Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Norway.
Glob Health Promot. 2013 Jun;20(2):30-8. doi: 10.1177/1757975913486684.
Despite health promotion's enthusiasm for the salutogenic model of health, researchers have paid little attention to Antonovsky's central ideas about the ease/dis-ease continuum, defined in terms of 'breakdown' (the severity of pain and functional limitations, and the degree medical care is called for, irrespective of specific diseases). Rather, salutogenesis research has a strong focus on how sense of coherence relates to a wide range of specific diseases and illness endpoints. We address two questions: Why has Antonovsky's health concept failed to stimulate research on breakdown, and how can the present emphasis on disease be complemented by an emphasis on positive well-being in the salutogenic model? We show that (i) the breakdown concept of health as specified by Antonovsky is circular in definition, (ii) it is not measured on the 'required' ease/dis-ease continuum, (iii) it is not measureable by any validated or reliability-tested assessment tool, and (iv) it has not so much been rejected by health promotion, as it has not been considered at all. We show that Antonovsky came to view breakdown as but one aspect of well-being. He was open to the idea of well-being as something more positive than the absence of pain, suffering and need for medical care. We suggest ways to move salutogenesis research in the direction of well-being in its positive sense.
尽管健康促进热衷于健康的形成模式，但研究人员很少关注 Antonovsky 关于易患/不易患连续体的核心思想，该连续体是根据“崩溃”（疼痛和功能限制的严重程度，以及需要医疗护理的程度，而不论具体疾病如何）来定义的。相反，形成研究非常关注的是，整体感如何与广泛的特定疾病和疾病终点相关。我们提出了两个问题：为什么 Antonovsky 的健康概念未能激发对崩溃的研究，以及如何通过强调形成模式中的积极幸福感来补充对疾病的关注？我们表明：（i） Antonovsky 规定的健康崩溃概念在定义上是循环的；（ii）它不是在“必需”的易患/不易患连续体上测量的；（iii）它不是通过任何经过验证或可靠性测试的评估工具来测量的；（iv）健康促进并没有拒绝崩溃概念，而只是完全没有考虑它。我们表明，Antonovsky 开始将崩溃视为幸福感的一个方面。他对幸福感的看法是积极的，认为幸福感不仅仅是没有痛苦、没有痛苦和不需要医疗护理。我们提出了一些方法，以使形成研究朝着积极幸福感的方向发展。
