Sense of coherence and coping in adolescents directly affected by the 1991--5 war in Croatia.

Abstract

This study was guided by the salutogenic model, and aimed to: 1. describe the social contexts of stronger and weaker SOC (sense of coherence) participants who were adolescents or entering adulthood in the war-affected regions in Croatia, and 2. identify how the levels of SOC related to their responses to the stressors in their social context. Qualitative longitudinal study design and methods were used for the analysis. In-depth semi-structured interviews, participant observations and SOC scale were carried out, and data were collected from 17 female participants twice during two years. The general social context of the participants was summarized with published materials on the similar subjects and analysis of the field-notes and the participants' narratives. In the analysis of the qualitative data, comparisons were made between the three SOC levels (low, middle, high levels categorized with SOC scores), relating to the participants' self-described social contexts. Childhood stability, acceptance of own ethnic identity, management of uncertainty, and the meanings of work emerged as the responses and resources that may influence SOC. How Ottawa Charter health promotion strategies can be adapted in the post-conflict regions is discussed and priorities of addressing strategies are suggested. The discussion points include: 1. the importance of re-orienting health services and creating supportive environments from the aspects of building the secure base of children and promoting health of the next generation; 2. the required personal skills that enabled adolescents to exercise control and make choices conducive to health in a social context of the a war-related turbulent society; 3. the needs for building healthy public policies to tackle unemployment and strengthening community action to rebuild social capital through work revenues.