By definition, holistic care addresses the whole person and not just medical diagnoses, test results, and vital signs. Communication is therefore a critical component in holistic care. The healthcare worker establishes rapport and empathy, gaining insight into the patient’s attitudes and perceptions of health, illness, and healthcare. Similarly, the healthcare worker inquires about the patient’s social network, their spiritual or religious values, and their goals in treatment.

Likewise, knowledge of the therapeutic relationship is an essential component of health promotion. The nature of the therapeutic relationship may differ for different members of the healthcare team, but all are based on fundamental ethical principles like autonomy and respect for privacy. For ideal health promotion goals, the therapeutic relationship needs to be built on trust and respect.

Communication takes place not just in face-to-face settings, but continually throughout the therapeutic relationship. Technology facilitates communication by allowing the patient to read and respond in their own time, and likewise offering the healthcare worker the chance to do the same. While digital communication does pose some challenges, and can lead to miscommunications, it is overall helpful in promoting patient care. Both the patient and the healthcare workers do need to set boundaries when using email, text, and other digital communication.

The nursing code of ethics governs the profession, providing the basis for standards of care and for core competencies. General ethical principles in nursing like respect, doing no harm, autonomy, beneficence, confidentiality, and privacy remain sacrosanct. Yet there are often grey areas and conflicts between multiple ethical principles. Contemporary issues in health promotion can often be resolved by analyzing the ethical principles at stake and determining which principle should take precedence, taking into account cross-cultural differences in values and the patient’s attitudes and beliefs.