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The field of health care has gradually become a replete of international interests with professionals and affiliate members of this sector increasingly enhancing the literature in the health care sector. Several terminologies and concepts have emerged as crucial aspects in the health care field with each of them carrying an important message (Bertuglia & Vaio, 2005). Currently, contrary to the traditional practices where medical departments had little knowledge on public health research, much has changed with healthcare research practices guided cognitively, rationally, and factually providing essential facts to public health. In this context, according to Resnicow and Scott (2008), health behavior change in the current system is becoming understandable “through the lens of chaos theory and complex adaptive systems” (p. 1382). Through the constantly changing paradigms in the health care sector, complexity and chaos are two essential terminologies that have increasingly become paramount in public health vocabulary. This essay seeks to provide comparative literature on complicated, chaos, and complexity as important expressions in the health care system.
Overview of these terminologies
The three terminologies, viz. complicated, chaos, and complexity, which carry different concepts in the field of Medicare, are equally core features of the health systems. Complicated is a terminology resulting from situational analysis in the health care science useful in explaining how the natural appearance of biological beings remains unprecedented (Bertuglia & Vaio, 2005). Complexity also carries a similar message broadening on the uniqueness of the natural state of biological, chemical, and mathematical science. According to (Sweeney & Griffiths, 2002), the complexity model perceives systems as dynamic in the sense that they change with time in a way that is dependent on previous circumstances. Chaos on the other hand is a health care terminology and a subset of complexity science that describes the complicated random behavior from diverse agents due to either time of great change or crisis (Sweeney & Griffiths, 2002). However, the terms remain unknown to many people even those in the field of health care.
Despite having different definitions in their meanings, the three terminologies possess some similarities in their dynamism in the health care system. Similarly, “both chaotic and complex systems form real examples of nonlinear dynamical systems” (Pearce & Merletti, 2006, p. 517). Both complex and chaotic systems are nonlinear and have feedback loops in the sense that small changes can possess significant striking effects that one cannot understand simply by analyzing each component individually. Bertuglia and Vaio (2005) posit that under the nonlinearity condition, they are both sensitive to initial conditions where two similar states together can initially follow different directions over time. Within the health care field, Resnicow and Scott (2008) find the two principles indispensable in understanding dynamics in health behavior and nursing in particular, where changes in health care involve linear quantum occasions, chaotic processes sensitive to initial conditions, and they occur in a complex adaptive system.
Another significant similarity of these terminologies and their respective systems is in the aspect of their properties. In simpler terms, complex, chaotic, and complicated systems both possess the aspect of emergent properties, where the three concepts can result from different or diverse ways. Hobbs and Manyon (2007) posit, “The three principle systems have the characteristic of emergent properties where they are unexplainable using linear models of either causality or interaction” (p. 565). Complexity studies undertaken to distinguish and simulate the three concepts in the health care system reveal that these science approaches consider emergent phenomena arising from an interface of several different factors including psychological, biological, social, technological, and even environmental. For instance, as postulated by Hobbs and Manyon (2007), interactions between patients and physicians encompass emergent properties that neither the patient nor the doctor can determine, “but develops through their interchange” (p. 565). A similar situation is eminent in nursing where management in this field involves controlling emergent behavior during a crisis.
Differences in the three concepts, viz. complicated, complexity, and chaos are coherent from their initial meanings and definitions where each of them carries a significantly different connotation. Rickles, Hawe, and Shiell (2007) posit, “Complex systems are highly composite ones, built up from very large numbers of mutually interacting subunits” (p. 933), where repeated relations result in influential collective behaviors with appropriate feedback to the individual parts. Chaotic systems have very few interacting subunits interacting in a way to produce intricate dynamics. Finally, complicated systems are capable of having several interacting subunits, but only play specific functional roles and follow simple guidance rules. In this context, the complex system differs from the rest since it is capable of surviving the removal of some of its parts by adapting to existing changes in the environment. For instance, Anderson and McDaniel (2002) found workers could adapt to changes in the health care setting, where removal of a single worker in a health care organization can force others to adapt to compensate.
Compared to the other two systems, the complex system has several differences that are more independent and significant. Complex adaptive systems generally differ from chaotic and complicated systems in the sense that the complex adaptive system bases its operations under conditions distant from equilibrium, as opposed to complex adaptive systems (Guerrini & Spagnuolo, 2004, p. 86). In nursing, individual behaviors are normally independent. Apart from being passively able to respond to events and situations, complex adaptive systems are capable of reorganizing themselves to form a new equilibrium. Contrary to this aspect, chaotic and complicated systems operate relatively on unstable equilibrium, thus susceptible to simple interferences. Similar situations are eminent in the biological and social parts of living things. Pearce and Merletti (2006) assert, “The brain reorganizes itself to learn from experience, species evolve to achieve a new ecosystem in response to events such as climate change or meteor strikes, and populations evolve in response to economic and social changes” (p. 515). This aspect simply explains that complexity system is diverse and cannot change simply by changing one of its components, thus it exhibits self-organization.
Chaotic systems differ from the complex adaptive system is another unique, but factual manner known as “attractiveness”. There exists principally two major characteristics of attractiveness namely fixed points and limit cycles. The fixed point is an attractor that does not move whereas limit cycles describe an attractor (based on a system) that rotates periodically over the equivalent set of states and by no means comes to rest. Chaotic systems “have strange attractors while on the contrary, complex systems possess evolving phase with a range of possible attractors” (Rickles, Hawe, & Shiell, 2007, p. 936). These concepts under the two paradigms are significantly applicable in health care science. Precisely, they apply mostly in biomedical science where general research and investigation on the two concepts associate chaos system with “good heath”. For instance, pathologies such as the heart, the brain, and the lungs affiliate with chaos in the situation where dynamics become increasingly stable with its attraction being a limit cycle. Rickles, Hawe, and Shiell (2007) affirm, “Heart disease, epilepsy, bipolarity and so on are considered to be dynamic diseases in that they are not associated with something that can manifest itself at an instant” (p. 934).
In a recap, literature pertinent to health care science is gradually growing with more of its concepts remaining strange to both the health care scientists and ordinary health care consumers. Therefore, its usage remains a misconception of the realities in health care science (Sweeney & Griffiths, 2002). Complicated, chaos, and complexity are some of the terminologies with concrete influence that have increasingly gained acknowledgment in the health care setting. Even though the three medical terminologies in literature possess significantly different meanings, they have some possible similarities and possible applications in health care as well, especially in their application. According to Materia and Baglio (2005), the major two concepts, viz. the complex adaptive systems, and the chaotic systems are in the number of interacting parts and the related impact that they possess on the properties and behavior of a given system. This element can be an example of healthy behavior in living things. According to Guerrini and Spagnuolo (2004), a great similarity is that both concepts are nonlinear in that small change can possess significant striking effects that one cannot understand simply by analyzing each component individually.
Anderson R., & McDaniel, R. (2002). Managing health care organizations: Where professionalism meets complexity science. Health Care Management Review, 25(1), 83–92.
Bertuglia, C., & Vaio, F. (2005). Nonlinearity, chaos and complexity: The dynamics of natural and social systems. Oxford, NY: Oxford University Press.
Guerrini, I., & Spagnuolo, R. (2004). Chaos and complexity: New practices for an emergent concept of family health in a Brazilian experience. Emergence: Complexity & Organization, 6(4), 83-90.
Hobbs, J., & Manyon, A. (2007). Complexity Science and Its Relevance for Primary Health Care Research. Annals of Family Medicine, 5(4), 564-565.
Holden, M. (2005). Complex adaptive systems: concept analysis. Journal of Advanced Nursing, 52(6), 651–657.
Materia, E., & Baglio, G. (2005). Health, science, and complexity. Journal of Epidemiological Community Health, 59, 534–535.
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Pearce, N., & Merletti, F. (2006). Complexity, simplicity, and epidemiology. International Journal of Epidemiology, 35, 515–519.
Resnicow, K., & Scott, E. (2008). Embracing Chaos and Complexity: A Quantum Change for Public Health. American Journal of Public Health, 98(8), 1382-1389.
Rickles, D., Hawe, P., & Shiell, A. (2007). A simple guide to chaos and complexity. Journal of Epidemiological Community Health, 61, 933–937.
Sweeney, K., & Griffiths, F. (2002). Complexity and healthcare: an introduction. New York, NY: Radcliffe Medical Press.