Hege Forbech Vinje

Is workplace health promotion research in the Nordic countries really on the right track

Aims: The aims of this scoping review of research on workplace health promotion interventions in the Nordic countries were to investigate: how the studies defined health; whether the studies intended to change the workplace itself (the settings approach); and whether the research focus regarding their definitions of health and use of settings approaches has changed in the past five-year period versus previous times. Methods: Using scientific literature databases, we searched for intervention studies labelled as “health promotion” in an occupational setting in the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) published from 1986 to 2014. We identified 63 publications and qualitatively analysed their content regarding health outcomes and their use of settings approaches. Results: The reviewed studies focused primarily on preventing disease rather than promoting positive measures of health. In addition, most studies did not try to change the workplace but rather used the workplace as a convenient setting for reaching people to change their behaviour related to lifestyles and disease prevention. Participatory and non-participatory settings approaches to promote well-being and other positive health measures have been used to a minor degree. The recent studies’ definitions of health and use of settings approaches did not differ much from the studies published earlier. Conclusions: Workplace health promotion in the Nordic countries should more often include positive health measures and settings approaches in intervention research. It is important to anchor workplace health promotion among important stakeholders such as unions and employers by arguing that sustainable production is dependent on workers’ health.

The Application of Salutogenesis to Work

Work is both detrimental and health promoting. Antonovsky accentuated the distinction between eliminating stressors and developing health-enhancing job characteristics. He elaborated on job characteristics that potentially relate to a sense of coherence, offering a dense description of a workplace where individuals experience meaningfulness, manageability, and comprehensibility. This chapter presents models, measures, and intervention approaches that relate to the double nature of work and to both its pathogenic and its salutogenic qualities. Hereby, the view of Antonovsky is enhanced, insofar that health-promoting, salutogenic job characteristics are not solely understood as buffering the pathogenic effects of stressors at work, but have a direct effect on positive health outcomes. Antonovsky’s original model is first specified and simplified for the context of work. Then, Antonovsky’s line of thinking is related to frameworks researching job resources and demands. After a review of the prevalence of salutogenic measures in worksite health promotion, the point of making salutogenesis more visible in work-related research and practice is elaborated upon. This is illustrated with a practical example of a survey-feedback process promoting salutogenic work. Finally, the implications and challenges for practice and future research on salutogenic work are discussed.

The Application of Salutogenesis in the Training of Health Professionals

In this chapter, we describe an empirically developed educational strategy that health profession training programmes could use to infuse students in the health professions with salutogenesis thinking and capability in their approach to patient care and health promotion activities. This strategy is based on years of research and teaching mental health, health promotion, and salutogenesis to students on bachelor, postgraduate, masters, and continuing education levels. Any educational strategy aiming to teach salutogenic practice should be grounded in the ontological stance that salutogenesis represents, and it should comprise salutogenesis as a body of knowledge, as a continuous learning process, as a way of working, and as a way of being. The overall objective is not the healing of diseases, but the facilitating and supporting of health-promoting processes leading to a person’s or group’s adaptive coping and enhanced ease and well-being. A key outcome of such training is that the student develops the capacity to manage herself in the salutogenic way. This means developing the capability called “self-tuning,” which is habitual self-sensitivity, reflection, and mobilizing of resources to maintain and improve one’s own health (“ease,” in Antonovsky’s terms). This is a form of self-care, the principles of which can be used by health professionals to assist patients and others to experience good health and well-being. A health professional’s “salutogenic capacity” is her degree of skill to help a person or group examine, mobilize, and deploy sufficient resources to achieve a shift towards the experience of good health and well-being. Salutogenic capacity can be expanded as part of the professional training, as described in this chapter. The methods learned can be applied after training, such that salutogenic capacity is strengthened and reinforced during the course of one’s career.

Building salutogenic capacity: a year of experience from a salutogenic talk-therapy group

Abstract The primary aim of this paper was to explore and increase knowledge about health-promoting processes among individuals participating in a salutogenic talk-therapy group using a qualitative explorative design. Data were collected through 11 individual interviews and one focus group interview. The informants were five women and two men participating in a salutogenic talk-therapy group over a period of one year. A general structure was identified as ‘A richer life’, which consisted of three main analysis-derived themes: ‘A well-functioning group’, ‘Who am I?’, ‘A community of like-minded individuals’. The main impression provided by these data is that although participants expressed their suffering and struggles with mental health problems, attending the group positively affected their lives and well-being. A good salutogenic group climate with high quality of social support, a redefinition of tension, and active participation seem crucial for initiating and promoting salutogenic processes.

Work, well-being and presence among researchers

Abstract The aim of this study was to investigate which work factors researchers in the institute sector consider important for their well-being and presence at work. We interviewed eight researchers in depth regarding work, well-being, and presence at work. By use of content analysis, we identified five main themes associated with well-being and presence at work: performing high-quality research; meaningful work; job demands; autonomy; and social support. The opportunity to perform high-quality research was the most important condition for the researchers’ well-being and presence at work. This theme seems to be intertwined with the association between all the other four themes and well-being and presence, and may therefore be regarded as being at a higher level than the other themes. To promote well-being and presence at work, it is important to provide administrative support and to organize work so that the researchers can concentrate on what they regard as core work tasks.

Aaron Antonovsky’s Development of Salutogenesis, 1979 to 1994

This chapter follows the development of Antonovsky’s thinking about health, stress, and coping from the middle of the 1950s and until 1994, from his awakening interest for the salutogenic question to his proposal of the Salutogenic Model of Health as a theory to guide health promotion. This chapter reproduces Antonovsky’s depiction of the salutogenic model of health from Chapter 7 in his book from 1979, Health, Stress and Coping, including his definitions of main constructs such as stress, health, breakdown, Generalized Resistance Resources, and Sense of Coherence. While the chapter briefly describes these constructs and their place in the salutogenic model of health as a whole, in-depth discussion of them is left to designated chapters. The role of this chapter is to provide an overview of the Salutogenic Model of Health the way Antonovsky wrote about it over nearly 30 years.

The Application of Salutogenesis in Mental Healthcare Settings

Research shows that sense of coherence is especially related to mental health. Thus, the relevance of applying salutogenesis in clinical settings is obvious. At the individual level, the professional healthcare worker aspires to be an expert and to create a conversational and interactional climate that will promote desirable change for, and in, the recipient of the mental healthcare service. This chapter emphasizes high quality social support in interplay with positive identity development as crucial resistance resources in a salutogenic approach in mental healthcare settings. Social support and identity are relevant in any discussion of group therapy, and a salutogenic orientation gives explicit attention to their interplay as resistance resources. While intervention research is still quite limited, some experimental evidence is presented in this chapter that indicates both the feasibility and the effectiveness of taking a salutogenic orientation into the mental health therapy setting.

Reorienting Norwegian mental healthcare services: listen to patients’ learning appetite

Reorientation of healthcare services towards more efficient health promotion interventions is an urgent matter. Despite policies and guidelines being in place, it is the least developed key action area of the Ottawa charter. User involvement, or the voice of the patient, is missing from the knowledge base of health promotion in the mental healthcare services. The aim of this study was to add experiential knowledge from former patients. We explored the lived experience of 12 former inpatients at a mental healthcare hospital. We describe what they perceive as mental health promoting efforts. A salutogenic theoretical framework and the methodology of interpretative phenomenological analysis were used. The analysis revealed an appetite for learning in order to develop an in depth understanding of their former experiences. This was motivated by a desire to master daily life despite living with an illness and to increase health and well-being. The participants perceived the learning processes within the healthcare setting as mental health promoting. This craving for a better life is compatible with health promotion. It may turn out to be an opportunity to complement the curative activity of healthcare services with health promotion educational activities.