The Holistic Assessment:
Psychological, Physiological, Cultural, Spiritual and Psychosocial
Wilfredo Mamaril
Sternberg College

The holistic assessment is an essential component of quality care that allows a psychiatric nurse to identify, diagnose and treat their patients based on every individual’s specific needs. A comprehensive assessment of a client’s health across multiple dimensions, such as their physiological, psychological, spiritual, cultural and psychosocial domains, are important “prerequisites for formulating an appropriate nursing diagnosis and plan of care” (Carniaux-Moran) particular to each patient. This assessment is achieved through interviews and assessments between the nurse and the client that “[varies] according to the state of the participants and the context in which the interview takes place” (Carniaux-Moran). It assists a nurse towards a more proficient and thorough diagnoses.
For one, it is vital to consider a client’s past and present physical condition in order to determine if any of these medical disorders have an impact on their mental health. For example, patients who present symptoms for some common psychiatric illness such as nervousness, irritability and insomnia, can actually be suffering from underlying medical condition such as hypothyroidism or low lithium levels. In order to overcome the shortcomings of the visual observation of symptoms, nurses often perform a medical workup to rule out organic illnesses and ensure that the client is well enough to undergo psychopharmacologic and psychiatric treatments. This medical workup consists of physical examinations, clinical laboratory tests such as serum and urine tests, vital sign assessments, liver and thyroid function tests, and specialized diagnostic procedures like MRI, EEG and PET scans. All this is to ensure that the patient is suffering from a psychiatric illness, as