Salutogenic Approach Research Articles

Development and Validation of the Midwifery Interventions Classification for a Salutogenic Approach to Maternity Care: A Delphi Study

Background/Objectives: This study aims to develop and validate a Midwifery Interventions Classification (MIC), which is an evidence-based, standardized taxonomy and classification of core midwifery interventions based on a salutogenic perspective for maternity care. Methods: This study described the consensus process up to the results regarding the validation of the MIC through a two-round Delphi survey involving three panels of stakeholders: Midwives, Healthcare Researchers, and Maternity Service Users. Results: The resulting MIC comprises 135 core midwifery interventions classified into Direct Midwifery care (n = 101 interventions), Indirect Midwifery Care (n = 52 interventions), and Community Midwifery Care (n = 13 interventions), reaching an overall consensus rate among experts equal to 87%. These interventions were, therefore, adapted specifically for the Italian midwifery care context, with potential for international transferability, implementation, and scalability. Conclusions: The MIC is pivotal to boosting quality improvement, education, and comparable data collection for research, sustaining midwives’ role in promoting optimal health for women, newborns, and families at large.

Health coaching: the node of health literacy & health promotion

Abstract Introduction To achieve sustainable health behaviors and outcomes to move from a precarious health situation to good health, people need to be supported in health literacy in behavior change that ensure interventions’ success. As a non-clinical approach, health coaching aims to increase a person’s levels of self-efficacy, confidence and resilience, by promoting the sense of coherence. This communication aims to identify the benefits that health coaching as a salutogenic approach can trigger. Methods The work is structured in a narrative review of literature and the lived experience of the authors in health coaching. Results The published research on health coaching and the systematic professional experience of the authors highlight: (1) the anchoring of health coaching in the salutogenic model and in the person-centered approach focused on individual characteristics and needs in driving healthy behaviors; (2) health coaching as a collaborative relationship with chronically ill people and people at risk of developing illness; (3) the role of health coaching as a sense of coherence (SOC) promoter; (4) health coaching as a new profession in the healthcare ecosystem (e.g. NHS, UK), cooperating with multidisciplinary teams. Discussion From A.Antonovsky’s model approach to health, the SOC stands out and constitutes one of the basic theories in health coaching interventions, by strengthening the person’s capabilities of comprehensibility, manageability, and meaningfulness. As an emerging profession, with ethical and a growing research foundation, it is facilitated by trained professionals in managing and monitoring health behavior change. Conclusions Health coaching aims to bring relevance, meaning and strategy to a person’s behavioral change. Health coaching demonstrates positive effects on several health parameters by supporting the implementation of health literacy development and empowering people to trigger sustainable changes that lead to healthier lifestyles.

A salutogenic approach towards children’s overall physical activities, coping behavior and resilience: a mediation analysis

Abstract Aim Physical activity (PA) has many benefits not only for a child’s physical development, but also for mental health and cognitive function which, in turn, results in broader social and environmental benefits. The World Health Organization announced recently that on average, children are not active enough. Following the salutogenic approach of questioning why people stay healthy as opposed to why they become ill, this study aims to examine the effects of overall physical activity (OPA) — including both 'non-sports physical activity' (including 'active play outdoors', 'active play indoors' and 'active mobility') and 'sports' — on children’s resilience and coping behavior. Methods Data was collected from 544 children in an age range of 6–19 years (online survey). Results Results show a two-dimensional construct including a non-sports physical activity dimension and a sports dimension (together, OPA) and the positive effects on children’s mental health. OPA as a concept contributes to the positive development of resilience skills in children. Furthermore, results show that the mediating role of coping behavior is another building block that can be targeted in terms of resilience in children. Conclusion Following the salutogenic approach to physical education and health, we posit that non-sports physical activity dimensions and sports dimensions are fundamental prerequisites for keeping children healthy. The OPA approach reveals joint implication pathways in addition to sport which help to increase children’s resilience.

Biophilic Design in Office Buildings: A Salutogenic Approach to Enhancing Well-being in the Built Environment

This research paper explores biophilic design principles in office buildings, focusing on promoting well-being andcreating salutogenic environments. It investigates key aspects of biophilic design, such as natural light, views of nature,indoor plants, and natural materials, and their impact on occupant well-being and productivity. The study uses a mixedmethods approach, combining quantitative surveys and qualitative interviews with office employees. The resultsreveal that biophilic design elements significantly contribute to improved well-being, including increased jobsatisfaction, reduced stress levels, and enhanced productivity. The study emphasizes the importance of incorporatingbiophilic design strategies in office buildings to create salutogenic environments that enhance employee well-being. Ithighlights the significance of natural elements in mitigating the negative effects of a sedentary work environment. Theresearch contributes to the field by providing empirical evidence supporting the implementation of biophilic design inoffices, emphasizing the benefits of a connection with nature for well-being and productivity.

Salutogenic approach paradigm of comprehensive and integrated health care

The health care approach denoted as salutogénesis was reviewed based on the historical, which conceives actions from integrality - integration precepts that enhance technical quality and enhance perceived quality (warmth) in order to achieve well-being and promote the building of a subject, family and community with a style of coping with the health situation that is paid by a professional with a way of thinking - acting proactively, not reactively, which favorably affects the quality of individual and collective life. In this sense, various current flat and electronic scientific publications have been valued, as well as recognized national and international texts, which supports the novelty of the model that is exposed, its usefulness and competitiveness and the relevance of applying it in the context of the Cuban health system. that has the person versus the community as the center, since such an approach always reorients - revitalizes, the promotion of health and prevents lifestyles that favor successfully facing various risks and conditions the reasonable effectiveness of avoiding a given disease and, of course, generating a qualitative enhancement - quantitative regarding, abort - restore, sequelae of damage to health in a given case, then power, from the state of apparent health, a Danger, Vulnerability and Risks type approach, for which it enhances Strengths and reverses Weaknesses and , turns Threats - Opportunities into its target and confronts them-boldly transforms, so that it enhances the well-being of the person, the family and the community.

Adolescents’ Perspectives on Coping with Bullying in the Digital Environment

This study examined the coping process of adolescents in the construction of a sense of coherence after experiencing bullying events in the digital environment. The content analysis of semi-structured interviews with 20 adolescents aged 14 to 18 (M = 16.85) revealed three themes: (1) the comprehension of the bullying as stemming from hatred and boredom; (2) managing the bullying by turning to the bully asking that they stop, deleting and forgiving after the event, and coping through self-isolation and with the support of family and friends; and (3) the emotional processing of anger, embarrassment, and sadness. All the data correlated with the a priori themes of the salutogenic approach, demonstrating a significant expression of the components of a sense of coherence. Understanding the adolescents’ coping process and their construction of a sense of coherence following their experience of cyberbullying may help practitioners design and implement tailored interventions for adolescents and their educators who are increasingly confronted with this issue.

Why did this happen to me? Causal attributions of illness and cultural health capital

This study examines how conversations between patients and clinicians about the causes of their health conditions relate to patient engagement in care. Leveraging cultural health capital (CHC) theory, we find that patient-physician discussions of health attributions are one mechanism to build patient understanding and activate engagement. We present a qualitative interpretive analysis of data collected in three phases with adult home health care patients: phone interviews (n = 28), field observations (n = 61), and semi-structured field interviews (n = 38). We find that engaging in discussions of causal health attributions with clinicians enables patients to overcome uncertainty, envision preventive actions, and engage in setting future goals. Such discussions must be supported by acknowledgement of the co-responsibility of individual factors and structural factors such as social determinants of health. These discussions are not easy to navigate but they can potentially help patients transition from a mindset of treating the disease (pathogenic approach) to an awareness of their available capabilities to improve health (salutogenic approach). This study contributes to research on attribution theory and cultural health capital theory by demonstrating how discussing causes for poor health can enable patients resolve doubts and accrue instrumental and symbolic resources that facilitate healing.

Sense of coherence and Covid-19 related stress: A three-wave longitudinal study.

Sense of coherence (SOC) is the fundamental concept of the salutogenic approach to health promotion. The main aim of the current longitudinal study is to consider whether SOC has had a positive effect in reducing people's levels of stress during the prolonged time of the pandemic or rather stress has posed a threat to SOC. A large sample of Italian adults completed an online questionnaire at three different moments of the Covid-19 pandemic (from March 2020 to May 2021). To test the reciprocal associations between SOC and stress we estimated a cross-lagged panel model. Results questioned the stability of SOC, which changed across the different moments of the pandemic, and its causal role with respect to stress since, after controlling for gender and age, it emerged a significant effect only from stress to SOC. The implications of these results and the further expansions of the study are discussed.

Health-based physical education in an elementary school: effects on physical self-concept, motivation, fitness and physical activity

ABSTRACT Background Promoting and developing health in Physical Education should not be limited to seeking to meet recommendations for physical activity and to increase motor competence or physical fitness, but should provide students with the motivation, confidence and knowledge required for them to be active for life. The Health-based Physical Education model (HbPE) is one of the most interesting models for health development. It takes a holistic perspective of health that is compatible with the salutogenic approach, where promoting and appreciating an active life is a core element (Haerens et al. 2011). Purpose The aim of this study was to examine the effects of a Health-based Physical Education programme on health-related factors (physical fitness and moderate-to-vigorous physical activity), emotional well-being (self-esteem and physical self-concept), and motivational factors (intention to be physically active and the degree of self-determination during practice). Methods A quasi-experimental design with pre- and post-test measures was applied to a sample composed of 131 schoolchildren aged 10 to 12 years (M = 10.87 ± 0.69) belonging to six randomly assigned class groups: three to the experimental group (n = 67) and three to the control group (n = 64). The experimental group participated in an intervention programme based on the HbPE model linked to a set of strategies to promote commitment, motivation and participation, while the control group completed a traditional programme for physical fitness improvement. As measures, we used Polar® HR monitors, the ALPHA-Fitness battery, the Motivation in Physical Education Questionnaire in Primary Education, the Intention to Be Physically Active Scale and the Pictorial Scale of Physical Self-Concept for Younger Children. Findings The experimental group showed higher levels of moderate-to-vigorous physical activity and a significant increase in physical fitness, including a reduction in BMI. Moreover, this group presented improvements in socio-emotional self-esteem, intrinsic motivation and the intention to be physically active. Nevertheless, against our hypothesis, quantitative analyses indicated no differences in physical self-concept. Conclusion These results support the use of HbPE as a model for designing and implementing health-promoting programmes that are compatible with a salutogenic approach. Apart from increasing physical activity and improving physical fitness, such programmes would provide knowledge and attitudes to foster practice beyond school.

Impact of Chronic Disease Self-Management Program on the Self-Perceived Health of People in Areas of Social Vulnerability in Asturias, Spain.

The Chronic Disease Self-Management Program (CDSMP) focuses on a health promotion perspective with a salutogenic approach, reinforcing the pillars of self-efficacy. The aim of this study was to assess the impact of the CDSMP on Self-perceived Health (SPH) in disadvantaged areas of Asturias, España. The study included vulnerable adults with experience of chronic diseases for over six months, along with their caregivers. The intervention consisted of a six-session workshop led by two trained peers. SPH was evaluated by administering the initial item of the SF-12 questionnaire at both baseline and six months post-intervention. To evaluate the variable "Change in SPH" [improvement; remained well; worsening/no improvement (reference category)], global and disaggregated by sex multivariate multinomial logistic regression models were applied. There were 332 participants (mean = 60.5 years; 33.6% were at risk of social vulnerability; 66.8% had low incomes). Among the participants, 22.9% reported an improvement in their SPH, without statistically significant sex-based differences, while 38.9% remained in good health. The global model showed age was linked to decreased "improvement" probability (RRRa = 0.96), and the "remaining well" likelihood drops with social risk (RRRa = 0.42). In men, the probability of "remaining well" decreased by having secondary/higher education (RRRa = 0.25) and increased by cohabitation (RRRa = 5.11). Women at social risk were less likely to report "remaining well" (RRRa = 0.36). In conclusion, six months after the intervention, 22.9% of the participants had improved SPH. Age consistently decreased the improvement in the different models.

Status of the Health Promoting University (HPU) globally and its relevance for emerging African HPUs: an integrative review and bibliometric analysis.

The Health Promoting Universities (HPU) concept is undertheorized, with no African university belonging to the International Network of Health Promoting Universities (IHPU). The study aimed to investigate the status of the HPU concept globally to inform emerging HPUs, more specifically in Africa, regarding its implementation. An integrative literature review of studies conducted between 1 January 2013 and 5 November 2023 was conducted from online databases (PubMed, Scopus, Web of Science, Lilacs, CINAHL and Medline). A VOS bibliometric analysis viewer was used to extract and analyze further relevant information that could have been missed in the review. From 1128 records, 22 (N = 22) articles including two reports met the inclusion criteria. The main findings were that: (1) the HPU network is growing as a global network though undertheorized and less reported on, (2) the implementation of the HPU depends on a plethora of underpinning philosophies such as salutogenic and whole systems approach, and diverse programs and initiatives, 3) the terms HPU and healthy universities are often used interchangeably but the whole systems approach appears to be consistent in many HPU interventions. However, five contextual challenges that emanated from this review were discussed, including the definition of the HPU concept, theories for the HPU concept, measurement of the HPU concept, coordination and methods for measuring the HPU concept status. These challenges present obstacles to measuring the status of the HPU concept beyond the number of affiliated universities and HPU initiatives. Despite the challenges, the HPU concept is gaining momentum globally, as evidenced by the growing list of universities (HPU network) involved and the proliferation of interventions/initiatives targeting university students.

Nurses’ experiences of integrating the salutogenic perspective with person-centered care for older people in Swedish nursing home care: an interview-based qualitative study

BackgroundEven though there has been a cultural change within residential aged care to a more person-centered care, there remain improvements to be made for a more consistent way of working. Using a salutogenic approach along with person-centered care is a potential way to promote it. This study aimed to describe nurses’ experiences of combining person-centered care with a salutogenic approach at a nursing home for older people.MethodsNine nurses, specially trained in salutogenesis and Sense of coherence, were individually interviewed using a semi-structured interview approach. Data was analysed through qualitative content analysis.ResultsThe nurses experienced that the residential aged care was improved by using salutogenesis and Sense of coherence as a complement to person-centered care. Core aspects of person-centered care were thereby promoted, as the resources of the older persons were emphasized, and aged care became more holistic. In addition to improved residential aged care, the results indicate that this manner of working also contributed to enhanced work satisfaction of the care personnel themselves.ConclusionsThe results suggest that a salutogenic approach facilitates the implementation of person-centered care by focusing on the older persons’ resources and maintaining health. The organization needs to prioritize training staff in salutogenesis and person-centered care, as it supports working toward a common goal and benefits both the older persons and the staff.

Salutogenic health measures: Psychometric properties of the Danish versions of the Flourish Index and the Secure Flourish Index.

Measurement of human flourishing represents a salutogenic approach to epidemiological and behavioral research emphasizing factors contributing to "good lives" rather than pathology. The objective of this study was to translate and psychometrically test the 10-item Flourish Index (FI) and 12-item Secure Flourish Index (SFI) in a convenience sample of Danish adults. A total of 325 participants completed a cross-sectional survey, with 148 of those participants completing the survey a second time (retest). Confirmatory factor analysis in a structural equation modelling framework was used to establish structural validity by comparing four different pre-specified models of the indexes. Additionally, internal consistency, convergent and incremental validity, and retest reliability were examined. The FI models exhibited superior structural validity compared with similar models of the SFI, although all models had good fits. Internal consistencies with McDonald's omega were 0.89 and 0.87 for the FI and SFI, respectively. The five (FI) or six (SFI) domains were happiness & life satisfaction, mental & physical health, meaning & purpose, character & virtue, close social relationships, and financial & material stability (λ4 = 0.51-0.91). Convergent and incremental validity tests supported predefined hypotheses. Retest analyses with the FI and SFI showed a high degree of retest reliability. Based on the psychometric evidence reported in this study, the Danish Flourish Index and Secure Flourish Index seem suitable for use with healthy adult Danes. The authors hope that this psychometric evaluation of the FI and SFI will stimulate research on patterns, health and economic outcomes, and predictors of human flourishing in Denmark.

Building community engagement with caregivers through online interaction and a salutogenic approach in a period of isolation.

Informal caregivers are essential figures that deal with the effects of dependence in the elderly. However, they suffer from poorer health-related quality of life, particularly regarding mental health. Social support is crucial, but this was suspended or dramatically reduced during the Covid-19 pandemic. Salutogenesis theory explores the contributing factors for the promotion and maintenance of health. Considering all these, we offered caregivers the opportunity to join a participatory project aimed at creating communication spaces where they could share experiences, think together about potential solutions, and explore which salutogenic actions they used in their daily basis and how they had changed during Covid-19 restrictions. We used a qualitative methodology with a socio-constructivist and phenomenological approach and purposive sampling. We organized two focus groups consisting of online semi-structured discussions with seven participants in total. Conversations were videotaped and transcribed and we conducted content thematic analyses using the NVivo software. Caregiving in our setting are primarily women with high levels of education that do not always feel comfortable with this load because it interferes with their personal and professional lives. The pandemic increased caregivers feelings of loneliness, resignation, and burden, directly affecting their mental health. Furthermore, the disappearance of prevention programs and the difficulties to access healthcare services produced negative consequences on the already fragile elderly and their family caregivers. The pandemic and its restrictions exacerbated the problematics affecting informal caregivers. Although these people are aware of their situation and have valued knowledge of how to improve their health, they cannot always put it into practice. We call policymakers to reframe interventions aimed at caregivers by introducing the voice of the community in the planning and to rethink the management of vulnerable people and their carers in other potential health crises.

Role of Music Therapy in Palliative Care-Methods and Techniques.

Palliative care is a vulnerable area of practice that requires a team to cater to the needs of physical, psychological, social, and spiritual needs and the requirements for unmet needs for patients under palliative care is quite large and increasing. India is creating awareness for palliative care stand at the foremost requirement as well as who can cater to patients who require palliative care. Along with many other treatments, therapies and supports being provided to patients, music therapy may play the role with preventative and curative periods of treatment, as well as support to cope and acceptance toward the inevitable for the patient as well for the caregivers. Music therapy provides a biopsychosocial and holistic approach to palliative care. Musical interventions include methods of receptive, improvisation, recreative, and creative spanning across many techniques and have been found to help with coping, expressing emotions, regulating emotions, acceptance, managing pain, and distress, supportive to caregivers through grief and bereavement. This paper hopes to provide an insight into the role of music therapy as a Salutogenic approach within a biopsychosocial framework and its need to be accepted in the Indian context.

Evaluating the relationship between built environment and salutogenic approach based on socioeconomic status in Shiraz, Iran

Evaluating the relationship between built environment and salutogenic approach based on socioeconomic status in Shiraz, Iran

Salutogenesis: A sense of coherence and health among British military veterans exposed to impactful life challenges - the emergence of post-traumatic growth and positive deviance within a life-story approach

Background This study sought to capture the perspectives and experiences of two sub-groups of military veterans, namely those who had previously been identified as offenders and those employed as practitioners within the criminal justice system in the United Kingdom. Methods The lead author undertook narrative inquiry in the form of life story research. The life stories of 17 in-depth interviews were conducted across England and Wales, allowing for insight into the lived experiences of two life story trajectories of the health of military veterans. Existing literature on salutogenesis, health, post-traumatic growth, and positive deviance has also been investigated. Results Life story interviews were transcribed verbatim and analyzed concurrently using thematic analysis to identify emergent themes. The researchers used thematic analysis as an analytical framework to allow descriptive themes from the literature on salutogenesis, health, post-traumatic, and positive deviance to be compared with those of life-story interviews. Conclusion The study adopts a salutogenic approach, which suggests that an important indicator for a sense of coherence is enabled through the positive utilization of resilience through the reconstruction of military identity and experience. Notably, the concept of salutogenesis demonstrates the ability to draw from internal and external resources as circumstances require, to survive, and because of this, the participants’ health is maintained or improved. Hence, adaptation was notable through the coherence identified by the identity of being a veteran noted between the two subgroups and represents a continuous and dynamic process. The study suggests that the development of a sense of coherence is not restricted to the early decades of life but is a continuous process as contexts, personal circumstances, and opportunities arise. This later point is realized through the presence of post-traumatic growth and positive deviance, as they aid in the nurturing and development of a renewed sense of coherence via the known identity of military service and life.

Self-efficacy, mindfulness, and perceived social support as resources to maintain the mental health of students in Switzerland’s universities of applied sciences: a cross-sectional study

BackgroundSwitzerland’s student population is at a particularly high risk of developing mental health disorders, creating a major challenge for Switzerland’s higher education establishments. Research to date has primarily sought to identify the risk factors affecting students’ mental health; however, their exposure to these factors is often unavoidable. Thus, the present study adopted a salutogenic approach focussing on the determinants of health. We examined the mental health resources available to students reported in the literature as being susceptible to helping them maintain good mental health despite their exposure to risk factors.MethodsIn February 2020, 2,415 first- and second-year bachelor’s degree students in applied sciences in French-speaking Switzerland completed an online questionnaire. The variables measured were self-evaluated mental health, perceived stress and three potential health resources: students’ feelings of self-efficacy, their capacity for mindfulness and their social support. The results were analysed using hierarchical linear regression models.ResultsWhen all the variables were included in the model without interaction effect, our results revealed that students’ self-evaluated mental health was negatively associated with perceived stress (β = -0.43, p < 0.001) and positively associated with the three potential health resources (self-efficacy: β = 0.26, p < 0.001; mindfulness: β = 0.10, p < 0.001; social support: β = 0.17, p < 0.001). An analysis of the interaction effects also revealed that a high level of self-efficacy was associated with perceived stress being less strongly linked to mental health (β = 0.29, p < 0.001).ConclusionsThese findings suggest that self-efficacy, mindfulness, and perceived social support are valuable resources for protecting students’ mental health. Thus, implementing interventions aimed at reinforcing them, could support students in applied sciences all along their academic pathway, in their classes and during their professional work experience placements.

A qualitative study exploring psychotherapy recipients’ perspectives on positive mental health

Traditionally, psychotherapy aims to address distressing emotions, thoughts, and behaviours in individuals, but it can also foster positive mental health (PMH) and earlier recovery by including salutogenic approaches in clinical practice. This study aimed to understand psychotherapy recipients’ perspectives on the meaning of PMH and how therapy could help them achieve it. A qualitative study was conducted among fifteen psychotherapy recipients seeking care at a mental health institute in Singapore. Their experiences were explored through semi-structured interviews. Inductive thematic analysis was conducted to identify key themes. Six themes on the meaning of PMH emerged – (i) acceptance of themselves and their emotions; (ii) positivity, which related to having a positive and optimistic outlook in different situations; (iii) resilience to bounce back from problems using healthy coping mechanisms; (iv) purpose in life which meant envisioning personal goals and working towards these; (v) social participation referred to having compassion, openness, and social skills to build supportive relationships; and (vi) euthymia represented being in a state without depression or anxiety and having better symptom management. Participants also narrated the ways in which psychotherapy had helped / can help them achieve their PMH goals. In this study, individuals receiving psychotherapy identified six key aspects of PMH as being relevant to them. By recognizing these unique perspectives around PMH, integrative and complementary therapy approaches can be designed to benefit people with mental health problems more effectively.

Parental coping with their child’s abandonment of Jewish Orthodox religious observance in Israel

ABSTRACT The current study’s focus was on the parental emotions, thoughts and coping methods of parents with their child’s abandoning the Jewish Orthodox belief system, using the salutogenic approach to study their sense of coherence and promote relevant professional instruction. Semi-structured interviews were held with 40 parents. Content analysis of the interview transcripts revealed three themes: 1) The parent’s comprehension of the reasons for the child’s abandoning religious observance as the surrounding influence of friends, the issue of military service and self-emotional difficulty. 2) The parent’s perception of the radical changes as manageable through hiding the changes and searching for comfort from the environment and through flexing demands from the child and tightening religious demands from the siblings. 3) The parents’ emotional processing of the child’s abandoning the belief system as arousing difficulty, deep sadness and fantasy, and hope for the child’s return to it. Results demonstrate that the parental sense of coherence was based on a dual attitude and the need for greater acknowledgement of parent-informed interventions that specifically address the issues of combining the child’s and parents’ need to reduce the family difficulty.