Antonovsky's Salutogenic Model Research Articles

Coping with a chronic disease.

Interviews were conducted with 55 experienced patients with insulin-dependent diabetes with the aim of identifying strategies for coping with diabetes. This study was based on a health-oriented approach known as Antonovsky's salutogenic model, which conceptualizes the person as being actively involved in maintaining biological, psychological, and social homeostasis. All patients had developed some strategy for maintaining biological balance. Twenty-two also had strategies for coping both psychologically and socially with the disease. The remaining 33 patients had developed either a psychological or a social strategy in addition to their biological strategies. The results indicate that it is important for the patient's well-being and self-esteem to establish all three coping strategies--biological, psychological, and social. The diabetes care team could be a valuable resource for the patient in this respect.

Self-reported symptom distress in cancer patients: Reflections of disease, illness or sickness?

This article examines the relationships between symptom distress in a heterogeneous group of cancer patients and a number of possible explanatory variables, categorized as demographic, medical/clinical, individual/psychosocial and variables related to patients' views of care provided by the health care system. A series of explorative multiple regression analyses were undertaken to this end. The data are derived from a cross-sectional study of cancer patients diagnosed in 1987 at one general hospital in the greater Stockholm area, using semi-structured interviews in conjunction with McCorkle and Young's Symptom Distress Scale, Antonovsky's Sense of Coherence Questionnaire, Cutrona and Russell's Social Provisions Scale and Smilkstein's Family APGAR. Symptom distress is studied as a cumulative index, as well as in terms of the sub-indexes of pain, appetite/nausea, functional aspects, psychological aspects and social aspects. When the four categories of explanatory variables are combined, considerably higher levels of variance are explained for all 6 indexes of the Symptom Distress Scale, than when the regression analyses are performed separately with each distinct category of explanatory variables. This provides a statistical illustration of the multifaceted and complex nature of symptom distress. The data are presented in the context of a conceptual discussion about the meaning of symptoms. Symptom distress, in this study, appears to reflect both personal and cultural experiences, that is ‘illness’ and ‘sickness’ processes, rather than primarily medical/clinical variables, or ‘disease’. Antonovsky's salutogenic model is suggested as a fruitful framework for further analysis.

A theoretical framework for psychiatric nursing practice

Traditionally, specific theoretical frameworks which are congruent with psychiatric nursing practice have been poorly articulated. The purpose of this paper is to identify and discuss a philosophical base, a theoretical framework, application to psychiatric nursing, and issues related to psychiatric nursing knowledge development and practice. A philosophical framework that is likely to be congruent with psychiatric nursing, which is based on the nature of human beings, health, psychiatric nursing and reality, is identified. Aaron Antonovsky's Salutogenic Model is discussed and applied to psychiatric nursing. This model provides a helpful way for psychiatric nurses to organize their thinking processes and ultimately improve the health care services that they offer to their clients. Goal setting and nursing interventions using this model are discussed. Additionally, application of the use of Antonovsky's model is made to nursing research areas such as hardiness, uncertainty, suffering, empathy and literary works. Finally, specific issues related to psychiatric nursing are addressed.

Evaluating Antonovsky's Salutogenic Model for its adaptability to nursing.

Despite dissatisfaction with disease-oriented models, nursing has not yet adopted a truly health-oriented paradigm. It is important that nurse theorists remain open to health-oriented conceptual models which, although developed in other disciplines, offer adaptability for nursing. In the accompanying article, Antonovsky's Salutogenic Model is analysed and evaluated for adaptability to nursing from its parent discipline, medical sociology. The central concern of this model, as its name suggests, is explaining how people manage to stay well despite omnipresent stressors. The difference between health breakdown and wellness may depend more upon one's outlook on life than upon the avoidance of stress. An orientation which views life activities as meaningful and perceives life events as comprehensible and manageable is called a sense of coherence. People who have a strong sense of coherence manage tension effectively and resist health breakdown. Nursing which strengthens the client's sense of coherence promotes wellness and fosters the client's ability to stay well or get well. Evaluation of the Salutogenic Model relative to its potential usefulness as a nursing paradigm is accomplished by applying the framework for analysis and evaluation of a model developed by Fawcett. The Salutogenic Model is determined to be explicit, comprehensible, logically congruent, and to have social significance, congruence and utility. We conclude that it is suitable for adaptation to the nursing milieu.