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Research: STRANDBERG and others,
Listed in Issue 151
Abstract
STRANDBERG and others, Lund University, Department of Clinical Sciences, Malmo, Family Medicine, Malmo University Hospital, SE-205 02, Malmo, Sweden, eva-lena.strandberg@ltblekinge.se, have studied what the word ‘holistic’ means to doctors and nurses in Sweden.
Background
The definition of primary care varies between countries. Swedish primary care is based on quality, accessibility, continuity, co-operation, and a holistic view. The meaning of holism in international literature differs between medicine and nursing. The question is, if the difference is due to different educational traditions. Due to the uncertainties in defining holism and a holistic view, the aim of this study was to explore the perceived meaning of a holistic view among general practitioners and district nurses.
Methodology
Seven focus group interviews with a purposive sample of 22 GPs and 20 nurses working in primary care in two Swedish county councils were conducted. The interviews were transcribed verbatim and analysed using qualitative content analysis.
Results
The analysis resulted in three categories, attitude, knowledge, and circumstances, with two, two and four subcategories respectively. A professional attitude involves recognizing the whole person; not only fragments of a person with a disease. Factual knowledge is acquired through special training and long professional experience. Tacit knowledge is about feelings and social competence. Circumstances can either be barriers or facilitators. A holistic view is a strong motivator and as such it is a facilitator. The way primary care is organised can be either a barrier or a facilitator and could influence the use of a holistic approach. Defined geographical districts and care teams facilitate a holistic view with house calls being essential, particularly for nurses. In preventive work and palliative care, a holistic view was stated to be specifically important. Consultations and communication with the patient were seen as important tools.
Conclusion
The 'Holistic view' is multidimensional, well implemented and very much alive among both GPs and District Nurses. The word holistic should really be spelled 'wholistic' to avoid confusion with complementary and alternative medicine.
References
Strandberg EL, Ovhed I, Borgquist L, Wilhelmsson S. The perceived meaning of a (w)holistic view among general practitioners and district nurses in Swedish primary care: a qualitative study. BMC Family Practice 8 : 8, 2007.
