Older Adults in Hospitals: Health Promotion When Hospitalized

The population of older adults (≥60 years) is currently growing. Thus, in the years to come it is expected that a high proportion of patients hospitalized will be in the older age range. In western countries, the proportion of older inpatients is about 40% in the medical and surgical hospitals units. Older people with illness is vulnerable to both physical and cognitive impairments as well as depression. Therefore, a health-promoting perspective and approach are highly warranted in clinical nursing care of older adults in medical hospitals. This chapter focuses on health promotion related to depressive symptoms, impairment in activities of daily living, and cognitive impairment in older hospitalized adults.

Future Perspectives of Health Care: Closing Remarks

The Covid-19 pandemic has demonstrated the vulnerability of our health care systems as well as our societies. During the year of 2020, we have witnessed how whole societies globally have been in a turbulent state of transformation finding strategies to manage the difficulties caused by the pandemic. At first glance, the health promotion perspective might seem far away from handling the serious impacts caused by the Covid-19 pandemic. However, as health promotion is about enabling people to increase control over their health and its determinants, paradoxically health promotion seems to be ever more important in times of crisis and pandemics. Probably, in the future, pandemics will be a part of the global picture along with the non-communicable diseases. These facts strongly demand the health care services to reorient in a health promoting direction.The IUHPE Global Working Group on Salutogenesis suggests that health promotion competencies along with a reorientation of professional leadership towards salutogenesis, empowerment and participation are required. More specifically, the IUHPE Group recommends that the overall salutogenic model of health and the concept of SOC should be further advanced and applied beyond the health sector, followed by the design of salutogenic interventions and change processes in complex systems.

SHAPE: A Healthy Aging Community Project Designed Based on the Salutogenic Theory

Salutogenesis introduces a paradigm that requires a perceptual change towards what creates health and how health can be facilitated. Removing the lens of pathogenesis, aging is an achievement to be embraced and older people are valued as assets for their wealth of experiences, resources, skills and knowledge. From the perspectives of older adults, the concept of healthy aging is multidimensional, comprising bio-psycho-social-spiritual health. Evidence shows that sense of coherence via resistance resources promotes health outcomes among older adults. However, very few works have attempted to operationalise the salutogenic theory to promote healthy aging among older community dwellers. This chapter provides a detailed description of the Salutogenic Healthy Aging Program Embracement (SHAPE) intervention for senior-only household dwellers. SHAPE represents an application of the salutogenic concepts: sense of coherence and resistance resources. SHAPE is an integrative person-centric multi-dimensional health resource program that employs an asset-based insight-oriented approach. Illustration of examples in which how the salutogenic concepts were operationalised in developing the SHAPE intervention approach, its content, activities and the conduction of the intervention are presented.

Nurse-Patient Interaction: A Vital Salutogenic Resource in Nursing Home Care

We are now witnessing a major change in the world’s population. Many people globally grow very old: 80, 90, and 100 years. Increased age is followed by an increased incidence of functional and chronic comorbidities and diverse disabilities, which for many leads to the need for long-term care in a nursing home. Quality of life and health promotive initiatives for older persons living in nursing homes will become ever more important in the years to come. Therefore, this chapter focuses on health promotion among older adults living in nursing homes. First, this chapter clarifies the concepts of health, salutogenesis, and pathogenesis, followed by knowledge about health promotion. Then insight and knowledge about the nursing home population is provided; what promotes health and well-being in nursing home residents?Health promotion in the health services should be based on integrated knowledge of salutogenesis and pathogenesis. The salutogenic understanding of health is holistic and considers man as a wholeness including physical, mental, social, and spiritual/existential dimensions. Research indicates that various health-promoting interventions, specifically the nurse–patient interaction, influence on older adults in nursing homes as a wholeness of body–soul–spirit, affecting the whole being. Hence, dimensions such as pain, fatigue, dyspnea, nausea, loneliness, anxiety, and depressive symptoms will be influenced through health-promoting approaches. Therefore, two separate studies on the health-promoting influences of nurse–patient interaction in nursing home residents were conducted. In total, nine hypotheses of directional influence of the nurse–patient interaction were tested, all of which finding support.Along with competence in pain and symptom management, health-promoting nurse–patient interaction based on awareness and attentional skills is essential in nursing home care. Thus, health care workers should be given the opportunity to further develop their knowledge and relational skills, in order to “refine” their way of being present together with residents in nursing homes. Health professionals’ competence involves the “being in the doing”; that is, both the doing and the way of being are essential in health and nursing care.

Health Promotion Among Cancer Patients: Innovative Interventions

There are growing interests in promoting health of patients with cancer targeting on prevention and control as there are several modifiable risk factors that can be controlled to prevent cancer such as smoking, sedentary lifestyle, and unhealthy behaviors. Once diagnosis of cancer has been determined, health promotion interventions can be targeted on helping patients overcome the physiological and psychological effects of the diagnosis. Health promotion interventions should continue during treatment, survivorship, and for those receiving palliative care. More specifically is the promotion of psychological health of patients with cancer. Introduction of the incidence of cancer, cancer risk protection interventions and innovative health promotion interventions along these different periods in the life of patients with cancer are presented. Some theoretical frameworks used in health promotion research with examples of studies are discussed.

Hope: A Health Promotion Resource

Hope is a phenomenon many nurses and patients are concerned about. One of the reasons for this interest may be that many patients today live with chronic illnesses, and hope is something positive and focuses on the future and opportunities. Hope is a way of feeling, thinking, and influencing one’s behavior. The way we view our health and health-related challenges are assumed to impact on hope. Hope is forward-looking, realistic, and multidimensional. It is a resource for health and health-promoting processes and can be considered a salutogenic resource and construct. This chapter highlights what hope means during illness, what research has so far been concerned with, how hope can be assessed, and how nurses can strengthen hope in patients.

Meaning-in-Life: A Vital Salutogenic Resource for Health

Based on evidence and theory, we state that facilitating and supporting people’s meaning-making processes are health promoting. Hence, meaning-in-life is a salutogenic concept.Authors from various disciplines such as nursing, medicine, psychology, philosophy, religion, and arts argue that the human search for meaning is a primary force in life and one of the most fundamental challenges an individual faces. Research demonstrates that meaning is of great importance for mental as well as physical well-being and crucial for health and quality of life. Studies have shown significant correlations between meaning-in-life and physical health measured by lower mortality for all causes of death; meaning is correlated with less cardiovascular disease, less hypertension, better immune function, less depression, and better coping and recovery from illness. Studies have shown that cancer patients who experience a high degree of meaning have a greater ability to tolerate bodily ailments than those who do not find meaning-in-life. Those who, despite pain and fatigue, experience meaning report better quality-of-life than those with low meaning. Hence, if the individual finds meaning despite illness, ailments, and imminent death, well-being, health, and quality-of-life will increase in the current situation. However, when affected by illness and reduced functionality, finding meaning-in-life might prove more difficult. A will to search for meaning is required, as well as health professionals who help patients and their families not only to cope with illness and suffering but also to find meaning amid these experiences. Accordingly, meaning-in-life is considered a vital salutogenic resource and concept.The psychiatrist Viktor Emil Frankl’s theory of “Will to Meaning” forms the basis for modern health science research on meaning; Frankl’s premise was that man has enough to live by, but too little to live for. According to Frankl, logotherapy ventures into the spiritual dimension of human life. The Greek word “logos” means not only meaning but also spirit. However, Frankl highlighted that in a logotherapeutic context, spirituality is not primarily about religiosity—although religiosity can be a part of it—but refers to a specific human dimension that makes us human. Frankl based his theory on three concepts: meaning, freedom to choose and suffering, stating that the latter has no point. People should not look for an inherent meaning in the negative events happening to them, or in their suffering, because the meaning is not there. The meaning is in the attitude people choose while suffering from illness, crises, etc.

Health Promotion Among Families Having a Newborn Baby

Pregnancy, childbirth, and the postpartum period are the stressful transition periods to parenthood. With medicalization of perinatal period, parents feel left out and less confident in their parenthood journey, which may pose serious threats to the family dynamics. Salutogenesis theory offers the potential to influence a shift away from negative health outlooks and outcomes, medicalization of childbirth, toward health promotion and positive well-being focus for maternity care services design and delivery in the future.

A Salutogenic Mental Health Model: Flourishing as a Metaphor for Good Mental Health

This chapter focuses on a salutogenic understanding of mental health based on the work of Corey Keyes. He is dedicated to research and analysis of mental health as subjective well-being, where mental health is seen from an insider perspective. Flourishing is the pinnacle of good mental health, according to Keyes. He describes how mental health is constituted by an affective state and psychological and social functioning, and how we can measure mental health by the Mental Health Continuum—Short Form (MHC-SF) questionnaire. Further, I elaborate on Keyes’ two continua model of mental health and mental illness, a highly useful model in the health care context, showing that the absence of mental illness does not translate into the presence of mental health. You can also read about how lived experiences of former patients support Keyes dual model of mental health and mental illness. This model makes it clear that people can perceive they have good mental health even with mental illness, as well as people with perceived poor or low mental health can be without any mental disorder. The cumulative evidence for seeing mental disorder and mental health function along two different continua, central mental health concepts, and research significant for health promotion are elaborated in this chapter.

Coping and Health Promotion in Persons with Dementia

For those who receive the diagnosis of dementia, their daily life is turned upside down. Dementia represents daily challenges in many aspects, cognitively, socially, emotionally and functionally. Most commonly, the dementia disorder is progressive, and currently there is no cure or treatment to stop it. Emphasizing coping and health-promotion among individuals having dementia is fundamental to obtain wellbeing as well as finding meaning-in-life. This chapter focuses on coping strategies among persons with dementia, how these are related to health-promotion, wellbeing and meaning-in-life and how nurses and health professionals can promote health and wellbeing in persons with dementia.