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. (shrink)

This article explains the attempts of nurses to practice humanistic, holistic care in line with their professionalizing strategy. Ideally, the intention of nurses is to broaden their concerns beyond the physiological needs of patients, thereby circumventing biomedical control over their work. However, the author argues that resource constraints, and the coalescing of biomedical and managerial definitions of patients, suggest that holistic notions of care are subjected to a new form of calculus and normalizing technology. Critically, nurses (...) are more preoccupied with the day-to-day struggle to free up resources for healthcare, in particular bed spaces, and to pre-empt the problem of bed blocking. Such work suggests that the ‘emptying of beds’ is not just a symbol of accomplishment for nursing work. From the governmentality theory of Foucault, the administration of ‘beds’ has become part of the managerial power/knowledge discourse and an instrument for making nurses toe the financial bottom-line. (shrink)

Christians care for orphans and children without parental care in different forms. However, in the Global South, care is primarily provided in orphanages or large residential settings. Despite good intentions, there are limitations to provide a nurturing family environment for the children in such care environment. With current knowledge of alternative child care and in light of the holistic ministry, this article suggests an approach for the church to care for orphans and children (...) at risk by focusing on the family and the local community. Additionally, simple steps to transition to holistic orphan care are offered. (shrink)

BackgroundRationing of care in nursing is nurses' inability to complete all care activities for patients because of scarcity in time and resource. Literature suggests that rationing of care is closely related to patient safety and quality of care. The phenomena have been defined and studied from varied perspectives and contexts. A systematic review of studies related to the concept was aimed at identifying and synthesizing the finding.MethodsThe review followed Preferred Reporting Items for Systematic Reviews and Meta‐analysis (...) guidelines, and literature searches were conducted in MEDLINE, CINAHL, PsycInfo, Web of Science and EMBASE databases. Fifty‐seven quantitative studies were included in the review.FindingsThe review observed that nursing activities addressing the emotional, educational, mobility and hygiene needs of the patients were commonly rationed. Antecedents of rationing included resource inadequacy and organizational work environment. Rationing influenced patient satisfaction, mortality and a number of adverse events and was associated with decreased job satisfaction, increased intention to leave and high turnover among nurses.DiscussionsThis review concludes that rationing in nursing is ubiquitous, embedded in the work environment and poses a threat to the professional health and philosophical base of nursing in addition to having serious implications on patients' safety. Strategies to reframe and reconsider organizational traits, and open discussion with other healthcare stakeholders can reduce rationing of nursing care. The review suggests future researchers adopt different methodological layout to study rationing. (shrink)

Introduction -- Healing justice and whole self-care -- Oppression, trauma, and healing justice -- Stress and the self-care revolution -- The whole self -- A skillful path of healing justice -- Holistic self-care practices and skills -- Connecting to the body -- Befriending the mind-heart -- Rediscovering spirit -- In the fabric of community -- Cultivating connections between person and planet -- Where the rubber meets the road -- The healing justice organization -- Healing justice on (...) the frontlines -- Widening the circle and coming home -- Notes -- Index. (shrink)

In the last two decades, studies on the relationship between spirituality and health have grown significantly in the International literature. In Brazil, the debate on this subject has reached greater visibility since 2009, mainly in the health sciences, with the appearance of the term "spiritual care". In theology, studies on spiritual care in the health care context are still scarce. This paper aims to contribute to the broadening of this reflection. Firstly, spiritual care is approached from (...) scientific publications in Portuguese language. Second, the interdisciplinary spiritual care model is presented as a holistic approach to patient care and consequences of applying a spiritual care model are outlined. The newly defined role of the hospital chaplains, pastoral counselors and spiritual caregivers is also discussed. As a conclusion, the paper mentions the main challenges going along with interdisciplinary spiritual care, especially those concerning the training of health care professionals. (shrink)

One of my main points in this study is that the knowledge of orthodox medical theory is an incomplete guide for practical action when relating to our patients' specifically human problems. By following a holistic perspective on patients' health and on our medical enterprise we will be more efficient as doctors. This standpoint is illuminated by means of two case reports. Instead of focusing on symptoms as such and letting them refer to orthodox medical theory, I explicitly relate to (...) the patients as if they are conveying a personal meaning by means of experienced symptoms. The experience of illness could be a successful strategy on the existential level although destructive on the technical biological level. A holistic theory of health can give doctors a good conceptual base when relating to people whose presented illnesses are to be regarded explicitly as their way of making themselves understood. The doctor's understanding of the patient's illness, of the theory of health, and of how health is regained, is dependent on the doctor's having the courage to reduce the distance to the patient, the courage to participate and be changed. (shrink)

Existing regulation of end-of-life care is flawed. Problems include poorly-designed laws, policies, ethical codes, training, and funding programs, which often are neither effective nor helpful in guiding decision-making. This leads to adverse outcomes for patients, families, health professionals, and the health system as a whole. A key factor contributing to the harms of current regulation is a siloed approach to regulating end-of-life care. Existing approaches to regulation, and research into how that regulation could be improved, have tended to (...) focus on a single regulatory instrument (e.g., just law or just ethical codes). As a result, there has been a failure to capture holistically the various forces that guide end-of-life care. This article proposes a response to address this, identifying “regulatory space” theory as a candidate to provide the much-needed holistic insight into improving regulation of end-of-life care. The article concludes with practical implications of this approach for regulators and researchers. (shrink)

The topic of this book is a comparison between holism in the philosophy and language and social holism on the one hand and holism about space-time and quantum systems on the other hand. The main claim is that holism in the humanities and holism in fundamental physics come under the same substantial, general conception of holism. That is to say: arguments to the effect that the holism of the mental is unscientific or that the mental is separated from the physical (...) owing to holism are not sound. The holism of the mental fits into a world-view that bases itself on scientific realism. The addressees of this book are all those who care about our view of the world and ourselves in the spirit of an argumentative examination of different positions. No familiarity with physics is presupposed. (shrink)

In order to care ethically nurses need to care holistically; holistic care includes religious/spiritual care. This research attempted to answer the question: Do nurses have the resources to offer religious care? This article discusses only one aspect - the provision of religious care within the Taiwanese health care system. It is assumed that, if hospitals do not provide enough religious services, nurses working in these hospitals cannot be fully ethical beings or cannot (...) respect patients’ religious needs. The relevant literature was reviewed, followed by a survey study on the provision of religious facilities and services. Aspects considered are: the religions influences in and on Taiwanese society; the religious needs of patients and their families; strategies that patients use to enable them to cope with their health care problems; professional motives for attuning to patients’ religious needs; and hospital provision for meeting the religious and spiritual needs of patients. A survey of nursing executives showed differences between religious service provision in hospitals with and without a hospice ward. The practical implications for hospital management and nursing practice are discussed. (shrink)

It has sometimes been suggested that quantum phenomena exhibit a characteristic holism or nonseparability, and that this distinguishes quantum from classical physics. One puzzling quantum phenomenon arises when one performs measurements of spin or polarization on certain separated quantum systems. The results of these measurements exhibit patterns of statistical correlation that resist traditional causal explanation. Some have held that it is possible to understand these patterns as instances or consequences of quantum holism or nonseparability. Just what holism and nonseparability are (...) supposed to be has not always been made clear, though, and each of these notions has been understood in different ways. Moreover, while some have taken holism and nonseparability to come to the same thing, others have thought it important to distinguish the two. Any evaluation of the significance of quantum holism and/or nonseparability must rest on a careful analysis of these notions. (shrink)

: Holistic health principles, practices, personnel, programs, and problems comprise the ingredients of the movement of holistic health as described in this book. Using medical anthropology as its main perspective, the text is written with health practitioners in mind, to provide a contract of an interrelated physical, mental, spiritual, and emotional view of healing with that of the established scientific view: that humans are composed of reducible parts and that medicine's job is to find causes of malfunctioning in (...) these parts. Public health issues such as quality care, cost, and the role of holistic health, are another focus of the book. Background information and history on holistic health, including philosophy and history, practices, functioning health centers, clientele characteristics, and trends favoring holistic health development are some of the topics discussed. A glossary and extensive bibliography are included as well as self-tests on wellness and social readjustments.. (shrink)

Ethically complex and challenging cases confront health care professionals in neonatal‐perinatal medicine more often than in most other subspecialties in medicine. Neonatologists regularly encounter situations where crucial life‐or‐death decisions need to be made in the best interest of an infant and its family. While physicians and their professional societies seem to dictate this best interest standard by weighing the risk of mortality and morbidities, parents may have other perspectives to be considered.Our review of programs for teaching ethics in Canadian (...) neonatal‐perinatal residency programs has revealed that 90 percent of them incorporated formal and informal medical ethics education, meeting the Royal College of Physician and Surgeons of Canada requirements, but that the teaching strategies, topics covered, and time devoted to teaching ethics are not standardized. Lectures and case presentations—the pedagogic strategy used by most programs—are not ideal for teaching communication skills. We propose, therefore, a holistic approach to teaching and training that imparts (1) a traditional understanding of ethical theory and reasoning, (2) advanced skills in communication and counseling, and (3) a disposition to engage in self‐reflection and to be aware of the emotional and spiritual dimensions of neonatal‐perinatal medicine. (shrink)

Peregrin and Svoboda propose an inferential and holistic approach to formalization, and a similar approach (to correctness) is considered by Brun. However, while the inferential criteria of adequacy explicitly endorsed by these authors may be holistic "in spirit," they are formulated for single formulas. More importantly, they allow the trivialization of equivalence and face problems when materially correct arguments come into play. Against this background, this paper tries to motivate holistic inferential criteria that compel us to distinguish (...) carefully between non-trivially equivalent formalizations as well as between materially and logically correct arguments on an inferential basis. (shrink)

The health theories of Nordenfelt and Boorse are compared. Critical attention is focused on Nordenfelt's description of his theory as one of holistic welfare, contrasting with Boorse's analytical and statistical approach. Neither theory is found to give an entirely satisfactory account of ‘health’ in scientific medicine or common usage. Because Nordenfelt attenuates the ontological significance of organs and organ parts and simplifies the role of statistics, his theory is regarded as weakly holistic. Boorse underrates the importance of non-statistical (...) evaluation. A mediating position, termed ‘strong holism’ is suggested as a way of integrating normative and statistical elements in a more adequate health concept. (shrink)

We care for our own future experiences. Most of us, trivially, would rather have them pleasurable than painful. When we care for our own future experiences we do so in a way that is different from the way we care for those of others (which is not to say that we necessarily care more about our own experience). Prereflectively, one would think this is because these experiences will be ours and no one else's. But then, of (...) course, we need to explain what it means to say that a future experience will be mine and how knowledge of this fact renders it rational for me to care for this experience in a special way. Indeed most philosophers take this route. But in doing so, they quickly stumble on insuperable problems. I shall argue that the problem of egocentric care, as it is sometimes called, can be solved by turning things upside down: it is much more fruitful to think that the special kind of care we feel for some future experiences (and not others) is part of what makes them ours should they occur. This requires an explanation of egocentric care for future experiences that does not draw in a theory of personal identity, but rather contributes to one. I will attempt to provide this explanation by making use of the idea of a diachronic mental holism. (shrink)

Ancient India recognized the supreme value of education in human life. The ancient thinkers felt that a healthy society was not possible without educated individuals. They framed an educational scheme carefully and wisely aiming at the harmonious development of the mind and body of students. What they framed was a very liberal, all-round education of a very high standard, calculated to prepare the students for a useful life in enjoying all aspects of life. This is essentially a universally applicable educational (...) framework highlighting the purpose of human life and interconnectedness at all levels of existence as a basis of human values. Insights from ancient Indian educational system are of great help in facilitating the production of a creative, ethical and a learning mind, which will concern itself not only with greater ‘progress’, but primarily or more importantly with the inner transformation of the human consciousness. (shrink)

Calling on the methodology of psychology, the authors explore the way illness alters the self-image of the sick person, and the way the experience changes the person who is ill. The reader is taken through the psychological impacts of the first clinical moment when the patient realizes he or she is in the altered state of illness, as well as the subsequent effects of pain, hospitalization, being bed-ridden, fatigued or disabled. The central thesis is that an integral picture of medicine (...) must include social-cultural aspects, the institutionalization of health care, and an attempt to provide patient-centered care. The approach taken is the empirically based psychosocial reflection of the disturbances to a person's self-image caused by various kinds of illness. Focusing on the world of the patient, the authors relate to problems concerning self-image, pain, exhaustion, isolation, handicaps, aging, dying and death. The relationships between patients and medical personnel are also examined. Concluding the work is an excellent bibliography keyed to the chapters of the text. (shrink)

Inequitable access to health care, social inequities, and racist and discriminatory care has resulted in the trend toward poorer health outcomes for Indigenous infants and their families when compared to non‐Indigenous families in Canada. How Indigenous mothers experience care during an admission of their infant to the Neonatal Intensive Care Unit has implications for future health‐seeking behaviors which may influence infant health outcomes. Nurses are well positioned to promote positive health care interactions and improve health (...) outcomes by effectively meeting the needs of Indigenous families. This qualitative study was guided by interpretive description and the Two‐Eyed Seeing framework and aimed to understand how Indigenous mothers experience accessing and using the health care system for their infants. Data were collected by way of interviews and a discussion group with self‐identifying Indigenous mothers of infants less than two years of age living in Hamilton, Ontario, Canada. Data underwent thematic analysis, identifying nursing strategies to support positive health care interactions and promote the health and wellness of Indigenous infants and their families. Building relationships, providing holistic care, and taking a trauma‐informed approach to the involvement of child protection services are three key strategies that nurses can use to positively impact health care experiences for Indigenous families. (shrink)

After nearly fifty years of mea culpas and explanatory additions, the biopsychosocial model is no closer to a life of its own. Bolton and Gillett give it a strong philosophical boost in The Biopsychosocial Model of Health and Disease, but they overlook the model’s deeply inconsistent position on dualism. Moreover, because metaphysical confusion has clinical ramifications in medicine, their solution sidesteps the model’s most pressing clinical faults. But the news is not all bad. We can maintain the merits of holism (...) as we let go of the inchoate bag of platitudes that is the biopsychosocial model. We can accept holism as the metaphysical open door that it is, just a willingness to recognize the reality of human experience, and the sense in which that reality forces medicine to address biological, psychological, and social aspects of health. This allows us to finally characterize Engel’s driving idea in accurate philosophical terms, as acceptance of consciousness in the context of medical science. This will not entirely pin down medicine’s stance on dualism, but it will position it clearly enough to readily improve patient care. (shrink)

Concepts. Health ; Disease ; Death -- Models and kinds. Causation and kinds ; Holism and reductionism ; Controversial diseases -- Evidence and inference. Evidence in medicine ; Objectivity and the social structure of science ; Inference ; Effectiveness, skepticism, and alternatives ; Diagnosis and screening -- Values and policy. Psychiatry: care or control? ; Policy ; Public health.

Moral particularists are united in their opposition to the codification of morality, and their work poses an important challenge to traditional ways of thinking about moral philosophy. Defenders of moral particularism have, with near unanimity, sought support from a doctrine they call “holism in the theory of reasons.” We argue that this is all a mistake. There are two ways in which holism in the theory of reasons can be understood, but neither provides any support for moral particularism. Moral particularists (...) are united in their opposition to the codification of morality in purely descriptive terms, but their opposition takes different forms. Sometimes particularists maintain that codifying the moral landscape is impossible. In other contexts particularists argue that moral principles are in any event unnecessary. In yet other contexts particularists contend that the codification of morality is undesirable, perhaps because it would encourage people to look less carefully at the case at hand.1 These are distinct theses, although particularists often endorse all three. As Jonathan Dancy, citing John McDowell puts it, “Particularism is at its crudest the claim that we neither need nor can see the search for an ‘evaluative outlook which one can endorse as rational as the search for a set of principles.’”2 On any interpretation, particularism poses an important challenge for traditional conceptions of moral philosophy.. (shrink)

Development is concerned with the transformation of people to foster their health, wholeness and growth. The link between health and development points to religion as potential social capital for development. There is an ongoing debate about the role of pastoral care as a religious resource in global healthcare contexts. This is unfortunately not the case in Africa, as pastoral care has not received sufficient attention for its role in healthcare and development in development discourses. The limited research on (...) pastoral care in healthcare contexts in Africa has implications for African healthcare systems, pastoral care and the delivery of an effective, holistic and quality healthcare service. Taking as its point of departure a thesis about the potential of religion as a social capital resource for development, the article argues for pastoral care as a viable religious resource for healthcare and development. Osmer’s theological task of good practice is employed as an interdisciplinary engagement in dialogue with selective perspectives in the disciplines of development and health and social sciences for appropriate analysis. (shrink)

The emerging concept of systems medicine (or ‘P4 medicine’—predictive, preventive, personalized and participatory) is at the vanguard of the post-genomic movement towards ‘precision medicine’. It is the medical application of systems biology, the biological study of wholes. Of particular interest, P4 systems medicine is currently promised as a revolutionary new biomedical approach that is holistic rather than reductionist. This article analyzes its concept of holism, both with regard to methods and conceptualization of health and disease. Rather than representing a (...) medical holism associated with basic humanistic ideas, we find a technoscientific holism resulting from altered technological and theoretical circumstances in biology. We argue that this holism, which is aimed at disease prevention and health optimization, points towards an expanded form of medicalization, which we call ‘holistic medicalization’: Each person’s whole life process is defined in biomedical, technoscientific terms as quantifiable and controllable and underlain a regime of medical control that is holistic in that it is all-encompassing. It is directed at all levels of functioning, from the molecular to the social, continual throughout life and aimed at managing the whole continuum from cure of disease to optimization of health. We argue that this medicalization is a very concrete materialization of a broader trend in medicine and society, which we call ‘the medicalization of health and life itself’. We explicate this holistic medicalization, discuss potential harms and conclude by calling for preventive measures aimed at avoiding eventual harmful effects of overmedicalization in systems medicine (quaternary prevention). (shrink)

Over the last fifty years a plethora of new spiritual practices has emerged in the Church of Sweden. Many fall within a category of holistic practices, aimed at engaging body, soul, and spirit. Among these, two categories are dominant: meditations and movement-based bodily practices. Some of these practices are contested by other Christians on a theological basis. The article asks: Who are the new ritual specialists teaching these practices? Why do they teach these practices? Why in the church? By (...) using a bottom-up perspective and studying practices which lie outside the traditional Christian religious rites, which has been the focus in research on the Church of Sweden, we find that the holistic practices are framed in a culture of care, focusing on bodily and spiritual wellbeing. We suggest that the predominance of women in body-movement practices should be understood as a generational feature rather than as an expression of the feminization of the church. Many of the leaders are women who were part of new spiritual movements as well as body-mind practices and various forms of dance in gyms and yoga studios in the 1990s and early 2000s, finding an openness to bringing their knowledge into the church. (shrink)

With no statutory definition of death, the accepted medical definition relies on brain stem death criteria as a definitive measure of diagnosing death. However, the use of brain stem death criteria in this way is precarious and causes widespread confusion amongst both medical and lay communities. Through critical analysis, this paper considers the insufficiencies of brain stem death. It concludes that brain stem death cannot be successfully equated with either biological death or the loss of integrated bodily function. The overemphasis (...) of the brain-stem and its consequences leaves the criteria open to significant philosophical critique. Further, in some circumstances, the use of brain stem death criteria causes substantial emotional conflict for families and relatives. Accordingly, a more holistic and comprehensive definition of death is required. (shrink)

Significant scientific and technological advances in intensive care have been made. However, patients in the intensive care unit may experience discomfort, loss of control, and surreal experiences. This has generated relevant debates about how to humanize the intensive care units and whether humanization is necessary at all. This paper aimed to explore how humanizing intensive care is described in the literature. A scoping review was performed. Studies published between 01.01.1999 and 02.03.2020 were identified in the CINAHL, (...) Embase, PubMed, and Scopus databases. After removing 185 duplicates, 363 papers were screened by title and abstract. Full-text screening of 116 papers led to the inclusion of 68 papers in the review based on the inclusion criteria; these papers mentioned humanizing or dehumanizing intensive care in the title or abstract. Humanizing care was defined as holistic care, as a general attitude of professionals toward patients and relatives and an organizational ideal encompassing all subjects of the healthcare system. Technology was considered an integral component of intensive care that must be balanced with caring for the patient as a whole and autonomous person. This holistic view of patients and relatives could ameliorate the negative effects of technology. There were geographical differences and the large number of studies from Spain and Brazil reflect the growing interest in humanizing intensive care in these particular countries. In conclusion, a more holistic approach with a greater emphasis on the individual patient, relatives, and social context is the foundation for humanizing intensive care, as reflected in the attitudes of nurses and other healthcare professionals. Demands for mastering technology may dominate nurses’ attention toward patients and relatives; therefore, humanized intensive care requires a holistic attitude from health professionals and organizations toward patients and relatives. Healthcare organizations, society, and regulatory frameworks demanding humanized intensive care may enforce humanized intensive care. (shrink)

Caring is at the core of what nurses and other health professionals do. But caring encompasses more than simply looking after people's physical health needs. People requiring any health service will have psychological needs that affect their feelings, thoughts, and behaviour. Good psychological care can even help improve physical health outcomes. An Introduction to Psychological Care in Nursing and the Health Professions explains and promotes the importance of psychological care for people when they become physically ill, giving (...) a sound theoretical basis to ensure care is evidence-based. It encourages the reader to think about the effects of illness and disability on patients, and to understand what can be done to identify and minimise any difficulties they might be experiencing in these areas. The chapters cover: the meaning and elements of care and holistic care; a model of psychological care in practice; the personal qualities and skills of carers that best underpin psychological care delivery, and how these might be enhanced; the knowledge needed for effective psychological caregiving; psychological care as it might be practised in a range of health care settings. This text contains key learning points, practical activities, reflective exercises and case illustrations. It is ideal for student and practising nurses, and health professionals who would like to improve their care for patients in this essential area. (shrink)

Background:It is stated that high ethical sensitivity positively affects the quality of nursing care. However, the relationship between nursing care quality and ethical sensitivity has not been clearly demonstrated in researches.Aim:This study was carried out to determine the relationship between surgical nurses’ care behaviors and their ethical sensitivity.Method:The sample of this cross-sectional, descriptive-correlational study consists of 308 nurses who worked at the surgical departments in four Turkish hospitals. The data were collected using the “Nurse Description Form” developed (...) by the researcher, “Caring Behaviours Inventory-24” and “Ethical Sensitivity Questionnaire.” Data were evaluated by the Mann Whitney U test, Kruskal Wallis one-way analysis of variance and Spearman correlation analysis.Ethical considerations:The study was approved by the ethics committee. Verbal and written consent was received from the nurses.Results:It was found in the study that nurses’ Caring Behaviours Inventory-24 total score median was 5.25 (4.83–5.58), nurses’ perception level of caring quality was high, median of Ethical Sensitivity Questionnaire total score was 89.00 (75.00–101.00) and nurses’ ethical sensitivity was moderate. A negative significant relation was found between nurses’ Caring Behaviours Inventory-24 total score and Ethical Sensitivity Questionnaire total score (r = -0.162; p = 0.009). A negative relation was also detected between nurses’ working period at the current clinic and providing benefit (r = -0.147; p = 0.012), holistic approach (r = -0.139; p = 0.018) and orientation (r = -0.175; p = 0.003) scores of Ethical Sensitivity Questionnaire sub-scales.Conclusion:Nurses’ perception levels of caring quality were high and their ethical sensitivity levels were moderate. It was found out that nurses’ ethical sensitivity increased together with their perception of caring quality, and as their working period at the current clinic increased, the ethical sensitivity also increased in terms of the sub-scales of providing benefit, holistic approach, and orientation. The factors that adversely affect the quality of nursing care and ethical sensitivity should be examined and attempts should be made to improve the working environment. (shrink)

This paper presents the author's model of humility structures that can be operationalized as behaviours and incorporated into healthcare practice, the Humility in Health Care Model. The Humility in Health Care Model expands and combines the concepts of cultural humility, holistic nursing, servant leadership and the Chinese concept ‘QIAN’. The paper identifies ways to create a regular practice of humility behaviours on the personal/interpersonal, leadership, systems and policy levels. The paper discusses the benefits of operationalizing humility, forces (...) that favour humility and barriers to practicing its behaviours. Suggestions for future research on humility in the healthcare professions are offered. (shrink)

In this paper it is argued that nurses should be holists whilst at the same time accepting that ‘holism’ is a contentious concept. One of the problems for a supporter of holism is that of which holism -- an attempt to outline the version of holism advocated is made by identifying only two versions of holism: The Strong theory and the Pragmatic theory of holism. By introducing this device it is hoped to avoid, if only by stipulation, some of the (...) more sophisticated nuances of holism drawn by other commentators. However despite a most judicious use of Ockham's Razor some detailed groundwork remains. In the first part of this paper a simple example is used which aims to articulate what are arguably some of the central issues within the holism debate. These issues are then placed within a wider philosophical context. The second part of the paper will offer definitions of Strong and Pragmatic holism. Drawing on specific examples from the nursing context it will be argued that the Pragmatic theory of holism is the theory of holism most compatible with nursing theory and practice. The methods employed in this paper are philosophical. Since the questions considered are conceptual rather than empirical requiring a discursive approach, utilising thought experiments and case implication to explore the issues. (shrink)

Popular visions of holistic health and holistic medicine are not so much reactions to perceived excesses of technological medicine as they are visions of the good life itself and how to attain it. This paper attempts to clarify some of the concepts associated with holistic health and medicine. The particular vision of holistic health presented here is well exemplified in the writings of Plato. First, I examine the scientific concept of holism and argue that, while medicine (...) is inadequately characterized by scientific reductionism, any plausible holistic medicine must make room for a limited scientific reductionism. Next, I analyze the complexity of Plato's usage of health and demonstrate some of the parallels between Plato's thought and popular and scientific visions of holistic health. Finally, I look at what Plato has to say about medical practice and the relation of medicine and philosophy as therapies for the whole person. (shrink)

Committee composition is a recurrent theme within the literature on Institutional Animal Care and Use Committees (IACUCs). The ability of IACUCs to ensure the ethical treatment of nonhuman research subjects depends upon who makes up these committees. Non-scientists and those not affiliated with the research institution have been deemed indispensable for the democratic, objective review of protocols and, thus, for ethical treatment. IACUCs’ critics and partners alike have persistently offered suggestions for how to further optimize committee composition towards these (...) ends. This paper contributes to the ongoing conversation by advocating for the addition of holistic species experts to IACUCs, arguing that holistic species experts are as indispensable for the political and epistemic viability of protocol reviews as non-scientists and non-affiliates. Holistic species experts are defined here as members of the larger community who have extensive firsthand experience with animals living and dying under relatively ideal conditions. If we accept that non-scientists and non-affiliates are crucial for IACUCs' ethical treatment of animals, then we have every reason to embrace holistic species experts. The values, welfare expertise, and productive epistemic dissonance that these experts bring to the table would prove invaluable. (shrink)

Practitioners of palliative care often argue for more resources to be provided by the state in order to lessen its reliance on charitable funding and to enable the services currently provided to some of those with terminal illnesses to be provided to all who would benefit from it. However, this is hard to justify on grounds of cost-effectiveness, since it is in the nature of palliative care that the benefits it brings to its patients are of short duration. (...) In particular, palliative care fares badly under a policy of QALY-maximisation, since procedures which prevent premature death (provided the life is of reasonable quality) or improve quality of life for those with longer life expectancy will produce more QALYs. This paper examines various responses to this problem and argues that in order to justify increased resources for palliative care its advocates must reject the ‘atomistic’ view of the value of life implicit in the QALY approach in favour of a ‘holistic’ or ‘narrative’ account. This, however, has implications which advocates of palliative care may be reluctant to embrace. (shrink)

In order to cope with the changing health needs in the community, an holistic approach on AIDS prevention and control with particular reference to essential quality was introduced at an educational seminar at Hebei Medical University in China, 1996. We have identified three major points in the present study through learning and research process: 1. The importance of ‘cultural norm’ for the unification of science and technology is identified for the community approach; 2. ‘community care’ emphasising human quality provides (...) unity in diversity for educational program; and 3. ‘community control’ emphasising quality assurance demonstrates the effectiveness for program analysis from the viewpoint of human centred systems. (shrink)

A multifaceted, holistic approach to identifying potential predictors is needed to eradicate workplace bullying. The current study investigated the impact of an unfavourable organisational climate that plays a role in breeding workplace bullying. The present study also postulated that individual personality differences mediate between a caring climate and workplace bullying. Similarly, the interaction between workplace bullying and personality impacts PTSD. We also checked the role of workplace bullying as a mediator between a caring climate and PTSD. This research tested (...) all the proposed hypotheses, and the study was conducted in Pakistan. The data is analysed using the two-step partial least square structural equation modelling procedure. The first part assesses the measurement model, while in the second step, the structural model is evaluated. The results supported all the proposed hypotheses of this study. Type A behaviour moderated the caring climate—person-related bullying relationship, whereas it did not moderate the caring climate—work-related bullying in the suggested direction. Type A behaviour is moderated for both types of bullying and PTSD. Results also show significant indirect effects of a caring climate on PTSD through workplace bullying. This study will contribute theoretically to filling the literature gap on studies of climate-bullying and bullying-stress using contingency factors. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hildegard and HolismSuzanne M. Phillips (bio) and Monique D. Boivin (bio)Keywordsbiopsychosocial, integration, medieval, mental illnessWe appreciate the careful and enriching commentary offered by Kroll and by Radden on our paper about holistic views of mental illness in the writings of the twelfth-century abbess and healer Hildegard of Bingen. Both reviewers are well-established figures in the study of historical perspectives on mental illness, an area that we have just (...) begun to explore. We are glad for the opportunity to respond to their observations and thereby to continue the dialogue.First, we would like to clarify our purpose in preparing this paper. Nowhere do we claim that Hildegard used a biopsychosocial model of mental illness, either in addressing the needs of the particular case of Sigewiza, or more generally in her writings on illness and health. In fact, we agree with Kroll (2007, 370), when he states that Hildegard did not use a biopsychosocial model. We use the term “biopsychosocial” only three times in the paper, always by contrast with what we see in Hildegard’s writings. The present-day biopsychosocial model focuses on getting a range of perspectives on the table, encouraging the consideration of biological, psychological, and social issues when thinking about mental illness. This is a good thing, but we argue that it does not go far enough. Specifically, there has been insufficient attention to ways these perspectives might interact.How, then, might we describe Hildegard’s way of conceptualizing mental illness? In place of the label “biopsychosocial model,” Kroll suggests that Hildegard’s approach could be described as a “religious model” (p. 372). Here we disagree. By our reading, Hildegard’s description of mental illness involves religious components, certainly, but also humoral, astrological, interpersonal, community, and intrapsychic components. Radden correctly notes that we are not so much interested in the particular components as we are in their interactions. We are attracted to Hildegard’s writings because she attends to these interactions. Our students, like Kroll’s (p. 371), are curious about mind–body relationships, which represent one example of the interplay between components. Our concern is that the current biopsychosocial model often fails to satisfy our own, and our students’, interest in the nature of those interactions. Our hope is that Hildegard’s writings might help us to think more richly about the interactions.As Radden (2007, 373) points out, present-day psychiatrists and psychologists do in fact use mul-ticausal accounts of depression. And we agree that such accounts need not be reductionistic (Kroll, 371). But we also recognize that psychology and psychiatry have well-established reductionist (more specifically, materialist) habits. To borrow [End Page 377] Kroll’s phrase, the biological model threatens “to swallow all other models” (p. 371). We must guard against such reductionism, given the habits of our disciplines. As we noted, McHugh and Slavney (1998) respond to that threat by building walls between the perspectives, suggesting that we might use different perspectives when thinking about different sorts of problems. We think that there ought to be more synthetic, holistic ways of responding to that threat, and we are hopeful that Hildegard’s writings can help us to develop those.At a basic level, we see Hildegard asking different questions than people ask today. On the first page of his commentary, for example, Kroll poses the question of “which of these three modalities [bio-, psycho-, social] may be sufficient” (p. 369) in the particular medieval text. We found that the sufficiency of one modality or another does not concern Hildegard. We are not able to speak to the general point that Kroll raises, that one or another element is emphasized depending on the goal of the medieval text; we can report our experience in reading Hildegard, where we found no sense in which one or another component is privileged. Even though Hildegard operated within a thoroughly religious context, we did not find examples of her subsuming other factors under religion. Everything interacts with spiritual concerns, to be sure, but everything also interacts with the biological, and with the interpersonal, and with the astrological. Although it may seem odd to us post-Darwinian thinkers, Hildegard’s model is essentially... (shrink)

Purpose of the study is explication of ethical and existential conditions of realization of human responsibility for the protection and recreation of the environment on a scale of the common world with all the other living beings. The crisis of the environment is the crisis of human morality. For responsible environmental management, it is necessary to form the ecological consciousness of society and reinterpret the anthropocentrism on the ethical foundations. The theoretical basis of the research is the analysis of ethical (...) and existential dimensions of understanding of the human environment ranging from the sphere of the home and the natural environment to the dimension of the common world of people and all the entities. The work clarifies the genesis of the concept of home from the ancient "oikos", household to the idea of home as a "hub", a base for mental and physical mobility in the contemporary technosphere. Correspondent to the transformation of the living world of mankind is the concept of communication and universal discourse of norms and values of human coexistence of J. Habermas, К.-О. Apel, D. Böhler, W. Kuhlmann, and others. The domain of the ecological consciousness and behaviour also requires motivation at the level of human feelings, beliefs, and convictions, which is represented by the philosophic and religious thought of H. Jonas, O. Leopold, K. M. Меуеr-Abich, A. Naess, the pope Francis, and others. As the result, the study proves the relevance of the concept of care about the common home based on the recognition of the value of the existence of all beings. Originality. The study explicates the genesis and meaning of the ethos of the common home with values of love, care, openness, solidarity, freedom, and responsibility which is proved to be the ethical and existential condition of the solution of the environmental crisis. The traditional anthropocentrism is reinterpreted towards the duty of people to be the centre of the responsibility for the existence of all beings that requires both reason and care. Conclusions. The ethics of care for our common home completes the moral duty of people as providers of the universal discourse who represent the interests of all beings. Concern for the preservation of the human environment and of all creation makes it possible for humanity to realize its universal responsibility in the world. The contemporaneous science and religious thought modify anthropocentrism to the holistic ethical understanding of human’s mission to be responsible for all beings. (shrink)