Ulrich Wiesmann

A salutogenic view on subjective well-being in active elderly persons

In this paper, subjective well-being as an indicator for successful aging is investigated from a salutogenic perspective that states that the sense of coherence plays a key role for psychological adaptation. It should be demonstrated that the sense of coherence mediates the relationship between generalized resistance resources and subjective well-being. One-hundred-and-seventy psychophysically active elderly persons (37 men) filled out a questionnaire assessing the sense of coherence, subjective well-being and resistance resources (such as age, education, physical health, activity level, social support and personality variables). It was found that resources co-varied with the sense of coherence and subjective well-being, accounting for 52 and 48% of the variance, respectively. The most important predictors were self-efficacy, self-esteem and education. After controlling for resources, the sense of coherence accounted for an additional 6% of the variance in well-being. The sense of coherence clearly mediated the relationship between resources and well-being. The findings corroborate the salutogenic idea that the sense of coherence creates, or maintains, a form of psychological integrity as represented by subjective well-being. The promotion of a strong sense of coherence should be a major aim of gerontological interventions.

A Salutogenic Analysis of Healthy Aging in Active Elderly Persons

The authors systematically explore relationships between generalized resistance resources (GRRs), the sense of coherence (SOC), and the healthease/dis-ease (HE-DE) continuum. A sample of 170 active older adults at the mean age of 67 years filled out a comprehensive questionnaire. The results indicate that 11 GRRs significantly predicted SOC (56% of variance accounted for) and that GRRs significantly predicted the HE-DE continuum (38%). Holding GRRs constant, SOC significantly accounted for 3% additional variance in health. Finally, SOC mediated GRRs’ effects on health. SOC proved to be a complete mediator for autonomy/identity resource gains, social external health locus of control, self-efficacy, and self-esteem, and a partial mediator for activity level and social support. The findings suggest that SOC plays a central role for health maintenance and health promotion in the third age because it pools resource influences on health. The authors recommend the application of salutogenic theory to intervention.

Sense of coherence, depressive feelings and life satisfaction in older persons: a closer look at the role of integrity and despair

Objectives: The present study investigated the relationship between Antonovskys sense of coherence (SOC) and well-being in a sample of Flemish elderly. In addition, the mediating role of Eriksons developmental task of integrity versus despair was examined in the relationship between SOC, depression, and life satisfaction. Method: Data on sociodemographic variables, SOC, depressive symptoms, life satisfaction, ego-integrity, and despair were collected. In total, 100 older persons with a mean age of 76.5 years participated. Mplus was used to test the mediating role of integrity and despair in the relationship between SOC and both life satisfaction and depression. Results: A positive relationship between SOC and well-being was found. More precisely, elderly individuals with a strong SOC experienced less depressive symptoms and higher levels of satisfaction with their life. In addition, mediation analysis indicated that the relationship between SOC and depressive symptoms was partially mediated by the positive resolution of the integrity–despair crisis, whereas the relationship between SOC and life satisfaction was fully mediated by integrity and despair. Conclusion: Our findings indicate that SOC might be a resource for greater well-being in the elderly. Furthermore, our study offers a partial explanation for the relations found and points to the importance of finding integrity and resolving despair in this stage of life.

An integrative theoretical framework of acculturation and salutogenesis

Abstract During the last two decades, the number of international migrants worldwide has constantly risen. In this context, cross-cultural dimensions of psychological disorders receive increased attention, especially depression, anxiety and post-traumatic stress disorders among the migrant population. In this paper we propose a theoretical framework for the understanding of migrant mental health. This framework combines elements from Berrys acculturation model and Antonovskys salutogenic theory. The former illustrates the main factors that affect an individuals adaptation in a new cultural context. The term acculturative stress denotes unresolved problems resulting from intercultural contact that cannot be overcome easily by simply adjusting or assimilating. The latter specifies the relationship between culturally associated stress and mental health more distinctive, introducing the concepts of generalized resistance resources and sense of coherence that determine mental health outcomes of migrants during acculturative stress periods. Specifically, we provide an integrative framework of acculturation and salutogenesis that helps to integrate inconsistent findings in the migrant mental health literature. The current paper focuses on the effect of resource factors for positive mental health outcomes in the migrant population and summarises some implications for future research activities.

Multiples Gesundheitsverhalten und Vulnerabilität im Geschlechtervergleich

Zusammenfassung. Mit dem neu entwickelten Fragebogen zum Multiplen Gesundheitsverhalten (MGV-39) wurde das Spektrum habituellen gesundheitsbezogenen Verhaltens einer studentischen Stichprobe erfasst. Die erhobenen 39 Verhaltensbereiche wiesen eine gute interne Konsistenz auf, was die Bildung eines Summenscores (MGV) erlaubte. In einer Hauptkomponentenanalyse liesen sich die 39 Verhaltenskategorien auf sechs Dimensionen reduzieren: Aktive Lebensgestaltung, Compliance, Substanzvermeidung, Sicherheitsorientierung, Ernahrung und Hygiene. Der MGV-39 erwies sich als sensitiv fur Geschlechtsunterschiede; das in der Literatur beschriebene Defizit von Mannern in der Compliance, Substanzvermeidung, Sicherheitsorientierung und Hygiene (sowie im MGV) konnte repliziert werden. In einem weiteren Schritt wurde der Zusammenhang zwischen MGV und Vulnerabilitat aus einer Geschlechterperspektive beleuchtet. Die Ergebnisse eines additiven hierarchischen Regressionsmodells wiesen auf, dass hoheres Alter, weibliches Geschlecht...

Psychosoziale Belastung und Unterstützungswunsch ambulanter Hauttumorpatienten

Eine wichtige Basis für eine adäquate psychoonkologische und soziale Betreuung von Tumorpatienten bildet die regelmäßige Evaluation der psychosozialen Belastungen und somit der Betreuungsbedürftigkeit. Hierfür stehen zahlreiche Fragebögen zur Verfügung. Ziel der Untersuchung war es, zu ermitteln, ob belastete Patienten Unterstützung wünschen und welches Screening‐Instrument ambulante Hauttumorpatienten präferieren.

A Salutogenic Analysis of Developmental Tasks and Ego Integrity vs. Despair.

This study examines the hypothesis that the outcome of the Eriksonian crisis of integrity vs. despair is dependent on successful coping with four developmental tasks: maintenance of active involvement, reevaluation of life satisfaction, developing a sense of health maintenance, and reevaluation of the sense of coherence (SOC). A selective sample of 170 rather healthy individuals at the mean age of 67 years filled out a questionnaire assessing everyday activities, satisfaction with past, present, and future life, healthy habits, SOC, and depression. In our final path-analytical model, the SOC had a significant direct effect on all endogenous variables; it also attenuated depression indirectly via activity and via satisfaction with present and future life. Satisfaction with present life showed the strongest mitigating direct effect on depression. The SOC is an important antecedent for successfully resolving the integrity vs. despair crisis, in that a strong SOC is a guiding force behind mastering the other three tasks.

Dimensions and profiles of the generalized health‐related self‐concept

OBJECTIVES We explore the significance of health as a potentially self-relevant category from the perspective of dynamic self-concept theory. Our intention was to describe the dimensional structure of the generalized health-related self-concept, to identify particular prototypes of health-related self-definition, and to see if these prototypes would differ with respect to appraisals of health behaviour and subjective health. DESIGN We conducted a cross-sectional questionnaire study involving 545 college students (23.3% male) at the mean age of 22 years. METHODS The self-administered questionnaire assessed a relevant spectrum of health-related cognitions denoting their generalized declarative knowledge about their health (the generalized health-related self-concept). Additionally, participants rated their multiple health behaviour, their perceived health, and their anticipated vulnerability. RESULTS A principal components analysis of the health-related cognitions revealed the following five dimensions: health-protective dispositions, health-protective motivation, vulnerability, health-risky habits, and external, avoidant motivation. A two-step cluster analysis of the five components identified six profiles of health-related self-concept: careless/carefree, omnipotents, risk-takers, mentally affected, reluctant-avoidant, and medically fragile. These prototypes could be successfully reclassified (97.6%). The six profiles differed with respect to their health behaviour and subjective health appraisals. CONCLUSIONS The dimensional structure represents both resources and deficits with respect to an individuals health-related self-concept. An individuals profile of these dimensions might correspond to a characteristic set of particular health needs and motivations. Successful health communications should follow a complementary strategy of affirming the self-concept.

Salutogenese im Alter

Zusammenfassung: Das Koharenzgefuhl (sense of coherence, SOC) ist ein zentrales Konzept in Antonovskys Salutogenese-Modell. Diese globale Orientierung bestimmt daruber, wie effektiv eine altere Person in der Lage ist, geeignete generalisierte Widerstandsquellen (GRRs) fur die Erhaltung ihrer Gesundheit zu aktivieren. 170 aktive altere Menschen (37 Manner) im mittleren Alter von 67 Jahren (Min-Max: 59–89) nahmen freiwillig an einer interdisziplinaren Studie uber gesundheitsbezogene Lebensqualitat und korperliche Aktivitat im Alter teil. SOC, GRRs und subjektive Gesundheitsmase (SF-36 Summenscores und Beschwerden-Liste) wurden per Fragebogen erhoben. Das SOC kovariierte signifikant mit 11 von 13 der erhobenen GRRs; Selbstwirksamkeit, Selbstwertgefuhl, Bildung und fatalistische Externalitat waren signifikante Pradiktoren. Nach statistischer Kontrolle der GRRs klarte das SOC jeweils signifikant zusatzliche Varianz im psychischen Gesundheitsniveau und im Beschwerdenstatus auf; dagegen erklarten SOC und GRRs das korperliche Gesundheitsniveau nicht. Schlieslich erwies sich das SOC als ein Mediator der Beziehung zwischen GRRs und dem psychischen Summenscore bzw. Beschwerdenstatus. Schlusselbegriffe: Salutogenese, Sense of Coherence, Lebensqualitat

Sense of coherence and pain experience in older age.

BACKGROUND We investigate to what extent pain in older individuals is predicted by on the one hand chronic morbidity as a resistance deficit, and on the other hand psychological resistance resources and the sense of coherence. For the first time, we tested the salutogenic hypothesis that the sense of coherence mediates the relationship between resources/deficits and pain. METHODS In our questionnaire study, we assessed selected psychological resistance resources (self-esteem, generalized self-efficacy, optimism, and social support), the number of self-reported medical diagnoses of chronic illness, the sense of coherence, and pain (SF-36 Bodily Pain subscale) in a sample of 387 older persons (at the mean age of 73.8 years). RESULTS Using hierarchical regression, we found that morbidity and sense of coherence were the only significant predictors of pain, with morbidity showing the strongest effect. Using path analysis, the sense of coherence was a mediator of the relationship between resistance resources/deficits and pain. CONCLUSIONS With respect to our analytical model, in which pain experience was the criterion variable, morbidity and the sense of coherence are important predictors of pain. Moreover, we found evidence for the salutogenic idea that the sense of coherence represents a mediator variable as it pools resistance/deficits influences on pain. We recommend a prospective design to explore these assumed causal chains in future research.