Beyond the Physical: A Critical Need for Holistic Patient Care

Author Bio: Madrika Mirza Kanjiani has been working as a teaching assistant at The Aga Khan University, School of Nursing and Midwifery, Pakistan. She completed her BScN in 2019 and MScN in 2023 from AKU-SONAM

Beyond the Physical: The Critical Need for Holistic Patient Care

A 45-year-old female patient frequently visited the pain management clinic with the complaint of chronic back pain. She has been taking analgesics to manage pain for a long time but at times pain becomes so severe that she has to visit the clinic., where a nurse routinely monitors her vital signs, and pain scores, while the doctor prescribes her additional pain medications. This time also, she reported to the emergency room again, with the complaint of more intense pain than previous pain episodes. Along with the physical assessment including vital signs monitoring, head-to-toe assessment, history of pain, medications taken at home, and comorbidities the attending physician also conducted a comprehensive mental health assessment. It was then identified that the underlying cause of the pain was anxiety, which had gone undiagnosed during her clinic visits.

Healthcare providers are responsible for offering holistic nursing care. The American Nursing Association (ANA ) describes holistic care as the integration of body, mind, emotion, spirit, sexual, cultural, social, energetic, and environmental principles and methods to improve health, promote well-being, and develop human potential (1). This case scenario highlights the commonly ignored aspect of health which is mental health and the importance of a holistic patient care approach in the timely identification and treatment of underlying cause.

Maslow’s Hierarchy of Needs

Maslow’s theory proposes five categories of human needs including physiological, safety, love and belonging, esteem, and self-realization, and recommends a hierarchical arrangement of these needs, implying their successive satisfaction. According to Maslow’s theory, psychological well-being comes under the category of safety, after an individual meets his physiological needs. If the physiological needs remain unaddressed, the patient can manifest physical symptoms like anxiety (2). This theory emphasizes the importance of addressing the needs for emotional security and mental well-being as one of the steps toward self-actualization. While caring for patients, both physical and mental assessment will ensure that both physical and psychological needs are met and a holistic approach is used.

Biopsychosocial model

Another model that emphasizes the importance of holistic patient care is a biopsychosocial model which implies that illness is a product of interactions among social, physical, and psychological factors (3). A physical injury is not always the cause of pain; other frequently neglected psychological or social elements may also be responsible. Psychological factors like anxiety can exacerbate pain perception by increasing muscle tension (4). Social factors like a lack of support can increase anxiety, and pain levels (5). This theory emphasizes the interlinkage between physical, psychological, and social factors and their impact on overall health. By considering all the components of the biopsychosocial framework, healthcare providers can develop tailored care plans that can promote comprehensive healing and overall quality of life.

Conclusion

In a nutshell, considering a comprehensive approach to care ensures that all the physical, social, emotional, and mental health needs of the patient are met, facilitating timely identification, and treatment of the underlying cause of illness. Along with the importance of an assessment of physical health, a mental health assessment is equally important, even if the symptoms may not be apparent, that doesn’t mean that they are not present. Therefore, healthcare professionals need to integrate a holistic approach to assessment and delivering patient care.

Recommendations

Mental health assessment must be included as 7^th vital sign to be monitored. Ongoing training and sessions of healthcare professionals must be conducted to emphasize a holistic approach to care. Holistic care models like Maslow’s hierarchy of needs and the biopsychosocial model must be considered as the basis of patient care to ensure comprehensive care delivery.

References

1.         Harrington L. American Nurses Association Releases New Scope and Standards of Nursing Informatics Practice. AACN Advanced Critical Care. 2015;26(2):93-6.

2.         Healy K. A Theory of Human Motivation by Abraham H. Maslow – reflection. Br J Psychiatry. 2016;208(4):313.

3.         Roberts A. The biopsychosocial model: Its use and abuse. Medicine, Health Care and Philosophy. 2023;26(3):367-84.

4.         Cimpean A, David D. The mechanisms of pain tolerance and pain-related anxiety in acute pain. Health Psychol Open. 2019;6(2):2055102919865161.

5.         Franqueiro AR, Yoon J, Crago MA, Curiel M, Wilson JM. The Interconnection Between Social Support and Emotional Distress Among Individuals with Chronic Pain: A Narrative Review. Psychol Res Behav Manag. 2023;16:4389-99.