Seeking a Common Language to Communicate about Holistic Health: A Factor Analysis of Instruments Used Across Disciplines In Holistic Health Research

Theoretical Background and research questions/hypothesis: The purpose of this study was to respond to a need for a common language in the area of holistic health through a factor analysis of three fields shaping the definition of health: health, wellness, and spirituality. The language we have available to discuss new ideas is critical. As researchers across disciplines have designed studies on holistic health, they have selected instruments with such varied language, that is has been difficult to compare their results. This study sought to take the first step in finding that common language by using a factor analysis of instruments common to holistic health research.

The transformation of the definition of health has moved through several paradigms: dichotomous, multidimensional, and holistic. Essentially, it has moved from an either/or proposition, which is considered the most elementalist perspective, to a holistic view of health where health is seen as a dynamic and interrelated system involving many factors. This transformation in health is certainly consistent with larger trends in physics, biology, and the social science towards holism. Quantum theory and systems theories played a significant role in helping the sciences to conceptualize the world in terms of interdependent relationships. Holism is now used to explain everything from organisms to ecosystems. Just as science has transformed, so too has health. Advances in medicine and technology have increased attention on health promotion and positive health. As the World Health Organization adopted the definition of health as involving the mind, body, and spirit, multiple disciplines have entered into the conversation about what constitutes optimal human functioning. However, the complexity and fragmentation surrounding our definitions of health and wellness have made it difficult for researchers to build upon prior empirical studies.

Methods:

The procedure for this study involved developing a packet of instruments, including two instruments each from the disciplines of health, wellness, and spirituality. An exploratory factor analysis was conducted using the subscales for each of the instruments to first consolidate factors with overlap, and to identify boundaries between distinctly different definitions. Second, results of the factor analysis were used to identify those factors that most strongly represent the construct of holistic health.

Results:

The findings indicated a 5-Factor Solution. The five factors were labeled: Environmental Engagement, Affect, Physical Functioning, Spiritual Connection, and Purpose and Resilience.

Conclusions:

The two compelling findings were first, constructs of health, wellness, and spirituality previously treated as unidimensional in the research literature, actually separated across factors. Second, subscales with similar labels across different health instruments were actually fragmented and had different meanings.

Implications for research and/or practice:

The results of this study has two primary benefits: improving research and informing healthcare reform. These five factors contribute to our understanding of health in the 21^st century and help practitioners shape instruments for holistic health research; thus, promoting organized progress in interdisciplinary communication. In turn, understanding significant indicators of health can help decrease health disparity and allow us to enhance population health.