Narrative view of the role of health promotion and salutogenesis in the treatment of chronic disease: viability and value for the care of cardiovascular conditions

Abstract

Health promotion provides a complementary scientific and practical approach to medicine, which may help to create, maintain and restore wellness even in the presence of disease and illness. Salutogenesis, as key concept, focuses upon the emergence of health and thus, leads to fortifying individuals' and communities' health determinants and resources. The potential integration of health promotion and medicine can contribute to a more person-centred focus of integrative care to address and realize individuals' health potential and needs, rather than merely an emphasis upon the underlying disease, such as congenital heart diseases. We posit that it is possible-and advisable-to address lifestyle modification aspects, and to change the focus of therapeutic encounters and health care programs to be more tailored to and aligned with individual needs, demands and expectations. By adopting a health promotional approach to the individual patient as person, their subjective biography, narrative and lifeworld can serve as resources for developing more beneficial coping styles, resilience and trajectories for personal growth over the life span, despite the occurrence and durability of chronic conditions, such as long-term cardiovascular disease. Implications, important contingencies and requirements for education and training of health-care professionals are addressed, as they are key issues that may affect the successful development and engagement of health promotion programs within health care systems at-large.

Personal and family factors for emotional distress in adolescents with chronic disease

“…This is evident in the works of Arrondo et al (2022) ; Cobham et al (2020) ; Ferro et al (2016) ; Lacomba-Trejo et al (2020) ; Määttä et al (2022) ; Pagerols et al (2022) ; and Zheng et al (2020) . The salutogenic perspective ( Antonovsky, 1987 ; Braun-Lewensohn et al, 2017 ) focuses on general psychological resources such as self-esteem and contextual factors such as family members that make significant life experiences and greater resilience against disease possible ( Roehrich et al, 2021 ; Shorey and Nebby, 2021 ; Oh et al, 2023 ), of which this study provides evidence. In general, the results are consistent with the theory (Hypothesis 2); that is, self-esteem serves as a positive personal resource, reducing emotional distress, and perceived threat of the disease predicts greater discomfort.…”

“…Likewise, it would be interesting to investigate in greater depth the relationship between adolescents’ perceived threat of the disease and greater psychological and behavioral control by parents. It is possible that personal salutogenic factors play mediating roles over family factors, as evidenced by a previous study on the perceived quality of life of adolescent children with asthma ( Valero-Moreno et al, 2023 ), or that the activation of personal resources can only occur in this vital stage if favorable contextual factors (family in this case) are present ( Roehrich et al, 2021 ; Shorey and Nebby, 2021 ; Oh et al, 2023 ). Future research could further explore this relationship to achieve a greater understanding of the role of contextual factors in the activation of personal psychological resources of salutogenesis in the chronically ill pediatric population and, more specifically, in adolescence.…”

“…From this perspective, if a person has these resources, he or she has more opportunities to face the challenges of life. This approach has been used in different studies in health psychology and in the child and adolescent population ( Roehrich et al, 2021 ; Shorey and Nebby, 2021 ; Oh et al, 2023 ). However, more importantly, individuals must have the ability to use these resources, that is, have a sense of coherence, to maintain health and promote quality of life; since illness is perceived as a threat or stressor also in childhood and adolescence ( Braun-Lewensohn et al, 2017 ).…”