Promoting sense of coherence: Salutogenesis among people with psoriasis undergoing patient education in climate therapy

BMC Psychology - Tập 1 Số 1 - Trang 1-8 - 2013
Langeland, Eva1, Robinson, Hilde S2, Moum, Torbjørn3, Larsen, Marie H2,4, Krogstad, Anne-Lene4,5, Wahl, Astrid K2
1Faculty of Health and Social Sciences, Institute of Nursing, Bergen University College, Bergen, Norway
2Medical Faculty, Department of Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
3Medical Faculty, Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
4Department of Rheumatology, Dermatology and Infectious Diseases, Oslo University Hospital, Oslo, Norway
5Medical Faculty, Institute of Clinical Medicine, University of Oslo, Oslo, Norway

Tóm tắt

There is a need for further investigation of sense of coherence (SOC), the central concept of salutogenesis, and its relationship with long-term illnesses such as psoriasis. The aim of this study is to investigate the development of SOC during patient education in the context of climate therapy and to explore factors that may predict changes in SOC among people with psoriasis. A prospective design included a baseline assessment and two follow-ups after a 3-week patient education and climate therapy programme (follow-up 1) and again 3 months later (follow-up 2). A total of 254 adults (aged 20–80) with psoriasis participated. SOC was measured by the SOC Questionnaire, illness perception was measured by the Revised Illness Perception Questionnaire, and positive and active engagement in life was measured by the positive and active engagement subscale of the Health Education Impact Questionnaire. Paired-sample t tests were used to evaluate changes in SOC from the baseline to follow-up. Multiple linear regression was used to analyse the ability of socio-demographic and clinical variables, illness perception and positive and active engagement in life to predict the changes in SOC. The SOC score changed significantly by 2.65 points, (95% CI = 0.621, 3.685) from the baseline to follow-up 1. SOC score was still improved by 1.15 points (95% CI = 0.073, 0.223) at follow-up 2. Baseline and change in positive and active engagement in life were linked to change in SOC with standardized beta 0.170 (95% CI = 0.024, 0.319) and 0.259 (95% CI = 0.092, 0.428), respectively. In addition illness coherence perception at baseline and change in emotional representations were significantly associated with the change in SOC with standardized beta 0.212 (95% CI = 0.073, 0.361) and –0.270 (95% CI = –0.481, –0,077), respectively. SOC improved significantly from before to after patient education in the context of climate therapy. The results indicate that improving positive and active engagement in life, coping with emotional distress and a coherent understanding of the illness might provide important opportunities to improve SOC among people with psoriasis.

Tài liệu tham khảo

citation_title=Health, Stress and Coping; citation_publication_date=1979; citation_id=CR1; citation_author=A Antonovsky; citation_publisher=Jossey-Bass citation_title=Unraveling the Mystery of Health; citation_publication_date=1987; citation_id=CR2; citation_author=A Antonovsky; citation_publisher=Jossey-Bass citation_journal_title=Social Science & Medicine; citation_title=The structure and properties of the sense of coherence scale; citation_author=A Antonovsky; citation_volume=36; citation_publication_date=1993; citation_pages=725-733; citation_doi=10.1016/0277-9536(93)90033-Z; citation_id=CR3 citation_journal_title=Health Promotion International; citation_title=The salutogenic model as a theory to guide health promotion; citation_author=A Antonovsky; citation_volume=11; citation_publication_date=1996; citation_pages=11-18; citation_doi=10.1093/heapro/11.1.11; citation_id=CR4 citation_journal_title=Nordic Journal of Psychiatry; citation_title=Making sense of different illness realities: restructuring of illness meaning among Swedish-born women; citation_author=S Bäärnhielm; citation_volume=59; citation_publication_date=2005; citation_pages=350-356; citation_doi=10.1080/08039480500319894; citation_id=CR5 citation_journal_title=International Journal of Dermatology; citation_title=Stress and quality of life in psoriasis: an update; citation_author=KH Basavaraj, M Navya, R Rashmi; citation_volume=50; citation_publication_date=2011; citation_pages=783-792; citation_doi=10.1111/j.1365-4632.2010.04844.x; citation_id=CR6 citation_journal_title=Pediatric Dermatology; citation_title=Climatotherapy at the Dead Sea for pediatric-onset psoriasis vulgaris; citation_author=D Ben-Amitai, M David; citation_volume=26; citation_publication_date=2009; citation_pages=103-104; citation_doi=10.1111/j.1525-1470.2008.00837.x; citation_id=CR7 citation_journal_title=Nursing & Health Sciences; citation_title=Does one’s sense of coherence change after an acute myocardial infarction? A two-year longitudinal study in Sweden; citation_author=E Bergman, D Malm, C Berterö, JE Karlsson; citation_volume=13; citation_publication_date=2011; citation_pages=156-163; citation_doi=10.1111/j.1442-2018.2011.00592.x; citation_id=CR8 citation_journal_title=Journal of Epidemiology and Community Health; citation_title=Validity of Antonovsky’s sense of coherence scale: a systematic review; citation_author=M Erikson, B Lindstrøm; citation_volume=59; citation_publication_date=2005; citation_pages=460-466; citation_doi=10.1136/jech.2003.018085; citation_id=CR9 citation_journal_title=Journal of Epidemiology and Community Health; citation_title=Antonovsky’s sense of coherence scale and the relation with health: a systematic review; citation_author=M Erikson, B Lindstrøm; citation_volume=60; citation_publication_date=2006; citation_pages=376-381; citation_doi=10.1136/jech.2005.041616; citation_id=CR10 citation_journal_title=Quality of Life Research; citation_title=Structural validity and temporal stability of the 13-item sense of coherence scale: prospective evidence from the population-based HeSSup study; citation_author=T Feldt, H Lintula, S Suominen, M Koskenvuo, J Vahtera, M Kivimäki; citation_volume=16; citation_publication_date=2007; citation_pages=483-493; citation_doi=10.1007/s11136-006-9130-z; citation_id=CR11 citation_journal_title=Journal of Clinical Nursing; citation_title=Influence of a lifestyle intervention among persons with psychiatric disability: a cluster randomized trial on symptoms, quality of life and sense of coherence; citation_author=KA Forsberg, T Bjørkman, PO Sandman, M Sandlund; citation_volume=19; citation_publication_date=2010; citation_pages=1519-1528; citation_doi=10.1111/j.1365-2702.2009.03010.x; citation_id=CR12 citation_journal_title=Psychology, Health & Medicine; citation_title=Adversarial growth in patients undergoing treatment for psoriasis: a prospective study of the ability of patients to construe benefits from negative events; citation_author=DG Fortune, HL Richards, CEM Griffiths, CJ Main; citation_volume=10; citation_publication_date=2005; citation_pages=44-56; citation_doi=10.1080/13548500512331315352; citation_id=CR13 citation_journal_title=Dermatologic Clinics; citation_title=Psychological factors in psoriasis: consequences, mechanisms and interventions; citation_author=DG Fortune, HL Richards, CEM Griffiths; citation_volume=23; citation_publication_date=2005; citation_pages=681-694; citation_doi=10.1016/j.det.2005.05.022; citation_id=CR14 citation_journal_title=Acta Obstetricia et Gynecologica Scandinavica; citation_title=Does childbirth after fertility treatment influence sense of coherence? A longitudinal study of 1,934 men and women; citation_author=M Habroe, L Schmidt, BE Holdstein; citation_volume=86; citation_publication_date=2007; citation_pages=1215-1221; citation_doi=10.1080/00016340701619258; citation_id=CR15 citation_journal_title=Journal of Health Psychology; citation_title=Factorial invariance of the 13-item Sense of Coherence Scale across gender; citation_author=JB Hittner; citation_volume=12; citation_publication_date=2007; citation_pages=273-280; citation_doi=10.1177/1359105307074256; citation_id=CR16 citation_journal_title=Journal of the American Academy of Dermatology; citation_title=Climatotherapy at the Dead Sea is a remittive therapy for psoriasis: combined effects on epidermal and immunologic activation; citation_author=E Hodak, AB Gottlieb, T Segal, Y Politi, L Maron, J Sulkes, M David; citation_volume=49; citation_publication_date=2003; citation_pages=451-457; citation_doi=10.1067/S0190-9622(03)00916-2; citation_id=CR17 citation_journal_title=International Journal of Nursing Studies; citation_title=The impact of social support on mental health service users’ sense of coherence: a longitudinal panel survey; citation_author=E Langeland, AK Wahl; citation_volume=46; citation_publication_date=2009; citation_pages=830-837; citation_doi=10.1016/j.ijnurstu.2008.12.017; citation_id=CR18 citation_journal_title=Patient Education and Counseling; citation_title=The effect of salutogenic treatment principles on coping with mental health problems — a randomised controlled trial; citation_author=E Langeland, T Riise, BR Hanestad, MW Nortvedt, K Kristoffersen, AK Wahl; citation_volume=62; citation_publication_date=2006; citation_pages=212-219; citation_doi=10.1016/j.pec.2005.07.004; citation_id=CR19 citation_journal_title=Global Health Promotion; citation_title=Flow and sense of coherence: two aspects of the same dynamic?; citation_author=J Lutz; citation_volume=16; citation_publication_date=2009; citation_pages=63-67; citation_doi=10.1177/1757975909339774; citation_id=CR20 citation_journal_title=Journal of the European Academy of Dermatology and Venereology; citation_title=Coping and psoriasis — a framework for targeted intervention; citation_author=D Metz, GBE Jemec; citation_volume=6; citation_publication_date=1996; citation_pages=27-31; citation_id=CR21 citation_journal_title=Journal of the American Academy of Dermatology; citation_title=Improved quality of life among patients with psoriasis after supervised climate therapy at the Canary Islands; citation_author=C Mork, AK Wahl; citation_volume=47; citation_publication_date=2002; citation_pages=314-316; citation_doi=10.1016/S0190-9622(02)00066-X; citation_id=CR22 citation_journal_title=Psychology & Health; citation_title=The revised illness perception questionnaire (IPQ-R); citation_author=R Moss-Morris, J Weinman, KJ Petrie, R Horne, LD Cameron, D Buick; citation_volume=17; citation_publication_date=2002; citation_pages=1-16; citation_doi=10.1080/08870440290001494; citation_id=CR23 citation_journal_title=Journal of Epidemiology and Community Health; citation_title=Sense of coherence and psychological well-being: improvement with age; citation_author=KW Nilsson, J Leppert, B Simonsson, B Staarin; citation_volume=64; citation_publication_date=2010; citation_pages=347-352; citation_doi=10.1136/jech.2008.081174; citation_id=CR24 citation_journal_title=Polski Merkuriusz Lekarski; citation_title=Sense of coherence in people suffering from psoriasis; citation_author=E Oglodek, B Augustynska, L Marek, A Araszkiewicz, W Placek, D Mos; citation_volume=27; citation_publication_date=2009; citation_pages=202-204; citation_id=CR25 citation_journal_title=Patient Education and Counseling; citation_title=The Health Education Impact Questionnaire (heiQ): an outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions; citation_author=RH Osborne, GR Elsworth, K Whitfield; citation_volume=66; citation_publication_date=2007; citation_pages=192-201; citation_doi=10.1016/j.pec.2006.12.002; citation_id=CR26 citation_journal_title=International Journal of Aging & Human Development; citation_title=The development of the sense of coherence: a retrospective study of early life experiences in the family; citation_author=S Sagy, H Antonovsky; citation_volume=51; citation_publication_date=2000; citation_pages=155-166; citation_doi=10.2190/765L-K6NV-JK52-UFKT; citation_id=CR27 citation_journal_title=Journal of the European Academy of Dermatology and Venereology; citation_title=Determinants of social anxiety and social avoidance in psoriasis outpatients; citation_author=G Schneider, G Heuft, J Hockmann; citation_volume=27; citation_publication_date=2011; citation_pages=383-386; citation_doi=10.1111/j.1468-3083.2011.04307.x; citation_id=CR28 citation_journal_title=Medical Care; citation_title=Patient experiences with information in a hospital setting: a multilevel approach; citation_author=M Veenstra, D Hofoss; citation_volume=41; citation_publication_date=2003; citation_pages=490-499; citation_id=CR29 citation_journal_title=Quality of Life Research; citation_title=Relationships between health domains and sense of coherence: a two-year cross-lagged study in patients with chronic illness; citation_author=M Veenstra, T Moum, E Røysamb; citation_volume=14; citation_publication_date=2005; citation_pages=1455-1465; citation_doi=10.1007/s11136-004-0015-8; citation_id=CR30 citation_journal_title=Journal of the American Academy of Dermatology; citation_title=No long-term changes in psoriasis severity and quality of life following climate therapy; citation_author=AK Wahl, C Mørk, BA Cooper, G Padilla; citation_volume=52; citation_publication_date=2005; citation_pages=699-701; citation_doi=10.1016/j.jaad.2005.01.117; citation_id=CR31 citation_title=Toward development of intervention methods for strengthening the sense of coherence (SOC): suggestions from Japan; citation_inbook_title=Asian Perspectives and Evidence on Health Promotion and Education; citation_publication_date=2011; citation_pages=118-132; citation_id=CR32; citation_author=Y Yamazaki; citation_author=T Togari; citation_author=J Sakano; citation_publisher=Springer