Wholistic Health Research Articles

“It trickles into the community”: A case study of the transfer of health promoting practices from school to community in Canada

The school is an ideal setting to promote children's health and is an equitable way to reach children in early developmental years. Healthy children are stronger learners and wholistic health approaches taken in schools can help children thrive. Interventions in the school are strengthened when school, home, and community work together, yet many interventions have not reported the school and community connection and influence. The purpose of this study was to determine if and how the intervention, APPLE Schools, has impacted the community environment. One community in Alberta, Canada was chosen as a case study. An instrumental case study approach was taken, and data generation was guided by focused ethnography. Data were generated through community partner interviews (n = 17) and document analysis. Reflexive thematic analysis was used to analyze data. Results were represented by three main themes and demonstrated APPLE Schools created impact beyond the school setting through a stepped approach: 1) Foundation: establishes a healthy school culture; 2) Action: tying the work of schools and communities together; and 3) Impact: changes in school practices ripple out to promote health in the community. This research provides compelling evidence that comprehensive school health approaches can impact community environments outside the school and result in stronger health promoting practices both within and outside the school.

Using latent class analysis to operationalize a wholistic assessment of Inuit health and well-being

ABSTRACT Many Indigenous cultures conceptualize health wholistically, whereby physical, mental, spiritual and relational dimensions of health are interconnected. Yet, quantitative approaches to studying Indigenous health remain anchored in western perspectives, that separate the dimensions of health. This paper aims to operationalize a wholistic indicator of health based on the IQI model of Inuit health. Variables from the 2017 Nunavik Health Survey (N = 1196) were selected based on their representativeness of IQI model. Exploratory Latent Class Analysis (LCA) was used to identify wholistic health profiles. Once participants assigned to their health profile, sociodemographic characteristics were compared across profiles, and multinomial regression models were used to examine the relationship between community-level social determinants of health and the profiles. The LCA revealed three health profiles, labelled as “excellent”, “good” and “fair” based on the distribution of answers to the indicators. Nunavimmiut in “excellent” and “good” health were more likely to: rate their health positively; be over 30 years old; be in a relationship; and have participated or volunteered in community events. Nunavimmiut in ”fair” health tended to report lower levels of community cohesion, family relationships, and emotional support. Intergrating culturally relevant models of health can support improved health status assessments and identify opportunities for health promotion.

A Concept Analysis of Cultural Appreciation in Addressing the Wholistic Health Needs of Indigenous People.

Aim: Cultural appreciation is found within the arts, psychology, counseling, health disciplines, and education. Currently, in the literature, there is not a strong link between cultural appreciation, nursing, and Indigenous people. The aim of this concept analysis is to analyze the concept of cultural appreciation for nurse educators, nurse researchers, and nurse leaders to apply to culturally appreciate Indigenous people within their geographical areas which can result in meeting their wholistic care needs. Design: This concept analysis of cultural appreciation uses Walker & Avant's (2019) approach to define cultural appreciation, antecedents, empirical referents, and consequences. Results: The antecedents of cultural appreciation are cultural appropriation, oppression, cultural prejudice, privilege, and lack of knowledge to integrate the wholistic health of Indigenous people into practice, education, and research. The defining attributes of cultural appreciation are awareness, knowledge acquisition, and desire. The consequence of cultural appreciation is wholistic care of Indigenous people as defined by their ways of knowing and being. Conclusion: The concept analysis of cultural appreciation integrates Indigenous wholistic health beliefs and ways of knowing and being that can advance holistic nursing knowledge for nurses, educators, and researchers.

Etuaptmumk (Two-Eyed Seeing) in Nature’s Way-Our Way: braiding physical literacy and risky play through Indigenous games, activities, cultural connections, and traditional teachings

Growing philosophical and empirical evidence shows that physical literacy and risky play enriches movement opportunities, while also fostering increased physical activity, wholistic health, and wellness across the lifespan. However, physical literacy and risky play have typically been theorized and practiced from a western worldview. In response, Nature’s Way-Our Way is an initiative designed to ground physical literacy and risky play in Indigenous games, activities, cultural connections, and traditional teachings, as enacted in Early Childhood Education Centres across Saskatchewan, Canada. This article explores Nature’s Way-Our Way’s theoretical underpinnings of Etuaptmumk (Two-Eyed Seeing), adopted to braid together the strengths of Indigenous Knowledges with western knowledge through practices of Indigenous métissage (land and story-based approaches to curriculum informed by relationality). Providing examples of culturally rooted resources, this article shows how the Nature’ s Way-Our Way initiative supports Indigenous self-determination and sovereignty to foster increased physical activity, wholistic health, and wellness across the lifespan.

Stepping Into the Circle: Inviting Spirit Through Medicine Wheel Teachings in the Expressive Therapies Continuum (Entrer dans le cercle : invitation de l’esprit à travers les enseignements de la roue médicinale dans le Continuum des Thérapies Expressives)

This article explores the intersections between colonial trauma and Indigenous identity as a centralizing factor of Indigenous wellness. Focusing on the Expressive Therapies Continuum theory, this author continues her research on using culturally significant materials and material interaction as a way to honor Indigenous knowledge. Taking a Two-Eyed Seeing approach, this author proposes changing the shape of the continuum from hierarchal to cyclical in order to invite clinicians to reflect on the role of Spirit and cultural identity as important elements when considering wholistic health. Using the teachings of the Medicine Wheel, the body, heart, mind, and Spirit are connected with the somatic/kinesthetic, perceptual/affective, cognitive/symbolic, and creative levels of the continuum.

Planting Seeds of Change: Voices of Indigenous Youth on Wholistic Health

Indigenous youth are key partners in improving our understanding of holistic health and identifying solutions to address health-related issues. The Urban Gardens Project was a community-based research partnership involving Indigenous youth co-researchers, Brandon University, Indigenous Knowledge Users, Elders, and Indigenous organizations in Winnipeg and Brandon, Manitoba. Using the Medicine Wheel as an analytic framework, the study identified key indicators of spiritual, mental, physical, and emotional wellbeing that Indigenous youth attributed to gardening. Findings illuminate the need for policies to foster Indigenous youth engagement, leadership, and urban gardening programs that advance Indigenous cultural practices to contribute to Indigenous health and wellbeing. The research was funded by the Canadian Institutes for Health Research (CIHR).

Wholistic Health Equity's Quality Conundrum.

Wholistic Health Equity's Quality Conundrum.

Indigenous Strength: Braiding Culture, Ceremony and Community as a response to the COVID-19 Pandemic

Purpose: The COVID-19 pandemic has impacted the physical, mental, emotional and spiritual health of urban Indigenous Peoples. We sought to examine innovations and changes in service delivery by Indigenous service providers in the community who are addressing community needs based on an Indigenous worldview.
 Basic Procedures: The research was a collaboration between an academic team, an Indigenous research associate, and an Indigenous oversight committee. Fifteen in-depth interviews were conducted with Indigenous service organizations, non-Indigenous organizations with Indigenous programming, Indigenous volunteer-based organizations and Indigenous volunteers. Participants were recruited based on having mandates that focussed on mental and emotional wellbeing, education, chronic health conditions, women and children and Indigenous cultural needs.
 Major Findings: Health inequities for urban Indigenous Peoples were compounded during the pandemic. The lack of local infrastructure contributed to increased volunteerism to deliver and improve access to services. Service interruptions and access barriers triggered innovative programming and a strengths-based response with activities embedded on the land, braided with language, ceremony and culture. Unmet community service needs and capacity development priorities were identified.
 Conclusions: Access to land, infrastructure and cultural programming is key to wholistic health for the urban Indigenous community. Despite continued inequities, the urban-based Indigenous response exemplifies the strengths-based approaches that helped to address pandemic impacts and demonstrated how Indigenous ways of knowing build strength and foster innovative program adaptations based on culture, ceremony and creating space for community.

No health without wholistic health: An empirical approach to mental health cultivation

No health without wholistic health: An empirical approach to mental health cultivation

Amxsame’ su sa ‘Nawalakw (the supernatural spirit wraps around us): impacts of Kwakwaka’wakw regalia making on identity, wellness and belonging in ‘Yalis, British Columbia

In this article, we share findings from a community-based Participatory Action Research project, titled Sanala, which means to be whole in Kwak’wala—the language of the Kwakwaka’wakw (Kwak̓wala-speaking people; a First Nation from what is now called Canada). In response to community priorities, the Sanala team initiated regalia as a weekly programme where people from the ‘Namgis tribe and other surrounding Kwakwaka’wakw Nations on the northwest coast of British Columbia, Canada, come together to create regalia. Participants learn about family crests, design and sew button blankets and dance aprons, and learn oral histories belonging to individuals and families, all within the context of Kwak’wala language revitalization and regalia making. We outline the impacts of this programme on identity, belonging, wholistic health and collective wellbeing, as well as implications for Participatory Action Research and community-led research aimed at strengthening individual and collective health and wellness through Indigenous languages and cultural continuity.

The Social Determinants of Mental Health: Assessment, Intervention, and Wholistic Health Equity: Part 2.

Purpose: The social determinants of mental health (SDoMH) continue to exert their fierce presence around the globe. The factors known to influence health outcomes equally impact mental health. A global mental health chasm has widened courtesy of COVID-19's intersection with every psychosocial aspect of functioning, inclusive of how people are born, live, learn, work, socialize, worship, and die. Racial, ethnic, and cultural inequities across the diversity, equity, and inclusion space have led to rising morbidity and mortality across every population. Part 2 of this article series is dedicated to assessment and intervention tools for the workforce. A key fifth or Quintile Aim of wholistic health equity is also presented to advance the industry's seminal quality compass, the Triple Aim, for the future. Learning Outcomes: After reading this article, learners will be able to: Finding/Conclusion: Access to quality wholistic health care encompasses pathophysiology, psychopathology, and psychosocial circumstances and remains a challenge across populations. Mental health, along with health disparities, has been fueled by systematic racism that has facilitated inadequate funding, poor reimbursement, decreased treatment options, and pervasive stigma across the cultural divide (e.g., race, ethnicity, gender, sexual orientation, familial status, disability, socioeconomic status). The SDoMH mandate a fresh lens by health and behavioral health professionals, and particularly case management, to ensure a more proactive and comprehensive approach to care. To achieve the successful outcomes mandated by this approach, the industry's quality compass, the Triple/Quadruple Aim, must be expanded to include a Quintile Aim of wholistic health equity. Implications for Case Management Practice: Case management's unique transdisciplinary composition has the workforce well positioned to effect grand change in population health perspectives. Wider attention to clinical and fiscal outcomes for health and mental health inequities mandates innovative approaches to patient care, which encompasses a wholistic health triad of pathophysiology, psychopathology, and psychosocial circumstances.

INSTRUCTIONS: The Social Determinants of Mental Health: Assessment, Intervention, and Wholistic Health Equity: Part 2.

Professional Case Management: September/October 2021 - Volume 26 - Issue 5 - p E17-E18 doi: 10.1097/NCM.0000000000000527

The Social Determinants of Mental Health: Definitions, Distinctions, and Dimensions for Professional Case Management: Part 1.

Purpose: The social determinants of health are a well-established health care industry priority. Robust data associated with psychosocial circumstances for populations validate poor health outcomes. However, another domain begs for inclusion and industry attention. A mental health chasm has emerged amid a post-COVID-19 landscape fraught with escalating health disparities, morbidity, and mortality. Themes of trauma, diversity, equity, and inclusion are major organizational imperatives. As a result, an expanded focus on the social determinants of mental health (SDoMH) mandates dedicated perspective. Part 1, of this 2 article series, on the SDoMH will provide distinct understanding of relevant industry terminology, historical drivers, and macro factors that influence mental health, along with health disparities. In addition, this article will set the foundation to advance the industry's quality compass, the Triple/Quadruple Aim. Learning Outcomes: After reading this article, learners will be able to: define the social determinants of mental health (SDoMH);distinguish them from the social determinants of health (SDoH);explore foundational concepts related to the SDoMH;understand upstream drivers of the SDoMH; andpresent evidence that validates attention to the wholistic health triad. Finding/Conclusion: Access to quality wholistic health care encompasses pathophysiology, psychopathology, and psychosocial circumstances, and is a considerable challenge across populations. Mental health, along with health disparities, has been fueled by enduring systematic racism that has facilitated inadequate funding, poor reimbursement, decreased treatment options, and pervasive stigma across diverse patient populations (e.g., race, ethnicity, gender, sexual orientation, familial status, disability, socioeconomic status). These SDoMH mandate a critical fresh lens by case management to ensure the most proactive and comprehensive approach to care. To achieve the successful outcomes mandated by this approach, the industry's quality compass, the Triple/Quadruple Aim must be expanded to include a Quintile Aim of wholistic health equity. Implications for Case Management Practice: Case management's unique transdisciplinary composition has the workforce well positioned to effect grand change in population health perspectives. Wider attention to clinical and fiscal outcomes for health and mental health inequities mandates innovative approaches to patient care, which encompass a wholistic health triad of pathophysiology, psychopathology, and psychosocial circumstances.

Arterial Compliance is Improved Following a Community-led 12-week Indigenous Wholistic Health and Wellness Program

Arterial Compliance is Improved Following a Community-led 12-week Indigenous Wholistic Health and Wellness Program

Importance of Spiritual Wellbeing in Community-Based Health Interventions in Indigenous Peoples in BC

Background: The health gap between Indigenous peoples and other populations in Canada is of concern. Various health promotion and wellness programs have been attempted in Indigenous communities, but many of these programs have been ineffectual partly because they are not culturally sensitive, culturally relevant, or wholistic. Purpose: This narrative review discusses the foundational concepts of wholistic health and community-based programming with reference to two programs based at the University of British Columbia (UBC), the Tu’Wusht Garden Project and the Summer Science Program, that integrate spiritual wellbeing into health programming. We further discuss how the frameworks from these programs can be used in other Indigenous communities. Foundational Concepts: The wholistic or Indigenous model of health is guided by the teachings of the Medicine Wheel and includes mental, physical, emotional, and spiritual wellbeing. While current health programs often address physical, emotional, and mental wellbeing, they frequently fail to incorporate spiritual wellbeing because of how diffuse spiritual wellbeing can be as a concept for health practitioners in Canada. Discussion: The Tu’Wusht Garden Project utilizes traditional activities (like gardening and ceremony) to integrate spiritual health into programming and engage Indigenous community members in health programming. The UBC Summer Science uses a contemporary Two-Eyed Seeing approach to blend Western and Indigenous health lessons. This includes spiritual health into programming and offsets any weakness of Western or Indigenous health models. Both programs have received strong support from Indigenous peoples. Conclusions: Collectively, these programs demonstrate the importance of including spiritual health lessons within health and wellness programming within Indigenous communities.

Enabling cultural safety in Indigenous primary healthcare.

The Aboriginal Health Access Centre (AHAC) and Aboriginal Community Health Centre Model of Wholistic Health and Wellbeing is critical to addressing inequities and barriers that limit access to comprehensive primary healthcare for Indigenous people. Even with this model in place, there are multiple points of intersection with mainstream healthcare service providers across health sectors. Further, there is considerable cultural diversity among Indigenous healthcare staff and professional groups. These factors place Indigenous people at risk of culturally unsafe experiences causing harm. Given this, it is essential that leaders focus on cultural safety education to address both intercultural frictions within the Indigenous centres and systemic and structural racism widespread within the broader healthcare system. This article explores how one AHAC has undertaken to examine these complex challenges, while offering some direction on leadership within the sector.

Using Two-Eyed Seeing to Explore Interagency Collaboration.

Background Health-care environments influence service delivery; approaches need to be more wholistic and culturally competent requiring effective interagency collaboration to bridge traditional Indigenous and mainstream health services. Despite considerable research on collaboration, the concept remains misunderstood, at worst, and formative, at best. Within the nexus of these two diverse health services, there is limited information on how collaborations could be created and sustained effectively. Purpose To explore the perspectives/experiences of collaboration of select Saskatchewan health professionals practicing across these diverse services to understand the concept from their perspectives. Methods This qualitative study explored collaboration through observation and interviews to elicit perspectives (two-eyed seeing) of health professionals working within the context of a traditional-mainstream health services partnership. Results Individual- and system-level factors and accountabilities are needed for successful cross-cultural collaboration and can be enabled by embedding the virtues of Indigenous and values of mainstream health services along with building and maintaining relationships, valuing difference, creating supportive environments and wholistic approaches, having the right people at the table, and making a change for impactful outcomes. Conclusion Findings support the need for implementing contextually relevant collaborative practice models for productive, wholistic health services. Two-eyed seeing provides the ability to capture and catalyze the tremendous value and strengths of both worlds, potentiating complementary aspects to meet the needs of clients and communities.

Experiences of Meaning in Life among Elementary School Students: Content Analysis Based on Major Concepts of Logotherapy

Purpose: The purpose of this study was to explore the experience of the meaning in life for elementary school students. Methods: The conceptual framework was based on the five main concepts (meaning in life, creativity, experiences, attitudes, choice and responsibility) of logotherapy. Data from 1,600 higher grade elementary school students were analyzed for content of meaning in life. Results: The experiences of meaning in life were identified as follows: Important things in my life (people close to me, things that brings me happiness, to live in earnest, surrounding environment), Activities I like to do (relaxing, achievements, family relationships), Experiences that made me feel like I am loved (taken care of by family, material recompense, being respected), Times when I feel grateful (receive love and care, health), Importance of choices (consequences of bad choices, result of good life choices). Conclusion: These results suggest that elementary school students can understand meaningcentered health education and this kind of education is necessary to promote their wholistic health.

Wholistic Health Care: Evolutionary Conceptual Analysis.

While performing a data search to define "wholistic health care", it was evident that a definite gap existed in published literature. In addition, there are different definitions and several similar terms (whole person care, wholistic health, whole person health, wholism, etc.), which may cause confusion. The purpose of this paper was to present the analysis of "wholistic health care" using Rodgers' Evolutionary Method. The method allows for the historical and social nature of "wholistic health care" and how it changes over time. Attributes, antecedents, and consequences of wholistic health care were reduced using a descriptive matrix. In addition, attributes that consistently occurred in wholistic health care were presented as essential attributes. Definitions of Wholistic Health Care Provider(s), Wholistic Health, Wholistic Illness, Wholistic Healing, and Patient were created from the analysis of the literature review of attributes, antecedents, and consequences of wholistic health care. Wholistic Health Care is defined as the assessment, diagnosis, treatment and prevention of wholistic illness in human beings to maintain wholistic health or enhance wholistic healing. Identified wholistic health needs are addressed simultaneously by one or a team of allied health professionals in the provision of primary care, secondary care, and tertiary care. Wholistic health care is patient centered and considers the totality of the person (e.g., human development at a given age, genetic endowments, disease processes, environment, culture, experiences, relationships, communication, assets, attitudes, beliefs, and lifestyle behaviors). Patient centered refers to the patient as active participant in deciding the course of care. Essential attributes of wholistic health care are faith (spiritual) integrating, health promoting, disease managing, coordinating, empowering, and accessing health care. Wholistic health care may occur in collaboration with a faith-based organization to mobilize volunteers to support and promote individual, family, and community health. A gap existed in literature regarding the definition of wholistic health care. In addition, a lack of clarity was identified due to the use of the concept, similar or related concepts. Conceptual clarity was sought through identification and definitions of attributes, Powered by Editorial Manager(®) and ProduXion Manager(®) from Aries Systems Corporation antecedents, and consequences. The theoretical definition of wholistic health care and conceptual model can be used to support the presence of the concept, develop model-based applications, and consistently test effectiveness.

Evolutionary conceptual analysis: faith community nursing.

The aim of the study was to report an evolutionary concept analysis of faith community nursing (FCN). FCN is a source of healthcare delivery in the USA which has grown in comprehensiveness and complexity. With increasing healthcare cost and a focus on access and prevention, FCN has extended beyond the physical walls of the faith community building. Faith communities and healthcare organizations invest in FCN and standardized training programs exist. Using Rodgers' evolutionary analysis, the literature was examined for antecedents, attributes, and consequences of the concept. This design allows for understanding the historical and social nature of the concept and how it changes over time. A search of databases using the keywords FCN, faith community nurse, parish nursing, and parish nurse was done. The concept of FCN was explored using research and theoretical literature. A theoretical definition and model were developed with relevant implications. The search results netted a sample of 124 reports of research and theoretical articles from multiple disciplines: medicine, education, religion and philosophy, international health, and nursing. Theoretical definition: FCN is a method of healthcare delivery that is centered in a relationship between the nurse and client (client as person, family, group, or community). The relationship occurs in an iterative motion over time when the client seeks or is targeted for wholistic health care with the goal of optimal wholistic health functioning. Faith integrating is a continuous occurring attribute. Health promoting, disease managing, coordinating, empowering and accessing health care are other essential attributes. All essential attributes occur with intentionality in a faith community, home, health institution and other community settings with fluidity as part of a community, national, or global health initiative. A new theoretical definition and corresponding conceptual model of FCN provides a basis for future nursing knowledge and model-based applications for evidence-based practice and research.