Salutogenesis is the origin of health and focuses on factors that support human health and well-being, rather than factors that cause disease (pathogenesis). More specifically, the "salutogenic model" originally addressed the relationship between health, stress, and coping through a study of Holocaust survivors. Despite going through the dramatic tragedy of the Holocaust, some survivors were able to thrive later in life. The discovery that there must be powerful factors causing health led to the development of salutogenesis. The term was coined by Aaron Antonovsky"),[1] professor of medical sociology. The salutogenic question posed by Aaron Antonovsky is:
Antonovsky's theories reject the "dichotomy of the traditional medical model that separates health and illness". He described the relationship as a continuous variable, what he called the "health-ease versus dis-ease continuum."[1] Salutogenesis encompasses more than the origins of health and has evolved to address the multidimensional causes of higher levels of health. Models associated with salutogenesis generally include holistic approaches related to at least the physical, social, emotional, spiritual, intellectual, vocational, and environmental dimensions.
Derivation
The word "salutogenesis" comes from the Latin salus (meaning health) and the Greek genesis (meaning origin). Antonovsky developed the term from his studies on "how people manage stress and stay well"[2] (as opposed to pathogenesis which studies the causes of diseases). He noted that stress is ubiquitous, but not all people have negative health outcomes in response to stress. Instead, some people achieve health despite their exposure to potentially disabling stressors.
In his 1979 book, Health, Stress and Coping, Antonovsky described a variety of influences that led him to question how people survive, adapt, and overcome even the harshest experiences of life stress. In her 1987 book, Unraveling the Mysteries of Health, she focused more specifically on a study of women and aging; found that 29% of women who had survived Nazi concentration camps had positive emotional health, compared to 51% of a control group. Their idea was that 29% of survivors were not emotionally affected by stress. Antonovsky wrote:
salutogenic architecture
Introduction
Salutogenesis is the origin of health and focuses on factors that support human health and well-being, rather than factors that cause disease (pathogenesis). More specifically, the "salutogenic model" originally addressed the relationship between health, stress, and coping through a study of Holocaust survivors. Despite going through the dramatic tragedy of the Holocaust, some survivors were able to thrive later in life. The discovery that there must be powerful factors causing health led to the development of salutogenesis. The term was coined by Aaron Antonovsky"),[1] professor of medical sociology. The salutogenic question posed by Aaron Antonovsky is:
Antonovsky's theories reject the "dichotomy of the traditional medical model that separates health and illness". He described the relationship as a continuous variable, what he called the "health-ease versus dis-ease continuum."[1] Salutogenesis encompasses more than the origins of health and has evolved to address the multidimensional causes of higher levels of health. Models associated with salutogenesis generally include holistic approaches related to at least the physical, social, emotional, spiritual, intellectual, vocational, and environmental dimensions.
Derivation
The word "salutogenesis" comes from the Latin salus (meaning health) and the Greek genesis (meaning origin). Antonovsky developed the term from his studies on "how people manage stress and stay well"[2] (as opposed to pathogenesis which studies the causes of diseases). He noted that stress is ubiquitous, but not all people have negative health outcomes in response to stress. Instead, some people achieve health despite their exposure to potentially disabling stressors.
In his 1979 book, Health, Stress and Coping, Antonovsky described a variety of influences that led him to question how people survive, adapt, and overcome even the harshest experiences of life stress. In her 1987 book, Unraveling the Mysteries of Health, she focused more specifically on a study of women and aging; found that 29% of women who had survived Nazi concentration camps had positive emotional health, compared to 51% of a control group. Their idea was that 29% of survivors were emotionally affected by stress. Antonovsky wrote:
In the salutogenic theory, people continually struggle with the effects of difficulties. These ubiquitous forces are called Generalized Resource Deficit (GRD),[3] on the other hand, there are Generalized Resistance Resources (GRR),[4] which are all resources that help a person cope and are effective in avoiding or combating a variety of psychosocial stressors. Some examples are resources such as money, ego strength, and social support.
Widespread resource deficits will cause coping mechanisms to fail whenever the Sense Of Coherence (SOC) is not strong enough to weather the current situation. This causes illness and possibly even death. However, if the sense of coherence is high, a stressor will not necessarily be harmful. But it is the balance between generalized resource deficits and resources that determines whether a factor will be pathogenic, neutral or healthy.[1][5].
Antonovsky's formulation was that RRGs enabled people to make sense of and manage events. He argued that over time, in response to the positive experiences provided by the successful use of different resources, an individual would develop an attitude that was the essential tool for coping with the situation.[1].
Sense of coherence
The “sense of coherence” is a theoretical formulation that provides a central explanation of the role of stress in human functioning. "Beyond the specific stressors one may encounter in life, and beyond one's perception and response to those events, what determines whether stress will cause harm is whether or not the stress violates one's sense of coherence."[6] Antonovsky defined Sense of Coherence as:[2][7].
In its formulation, the sense of coherence has three components:
According to Antonovsky, the third element is the most important. If a person believes that there is no reason to persist and survive and face challenges, if he has no sense of meaning, then he will have no motivation to understand and handle events. His essential argument is that "salutogenesis" depends on experiencing a strong "sense of coherence." Their research showed that a sense of coherence predicts positive health outcomes.
Application fields
Health and Medicine
Antonovsky saw his work as primarily aimed at the fields of health psychology, behavioral medicine, and health sociology.[2] It has been adopted as a term to describe contemporary approaches to nursing,[9] psychiatry,[10] integrative medicine,[11] and healthcare architecture.[12][13] The salutogenic framework has also been adapted as a method for on-the-fly decision making; The method has been applied for emergency care[14][15] and for healthcare architecture.[13][16][17][18][19].
Workplace
The sense of coherence with its three components meaning, manageability and understandability has also been applied to the workplace.[20][21].
Significance is considered to be related to the feeling of participation and motivation and to the perceived meaning of work.[22] The meaning component has also been related to job control&action=edit&redlink=1 "Job (workplace) control (not yet written)") and task meaning. Job control means that employees have more authority to make decisions about their work and the work process. The importance of the task implies:
The manageability component is considered to be linked to work control, as well as access to resources.[22] It has also been considered to be related to social skills and confidence. Social relationships are also related to the meaning component.[24].
The comprehensibility component can be influenced by constant feedback at work,[24] for example, in relation to performance evaluation.
Salutogenic perspectives are also considered in office design.[25][26].
References
[1] ↑ a b c d Antonovsky, A. "Health, Stress and Coping" San Francisco: Jossey-Bass Publishers, 1979.
[2] ↑ a b c d Antonovsky, A. Unraveling The Mystery of Health - How People Manage Stress and Stay Well, San Francisco: Jossey-Bass Publishers, 1987.
[7] ↑ Antonovsky, Aaron. Studying Health vs. Studying Disease, Lecture at the Congress for Clinical Psychology and Psychotherapy, Berlin, 19 February 1990. available online from the Universidade Nova de Lisboa.: http://www.ensp.unl.pt/saboga/soc/pulic/soc_AAconference_berlim_91.pdf
[9] ↑ England, M., & Artinian, B. (1996). Salutogenic Psychosocial Nursing Practice. Journal of Holistic Nursing, 14(3), 147-195.
[10] ↑ Bergstein, M., Weizman, A., & Solomon, Z. (2008). Sense of Coherence Among Delusional Patients: Prediction of Remission and Risk of Relapse. Comprehensive Psychiatry, 49, 288-296.
[11] ↑ Rakel D, Fortney L. The Healing Encounter. In: Integrative Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:20-26.
[12] ↑ Dilani, A. P. D. (2008). Psychosocially supportive design: A salutogenic approach to the design of the physical environment. Design and Health Scientific Review, 1(2), 47-55.
[13] ↑ a b Golembiewski, J. (2010). Start making sense; Applying a salutogenic model to architectural design for psychiatric care. Facilities, 28(3).
[14] ↑ Golembiewski, J. (2009). Moving from theory to praxis on the fly; Introducing a salutogenic method to expedite mental healthcare provision. Paper presented at the Australian Rural and Remote Mental Health Symposium.
[15] ↑ Golembiewski, J A (June 2012). «Moving from theory to praxis on the fly; Introducing a salutogenic method to expedite mental healthcare provision.». The Australian Journal of Emergency Management 27 (2): 42-47.
[16] ↑ Golembiewski, J A (5 de marzo de 2010). «Start making sense; Applying a salutogenic model to architectural design for psychiatric care.». Facilities 28 (3/4): 100-117. doi:10.1108/02632771011023096.: https://dx.doi.org/10.1108%2F02632771011023096
[17] ↑ Golembiewski, Jan A (April 2012). «Psychiatric design: Using a salutogenic model for the development and management of mental health facilities». World Health Design Scientific Review 5 (2): 74-79.: https://www.academia.edu/1519834
[18] ↑ Golembiewski, Jan A (2012). «Salutogenic design: The neural basis for health promoting environments». World Health Design Scientific Review 5 (4): 62-68.: https://www.academia.edu/2456916
[19] ↑ Miedema, Elke; Lindahl, Göran; Elf, Marie (2019). «Conceptualizing health promotion in relation to outpatient healthcare building design: a Scoping review». HERD (en inglés) 12 (1): 69-86. ISSN 1937-5867. doi:10.1177/1937586718796651.: https://research.chalmers.se/en/publication/509459
[20] ↑ Gregor J. Jenny, Georg F. Bauer, Hege Forbech Vinje, Katharina Vogt, Steffen Torp, The Application of Salutogenesis to Work. In: The Handbook of Salutogenesis, 3 September 2016, pp. 197-210. DOI 10.1007/978-3-319-04600-6_20.
[22] ↑ a b U. Lindmark, P. Wagman, C. Wåhlin, B. Rolander (9 de noviembre de 2016). «Workplace health in dental care – a salutogenic approach». International Journal of Dental Hygiene 16 (1): 103-113. PMC 5811775. PMID 27860378. doi:10.1111/idh.12257.: https://es.wikipedia.org//www.ncbi.nlm.nih.gov/pmc/articles/PMC5811775
[23] ↑ Georg F. Bauer; Gregor J. Jenny (1 de julio de 2013). Salutogenic organizations and change: The concepts behind organizational health intervention research. Springer Science & Business Media. p. 81. ISBN 978-94-007-6470-5.: https://books.google.com/books?id=yRBAAAAAQBAJ&pg=PA81
[24] ↑ a b Georg F. Bauer; Gregor J. Jenny (1 de julio de 2013). Salutogenic organizations and change: The concepts behind organizational health intervention research. Springer Science & Business Media. p. 82. ISBN 978-94-007-6470-5.: https://books.google.com/books?id=yRBAAAAAQBAJ&pg=PA82
[25] ↑ Forooraghi, Melina; Miedema, Elke; Ryd, Nina; Wallbaum, Holger (18 de marzo de 2020). «Scoping review of health in office design approaches». Journal of Corporate Real Estate (en inglés) 22 (2): 155-180. ISSN 1463-001X. doi:10.1108/JCRE-08-2019-0036.: https://www.emerald.com/insight/content/doi/10.1108/JCRE-08-2019-0036/full/html
In the salutogenic theory, people continually struggle with the effects of difficulties. These ubiquitous forces are called Generalized Resource Deficit (GRD),[3] on the other hand, there are Generalized Resistance Resources (GRR),[4] which are all resources that help a person cope and are effective in avoiding or combating a variety of psychosocial stressors. Some examples are resources such as money, ego strength, and social support.
Widespread resource deficits will cause coping mechanisms to fail whenever the Sense Of Coherence (SOC) is not strong enough to weather the current situation. This causes illness and possibly even death. However, if the sense of coherence is high, a stressor will not necessarily be harmful. But it is the balance between generalized resource deficits and resources that determines whether a factor will be pathogenic, neutral or healthy.[1][5].
Antonovsky's formulation was that RRGs enabled people to make sense of and manage events. He argued that over time, in response to the positive experiences provided by the successful use of different resources, an individual would develop an attitude that was the essential tool for coping with the situation.[1].
Sense of coherence
The “sense of coherence” is a theoretical formulation that provides a central explanation of the role of stress in human functioning. "Beyond the specific stressors one may encounter in life, and beyond one's perception and response to those events, what determines whether stress will cause harm is whether or not the stress violates one's sense of coherence."[6] Antonovsky defined Sense of Coherence as:[2][7].
In its formulation, the sense of coherence has three components:
According to Antonovsky, the third element is the most important. If a person believes that there is no reason to persist and survive and face challenges, if he has no sense of meaning, then he will have no motivation to understand and handle events. His essential argument is that "salutogenesis" depends on experiencing a strong "sense of coherence." Their research showed that a sense of coherence predicts positive health outcomes.
Application fields
Health and Medicine
Antonovsky saw his work as primarily aimed at the fields of health psychology, behavioral medicine, and health sociology.[2] It has been adopted as a term to describe contemporary approaches to nursing,[9] psychiatry,[10] integrative medicine,[11] and healthcare architecture.[12][13] The salutogenic framework has also been adapted as a method for on-the-fly decision making; The method has been applied for emergency care[14][15] and for healthcare architecture.[13][16][17][18][19].
Workplace
The sense of coherence with its three components meaning, manageability and understandability has also been applied to the workplace.[20][21].
Significance is considered to be related to the feeling of participation and motivation and to the perceived meaning of work.[22] The meaning component has also been related to job control&action=edit&redlink=1 "Job (workplace) control (not yet written)") and task meaning. Job control means that employees have more authority to make decisions about their work and the work process. The importance of the task implies:
The manageability component is considered to be linked to work control, as well as access to resources.[22] It has also been considered to be related to social skills and confidence. Social relationships are also related to the meaning component.[24].
The comprehensibility component can be influenced by constant feedback at work,[24] for example, in relation to performance evaluation.
Salutogenic perspectives are also considered in office design.[25][26].
References
[1] ↑ a b c d Antonovsky, A. "Health, Stress and Coping" San Francisco: Jossey-Bass Publishers, 1979.
[2] ↑ a b c d Antonovsky, A. Unraveling The Mystery of Health - How People Manage Stress and Stay Well, San Francisco: Jossey-Bass Publishers, 1987.
[7] ↑ Antonovsky, Aaron. Studying Health vs. Studying Disease, Lecture at the Congress for Clinical Psychology and Psychotherapy, Berlin, 19 February 1990. available online from the Universidade Nova de Lisboa.: http://www.ensp.unl.pt/saboga/soc/pulic/soc_AAconference_berlim_91.pdf
[9] ↑ England, M., & Artinian, B. (1996). Salutogenic Psychosocial Nursing Practice. Journal of Holistic Nursing, 14(3), 147-195.
[10] ↑ Bergstein, M., Weizman, A., & Solomon, Z. (2008). Sense of Coherence Among Delusional Patients: Prediction of Remission and Risk of Relapse. Comprehensive Psychiatry, 49, 288-296.
[11] ↑ Rakel D, Fortney L. The Healing Encounter. In: Integrative Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:20-26.
[12] ↑ Dilani, A. P. D. (2008). Psychosocially supportive design: A salutogenic approach to the design of the physical environment. Design and Health Scientific Review, 1(2), 47-55.
[13] ↑ a b Golembiewski, J. (2010). Start making sense; Applying a salutogenic model to architectural design for psychiatric care. Facilities, 28(3).
[14] ↑ Golembiewski, J. (2009). Moving from theory to praxis on the fly; Introducing a salutogenic method to expedite mental healthcare provision. Paper presented at the Australian Rural and Remote Mental Health Symposium.
[15] ↑ Golembiewski, J A (June 2012). «Moving from theory to praxis on the fly; Introducing a salutogenic method to expedite mental healthcare provision.». The Australian Journal of Emergency Management 27 (2): 42-47.
[16] ↑ Golembiewski, J A (5 de marzo de 2010). «Start making sense; Applying a salutogenic model to architectural design for psychiatric care.». Facilities 28 (3/4): 100-117. doi:10.1108/02632771011023096.: https://dx.doi.org/10.1108%2F02632771011023096
[17] ↑ Golembiewski, Jan A (April 2012). «Psychiatric design: Using a salutogenic model for the development and management of mental health facilities». World Health Design Scientific Review 5 (2): 74-79.: https://www.academia.edu/1519834
[18] ↑ Golembiewski, Jan A (2012). «Salutogenic design: The neural basis for health promoting environments». World Health Design Scientific Review 5 (4): 62-68.: https://www.academia.edu/2456916
[19] ↑ Miedema, Elke; Lindahl, Göran; Elf, Marie (2019). «Conceptualizing health promotion in relation to outpatient healthcare building design: a Scoping review». HERD (en inglés) 12 (1): 69-86. ISSN 1937-5867. doi:10.1177/1937586718796651.: https://research.chalmers.se/en/publication/509459
[20] ↑ Gregor J. Jenny, Georg F. Bauer, Hege Forbech Vinje, Katharina Vogt, Steffen Torp, The Application of Salutogenesis to Work. In: The Handbook of Salutogenesis, 3 September 2016, pp. 197-210. DOI 10.1007/978-3-319-04600-6_20.
[22] ↑ a b U. Lindmark, P. Wagman, C. Wåhlin, B. Rolander (9 de noviembre de 2016). «Workplace health in dental care – a salutogenic approach». International Journal of Dental Hygiene 16 (1): 103-113. PMC 5811775. PMID 27860378. doi:10.1111/idh.12257.: https://es.wikipedia.org//www.ncbi.nlm.nih.gov/pmc/articles/PMC5811775
[23] ↑ Georg F. Bauer; Gregor J. Jenny (1 de julio de 2013). Salutogenic organizations and change: The concepts behind organizational health intervention research. Springer Science & Business Media. p. 81. ISBN 978-94-007-6470-5.: https://books.google.com/books?id=yRBAAAAAQBAJ&pg=PA81
[24] ↑ a b Georg F. Bauer; Gregor J. Jenny (1 de julio de 2013). Salutogenic organizations and change: The concepts behind organizational health intervention research. Springer Science & Business Media. p. 82. ISBN 978-94-007-6470-5.: https://books.google.com/books?id=yRBAAAAAQBAJ&pg=PA82
[25] ↑ Forooraghi, Melina; Miedema, Elke; Ryd, Nina; Wallbaum, Holger (18 de marzo de 2020). «Scoping review of health in office design approaches». Journal of Corporate Real Estate (en inglés) 22 (2): 155-180. ISSN 1463-001X. doi:10.1108/JCRE-08-2019-0036.: https://www.emerald.com/insight/content/doi/10.1108/JCRE-08-2019-0036/full/html