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Evidence for Practice: Research Abstracts from the Journal of Holistic Nursing

Our solutions and services expedite the creation and delivery of consistent, compliant, high-quality and global content — both physical and digital. Our services include technology consultancy, implementation, and management services as well as technical writing, medical translation, and linguistic validation. For more information, go to www. View source version on businesswire. March 27, UTC. The components that help us to see and to hear the reality constitute the whole. When viewed from this aspect, the holistic approach also applies to the field of medicine.

While the concept of holism was first defined in the 's; in , in the medical field, J. Human is considered to be part of the universe, nature, and supernature, in which they exist. In this perception, the spirit and body are designed with disease and health. A holistic approach is regarded in a variety of different respects of the holistic care.

Humans are valuable; above all, they are just humans. The human is an entity with the most developed intelligence among the living beings and who can think, reason, communicate and plan for the future. So, the human is honorable. Human is an entity different in many other respects intelligence, apprehension, memory, imagination, expression, opinions, speech, morals, modesty, curiosity, anxiety, happiness, regret and has superior qualities and skills thanks to these respects in general.

People, possessing integrity, are born, grow, age and die after living on earth for some time. People should be evaluated and treated with holistic approach due to their nature when required. In order for a quality service to be provided in the field of health, a health professional is expected to be a good listener, a good speaker, a fine thinker, understanding and feeling of the emotions of the others with good recommendations.

In the philosophy of holistic care, focusing on the individualism, which acknowledges that there is a strong relationship between body, mind and spirit, it is emphasized that every aspect of the human dimension is uniquely single as well as interconnected with each other. In the philosophy of holistic care, the holistic treatment and care approaches along with the holistic diagnosis must be evaluated together.

In the concept of holism within the philosophy of holistic care, the physical and spiritual needs should be prioritized without ignoring the medical treatment applications. It can be stated that meeting the psychosocial needs effectively among these needs has a positive contribution in decreasing the physical needs and as well as increasing the effectiveness of the medical treatment.

Health is the harmony between the body, mind and spirit.

Open Science Commons: a holistic and ecological view of science

Therefore, the holistic health of the individual is possible with the implementation of all the treatment types including spirituality [ 6 ]. Spirituality is an effort to understand and acknowledge the individual's relationships between themselves and other humans, their function in life and the meaning of life. At the same time, it is the result of knowledge gained throughout life and involves elements meaningful to an individual, which makes the purpose of life [ 6 — 8 ].

When providing nursing services, knowing these concepts will be guiding for professionals [ 9 ]. It is an inherited innate awareness to help others. Individual's comprehension of their own spirituality, increases internal peace and individual's own pleasure. Spirituality is the learning and changing process as a result of supreme power and individual relationship.

A person, who can successfully execute this as it is supposed to be, that is, a person, who can comprehend their ego, may understand their environment, the incidents and people better [ 8 , 10 ]. When evaluated from this perspective, it can be seen that the majority of the holistic medicine applications tend to promote this belief and ego.

Nowadays, it is considered to be a broad concept rather than being bound to a traditional religion for many people. Spiritualism expresses a metaphysical notion, according to which the universe is based on a spiritual basis, and the substance is independent of the spirit. It is important that the nurses take the concept of spirituality into account within the nursing plans, for which they are responsible for performing when delivering health care [ 15 ]. Spirituality is confused with many concepts.


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When the similarities and differences between concepts are specified, it will be possible to explain spirituality better. When spirituality and similar concepts are explained:. The lexical meaning of the word belief is being bound to an idea, believing in a religion, belief in a thing, notion or discipline. In addition to these, it also means a fixed notion since it has been accepted widely and an established general opinion [ 6 , 8 , 16 — 18 ].

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James W. Fowler defines the word belief as a component of the main motivations of the individuals oriented towards life in its most general sense. When evaluating the belief development process, Fowler does not only emphasize the relational nature but also the imaginary nature. Fowler states that there is a significant relationship between the comprehension and evaluation forms of the human, and surrendering to the belief and imagination methods.

Fowler believes that the belief is universal, unique to the human being's nature and correlated with human's interpretation process [ 19 ]. Spirituality is the sum of everything that the individual is associated with beyond the material and the intrinsic sources regarding their central meanings. Spirituality can also be defined as making an effort for the meaning of life, its purpose and the inner peace without any God belief beyond a religious dependence.

Spirituality is also defined as a high level of belief, becoming divine or the infinite power of energy [ 11 , 20 ]. Not all the concepts of spirituality are associated with a religion. In an evaluation relating to spirituality, it is seen that the majority of the modern conceptions are in line with one of the three categories. Thereby, spirituality is seen to be a multidimensional structure [ 21 ]. The dimensions of the spirituality is a matter, which focuses on making an effort to be in harmony with the universe, striving to find the answers about infinity, and individual's focus on emotional distress, physical disease or death [ 11 , 20 ].

Religion derived from the Latin stem religio, meaning the relationship between the human and a greater power than human. The researchers specified at least three historical definitions of this term: 1 supernatural power, in which individuals are motivated or tied, 2 an emotion emerging in an individual who apprehends such power and 3 the ritualistic behaviors that are done for this power. In the study conducted by Wilfred Cantwell Smith — , it is put forth that the religion has been gradually materialized, in other words, religion, which is mostly an abstract process, is turned into a concrete matter through a certain system for example, religious groups, theological traditions, major world religions, etc.

Religious thinking is a mental source for grasping the inside story of the final problems regarding the human existence [ 21 ]. It is a societal institution, which systematizes believing in God, supernatural powers, diverse divine beings; a piety, and an organization, which provides and consolidates in the form of beliefs, rules, institutions, ethics and symbols.

Religion is also defined as a system, which anticipates a lifestyle for believers and involves the sacred and metaphysical values or the concept of God within the belief system. In a survey conducted with 21, participants across 12 regions of Turkey, while About While It was found that Even though the religious beliefs and rituals are commonly practiced in the United States, it is seen that their implementation and evaluation are less common in the medical applications. According to a Gallup poll conducted in , According to the survey conducted in nine European countries, a majority of the population believes that did not think that a belief in God was a necessary part of being moral.

Spirituality can be considered as the first component of the religion; however, it is a very broad term, which cannot be limited only to religious beliefs and applications. Spiritual beliefs or values may or may not be correlated with an organized religion. Besides, people without strong religious beliefs have spiritual dimensions as well. Spiritual values and beliefs are concepts beyond a belief in the power and consist of beliefs subjects such as health, death, sin, life after death and responsibility for others.

It is a traditional, ritual and specific doctrine different than that of religion spirituality. Spiritualism is a lot more comprehensive than the religious applications, however, may include religious applications as well [ 7 , 8 , 20 ].

Journal of Holistic Health

Spiritual needs are needs that promote the spiritual power of an individual or reduce the spiritual deprivation. Humans can meet these needs by means of relations with humans or God. Spiritual needs can be defined as trust, hope, love, truth, need for finding out the meaning and purpose of life, relationships, forgivingness, creativity, experiencing, need for emotional feelings tranquility, comfortableness , need for speaking, consolation, rituals, praying and worshipping [ 6 , 20 ]. Spiritual needs and applications are very important concepts for many patients; however, they are ambiguous terms for the health professionals.

Throughout history, the doctors have been trained to diagnose and treat disease and received little or no education regarding the spiritual dimension of the patient. In addition to this, it has been alleged that the professional ethical approach permits the doctor to implement their professional practice but not to question the patient's beliefs, and the deficiency in the concept is tried to be explained as such.

When the deficiency is combined with the differences in societal beliefs, religious rituals and spiritual applications, a wide range of belief systems emerge. As a matter of fact, no doctor is expected to comprehend the individual applications of different belief systems. What is expected is necessary sensitivity since individual needs may show variations. When conditions that may arise as a result of spirituality is addressed, it is understood that while the spiritual values help individuals feel themselves better, the spiritual distress occurs in a group of individuals, who are having trouble with their belief and value system, which gives meaning to life and brings hope and power, or in a group of individuals who are at risk.

Spiritual distress occurs when the individual's values and beliefs are under threat in the environment they live in or the individual is in an existential crisis. Spiritual distress emerges at times when the individual is in a despair condition or unable to find a reason to live.

The individual feels a moral gap. Besides, as a result of spirituality, conditions such as spiritual pain, spiritual alienation, spiritual anxiety, spiritual guilt, spiritual anger, spiritual loss, spiritual despair, disappointment, displeasure, gap, regret, guiltiness, grief may emerge [ 25 ]. Health is the harmony between body, intelligence and spirit. Therefore, in order to help the individual to protect and sustain the integrity of their existence, a care system medical and nursing care , which will ensure the care of individual's existence, should be implemented.

The fundamental care functions are to protect and enhance health, prevent diseases and relief pain. Thanks to this point of view, providing care for the spiritual dimension of an individual must be part of the fundamental functions of the health professionals. Individual's needs such as hope, finding the meaning and purpose of life, love and belonging to somewhere are their spiritual needs and in this case, it is a therapeutic application for health professionals to listen to the individual's concerns, empathize with the individual and respond these needs.

It is important to evaluate all the humans with this perspective and plan approaches, which will enhance the health of the individual holistically. There are many effective factors for the spiritual approach to be included within the care services. The opinion system, spiritual needs and comprehending the physical care, hope for health, willingness and sensitivity, which are particularly at the center of the care service among the factors, has been effective.

However, the conducted studies show that the patient's spirituality has been ignored and the spiritual care is insufficient Wong and Lee ; [ 27 ]. The researchers state that the most important reason for the lack of spiritual care is the time constraint and educational deficiencies. According to a study conducted on nurses, the nurses both consider the issue about spirituality and spiritual care important and meet the work requirements only There are significant principles, which must be taken into account, regarding spiritual care. These are as follows: It must be aimed to explain the power of individual regarding the spiritual needs as much as the existing and potential problems.


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The primary purpose of the health professionals in spiritual care must be to evoke the spiritual sources of an individual. Spiritual care must be planned to respond to the spiritual needs of an individual, not to alter their beliefs or change their perspective. Spiritual diagnosis and care must be built upon a reliable and sensitive relationship between the patient and physician. The care must be planned so that it would involve the culture, social and spiritual sources of the individual as well as their idea and religious applications. When sharing information about the patients among team members, they must be aware of the personal limitations.

The importance of mentioning the spiritual care in health applications in written must be taken into consideration and the necessary regulations must be established [ 11 ]. The studies suggest that the religious beliefs and spiritual applications of the patients are important factors when deciding to cope with diseases and even in termination of life and in the resolution of ethical dilemmas regarding treatment options.

Improving the Quality of Life: A Holistic Scientific Strategy

It has been found that determining the spiritual beliefs of the patients during the healing process with correct questions and independent of our own belief systems within the communication process is very helpful and easier when giving explanatory information regarding the treatment process and its results [ 23 , 28 ]. Thus, physicians need to inquire about the patient's spirituality and to learn how religious and spiritual factors may help the patient cope with the current illness, and conversely when religious struggle indicates the need for referral to the chaplain.

The idea that there is a correlation between the tendency towards spiritual needs and religiosity is a popular belief around the world. However, it can be stated that this is not directly correlated with delivering the health care and religiosity. Religion and spiritual beliefs play an important role for many patients. When illness threatens the health, and possibly the life of an individual, that person is likely to come to the physician with both physical symptoms and spiritual issues in mind.

Humans grapple with common issues of infirmity, suffering, loneliness, despair and death while searching for hope, meaning and personal value in the crisis of illness [ 32 ]. Religion is generally understood as a set of beliefs, rituals and practices, usually embodied within an institution or an organization. Spirituality, on the other hand, is commonly thought of as a search for what is sacred in life, one's deepest values, along with a relationship with God, or a higher power, that transcends the self.

Persons may hold powerful spiritual beliefs and may or may not be active in any institutional religion. Many physicians and nurses have intuitive and anecdotal impressions that the beliefs and religious practices of patients have a profound effect upon their existential experiences with illness and the threat of dying. Recent research supports this notion. It has been found that when patients face a terminal illness, religious and spiritual factors often figure into their coping strategies and influence important decisions such as the employment of advance directives, the living will and the Durable Power of Attorney for Health Care [ 23 , 33 , 34 ].

In such cases, it is very important to determine the necessary comforting factors for the patient to trust the higher power and cope with the existing crisis.

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The evidence in the medical literature that suggests a strong relationship between spirituality and medicine is increasing [ 35 ]. In a conducted study, it was found that religion and spirituality had positive effects on physical health and the nurses had a tendency to believe spirituality as a religious need. According to a study conducted with patients by Dr. According to the studies conducted in the United States and the UK, it was discovered that praying reduces the symptoms and accelerate the healing process.

The chaplains prayed for cardiac patients, receiving treatment at St. According to the study conducted by Columbia University, people with reproductive problems were regularly prayed for. In another study conducted on cardiac patients by the Hospital of San Francisco, patients were regularly prayed for and it was revealed that the patients, prayed for by strangers, responded to the pharmacotherapy faster [ 36 , 37 ].

It has been shown in many studies that the spiritual dimension has a clear effect on health, wellness and quality of life [ 27 , 38 , 39 ].

Background

In the study conducted by Strang et al. In the study made by Narayanasamy , it was discovered that the nurses were not enough aware of the spiritual needs of the patients and emphasized that there was a lack of background information on creating the nursing care scheme about the spiritual care [ 40 ].

According to the survey conducted to determine the spiritual values by Wong et al. Fehring et al.