Healing is a commonly used term, and yet rigorous
research on the definition and meaning of healing has
been published infrequently, and understanding of the
concept remains confusing and inexact. Clinicians and
patients are overwhelmed with a healthcare system
focused on disease over health creation, reductionist,
fragmented, costly, and often ineffective. In response,
there has been an increasing recognition that quality
healthcare and the delivery of that care need to take a
more holistic, patient-centric approach, an approach that
emphasizes healing as important as curing. In 2004,
Samueli Institute, Alexandria, Virginia, proposed a whole-
system, healing-focused framework for delivering care
and coined the term optimal healing environments (OHE).
An OHE is comprised of people in relationships, their
health-creating and healing behaviors, and the
surrounding physical environment. An OHE supports and
stimulates patient healing by addressing the social,
psychological, physical, spiritual, and behavioral
components of healthcare, enabling the person's innate
capacity to heal. The OHE framework ( Figure ) is
composed of 4 domains or integrated environments that
reinforce each other by acting synergistically. Each
environment is applicable on a personal level to the
important relationships in our lives and to the
organizations and physical environments where we work,
play, and receive healthcare.
Figure
Optimal Healing Environments framework.
Originally developed by consensus of experts, the OHE
framework evolved over the past decade through insight
gained at exemplar organizations and practices, and new
information generated through research activities. The
individual constructs as described lacked operational
definitions to guide measurement. The research team
wanted to create operational definitions for each of the
concepts in the OHE framework to inform future research
and facilitate measurement and evaluation of the
concepts. Since healing is the desired outcome of an OHE
and is central to all other constructs in the framework,
the research team made the decision to subject healing to
concept analysis methodology. The aim of this article is to
describe the use of a rigorous methodology, concept
analysis, to clarify the meaning of healing and propose an
operational definition of healing in order to further the
scientific understanding and translation of OHEs into
practice.
