The converging paradigms of holism and complexity: An exploration of naturopathic clinical case management using complexity science principles

被引:4
作者
Graham, Kim D. [1 ]
Steel, Amie [1 ]
Wardle, Jon [2 ]
机构
[1] Univ Technol Sydney, Fac Hlth, Australian Res Ctr Complementary & Integrat Med, 15 Broadway St, Sydney, NSW, Australia
[2] Southern Cross Univ, Natl Ctr Naturopath Med, Lismore, NSW, Australia
关键词
case management; clinical reasoning; complexity science; primary health care; GUT-BRAIN AXIS; HEALTH-CARE; OUTCOMES RESEARCH; IMMUNE-SYSTEM; WHOLE SYSTEMS; MEDICINE; STRESS; MODEL; COMPLEMENTARY; CONSULTATIONS;
D O I
10.1111/jep.13721
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Rationale Traditional whole systems of medicine, such as naturopathy, are founded upon holism; a philosophical paradigm consistent with contemporary complexity science. Naturopathic case management is predicated upon the understanding of an intimately interconnected internal physiological and external context of the human organism-potentially indicating a worldview aligned with a complexity perspective. In this study we investigate naturopathic clinical reasoning using a complexity lens with the aim of ascertaining the extent of correspondence between the two. Method Mind maps depicting case presentations were sought from Australian degree qualified naturopaths. A network mapping was undertaken, which was then analysed in accordance with a complexity science framework using exploratory data analysis and network analysis processes and tools. Results Naturopathic case schematics, in the form of mind maps (n = 70), were collected, network mapped, and analysed. A total of 739 unique elements and 2724 links were identified across the network. Integral elements across the network were: stress, fatigue, general anxiety, systemic inflammation, gut dysbiosis, and diet. A modularity algorithm detected 11 communities, the primary ones of these representing the nervous system and mood; the gastrointestinal tract, liver, and nutrition; immune function and the immune system; and diet and nutrients. Conclusions Naturopathic case management is holistic and based on a perspective of an integrated physiology and external context of the human organism. The traditional concept of holism, when subjected to a complexity lens, leads to the emergence of a contemporary holistic paradigm cognisant of the human organism being a complex system. The application of complexity science to investigate naturopathic case management as employed in this study, demonstrates that it is possible to investigate traditional philosophies and principles in a scientific and critical manner. A complexity science research approach may offer a suitable scientific paradigm to develop our understanding of traditional whole systems of medicine.
引用
收藏
页码:662 / 681
页数:20
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