Cecon-Stabel Natalia, Demirer Ibrahim, Pfaff Holger, Dresen Antje
Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences, Faculty of Medicine at the University Hospital, University of Cologne, Cologne, Germany.
Health Psychol Rep. 2024 Oct 7;12(4):322-336. doi: 10.5114/hpr/189462. eCollection 2024.
Sense of coherence (SoC), a key concept in the theory of salutogenesis, influences the pathway to promote or maintain health. Utilising psycho-oncological care (PC) can be allocated to the dimension of 'tension management' within this theory. We aimed to evaluate tension management and SoC in the context of PC by analysing whether PC consultations and therapeutic alliance influenced patients' SoC over time.
Patients who received PC were surveyed twice (after 3 and 12 months) about their care experiences, including therapeutic alliance and SoC. Survey data were matched to care documentation data, which contain consultation dates and sociodemographics. Four stepwise regression analyses were conducted with overall SoC and its subscales of meaningfulness, comprehensibility and manageability at T2 as outcome variables. The predictors are therapeutic alliance and the number of consultations (T1).
One hundred patients filled out all three SoC subscales at T1 and T2 and were treated by a psycho-oncologist. Therapeutic bond predicted the change in overall SoC (β = .34, = 2.26, = .026) and manageability (β = .47, =3.02, = .003). The number of consultations predicted overall SoC (β = .16, = 2.05, = .043), meaningfulness (β = .21, = 2.51, = .014) and manageability (β = .17, = 2.07, = .041).
Our results suggest that part of successful tension management in PC is a good therapeutic bond and the number of needs-oriented consultations utilised. These predictors affect SoC subdimensions differently.
连贯感（SoC）是健康生成理论中的一个关键概念，影响着促进或维持健康的途径。在该理论中，利用心理肿瘤护理（PC）可归为“压力管理”范畴。我们旨在通过分析PC咨询和治疗联盟是否随时间影响患者的SoC，来评估PC背景下的压力管理和SoC。
接受PC的患者在3个月和12个月后接受了两次关于其护理体验的调查，包括治疗联盟和SoC。调查数据与护理记录数据相匹配，护理记录数据包含咨询日期和社会人口统计学信息。以T2时的总体SoC及其意义、可理解性和可管理性子量表作为结果变量，进行了四项逐步回归分析。预测因素为治疗联盟和咨询次数（T1）。
100名患者在T1和T2时填写了所有三个SoC子量表，并由一名心理肿瘤学家进行治疗。治疗关系预测了总体SoC的变化（β = .34，t = 2.26，p = .026）和可管理性（β = .47，t = 3.02，p = .003）。咨询次数预测了总体SoC（β = .16，t = 2.05，p = .043）、意义（β = .21，t = 2.51，p = .014）和可管理性（β = .17，t = 2.07，p = .041）。
我们的结果表明，PC中成功进行压力管理的部分因素是良好的治疗关系和所采用的以需求为导向的咨询次数。这些预测因素对SoC子维度的影响各不相同。
