130 HOLISTIC NURSING PRACTICE • MAY/JUNE 2012
prevent certain diseases. Every person continues on a journey to achieving his or her full potential and maximizing his or her wellness.8
The philosophical argument of realism aligns with the concept of wellness. Realism explains the reality of a phenomenon. Wellness from a realist perspective asks, “What is the reality of wellness? What does wellness look, act, and feel like? Wellness will look, act, and feel different for every patient. Realities are unique to individuals’ environments, genetics, and experiences.9 Patients’ realities will influence their views and perception of wellness.
Wellness embraces an empirical philosophy; however, this philosophy differs from empirical research and practice and expands to the patient’s experience. John Locke, a philosophical empirical thought leader, proclaims that knowledge is derived through experience.8 Personal patient experiences will determine his or her definition of wellness. Nurses cannot possibly acquire the experience of each individual patient. Every patient who interacts with a nurse will possess different knowledge compared with the previous patient. Knowledge creates worlds for patients, worlds that translate into unique and diverse definitions and understandings of wellness.
Wellness is difficult to conceptualize, which may explain the omission in definition and paradigm development within the nursing profession. In the absence of a universal, clearly defined understanding of the word and concept of wellness, the National Wellness Institute10 provides this clear definition of wellness: wellness is a multidimensional and holistic state of being that is conscious, self-directed, and constantly evolving to achieve one’s full potential. Wellness is an ever-changing process that encompasses multiple dimensions, known as the Six Dimensions of Wellness: intellectual, spiritual, emotional, physical, occupational, and social dimensions.10,11 The Six Dimensions of Wellness reflect unique characteristics that interconnect with one another to represent the person as a whole. Table 1 provides the definition for each of the Six Dimensions of Wellness.
HISTORY OF WELLNESS IN NURSING
According to the National Wellness Institute,10 a professional ca
n determine whether he or she practices within a wellness approach if he or she answers “yes” to the following 3 questions: “Does this help patients
TABLE 1. Definitions of the Six Dimensions of Wellnessa
Dimension of Wellness Definition
Occupational wellness
Ability to contribute unique skills to personally meaningful and rewarding paid or unpaid work
Social wellness Ability to form and maintain positive personal and community relationships
Intellectual wellness
Commitment to lifelong learning through continuous acquisition of skills and knowledge
Physical wellness Commitment to self-care through regular participation in physical activity, healthy eating, and appropriate health care utilization
Emotional wellness
Ability to acknowledge personal responsibility for life decisions and their outcomes with emotional stability and positivity
Spiritual wellness Having purpose in life and a value system
aBased on definitions from Hettler.11
achieve their full potential? Does this recognize and address the whole patient? Does this affirm and mobilize positive qualities and strengths?”10 The nursing frameworks of Florence Nightingale, Virginia Henderson, and Margaret Newman are examined for congruency with wellness profession guidelines of the National Wellness Institute.
Florence Nightingale’s theory supports wellness by addressing the whole patient and affirming his or her positive qualities and strengths.6 Nightingale believed that patients should be placed in optimal environments that allow nature to act. Her theory promoted nature as the ultimate cure for any disease process. According to Nightingale’s theory, environments are multidimensional. The air people breathe, the food people eat, the company people keep, and the conditions people live will interact to promote or prevent healing.6
Nightingale believed that nurses should work to prevent disease and care for well patients with the same approach as caring for sick patients.6 She explained that diseases proliferate for years before manifesting into clinical symptoms. Therefore, nurses can improve the environment of well patients to prevent disease. Improving the environment could be
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