From disease-focused care to wellbeing

Where healthcare used to focus primarily on treating symptoms, we now increasingly see attention for what makes life meaningful. Not only what someone is lacking is central, but also what someone needs to feel well.

This development aligns with insights from psychology, in which wellbeing is linked to the fulfilment of fundamental psychological needs.

The psychological foundation of positive health

A well-known theory in psychology states that people have three basic psychological needs: having meaningful social relationships, experiencing autonomy, and feeling competent (“self-determination theory’s basic psychological needs”, book: Intrinsic Motivation and Self-Determination in Human Behavior 1985, Deci and Ryan 1987). The theory suggests that there is a positive relationship between fulfilling these needs and experiencing positive feelings and thoughts (Baumeister and Leary 1995).

These positive feelings and thoughts ultimately lead to positive behaviour, such as greater intrinsic motivation, increased self-confidence, more participation, healthier lifestyle choices like a balanced diet and sufficient physical activity, and improved mental and physical wellbeing.

These health-promoting activities in turn stimulate positive feelings and thoughts. Ultimately, this leads to healthier living, rather than merely avoiding illness. The concept of positive health is grounded in this theory.

What exactly is the concept of positive health?

The concept of positive health was introduced in 2011 by Machteld Huber and colleagues and published in the British Medical Journal. Health is defined as:

The ability of people to adapt and to manage their own lives, in the face of physical, emotional and social challenges.

This definition emerged from international research, which showed that healthcare professionals often focused primarily on physical functioning, while patients experienced health much more broadly, including meaning, quality of life and social wellbeing.

Huber and colleagues also proposed that a holistic view of health can be organised into six dimensions:

1. Bodily functions, such as energy, fitness and physical functioning
2. Mental functions and perception, such as resilience, dealing with challenges and meaning
3. Spiritual and existential dimension, such as life goals and personal values
4. Social participation, such as meaningful relationships, participation in society and support from others
5. Quality of life
6. Daily functioning

These insights ultimately led to the concept of positive health and the development of a dialogue tool in which these six dimensions are discussed. Since then, this perspective on health has gained traction within contemporary healthcare.

Although there is ongoing debate among researchers about whether the concept is entirely new and about the validity of the proposed measurement instruments, there is broad agreement that the concept is highly applicable in practice. Making positive health personally meaningful helps people lead a meaningful, balanced and resilient life, even when living with chronic illness.

How can I foster a positive view of my own health?

1. Increase awareness of what truly matters
   Take time to focus on what gives your life meaning and energy. Ask yourself: “What gives me a sense of purpose, appreciation or connection?” Write down one activity that truly matters to you and plan time for it each week.

2. Work on daily resilience
   Try to accept that challenges are part of life and focus on how you respond to them. Instead of asking “Why is this happening to me?”, ask “What can I learn from this?”. Develop a strategy that helps you cope, such as focusing on your breathing, talking to someone, walking in nature, or writing your thoughts and feelings in a journal.

3. Care for your body as a foundation
   Physical wellbeing supports mental and emotional health. Do things that are good for your body. Start small and take achievable steps. Cycle a sunny route on Bike Labyrinth, go outside for a short walk if possible, or enjoy the sunshine under a warm blanket. Aim for regular, sufficient sleep and eat mindfully.

4. Strengthen and deepen social connections
   Positive health grows through contact with others. Meet with someone once a week for a conversation. Dare to ask for support and offer support when you can. This deepens social connection.

5. Focus on what is going well
   Train your awareness to focus on strengths and possibilities. Each day, name one thing that went well and that you feel grateful for. Acknowledge what went well and the effort you put into it, rather than focusing only on the end result.

6. Take responsibility and adjust goals when needed
   Positive health is about self-management and adaptability. Set small goals and reflect on them regularly without being critical of yourself, simply to adjust them to your situation if needed. If cycling for 15 minutes without interruption is not feasible, cycle for 15 minutes with breaks, or choose a shorter route. Bike Labyrinth offers a wide range of routes. Above all, enjoy the scenery, the sunlight and the sights.