Heggdal Kristin, Lovaas Beate Jelstad
Lovisenberg Diaconal University College, Oslo, Norway.
VID Specialized University, Oslo, Norway.
Scand J Caring Sci. 2018 Jun;32(2):690-697. doi: 10.1111/scs.12498. Epub 2017 Jul 12.
Chronic illness health interventions aim to strengthen individuals' wellness resources, in addition to their ability to handle their condition. This presupposes a partnership between patients and professionals and flexibility in care organization.
This study aims to investigate possible changes in individuals' sense of coherence while living with long-term illness as they engage in a broadly applicable health promotion intervention developed in specialist care settings that was later implemented in the community care context.
This study had a pre-postdesign. Sense of coherence was measured using the SOC-29 questionnaire at baseline and within 14 days of programme completion. The total baseline sample included 108 Norwegian adults (aged 21-89) with chronic illness. Data were analysed using paired samples t-tests.
In both clinical sites, the total sample's mean SOC score changed positively from the baseline to the follow-up 4 months later. This change was larger for the participants in the community care context. Manageability increased significantly for women. Significant positive changes in SOC score and the manageability dimension were also identified among participants who had children. Similar findings were found for those who were living with a partner, as well as for public transfer payment recipients.
The intervention contributed to a positive change in participants' SOC while living with illness. The findings revealed that the intervention is a flexible health promotion tool across age, diagnostic categories and clinical sites. The community participants' SOC changed the most, which indicates that the intervention is especially relevant in the follow-up of persons living with long-term illness within the community. The intervention contributes to a shift of perspectives in health care towards strenght-based care and health within illness.
慢性病健康干预旨在增强个人的健康资源以及应对自身疾病的能力。这需要患者与专业人员之间建立伙伴关系，并在护理组织方面具备灵活性。
本研究旨在调查患有长期疾病的个体在参与一项在专科护理环境中开发、随后在社区护理环境中实施的广泛适用的健康促进干预措施时，其连贯感可能发生的变化。
本研究采用前后设计。在基线时以及项目完成后14天内，使用SOC - 29问卷测量连贯感。基线总样本包括108名患有慢性病的挪威成年人（年龄在21 - 89岁之间）。使用配对样本t检验分析数据。
在两个临床地点，总样本的平均SOC得分从基线到4个月后的随访均呈正向变化。社区护理环境中的参与者这种变化更大。女性的可管理性显著提高。在有孩子的参与者中，SOC得分和可管理性维度也出现了显著的正向变化。在有伴侣的参与者以及领取公共转移支付的参与者中也发现了类似的结果。
该干预措施有助于患病参与者的SOC产生积极变化。研究结果表明，该干预措施是一种跨越年龄、诊断类别和临床地点的灵活的健康促进工具。社区参与者的SOC变化最大，这表明该干预措施在社区中长期患病者的随访中尤为相关。该干预措施有助于医疗保健视角向基于优势的护理和疾病中的健康转变。
