PRIME

Partnerships in International Medical Education

Body, Mind and Spirit all need careWhat is Whole Person Healthcare?

Although you may not have given it any particular thought, most patients already know instinctively that ill health and disease inevitably affects the whole person. Body, mind and spirit. Like many of the most important things in life the idea is so simple that in all the complexity of modern life, let alone modern healthcare, we simply overlook it.

At its most simplistic it is the balance between the body, mind and spirit that make up the individual.

In healthcare an imbalance in any one of these will inevitably affect the others. This may seem obvious, but in much of modern healthcare education and practice the focus on the complexities of physical diagnosis and treatment means there is little time to discover the emotional or spiritual effects of the disorder.

For example, a chronic, enduring pain will inevitably affect the patient’s ability to do everyday actions - such as hug their children. It may also lead to an inability to cope with daily tasks or the needs of others. A physical or psychological illness has an effect on emotional and spiritual wellbeing and this should be taken into account by healthcare workers.

Modern end of life care will probably include some practical and pharmacological interventions but it may also include the offer of some form of spiritual care from, for example, a counsellor or hospital chaplain. This is a good example of whole person care.

As patients we know that a hospital stay, particularly an extended stay, may lead to feelings of isolation, loss of hope, fear of being unable to cope in the outside world or depression - any of which can have a profound effect on recovery time. Research shows that, on average, those receiving care from a chaplain go home earlier. 1

A routine visit to the GP can cause high levels of anxiety. Even the common cold may leave us feeling low, or lacking energy. Physical problems affect our mind and spirit. The converse is also true – there is evidence that shows hopelessness can lead to increased levels of heart disease and cancer. 2

Sometimes people complain that the healthcare profession treats them as a number and not a person, with no proper explanation of what is being done or what will happen next. This lack of thoughtfulness or regard to hopes and fears happens when the whole person – body, mind and spirit – is not being considered. We all know how we would like our mothers to be treated, with courtesy, concern and kindness, but think how many times you have spoken to a friend or colleague who has not received these things.

It seems that in our desire to find new treatments and diagnostic tools we may have overlooked a basic need of all patients – that of being seen, diagnosed and treated not as a leg, a kidney or a brain, but as a whole person.

This is the balance that PRIME seeks to redress.

References:
1. Florell JL, Bulletin of the American Protestant Hospital Association 1973; 37: 29-36
2. Psychosomatic Medicine 65:201-210 (2003) © 2003 American Psychosomatic Society