A Systematic Review of Randomized Controlled Trials on Interventions Adopting Body-Mind-Spirit (BMS) Model on Holistic Well-Being

Abstract

Background This systematic review aims to examine existing randomized controlled trials on interventions adopting Body-Mind-Spirit (BMS) model and evaluated the effectiveness of holistic well-being outcomes. Following three key concepts of the BMS model, our review questions included (1) How was BMS defined? (2) What activities were included, and how were they related to BMS dimensions? (3) What were interventionists’ backgrounds, and whether they received BMS training? (4) What were holistic outcomes? and (5) What were the effectiveness and qualities of studies? Methods Searches were performed using nine databases for the studies published through August 2020. The process follows PRISMA protocol, and the “risk of bias” tool from the Cochrane Handbook was utilized to determine the quality of included studies. Results Across 20 included studies, 18 (90%) presented a BMS definition, but only seven (35%) included all three key concepts of the BMS model. Eight studies (40%) offered detailed descriptions of body, mind, and spirit sections, and 12 (60%) mentioned cultural factors. Only five (25%) specified the body, mind, and spirit activities, and only three (15%) reported the BMS training in detail. Seven studies (35%) showed effectiveness in holistic outcomes. Only three (15%) were considered as high quality. Conclusion A unified definition of the BMS model and the guideline to apply the BMS model to design and implement interventions are highly recommended to provide a standard framework for researchers to conduct future studies. The reason for low quality is because the lack of adequate allocation concealment and blindings.

Effects of a biopsychosocial‐spiritual group therapy on quality of life among institutionalized older adults with disabilities: A randomized controlled trial

“…The traditional biomedical care approach has been insufficient to meet the complex needs of senior residents living with long-term multimorbidity and irreversible disability (Li et al, 2022). Shifting from the symptomatic treatment model, the importance of holistic health care within residential care settings has been widely recognized nowadays.…”

“…Shifting from the symptomatic treatment model, the importance of holistic health care within residential care settings has been widely recognized nowadays. 'Whole person' or holistic health is defined as an internal balance between body, mind, spirit and social well-being, even co-existing with the presence of a disease or impairment (Li et al, 2022). Current trends of an integrative approach to holistic care, as the defining feature of general practice, addresses not only an individual's biological but also his/her psychological, social, spiritual and ecological dimension (Thomas et al, 2018).…”

“…Our findings also showed significant improvement on intervention group participants' 'psychological/spiritual wellness' QoL and meaning in life; such psycho-spiritual intervention effect can also be maintained for at least 1 month. Previous empirical studies have confirmed the effects of body-mind-spirit integrated therapy to enhance mental health and spiritual well-being (Chan et al, 2006;Li et al, 2022). This effectiveness derives from incorporating core activities, based on mental and spiritual components of the BPS-S model, including sharing current life challenges, life storytelling, promise of forgiveness and letting go.…”

“…First introduced in 1977, the bio‐psycho‐social model has provided a theoretical foundation for proactive and holistic care—and psychological and social factors jointly contributed to illness rather than only giving primacy to biological factors (Engel, 1977). Holistic, whole person and bio‐psycho‐social terminology have thus been used interchangeably in literatures (Li et al, 2022), despite the concepts of whole person and holistic health were believed to be more comprehensive than bio‐psycho‐social care (Thomas et al, 2018). Sulmasy (2002) further expanded from this basis (Engel, 1977; White et al, 1996) through encompassing the spiritual aspect.…”

“…However, several implementation issues remain: first, there has been a lack of consensus on the kinds of activities to be included in the intervention that applied body‐mind‐spirit approaches. Currently, activities within intervention schemes do not necessarily cover all body‐psycho‐social dimensions or link to each dimension (Li et al, 2022), and dynamic interaction and connection as the core between each dimension may not be properly addressed in the design of intervention activities. Second, it may be questionable whether those chosen outcome indicators can accurately reflect the overall effectiveness of the holistic approach, since most studies chose only physical or mental health outcomes but not the holistic ones, such as whole person wellness or QoL (Lee et al, 2018; Li et al, 2022).…”