© Borgis - New Medicine 3/2009, s. 53-55
*Ewa Ogłodek1, Danuta Mo?2, Aleksander Araszkiewicz1, Waldemar Placek3
Sense of Coherence in Parents Taking Care of Children With Psoriasis and Schizophrenia
1Chair and Clinic of Psychiatry of the Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Poland
2Individual medical practice
3Chair and Clinic of Dermatology, Sexually Transmitted Diseases and Immunodermatology of the
3Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Poland
Summary
Aim. The salutogenic theory focuses on predictors of positive health outcomes. Antkovsky claims that the stronger a person´s sense of coherence, when confronted with a stressor, the more likely it is that the person will: be motivated to cope (meaningfulness), believe that the challenge is understood (comprehensibility) and believe that resources to cope are available (manageability). The aim of the research was to evaluate the sense of coherence in parents taking care of children with psoriasis and schizophrenia.
Material and Method. 32 parents (mothers and fathers) of patients with schizophrenia and psoriasis were examined. The patients were under the care of the Chair and Clinic of Psychiatry of the Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz. A survey questionnaire was used as the method of examination. In order to measure the sense of coherence, the Life Orientation Questionnaire (SOC-29) was applied.
Results. The previously mentioned relationship suggests that an increase of the sense of coherence may influence the effectiveness of dealing with the stress of having a close family member fall ill with schizophrenia and psoriasis.
Conclusions. The obtained results may be used to form a support model for families of mentally ill patients, which means that they may be used both in therapy and rehabilitation.
Introduction
Falling ill with schizophrenia and psoriasis is associated with a change in a patient´s approach to his or her immediate social environment. The patient´s family has to face the necessity of accepting everything the disease brings with it. Coherence is a factor which has a great impact on the way of fighting the disease, treatment and rehabilitation.
The "sense of coherence" (SOC) model based on Antonovsky´s concept of salutogenesis has mainly been validated in patients with psoriasis (psychosomatic illness) and schizophrenia and their families [1].
In family members of patients suffering from chronic illnesses some mental processes, particularly emotional stress, might serve as an important factor triggering mental illness [2, 3].
Antonovsky examined health-promoting factors and developed the concept of sense of coherence (SOC) to explain why some people become ill when stressed while others remain healthy. Sense of coherence is defined as „global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence”. Sense of coherence generally expresses an individual view of the world and has three components: comprehensibility (the extent to which stimuli from one´s external and internal environment are structured, explicable and predictable) manageability (the extent to which resources are available to a person to meet the demands posed by these stimuli) and meaningfulness (the extent to which these demands are challenges worthy of investment and engagement) [4].
Aim
The aim of the research was to evaluate the sense of coherence in parents taking care of children with psoriasis and schizophrenia.
Material and Method
32 parents (mothers and fathers) of adult children with schizophrenia and psoriasis were examined. There were 16 men and 16 women in the study group. A survey was used as the method of research.
DSM-IV classification was used in the psychiatric examination of the adult children in question and paranoid schizophrenia was diagnosed.
This was followed by a survey of the parents by means of the Life Orientation Questionnaire (SOC-29).
Results
Figure 1 presents percentage distributions of the three components of sense of coherence (SOC) in the male and the female parts of the study group. It was found that the components manageability and meaningfulness are significantly higher in men than in women. The previously mentioned relationship suggests that the increase of 2 components of the sense of coherence may influence the capacity to deal effectively with the stress of having a close family member fall ill with schizophrenia and psoriasis.
Fig. 1 Sense of coherence: comprehensibility, manageability and meaningfulness.
Discussion
In our investigation 32 parents (mothers and fathers) of adult children with schizophrenia and psoriasis were surveyed by means of the Life Orientation Questionnaire (SOC-29). The analysis of the SOC-29 questionnaire in this group revealed that two of the components of sense of coherence, manageability and meaningfulness, are significantly higher in men than in women.
Such results may indicate difficulties experienced by parents taking care of children with schizophrenia and psoriasis. Mothers of ill children were found to have lower manageability and meaningfulness and higher comprehensibility. Mothers concentrated on the emotional experiences concerning their children´s diseases. They often felt angry, guilty and tense, and coped poorly with specific tasks concerning the care of children with schizophrenia and psoriasis. Fathers of the children showed higher manageability and meaningfulness and lower comprehensibility than mothers. Fathers more often than mothers made efforts to cope better with problems of their chronically ill children, but put less effort than mothers into understanding the disease.
According to Bergstein M et al. and Endler PC et al. [5, 6] people who have developed a strong sense of coherence tend to perceive their situation as understandable, manageable and meaningful. Strong sense of coherence suggests that an individual possesses resources (such as social support and ego identity) that enable the person to cope with various kinds of stressful life events [7].
Salutogenesis is a concept based on stress and resilience. The sense of coherence is based on three components which are considered prerequisites for salutogenesis: comprehensibility, meaningfulness and manageability [8, 9].
The salutogenic perspective might in several advantageous aspects contribute to the care and support for parents of patients with a long and persistent chronic illness such as schizophrenia and psoriasis.
General resistance resources assist the individual in developing a strong sense of coherence and serve as coping resources that protect the individual from the negative impact of the tension associated with stress [10, 11]. Consistent experiences form the basis for comprehensibility; experiences reinforcing the individual´s belief that resources are available to meet life´s demands form the basis for manageability; and experiences involving participation in shaping outcomes form the basis for meaningfulness. Sense of coherence is not meant to be a specific coping style. Rather, a person with a strong sense of coherence, who believes that he or she understands a problem and sees it as a challenge, is more likely to select the most appropriate coping behaviour for a specific problem [12, 13].
Beside specific stress factors that one might encounter in life, and one´s perception and response to those events, the factor which determines whether stress will cause harm is whether or not the stress violates your sense of coherence.
Conclusions
1. Two components of the sense of coherence, manageability and meaningfulness, are significantly higher in men than in women.
2. Fathers of children with the chronic diseases schizophrenia and psoriasis more often than mothers committed themselves to activities leading to overcoming stressful situations related to the disease. Fathers put less effort than mothers into understand the disease.
3. The obtained results may be used to form a support model for families of mentally ill patients, which means that they may be used both in therapy and rehabilitation.
Piśmiennictwo
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