Cancer patients' sense of coherence - psycho-oncological consultations and therapeutic alliance as salutogenic factors.

Abstract

Background: 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.

Participants and procedure: 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).

Results: 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, t = 2.26, p = .026) and manageability (β = .47, t =3.02, p = .003). The number of consultations predicted overall SoC (β = .16, t = 2.05, p = .043), meaningfulness (β = .21, t = 2.51, p = .014) and manageability (β = .17, t = 2.07, p = .041).

Conclusions: 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.