Measuring Whole Person Health

Objective

To review proposed Whole Person Health (WPH) domains and existing WPH measurement instruments. Introduction: WPH clearly involves multiple domains (e.g., physical, mental, spiritual). To date, however, there is little consensus on which domains should be included in WPH, and WPH as an outcome is often conflated with WPH determinants (i.e., whole-person care). We conducted a scoping review of conceptual domains and existing WPH measurement instruments.

Eligibility Criteria

Peer-reviewed articles and gray literature published from January 2014 to December 2023 that included a theoretical model or empirical measure of self-reported "whole person health" were reviewed. Theoretical/conceptual sources and empirical studies with observational or intervention study designs, including adults 18 or older, were eligible for inclusion. Studies focusing on pediatric populations, educational and personality constructs, and whole health systems of care without mentioning WPH were excluded.

Methods

We searched five databases (PubMed, CINAHL, PsycINFO, ERIC, and Web of Science) and Google Scholar for peer-reviewed articles and gray literature published in English. Two research team members screened articles and extracted study characteristics. Results describe WPH conceptual domains, published self-report measures, and their psychometric properties.

Results

Our search identified 1143 unique sources, with 29 deemed eligible for review. Eleven conceptual articles mentioned four to six of seven total WPH domains each: biological/physical, behavioral/mental, social, environmental, spiritual, socioeconomic, and individual/other. Our search identified six WPH measures. All six WPH measures included assessments of the biological/physical, behavioral/mental, social, and spiritual domains, and all the conceptual WPH domains were assessed by at least one self-report measure. The self-report measures had a stronger emphasis on the assessment of spirituality and individual domains relative to the conceptual models and were less likely to include assessments of environmental and socioeconomic domains.

Conclusions

The results of this scoping review provide a greater understanding of the domains involved in WPH as a multidimensional construct. Although no existing WPH measures are suitable for broad use, their structural commonalities imply that WPH measure development efforts should consider the assessment of physical, mental, social, spiritual, and individual domains.