the 6 principles of integrative nursing are used to frame the comparison of the two perspectives on whole - person / whole - systems health and wellbeing . these principles include ( 1 ) human beings are whole systems , inseparable from their environments ; ( 2 ) human beings have the innate capacity for health and wellbeing ; ( 3 ) nature has healing and restorative properties that contribute to health and wellbeing ; ( 4 ) integrative nursing is person - centered and relationship - based ; ( 5 ) integrative nursing is informed by evidence and uses the full range of therapeutic modalities to support / augment the healing process , moving from least intensive / invasive to more , depending on need and context ; and ( 6 ) integrative nursing focuses on the health and wellbeing of caregivers as well as those they serve . in din teachings , to live in a state of hzh requires conscious awareness of the collective and interrelated relationships between self and others . others are broadly defined and include the universal whole : ( 1 ) the elements of nature , including animals and insects ; ( 2 ) the creator ; ( 3 ) the din holy people ; ( 4 ) spirits ; ( 5 ) mother earth ; ( 6 ) father sky ; and ( 7 ) the distinct characteristics and cycles within nature and the universe such as seasons , night , day , sun , moon , stars , time . the conscious awareness of this inseparable interrelatedness between human beings and their environment establishes an ownership with responsibility to honor and respect each aspect of ourselves and our inseparable connections to nature and the universe . the inseparable nature between humans and the universal whole lends to the reality of a pre - existing network of internal , external , and existential support for each human being . these relational systems ( self , relatives , community , healthcare , healing systems , healers , nature and the environment , culture , and spirits ) support human beings on physical , mental , emotional , spiritual , and existential planes to meet our biopsychosocialspiritual needs . recognizing the existence and availability of these supportive entities is critical to establishing and maintaining health and wellbeing . hzh is built on positive certainties of the innate capacity of each individual to achieve wholeness , happiness , health , balance , harmony , and ultimate wellbeing through attentive conscious practice of the hzh attributes . the hzh teachings emphasize the utmost sacredness of the collective human body - mind - spirit that is naturally situated within the healing resources of the environment ( eg , family , community , spirits , nature , animals ) . hzh becomes disrupted as a result of irresponsible thoughts , speech , or behavior , resulting in disharmony , or hchx , which is manifested as chaos , ignorance , evil , sadness , grief , disharmony , imbalance  all that is contra to hzh . however , the din belief in the human being 's innate ability and capacity to heal empowers those experiencing hchx with the hope of re - establishing individual , community , and environmental health through conscious participation in the process to attain hzh . a din restorative healing ceremony based on the hzh teachings is the hzhji ( blessing way ) ceremony . the hzhji ceremony is performed when one needs additional support from a healer , the extended family , spirits , nature , and the din holy people to re - establish a state of hzh . hzh recognizes and honors the healing energy and restorative properties of nature and the universal whole . the hzh teachings insist on a high regard for animals , living creatures , nature , and elements of the earth because of their influence ( both negative and positive ) on the health and wellbeing of human beings . recognizing that animals , all living creatures , and elements of nature ( water , minerals , plants , air ) serve as sources of food , shelter , spiritual guidance , and spiritual healing , the din people hold them as sacred . din and american indian ( ai ) healing ceremonies incorporate elements of nature ( plants , herbs , air , fire , water , earth ) , living animals and living creatures , and nonliving animal essence ( feathers , hides , bones , and tissue ) to cleanse , purify , and restore optimal body - mind - spirit wellbeing . likewise , the din make sacred offerings to animals and nature to honor their interdependent relationship and express gratitude for their support , ensuring day - to - day opportunities for the healing exchanges and interactions . the teachings of hzh stress the importance of nurturing and sustaining relationship with self and others through respectful thought , speech , and behavior . relationship with self is viewed as most critical , requiring full understanding of the sacred nature of the collective body - mind - spirit . when the sacred miracle of self is fully embraced , the person operates from a grounded , person - centered perspective and is prepared to extend the honor to external relationships that are not limited to other human beings ; the din often extend relationships to animals , spirits , and elements of nature . constant practice of respect for self and others helps a person master the teachings of hzh and an awareness of the differences between positive , nurturing relationships and negative , destructive relationships . recognizing the sacredness of self enables recognition of the sacredness of others , thus establishing the essential , interdependent , dynamic nature of relationships that are viewed as sources of stability and support . ai cultural teachings imply that relationships are everlasting , undergoing only temporary disruptions at times of separation , death , or physical absence . when a relationship becomes disrupted , the disruption impacts the collective unified whole , including friends and distant relatives , pets and animals , the collective environment , and perhaps even spiritual ancestors and future generations . hzh teachings remind us of the often forgotten relationships between living beings , elements of nature , and inanimate objects , such as the relationship one has with his or her home or with sacred items such as protective stones and arrowheads . the din honor their relationship with the home by blessing and showing gratitude for the home . recognizing the sacred protective and sheltering properties of homes , the din bestow honor and respect on the home through song and action . homes are often adorned with objects that protect the home and the people , animals , inanimate objects , and spirits within . the effort of maintaining relationships is constant , a grounding force that promotes individual , spiritual , and collective health and strength . generosity and reciprocity are significant in hzh philosophy and precious gem ( white shell , turquoise , abalone , and jet ) and corn offerings are symbolic of the honored relationships between humans and mother earth , father sky , lightning , the sun , the moon , the creator , and the holy people . likewise , reciprocal exchanges of support , food , gifts , love , compassion , and respect are viewed as a means of maintaining relationship . honoring , preserving , sustaining , and nurturing positive and healthy interdependent relationships may be the richest source of internal , external , and existential health protection attained through the practice of din hzh . integrative nursing is informed by evidence and uses the full range of therapeutic modalities to support / augment the healing process , moving from least intensive / invasive to more , depending on need and context . the survival and transfer of the hzh philosophy across generations of din serve as evidence of the value and significance of these teachings for the health and wellbeing of the din . because hzh philosophy embraces all mechanisms that lead to wellbeing , the full range of therapeutic healing modalities ( eg , western medicine , ai medicine , ai spiritual healing , ai healing ceremonies , complementary and alternative health options ) that support the attainment of physical , mental , spiritual , emotional , social , and environmental wellbeing align with the goal of hzh . there remains limited western scientific evidence to confirm the health protective benefits of ai cultural wisdom ; however , emerging scientific literature does support and recognize the validity of indigenous ways of knowing as a source of rigorous and relevant knowledge relevant for the improved health of indigenous people . the ways in which american indians and indigenous people view and approach knowledge differ from the ways in which western scientific , evidence - based knowledge is viewed and approached . indigenous knowledge is shared , transmitted orally , role - modeled , and often received interpersonally or through spiritual processes , ceremony , interpretation of symbols and divination , and through dreams and visions . indigenous knowledge in the form of culture , stories , chants , song , and prayer is also thought to be alive , and the sharing of this knowledge requires levels of care and respect in the exploration and transmission of the knowledge . harvey emphasizes the need for a constructive synthesis of differing worldviews , ideologies , and technologies through the application of indigenous wisdom as a means to improve the health of indigenous populations . the evidence supporting hzh as a health - sustaining philosophy is apparent in the survival of the din as well as in the survival of the oral teachings and patterned behaviors of the din . these patterns of din thought , speech , and behavior have endured for generations , despite the historical traumatic events of the past . yet to improve the health of the din , the tenets of hzh philosophy must be explored , understood , correctly translated , and conveyed to the people using methods such as storytelling , talking circles , or broadcasting via older ( radio ) and contemporary ( social networking ) media  communicating the significant benefits of the ancient , time - honored hzh wisdom to all generations of din as well as all individuals interested in sharing in this valuable health - sustaining knowledge . when the din seek and receive healing in the form of ceremony , prayer , or medical care , hzh principles require them to show gratitude for the healing by presenting a token , a gift , or a ceremonial offering to the healer , which may include the caregiver , nature , holy people , or the creator . this offering not only represents gratitude for the healing received but also serves as a protective shield of energetic intention ; the recipient of the healing provides a method to ensure the safety and protection of the healer , whose service is sometimes hazardous and exhausting . this offering demonstrates the recipient 's genuine concern for the wellbeing of the healer or caregiver ; the health of the individual seeking healing and the health of the healer providing the healing service are both valued within the hzh philosophy . in din teachings , to live in a state of hzh requires conscious awareness of the collective and interrelated relationships between self and others . others are broadly defined and include the universal whole : ( 1 ) the elements of nature , including animals and insects ; ( 2 ) the creator ; ( 3 ) the din holy people ; ( 4 ) spirits ; ( 5 ) mother earth ; ( 6 ) father sky ; and ( 7 ) the distinct characteristics and cycles within nature and the universe such as seasons , night , day , sun , moon , stars , time . the conscious awareness of this inseparable interrelatedness between human beings and their environment establishes an ownership with responsibility to honor and respect each aspect of ourselves and our inseparable connections to nature and the universe . the inseparable nature between humans and the universal whole lends to the reality of a pre - existing network of internal , external , and existential support for each human being . these relational systems ( self , relatives , community , healthcare , healing systems , healers , nature and the environment , culture , and spirits ) support human beings on physical , mental , emotional , spiritual , and existential planes to meet our biopsychosocialspiritual needs . recognizing the existence and availability of these supportive entities is critical to establishing and maintaining health and wellbeing . hzh is built on positive certainties of the innate capacity of each individual to achieve wholeness , happiness , health , balance , harmony , and ultimate wellbeing through attentive conscious practice of the hzh attributes . the hzh teachings emphasize the utmost sacredness of the collective human body - mind - spirit that is naturally situated within the healing resources of the environment ( eg , family , community , spirits , nature , animals ) . hzh becomes disrupted as a result of irresponsible thoughts , speech , or behavior , resulting in disharmony , or hchx , which is manifested as chaos , ignorance , evil , sadness , grief , disharmony , imbalance  all that is contra to hzh . however , the din belief in the human being 's innate ability and capacity to heal empowers those experiencing hchx with the hope of re - establishing individual , community , and environmental health through conscious participation in the process to attain hzh . a din restorative healing ceremony based on the hzh teachings is the hzhji ( blessing way ) ceremony . the hzhji ceremony is performed when one needs additional support from a healer , the extended family , spirits , nature , and the din holy people to re - establish a state of hzh . hzh recognizes and honors the healing energy and restorative properties of nature and the universal whole . the hzh teachings insist on a high regard for animals , living creatures , nature , and elements of the earth because of their influence ( both negative and positive ) on the health and wellbeing of human beings . recognizing that animals , all living creatures , and elements of nature ( water , minerals , plants , air ) serve as sources of food , shelter , spiritual guidance , and spiritual healing , the din people hold them as sacred . din and american indian ( ai ) healing ceremonies incorporate elements of nature ( plants , herbs , air , fire , water , earth ) , living animals and living creatures , and nonliving animal essence ( feathers , hides , bones , and tissue ) to cleanse , purify , and restore optimal body - mind - spirit wellbeing . likewise , the din make sacred offerings to animals and nature to honor their interdependent relationship and express gratitude for their support , ensuring day - to - day opportunities for the healing exchanges and interactions . the teachings of hzh stress the importance of nurturing and sustaining relationship with self and others through respectful thought , speech , and behavior . relationship with self is viewed as most critical , requiring full understanding of the sacred nature of the collective body - mind - spirit . when the sacred miracle of self is fully embraced , the person operates from a grounded , person - centered perspective and is prepared to extend the honor to external relationships that are not limited to other human beings ; the din often extend relationships to animals , spirits , and elements of nature . constant practice of respect for self and others helps a person master the teachings of hzh and an awareness of the differences between positive , nurturing relationships and negative , destructive relationships . recognizing the sacredness of self enables recognition of the sacredness of others , thus establishing the essential , interdependent , dynamic nature of relationships that are viewed as sources of stability and support . ai cultural teachings imply that relationships are everlasting , undergoing only temporary disruptions at times of separation , death , or physical absence . when a relationship becomes disrupted , the disruption impacts the collective unified whole , including friends and distant relatives , pets and animals , the collective environment , and perhaps even spiritual ancestors and future generations . hzh teachings remind us of the often forgotten relationships between living beings , elements of nature , and inanimate objects , such as the relationship one has with his or her home or with sacred items such as protective stones and arrowheads . the din honor their relationship with the home by blessing and showing gratitude for the home . recognizing the sacred protective and sheltering properties of homes , the din bestow honor and respect on the home through song and action . homes are often adorned with objects that protect the home and the people , animals , inanimate objects , and spirits within . the effort of maintaining relationships is constant , a grounding force that promotes individual , spiritual , and collective health and strength . generosity and reciprocity are significant in hzh philosophy and precious gem ( white shell , turquoise , abalone , and jet ) and corn offerings are symbolic of the honored relationships between humans and mother earth , father sky , lightning , the sun , the moon , the creator , and the holy people . likewise , reciprocal exchanges of support , food , gifts , love , compassion , and respect are viewed as a means of maintaining relationship . honoring , preserving , sustaining , and nurturing positive and healthy interdependent relationships may be the richest source of internal , external , and existential health protection attained through the practice of din hzh . integrative nursing is informed by evidence and uses the full range of therapeutic modalities to support / augment the healing process , moving from least intensive / invasive to more , depending on need and context . the survival and transfer of the hzh philosophy across generations of din serve as evidence of the value and significance of these teachings for the health and wellbeing of the din . because hzh philosophy embraces all mechanisms that lead to wellbeing , the full range of therapeutic healing modalities ( eg , western medicine , ai medicine , ai spiritual healing , ai healing ceremonies , complementary and alternative health options ) that support the attainment of physical , mental , spiritual , emotional , social , and environmental wellbeing align with the goal of hzh . there remains limited western scientific evidence to confirm the health protective benefits of ai cultural wisdom ; however , emerging scientific literature does support and recognize the validity of indigenous ways of knowing as a source of rigorous and relevant knowledge relevant for the improved health of indigenous people . the ways in which american indians and indigenous people view and approach knowledge differ from the ways in which western scientific , evidence - based knowledge is viewed and approached . indigenous knowledge is shared , transmitted orally , role - modeled , and often received interpersonally or through spiritual processes , ceremony , interpretation of symbols and divination , and through dreams and visions . indigenous knowledge in the form of culture , stories , chants , song , and prayer is also thought to be alive , and the sharing of this knowledge requires levels of care and respect in the exploration and transmission of the knowledge . harvey emphasizes the need for a constructive synthesis of differing worldviews , ideologies , and technologies through the application of indigenous wisdom as a means to improve the health of indigenous populations . the evidence supporting hzh as a health - sustaining philosophy is apparent in the survival of the din as well as in the survival of the oral teachings and patterned behaviors of the din . these patterns of din thought , speech , and behavior have endured for generations , despite the historical traumatic events of the past . yet to improve the health of the din , the tenets of hzh philosophy must be explored , understood , correctly translated , and conveyed to the people using methods such as storytelling , talking circles , or broadcasting via older ( radio ) and contemporary ( social networking ) media  communicating the significant benefits of the ancient , time - honored hzh wisdom to all generations of din as well as all individuals interested in sharing in this valuable health - sustaining knowledge . when the din seek and receive healing in the form of ceremony , prayer , or medical care , hzh principles require them to show gratitude for the healing by presenting a token , a gift , or a ceremonial offering to the healer , which may include the caregiver , nature , holy people , or the creator . this offering not only represents gratitude for the healing received but also serves as a protective shield of energetic intention ; the recipient of the healing provides a method to ensure the safety and protection of the healer , whose service is sometimes hazardous and exhausting . this offering demonstrates the recipient 's genuine concern for the wellbeing of the healer or caregiver ; the health of the individual seeking healing and the health of the healer providing the healing service are both valued within the hzh philosophy . recognizing that the 566 federally recognized american indian / alaska native ( ai / an ) tribes in the united states are strikingly different in their own culture , geographic region , language , dress , food , ceremonies , philosophies , beliefs , and teachings , we believe that the din hzh wellness philosophy provides an important example of one tribal philosophy on wellness . sharing the din hzh philosophy re - introduces this philosophy to the din while informing other ai / an nations , global indigenous cultures , and even nonindigenous people of the world who may benefit from these health - sustaining lifeways . though this wisdom comes from the din , it is offered as a prompting framework for other ai / an tribes , villages , pueblos , and indigenous people of the world to explore , reexamine , and bring forth their own distinct and innate wellness philosophies as mechanisms for health promotion . for the indigenous populations who may have lost elements or the entirety of their own distinct cultural wisdom due to historical adversities of the past , the 6 tenets of the hzh wellness philosophy are intertribally relevant because of the vast cultural similarities of our people . in addition , the attributes of the hzh philosophy are universally relevant to all individuals and communities or agencies that may be interested in novel or ancient ways to promote the health and wellbeing of the people of the world . the hzh wellness philosophy and the hzh resilience model ( figure ) also serve as frameworks through which more biomedically focused healthcare providers can become acquainted with cultural world - views of ai / an people . it is important to keep in mind that these frameworks provide only a brief glimpse into a differing cultural worldview ; integrate this ai / an cultural wisdom with care and caution . remember , the ai / an worldview honors knowledge , stories , and cultural wisdom as sacred entities ; when we fold it into our clinical settings , we should do so with honor and respect by including ai / an cultural experts as part of the planning and implementation process . this cautionary approach communicates our understanding and our respect of the cultural values and ensures accurate implementation of unique culturally tailored approaches for wellbeing and health . the stunning alignment of integrative nursing principles and the hzh wellness philosophy illustrates the power of the integrative nursing meta - theoretical perspective and how we can transform healthcare delivery , moving us from parallel healthcare systems ( indigenous and biomedical ) to a healthcare system that is inclusive and responsive to the needs of our varied populations . ai cultural wisdom is essential to the well - being of the din and all indigenous populations who experience considerable health disparities that have not been adequately addressed by current biomedical efforts . the collective literature on ai / an culture consistently emphasizes the health - protective nature of shared intertribal cultural wisdom across ai / an tribes , villages , and pueblos . and it is critical that we embrace the benefits of cultural wisdom while recognizing the inherent wholeness that can be used as a valuable alternative to or in combination with biomedicine . removing someone 's cultural wisdom is destructive and leaves an existential hole in the body - mind - spirit , creating vulnerabilities to physical , mental , and social ills . ongoing refusal of our health - care system to acknowledge the need for and benefit of our cultural practices and health beliefs continues to inflict the trauma of our past , adding to the chronic stress that has resulted from historical traumas and attempts to eradicate our culture . integrative nursing offers the opportunity to re - introduce cultural wellness wisdom , such as the din hzh philosophy , as a means to improve the health of individuals . integrative nursing , through the acceptance and validation of indigenous health - sustaining wisdom , contributes to the delivery of effective , authentic , culturally tailored , whole - person and whole - system patient - centered , relationship - based healthcare . this article began with an excerpt from the the fundamental law of the navajo nation , which reminds us of the diversity of the world while also reminding us of the importance of the individual yet distinct needs of each culture . as individuals , we must never forget how we embody the origins of our cultures and that it is only natural that our healing mechanisms should embody the wealth of rich and diverse healing wisdom . integrative nursing offers the scientifically based platform that will bring forth increased collaboration among healers and healthcare providers and will transform healthcare delivery that is focused on the health and wellbeing of the biopsychosocialspiritual beings of the world . hzh nahasdl : happiness , health , harmony , peace , wellbeing , beauty , and all that is good  restored .
hzh is the complex wellness philosophy and belief system of the din ( navajo ) people , comprised of principles that guide one 's thoughts , actions , behaviors , and speech . 
 the alignment of integrative nursing principles and the hzh wellness philosophy illustrates the power that integrative nursing offers as a meta - theoretical perspective that can transform our healthcare system so that it is inclusive and responsive to the needs of our varied populations . 
 integrative nursing offers the opportunity to re - introduce cultural wellness wisdom , such as hzh , as a means to improve whole - person / whole - systems wellbeing and resilience . 
 integrative nursing , through the acceptance and validation of indigenous health - sustaining wisdom , contributes to the delivery of effective , authentic , culturally tailored , whole - person / whole - system , patient - centered , relationship - based healthcare . 
 highlighting the din hzh philosophy re - introduces this philosophy to the din , other american indian / alaska native nations , global indigenous cultures , and even nonindigenous people of the world as a means to promote and sustain global health and wellbeing .