title: The role of the spiritual dimension of the self as the prime determinant of health.
abstract: OBJECTIVE
  To present a clinical commentary on the relationship of spirituality to healthcare for those with chronic physical conditions.
  
  
  METHODS
  A spiritually based theory of self-identity was presented, based on selected literature to identify the process of health attainment for those with chronic conditions. The resultant Health Change Process Theory was then discussed in relation to relevant empirical research and the implications for rehabilitation practice were outlined.
  
  
  RESULTS
  The development of a resilient, intrinsic, spiritually based concept of self was found to be pivotal to health outcomes in rehabilitation. This was then incorporated within a Health Change Process Theory to explain and predict the course followed by people with chronic disorders to achieve health.
  
  
  CONCLUSIONS
  The Health Change Process Theory provides an inclusive framework within which acute and chronic rehabilitation healthcare can be merged to maximise health outcomes. Nevertheless, a need remains to develop a quantitative measure of individual holistic health, based on this theory, to facilitate its use in rehabilitation practice. This paper forwards an explanation for the process that people experiencing chronic physical disabilities undergo as they achieve health. A concept of self that identifies the spiritual core as the component that determines the constancy and continuity of self as a whole which is necessary for health is presented as the basis of the rehabilitative health process.
authors.affiliation: Queen Elizabeth Hospital, Rotorua, New Zealand.
authors.forename: K
authors.initials: K
authors.lastname: Faull
authors.forename: M D
authors.initials: MD
authors.lastname: Hills
mesh_terms: D000223:Adaptation, Psychological; D002908:Chronic Disease / Q000523:psychology* / Q000534:rehabilitation; D006262:Health; D006801:Humans; D012649:Self Concept; D029181:Spirituality