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Learning Objective 1: The learner will be able to describe the historical and philosophical imperative for a clear concept of healing in modern nursing.
Learning Objective 2: The learner will be able to appreciate the diversity of meanings of the term “healing” within healthcare literature and articulate a synthesized concept bridging these.
We often hear nurses say healing is at the heart of nursing and curing is the focal point of medicine, creating a dichotomy between these two health profession groups. In the healthcare literature “healing” is applied to a range of phenomena, including wound healing, healing from childhood abuse and spiritual healing. This lack of conceptual clarity presents a significant barrier in both measuring healing as an outcome and developing healing interventions directed by nurses and other health care providers.
Methods
Initial literature searches for the term “healing” in major healthcare databases yielded over 500,000 results. Subsequently searches were limited to CINHAL for the terms “healing concept” or “healing definition.” Inclusion criteria were: English language; 2007-2012; and engagement in definition of healing, either centrally or peripherally. There were 11 articles appropriate for analysis. A new concept of healing was synthesized.
Results
Key findings included divergent perspectives on the nature of healing. Most conceptualizations located healing within the physiological domain, though it was also conceptualized to occur in the mental and spiritual domains. The requirement for intentionality in healing was nearly evenly divided, with slightly more definitions not requiring it. There was also disagreement amongst authors as to the predictability of healing.
The synthesized concept of healing includes four stages of healing that bridge these differences: cure seeking, adaptation, interpretation of injury/illness through narrative and identity, and reinterpretation of narrative and identity.
Conclusion
The need for clarifying the healing concept rests on its centrality to nursing. The risk of dichotomizing healing and curing is to artificially separate these intertwined concepts, leading to unbalanced approaches to patient care.
The synthesized conceptualization of healing above offers testable hypotheses for instrument development. Measuring healing would provide feedback to nurses about the effectiveness of their care and assist researchers develop interventions that support healing.