Van Sell et al., Int J Nurs Clin Pract 2018, 5: 282 https://doi.org/10.15344/2394-4978/2018/282 International Journal of Nursing & Clinical Practices Concept Analysis Open Access Holism: A Concept Analysis Eileen McMillan1, Natalina Stanga2 and Sharon L. Van Sell3,* 1Graduate Nursing Program, Texas Woman’s University, United States of America 2Graduate Nursing Program, Texas Woman’s University, United States of America 3Professor, The Houston J. and Florence A. Doswell College of Nursing, Texas Woman’s University, United States of America Abstract Publication History: The concept of holism is not new to the world of healthcare in other countries, but in the practice Received: April 04, 2018 of traditional Western medicine, holism is still emerging. Holism is including the whole being, mind, Accepted: June 21, 2018 body, and soul, acknowledging that the whole is more than a sum of the parts. The concept of holism Published: June 23, 2018 was analyzed according to the Walker and Avant methodology to guide nursing practice to offer more Keywords: comprehensive care to patients. Attributes of the concept are total, balanced, mind, body, and spirit, and whole. Antecedents were analyzed and are knowledge, understanding, relationships, and intention. Advanced practice nursing, Body, Furthermore, the identified consequences of the concept were healing, peace, wellness, and Zen. To Holism, Mind, Spirit, Whole demonstrate holism in nursing a model, borderline, and contrary casesare laid out. Finally, a discussion about how the concept of holism enhances care given by the advanced practice nurse. Holism loosely means including the whole being, mind, body, and broaden the perspective of what constitutes the essence of a human soul, taking into account that something is more than a sum of the being, leading to a multidimensional approach to patient care. parts. Consequently, a disturbance in one part of the whole system affects all the other parts of the system. One part cannot function Holism Relates Theory to Practice without the whole. The responsibility of those in the healthcare profession, including the advanced practice nurse (APN), is to provide According to Walker and Avant [2], theory development “provides care to those in need. There are many different ways to provide care. a way to identify and express key ideas about the essence of practice” The medical model of healthcare is to break down an individual (p. 3). Theory helps the discipline of nursing by providing a more into their parts, separate from the whole, focusing on the cell as the complete and insightful disposition to the practice of nursing. The most basic component of living matter. Medical school students are concept of holism is deeply rooted in the discipline of nursing and is not even taught the word holism when studying medicine [1]. As not new to the practice of nursing. Many nursing theories have used a result, the medical model leads one to focus more on the disease holism to relate theory to practice. The concept of holism was present than the individual. Nursing schools, on the other hand, do teach in Martha Rogers’ theory of science of unitary and irreducible human that the important of focusing on more than merely the disease and beings. According to Rogers [3], “Man is a unified whole possessing associated symptoms because a person is more than a disease process. integrity and manifesting characteristics that are more than and Nursing has always been regarded as more holistic in nature, focusing different from the sum of his parts” (p. 47). The focus of the theory on more than the diagnosis, looking at all the interconnected pieces was on the interconnectedness of the unitary human being and the of an individual. Nurses as holistic practitioners view the individual environment. A person is an indivisible, pan-dimensional energy field as a whole, concerned with the interrelationship of the body, mind, representing a whole that cannot be divided into parts[3]. The human and spirit. As healthcare is changing with healthcare reform, patient energy field must coexist within the environment which is also an satisfaction and patient-centeredness are coming to the forefront in energy field identified by pattern [3]. hospitals and clinics alike. The medical model of treating a patient as a disease process is not patient-centered, whereas holistic nursing’s focus Another theorist that used holism as a basis for theory development on treating the entire patient is the essence of patient-centeredness. is Jean Watson. The theory of human caring/caring science focused on caring and love as universal forces [4]. Watson recognized the Aims and Purposes of Concept Analysis importance of the spiritual and ethical dimensions of the human caring process. The transpersonal caring relationship goes beyond “Concept analysis is a process of examining the basic elements the ego to a higher spiritual caring created by caring moments [4]. of a concept which can be useful in refining ambiguous concepts Heart-centered caring based on practicing and honoring wholeness in a theory” (p. 158) [2]. The purpose of concept analysis is to of mind, body, and spirit of self. Watson’s transpersonal caring clarify the meaning of a concept to avoid diluting the relevancy and relationship incorporated inner harmony by maintaining balance [4]. understanding. In the field of nursing, concepts become vague and The principles of the theory of human caring/caring science aligned overused and therefore lose their true and precise meaning. Concept with the tenets of holism. analysis seeks to “distinguish that concept from ones that are similar to, but not the same as, that concept” (p. 158) [2]. The ultimate goal of *Corresponding Author: Dr. Sharon L. Van Sell, The Houston J. and Florence A. the process is to answer the question “Why am I doing this analysis?” Doswell College of Nursing, 5500 Southwestern Medical Avenue, #7209, Dallas, Texas, 75235-7299, USA, Tel: 1-864-275-3527, Fax: 214-689-6539; E-mail: (p. 161) [2]. The liberal use of a term within a discipline can lead to the [email protected] term becoming meaningless. In nursing, widely used is the concept of holism since the first coining of the term in the early1900’s. The Citation: McMillan E, Stanga N, Van Sell SL (2018) Holism: A Concept Analysis. Int J Nurs Clin Pract 5: 282. doi: https://doi.org/10.15344/2394-4978/2018/282 concept of holism appears across multiple disciplines with different meanings and applications, thus seeking a more precise holism Copyright: © 2018 Van Sell et al. This is an open-access article distributed definition of advanced practice nursing are imperative to the nursing under the terms of the Creative Commons Attribution License, which permits discipline. For the APN, the purpose of the concept of holism is to unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Int J Nurs Clin Pract IJNCP, an open access journal ISSN: 2394-4978 Volume 5. 2018. 282 Citation: McMillan E, Stanga N, Van Sell SL (2018) Holism: A Concept Analysis. Int J Nurs Clin Pract 5: 282. doi: https://doi.org/10.15344/2394-4978/2018/282 Page 2 of 6 Definitions and Uses of Holism According to Chinese philosophy, everything that exists has the two aspects of yin and yang [19]. Poor health is the result of an imbalance The word holism comes from the Greek holo- meaning “whole, of yin and yang [19]. entire, complete” [5]. According to dictionary.com, the suffix -ism is Mind, body, and spirit (MBS) are interconnected elements that “used to form action nouns from verbs” [6]. The general definition make up the person and cannot be separated into individual parts. of holism as stated by the Merriam-Webster Online Dictionary is “a “The Nous, the Physical, and the Psyche cannot be independent parts, theory that the universe and especially living nature is correctly seen because of interconnections, a disturbance in one part affect the in terms of interacting wholes (as of living organisms) that are more other parts, which are exhibited physically, psychically and mentally than the mere sum of elementary particles” [7]. The word holism was (noetic) depending on the part that suffers” (p. 77) [18]. Many first coined by J.C. Smuts, a South African philosopher, in his book cultures and religions utilize the MBS notion. MBS is explained by the Holism and Evolution [8]. Smuts regarded holism as being “grounded following, ‘mind’ refers to ‘mental processes,' while the body is said to in evolution and is an ideal that guides human development and include the physical, biological, and chemical aspects of an individual. one’s level of personality actualization” [8]. Holism is the opposite Spirituality is defined variously as existential reality, connectedness, of reductionism, which defines breaking something complicated and energy” (p. 1756) [20]. down into straight forward parts [9]. Reductionism used by the medical practice as a principle foundation for understanding disease, Whole means “not divided or disjoined; in one unit” [21]. The but only takes the biology of the disease into account and does not concept of holism is based on the conglomerate of the whole. Dividing address psychology, or behavioral components of disease [10]. Smuts the whole into pieces as the medical practice does break the individual argued that reductionism produces a view of the natural world that apart and is in no way an optimal approach to the understanding of constitutes “a mere collection of disjecta membra, drained of all union an individual. The nurse practitioner tailors care for the whole person or mutual relations, dead, barren, inactive, unintelligible” (p. 13) [8]. that addresses personal, social, environmental, and cultural factors Reductionism does not take into account all the parts of the whole [22].