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

Eva Langeland,Hilde S Robinson,Marie H Larsen,Anne-Lene Krogstad,Astrid K Wahl,Torbjørn Moum

doi:10.1186/2050-7283-1-11

Eva Langeland, Hilde S Robinson + Show 4 more

Open Access

https://doi.org/10.1186/2050-7283-1-11

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Abstract

BackgroundThere 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.MethodsA 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.ResultsThe 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.ConclusionsSOC 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.

Highlights

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
Study design and population The present study was a follow-up study with a pre–post study design of Norwegian patients with psoriasis, age 20 years and older, who were remitted to a climate therapy programme for 3 weeks at the Canary Islands located in the Atlantic Ocean at 28°N, 16°W
The results indicate that improving positive and active engagement in life, emotional well-being and a coherent understanding of the illness might provide important opportunities to improve SOC among people with psoriasis

Summary

Introduction

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 concept of sense of coherence (SOC), the main concept in the theory of salutogenesis, may help explain the sustenance for our growth as human beings. Antonovsky (1987) defined SOC as a global orientation expressing the extent to which one has a pervasive, enduring, and dynamic feeling of confidence that the stimuli derived from one’s internal and external environments in the course of living are structured, focuses on peoples’ active adaptation in the interplay between their SOC and use of GRR. The health of a person could affect their SOC (Veenstra et al 2005) because it might influence such as the ability to use the different GRR. Awareness of the health care provider about ways to strengthen the patient’s SOC may be important in communication with, and the assessment and treatment of, people with chronic diseases such as psoriasis

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