Healthcare continues to advance, and treatments that were once only dreamed of have become mainstream. Today's healthcare provision could be perceived as requiring only the prescribed medication and a series of technological skills that are performed competently and supported by evidence. Yet, at the heart of healthcare encounters are issues that are as complex as the treatments, requiring a vision of the whole person as an individual human being.
We are reminded that the World Health Organization (WHO) defined health as a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity (WHO, 1946). Despite some challenges to this definition (Huber et al, 2011), the facets of health outlined remain universal and relevant, and have not been suitably amended or replaced; physical, mental and social attributes are still beneficial divisions of health. At the time of the WHO publication, attitudes to public health were challenged by this holistic but theoretical definition of health, marking a departure from a disease-oriented physical, biomedical and expert-dominated view of health. It is opportune to be reminded that the emphasis of the definition was that health is greater than a physiological and medical issue.
The features in this issue of the BJCN support a whole-person view (physical, mental and social) of health and the lay perceptions necessary for meeting the complex needs of patients and their families. Lay perceptions are defined as the implicit mental representations of phenomena held by everyday people (Downey and Chang, 2013) and act as a useful adjunct to the WHO definition. Lay concepts of health and illness are different to biomedical definitions and, therefore, add further complexities to the treatment and prevention of illness (Breakwell, 2000; Hunt et al, 2001). A paper in this issue presents a model of community nursing services piloted in London, based on the Dutch Buurtzorg organisation (Buurtzorg, 2019), which strives to put humanity before bureaucracy while meeting the real (lay) health and social needs of people.
Personal definitions of health vary; however, lay people and health professionals would agree that individuals are greater than a mechanistic human body with moving parts that sometimes go wrong or wear out. A return to views of health before the WHO (1946) definition would be a retrograde step for healthcare; the needs of the whole person must be addressed, not only physiological and medical concerns. In all healthcare interactions, the synergy of the dimensions of health and the opinions of both the lay person and the professional need to be acknowledged. Whole-person healthcare must continue to be embraced, with teaching and role modelling imprinting this philosophy on the next generation of health professionals. And, of course, medical advancements and technology must be symbiotically entwined within the provision of whole-person healthcare.