Research guidelines for assessing the impact of healing relationships in clinical medicine.

Full Abstract

This paper charts a course for assessing the impact of healing relationships in clinical medicine. The system of healing relationships is multidimensional, longitudinal, contextual, and emergent. In a new conceptual model, healing relationships are identified in terms of the conditions of healing intention, motivation, and information transfer, and in terms of the attributes of emotional engagement, mindfulness, and trust. Five components of quality in healing relationships--adaptability, cohesion, growth, caring-in-relation, and commitment--are noted, and the importance of timing, attunement, and cultural meaning systems are described. Communication, clinical method, caring, competence, and treatment characteristics are differentiated as mediating processes; expectancy and conditioning are positioned as antecedents of healing relationships. Multiple personal and contextual outcomes are addressed with a recommendation for assessing a minimal set of each, including symptom resolution, health status, sense of coherence, patient enablement, cost effectiveness, quality of care, efficiency, access, and healer satisfaction. A wheel of knowledge connects 3 ways of knowing--personal, connected, and objective--with appropriate methodology and research designs. Applying this wheel to the issue of assessing impact in healing relationships reveals the need for multiple methods, perspectives, and triangulations. A critical multiplist strategy is one means for advancing this area of research. A double-helix trial design is introduced, in which one strand consists of a standard quantitative approach and the other consists of qualitative methods. The 2 strands are bonded by the questions addressed and by the participants in the study.

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Author information

Author/s: Miller, William L (WL); Crabtree, Benjamin F (BF); Duffy, M Bridget (MB); Epstein, Ronald M (RM); Stange, Kurt C (KC);

Affiliation: Healing Relationships in Clinical Medicine Writing Group, Lehigh Valley Hospital and Health Network, Allentown, Pa., USA.

Journal and publication information

Publication Type: Journal Article

Journal: Alternative therapies in health and medicine (Altern Ther Health Med), published in United States. (Language: eng)

Reference: -2003 May-Jun; vol 9 (issue 3 Suppl) : pp A80-95

Dates: Created 2003/06/02; Completed 2003/07/17; Revised 2004/11/17;

PMID: 12776467, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

ErratumIn: Altern Ther Health Med. 2003 Sep-Oct;9(5):17.

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