Mental Health: Global Challenges of XXI Century
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Public Health Strengthening in the Context of Community Adaptation to the Consequences of a Military Conflict: Salutogenic Approach

(Larysa Korobka)

Institute for Social and Political Psychology, the National Academy of Educational Sciences of Ukraine, Kyiv


Introduction. When a problem of strengthening public health in the process of community adaptation to the consequences of a military conflict is being analysed, special attention is paid to finding factors of promotion the well-being and personal growth of a member of a community. In respect to this, we do believe that salutogenic approach (from Latin ‘salus’ – well-being, happiness) can be the footing for strengthening both individual and public health as well as for constructive behavioural and social changes.

Approach. The study of this problem is based on a salutogenetic concept (A.Antonovsky, 1984; 1996) and its main notion – "sense of coherence" (SOC), which includes three components – "comprehensibility", "manageability", "meaningfulness" – as a health key element and a determining factor for public health improvement and maintenance.

As well as that we are guided by understanding adaptation as a capacity for restorative efforts of both an individual, a family, and a community (F.H.Norris, V.Pfefferbaum, S.Stevens, 2008), where the concept of "resilience" is defined as:

- viability, resistance to trauma, psychological flexibility;

- dynamic process in which positive adaptation takes place in conditions of trouble;

- well-being maintenance despite these difficulties (G.Bonanno, 2007; N.Garmezy, 1986).

Along with that we regard adaptation in difficult life situations as a process of "positive adaptation" or "post-traumatic growth" which is the result of accepting and dealing with the reality accompanied by positive changes at the level of personality, group, and society (R.Tedeschi, L.Calhoun, 2004; S.Joseph, P.Linley, 2006; M.Seligman, 2000; V.Klimchuk, 2016).

As modern psychological research shows, sense of coherence (S.Suominen, H.Blomberg, 2001), resilience (А.Morgan, 2007; F.H.Norris, 2008) and post-traumatic growth (R.Tedeschi, L.Calhoun, 2004) are connected with health, well-being and orientation to healthy lifestyle.

Purpose. This paper is focused on study the connection of SOC with indicators of subjective assessment of the state of health, well-being, quality of life, sense of security, adaptability to the consequences of a military conflict. The purpose of the study is to show the possibility of a salutogenic approach to strengthen both individual and public health.

Design. In the empirical study, 200 people took part – representatives of the professional pedagogical community from three regions of Ukraine – Sumy, Chernihiv and Dnipro (165 women and 35 men aged 25 to 59 years). A questionnaire was used that included questions on identifying a subjective assessment of the quality of life, health, adaptability, safety, attitudes towards the future and other areas of life; Questionnaire "Sense of Coherence" (SOC) by A. Antonovsky and "Questionnaire for Post-Traumatic Growth" R. Tedeschi, L.Calhoun.

Results. According to our research of the community adaptation to the consequences of a military conflict there exist positive correlation (p≤0,01) between the subjective assessment of adaptability and the assessment of health, well-being, quality of life, satisfaction with life-style, a sense of security, an internal control locus, and indicators of posttraumatic growth.

There is a positive correlation between the subjective assessment of adaptability and the assessment of health, well-being, quality of life, satisfaction from the way life is formed, the sense of security, the internal control locus, and by the integral index of posttraumatic growth.

Also, it has been defined that the higher SOC and its components are, the higher level of subjective well-being, satisfaction with one’s health (p≤0,01) is as well as adaptability to the consequences of a military conflict (p≤0,01).

Significant differences were found between people with high and low levels of subjective well-being by the indicators "comprehensibility" (p≤0,05), "manageability" (p≤0,01), "meaningfulness" (р≤0,01), and by the integral index of SOC and posttraumatic growth (р≤0,01). This is evidence that persons with a high index of SOCs who believe that the world is understandable, consistent, not chaotic, believe in their ability to help themselves, rely on their own resources or on the support of others. They see the meaning of life, feel happier, are more satisfied with life, and have higher indicators of post-traumatic growth, higher levels of trust and satisfaction with their health.

Practical value. Thus, the theoretical and empirical analysis of the problem gives grounds for constructing a social and psychological model for strengthening public health in the process of community adaptation to the consequences of a military conflict. This model will include:

- increasing the SOC that would facilitate the transition from "risk factor" to "salutogenic" orientation in which people develop their potential and ability to control their own health and well-being;

- the promotion of psychological resilience as an ability to live a full and productive life despite different constraints;

- increasing the ability to use a stressful situation as an opportunity for further development and achievement of a higher functioning level (post-traumatic growth);

- the facilitation of one or another form of communication aimed at improving awareness on health issues and gaining competence in maintaining it;

- strengthening reflexive processes and increasing readiness for change.

Practical realization of this model will have high social value.

Conclusions. SOC, resiliency and posttraumatic growth are connected with health, well-being and orientation to healthy lifestyle. The more evident they are, the more chances for a person’s moving towards better health.

SOC, resiliency and posttraumatic growth are indicators of that social and psychological community resource which ensures the success of its adaptation and strengthening of both individual and public health.

Salutegenesis is a valuable approach to strengthening public health in the context of community adaptation to the consequences of a military conflict.


Keywords: salutogenic approach, resilience approach, post-traumatic growth, strengthening public health, community adaptation to the consequences of a military conflict.


References.

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