello, Joel Zamora; Beyers, Carl; Por, Jitna

Reflection is a skill that nurses are expected to practise to help them continually re-evaluate their personal effectiveness in problem solving. This skill is necessary when caring for patients who are experiencing the complex challenges linked to psychosexual and psychosociological behavioural changes associated with HIV infection and recurrent sexually transmitted co-infections (STC-I). The Johns model of structured reflection was used in the reflection described here to aid the critical thinking process in helping a nurse to manage and deliver up-to-date, effective care and to develop a strong nurse-patient therapeutic relationship. A holistic approach is key to delivering care to patients with recurrent STC-I. This involves taking a sexual health history and establishing the correct diagnosis, followed by the administration of pharmaceutical and psychotherapeutic treatments to facilitate psychosexual, psychosocial, and psychological changes. This article uses a reflective learning experience in caring for a patient with recurrent STC-I to give insights on psychosexual and psychosociological behavioural strategies. Used with a diagnosis and pharmacological intervention, these strategies can be put into nursing practice and enhance the quality of nursing care.

Book review: Preventing Crime. A Holistic Approach.

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Andrea Díaz Rozas

2017-12-01

Full Text Available Book review. Tore Bjørgo. Preventing Crime. A Holistic Approach. London: Palgrave Macmillan, 2016. 9781137560476 (Hb 93.59€, 9781349569786 (Pb 41.59€, 9781137560483 (eBook 76.99€.Reseña. Tore Bjørgo. Preventing Crime. A Holistic Approach. Londres: Palgrave Macmillan, 2016. 9781137560476 (Td 93.59€, 9781349569786 (Tb 41.59€, 9781137560483 (e-Libro 76.99€.DOWNLOAD THIS PAPER FROM SSRN: https://ssrn.com/abstract=3092188

Perioperative Care of the Transgender Patient.

Science.gov (United States)

Smith, Francis Duval

2016-02-01

Transgender patients are individuals whose gender identity is not related to their biological sex. Assuming a new gender identity that does not conform to societal norms often results in discrimination and barriers to health care. The exact number of transgender patients is unknown; however, these patients are increasingly seen in health care. Transgender individuals may experience provider-generated discrimination in health care facilities, including refusal of service, disrespect, and abuse, which contribute to depression and low self-esteem. Transgender therapies include mental health counseling for depression and low self-esteem, hormone therapy, and sex reassignment surgery. Health care professionals require cultural competence, an understanding of the different forms of patient identification, and adaptive approaches to care for transgender patients. VA (Veterans Affairs) hospitals provide a model for the care for transgender patients and staff. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Teamwork and Patient Care Teams in an Acute Care Hospital.

Science.gov (United States)

Rochon, Andrea; Heale, Roberta; Hunt, Elena; Parent, Michele

2015-06-01

The literature suggests that effective teamwork among patient care teams can positively impact work environment, job satisfaction and quality of patient care. The purpose of this study was to determine the perceived level of nursing teamwork by registered nurses, registered practical nurses, personal support workers and unit clerks working on patient care teams in one acute care hospital in northern Ontario, Canada, and to determine if a relationship exists between the staff scores on the Nursing Teamwork Survey (NTS) and participant perception of adequate staffing. Using a descriptive cross-sectional research design, 600 staff members were invited to complete the NTS and a 33% response rate was achieved (N=200). The participants from the critical care unit reported the highest scores on the NTS, whereas participants from the inpatient surgical (IPS) unit reported the lowest scores. Participants from the IPS unit also reported having less experience, being younger, having less satisfaction in their current position and having a higher intention to leave. A high rate of intention to leave in the next year was found among all participants. No statistically significant correlation was found between overall scores on the NTS and the perception of adequate staffing. Strategies to increase teamwork, such as staff education, among patient care teams may positively influence job satisfaction and patient care on patient care units. Copyright © 2015 Longwoods Publishing.

[Palliative care and end-of-life patients in emergency situations. Recommendations on optimization of out-patient care].

Science.gov (United States)

Wiese, C H R; Vagts, D A; Kampa, U; Pfeiffer, G; Grom, I-U; Gerth, M A; Graf, B M; Zausig, Y A

2011-02-01

At the end of life acute exacerbations of medical symptoms (e.g. dyspnea) in palliative care patients often result in emergency medical services being alerted. The goals of this study were to discuss cooperation between emergency medical and palliative care structures to optimize the quality of care in emergencies involving palliative care patients. For data collection an open discussion of the main topics by experts in palliative and emergency medical care was employed. Main outcome measures and recommendations included responses regarding current practices related to expert opinions and international literature sources. As the essential points of consensus the following recommendations for optimization of care were named: (1) integration of palliative care in the emergency medicine curricula for pre-hospital emergency physicians and paramedics, (2) development of outpatient palliative care, (3) integration of palliative care teams into emergency medical structures, (4) cooperation between palliative and emergency medical care, (5) integration of crisis intervention into outpatient palliative emergency medical care, (6) provision of emergency plans and emergency medical boxes, (7) provision of palliative crisis cards and do not attempt resuscitation (DNAR) orders, (8) psychosocial aspects concerning palliative emergencies and (9) definition of palliative patients and their special situation by the physician responsible for prior treatment. Prehospital emergency physicians are confronted with emergencies in palliative care patients every day. In the treatment of these emergencies there are potentially serious conflicts due to the different therapeutic concepts of palliative medical care and emergency medical services. This study demonstrates that there is a need for regulated criteria for the therapy of palliative patients and patients at the end of life in emergency situations. Overall, more clinical investigations concerning end-of-life care and unresponsive

Perceptual expertise: can sensorimotor experience change holistic processing and left-side bias?

Science.gov (United States)

Tso, Ricky Van-yip; Au, Terry Kit-fong; Hsiao, Janet Hui-wen

2014-09-01

Holistic processing and left-side bias are both behavioral markers of expert face recognition. By contrast, expert recognition of characters in Chinese orthography involves left-side bias but reduced holistic processing, although faces and Chinese characters share many visual properties. Here, we examined whether this reduction in holistic processing of Chinese characters can be better explained by writing experience than by reading experience. Compared with Chinese nonreaders, Chinese readers who had limited writing experience showed increased holistic processing, whereas Chinese readers who could write characters fluently showed reduced holistic processing. This result suggests that writing and sensorimotor experience can modulate holistic-processing effects and that the reduced holistic processing observed in expert Chinese readers may depend mostly on writing experience. However, both expert writers and writers with limited experience showed similarly stronger left-side bias than novices did in processing mirror-symmetric Chinese characters; left-side bias may therefore be a robust expertise marker for object recognition that is uninfluenced by sensorimotor experience. © The Author(s) 2014.

A meta-analysis and review of holistic face processing.

Science.gov (United States)

Richler, Jennifer J; Gauthier, Isabel

2014-09-01

The concept of holistic processing is a cornerstone of face recognition research, yet central questions related to holistic processing remain unanswered, and debates have thus far failed to reach a resolution despite accumulating empirical evidence. We argue that a considerable source of confusion in this literature stems from a methodological problem. Specifically, 2 measures of holistic processing based on the composite paradigm (complete design and partial design) are used in the literature, but they often lead to qualitatively different results. First, we present a comprehensive review of the work that directly compares the 2 designs, and which clearly favors the complete design over the partial design. Second, we report a meta-analysis of holistic face processing according to both designs and use this as further evidence for one design over the other. The meta-analysis effect size of holistic processing in the complete design is nearly 3 times that of the partial design. Effect sizes were not correlated between measures, consistent with the suggestion that they do not measure the same thing. Our meta-analysis also examines the correlation between conditions in the complete design of the composite task, and suggests that in an individual differences context, little is gained by including a misaligned baseline. Finally, we offer a comprehensive review of the state of knowledge about holistic processing based on evidence gathered from the measure we favor based on the 1st sections of our review-the complete design-and outline outstanding research questions in that new context. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Collaborative care management effectively promotes self-management: patient evaluation of care management for depression in primary care.

Science.gov (United States)

DeJesus, Ramona S; Howell, Lisa; Williams, Mark; Hathaway, Julie; Vickers, Kristin S

2014-03-01

Chronic disease management in the primary care setting increasingly involves self-management support from a nurse care manager. Prior research had shown patient acceptance and willingness to work with care managers. This survey study evaluated patient-perceived satisfaction with care management and patient opinions on the effectiveness of care management in promoting self-management. Qualitative and quantitative survey responses were collected from 125 patients (79% female; average age 46; 94% Caucasian) enrolled in care management for depression. Qualitative responses were coded with methods of content analysis by 2 independent analysts. Patients were satisfied with depression care management. Patients felt that care management improved their treatment above and beyond other aspects of their depression treatment (mean score, 6.7 [SD, 2]; 10 = Very much), increased their understanding of depression self-management (mean score, 7.2 [SD, 2]; 10 = Very much), and increased the frequency of self-management goal setting (mean score, 6.9 [SD, 3]; 10 = Very much). Predominant qualitative themes emphasized that patients value emotional, motivational, and relational aspects of the care manager relationship. Patients viewed care managers as caring and supportive, helpful in creating accountability for patients and knowledgeable in the area of depression care. Care managers empower patients to take on an active role in depression self-management. Some logistical challenges associated with a telephonic intervention are described. Care manager training should include communication and motivation strategies, specifically self-management education, as these strategies are valued by patients. Barriers to care management, such as scheduling telephone calls, should be addressed in future care management implementation and study.

ISLAMIC CARING MODEL ON INCREASE PATIENT SATISFACTION

Directory of Open Access Journals (Sweden)

Muh. Abdurrouf

2017-04-01

Full Text Available Introduction: Patient satisfaction was important aspect that must be considered by health service providers, patients who were not satisfied will leave the hospital and be a competitor's customers so be able caused a decrease in sales of products/services and in turn could reduce and even loss of profit, therefore, the hospital must provided the best service so that it could increase patient satisfaction. The purpose of this study was to exams the effect of Islamic caring model on increase patient satisfaction.. Method: This study was used pre-experimental design, the respondents were 31 patients in the treatment group assigned Islamic caring and 31 patients with a kontrol group that were not given Islamic caring Inpatient Surgical Sultan Agung Islamic Hospital Semarang by using consecutive sampling techniques, patient satisfaction data collected through questionnaires and analyzed with Mann-Whitney test, as for finding out the Islamic caring for patient satisfaction were analyzed with spearmen's rho test. Result: The results showed that there was a significant influence of Islamic caring for perceived disconfirmation (p=0,000 there was a perceived disconfirmation influence on patient satisfaction significantly (p=0,000, there was a significant influence of Islamic caring for patient satisfaction in the treatment group with a kontrol group (p=0.001. Discussion: Discussion of this study was Islamic caring model effect on the increase perceived disconfirmation and patient satisfaction, Perceived disconfirmation effect on patient satisfaction, patient satisfaction who given Islamic caring was increase, patients given Islamic caring had higher satisfaction levels than patients who not given Islamic caring. Suggestions put forward based on the results of the study of Islamic caring model could be applied in Sultan Agung Islamic Hospital as a model of nursing care, Islamic caring behavior can be learned and improved through training and commitment and

Impairment of holistic face perception following right occipito-temporal damage in prosopagnosia: converging evidence from gaze-contingency.

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Van Belle, Goedele; Busigny, Thomas; Lefèvre, Philippe; Joubert, Sven; Felician, Olivier; Gentile, Francesco; Rossion, Bruno

2011-09-01

Gaze-contingency is a method traditionally used to investigate the perceptual span in reading by selectively revealing/masking a portion of the visual field in real time. Introducing this approach in face perception research showed that the performance pattern of a brain-damaged patient with acquired prosopagnosia (PS) in a face matching task was reversed, as compared to normal observers: the patient showed almost no further decrease of performance when only one facial part (eye, mouth, nose, etc.) was available at a time (foveal window condition, forcing part-based analysis), but a very large impairment when the fixated part was selectively masked (mask condition, promoting holistic perception) (Van Belle, De Graef, Verfaillie, Busigny, & Rossion, 2010a; Van Belle, De Graef, Verfaillie, Rossion, & Lefèvre, 2010b). Here we tested the same manipulation in a recently reported case of pure prosopagnosia (GG) with unilateral right hemisphere damage (Busigny, Joubert, Felician, Ceccaldi, & Rossion, 2010). Contrary to normal observers, GG was also significantly more impaired with a mask than with a window, demonstrating impairment with holistic face perception. Together with our previous study, these observations support a generalized account of acquired prosopagnosia as a critical impairment of holistic (individual) face perception, implying that this function is a key element of normal human face recognition. Furthermore, the similar behavioral pattern of the two patients despite different lesion localizations supports a distributed network view of the neural face processing structures, suggesting that the key function of human face processing, namely holistic perception of individual faces, requires the activity of several brain areas of the right hemisphere and their mutual connectivity. Copyright © 2011 Elsevier Ltd. All rights reserved.

Schizophrenic Patients’ Attitudes to Therapists Using Behavioral and Holistic-Humanistic Techniques

OpenAIRE

STARK, F. MICHAEL; LIBERMAN, ROBERT PAUL; CORRIGAN, PATRICK W.

1992-01-01

In a preliminary study of patients‘ perceptions of therapists’ styles, 18 subjects with diagnoses of schizophrenia were randomly assigned either to social skills training or holistic health therapy. Four therapists conducted each treatment session in pairs, rotating between treatment conditions daily. At the end of 10 weeks of treatment, patients were able to discriminate among therapists on three interactional styles—"understanding," "independence-encouraging," and "and "criti...

Effects of Instructions on Theme Grading: Grammatical vs. Holistic

Science.gov (United States)

Follman, John; And Others

1971-01-01

Twelve college seniors in an English methods course were assigned to three treatment groups, Grammatical, Holistic, and Both. Each group received different instructions but graded the same 10 themes. Themes graded for grammatical errors received lower grades than the same themes graded holistically. (NH)

Implementing an Holistic Approach in Vocational Education and Training

Science.gov (United States)

McGrath, Donna-Louise

2007-01-01

Although the phrase "holistic approach" is increasingly used in reference to vocational education and training (VET) in Australia, there appears to be a paucity of literature which extensively conceptualises or details its practical application. Existing references to an "holistic approach" appear indicative of an integrated…