ORIGINAL PAPER
Cancer patients’ sense of coherence – psycho-oncological consultations and therapeutic alliance as salutogenic factors
1
Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences, Faculty of Medicine at the University Hospital, University of Cologne, Cologne, Germany
Submission date: 2024-01-17
Acceptance date: 2024-05-28
Online publication date: 2024-10-07
Publication date: 2024-10-30
Corresponding author
Natalia Cecon-Stabel
Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences, Faculty of Medicine at the University Hospital, University of Cologne, Cologne, Germany
Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences, Faculty of Medicine at the University Hospital, University of Cologne, Cologne, Germany
Health Psychology Report 2024;12(4):322-336
KEYWORDS
TOPICS
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 theo-ry. 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 sociodemo-graphics. Four stepwise regression analyses were conducted with overall SoC and its subscales of meaningfulness, compre-hensibility and manageability at T2 as outcome variables. The predictors are therapeutic alliance and the number of consul-tations (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 num-ber of consultations predicted overall SoC (β = .16, t = 2.05, p = .043), meaningfulness (β = .21, t = 2.51, p = .014) and man-ageability (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.
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 theo-ry. 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 sociodemo-graphics. Four stepwise regression analyses were conducted with overall SoC and its subscales of meaningfulness, compre-hensibility and manageability at T2 as outcome variables. The predictors are therapeutic alliance and the number of consul-tations (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 num-ber of consultations predicted overall SoC (β = .16, t = 2.05, p = .043), meaningfulness (β = .21, t = 2.51, p = .014) and man-ageability (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.
REFERENCES (85)
1.
Antonovsky, A. (1987). Unraveling the mystery of health: How people manage stress and stay well. Jossey-Bass.
2.
Applebaum, A. J., DuHamel, K. N., Winkel, G., Rini, C., Greene, P. B., Mosher, C. E., & Redd, W. H. (2012). Thera-peutic alliance in telephone-administered cognitive-behavioral therapy for hematopoietic stem cell transplant survivors. Journal of Consulting and Clinical Psychology, 80, 811–816. https://doi.org/10.1037/a00279....
3.
Bar-Sela, G., Yochpaz, S., Gruber, R., Lulav-Grinwald, D., Mitnik, I., & Koren, D. (2016). The association between the strength of the working alliance and sharing concerns by advanced cancer patients: a pilot study. Support-ive Care in Cancer, 24, 319–325. https://doi.org/10.1007/s00520....
4.
Black, E. K., & White, C. A. (2005). Fear of recurrence, sense of coherence and posttraumatic stress disorder in haematological cancer survivors. Psycho-Oncology, 14, 510–515. https://doi.org/10.1002/pon.89....
5.
Boman, L., Björvell, H., Langius, A., & Cedermark, B. (1999). Two models of care as evaluated by a group of women operated on for breast cancer with regard to their perceived well-being. European Journal of Cancer Care, 8, 87–96. https://doi.org/10.1046/j.1365....
6.
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy, 16, 252–260. https://doi.org/10.1037/h00858....
7.
Bussmann, S., Vaganian, L., Gerlach, A. L., Kusch, M., Labouvie, H., & Cwik, J. C (2023). Screening and assessment for cancer patients’ psychosocial support needs: Development and validation of the psychosocial risk ques-tionnaire. European Journal of Oncology Nursing, 63, 102240. https://doi.org/10.1016/j.ejon....
8.
Cecon, N., Pfaff, H., Lee, S., & Dresen, A. (2021). A salutogenic model predicting the need for psycho‐oncological care and its utilisation – the role of generalised resistance resources and sense of coherence. European Journal of Cancer Care, 30, e13335. https://doi.org/10.1111/ecc.13....
9.
Cecon-Stabel, N., Salm, S., Pfaff, H., Dresen, A., & Krieger, T. (2023). Patients’ perspectives on the quality of care of a new complex psycho-oncological care programme in Germany – external mixed methods evaluation re-sults. BMC Health Services Research, 23, 759. https://doi.org/10.1186/s12913....
10.
Cecon-Stabel, N., Omairat, M., Salm, S., Hagemeier, A., Dresen, A., & Krieger, T. (2024). Does the mode of care delivery affect therapeutic alliance, patient care satisfaction or patient reported outcomes? Psycho-oncological care evaluation data collected during the COVID-19 pandemic. Journal of Psychosocial Oncology. https://doi.org/10.1080/073473....
11.
Crits-Christoph, P. (1999). Alliance and technique in short-term dynamic therapy. Clinical Psychology Review, 19, 687–704. https://doi.org/10.1016/S0272-....
12.
Diegelmann, C. (2016). TRUST: Impulse für einen Behandlungsansatz – Salutogenese, Resilienz und Positive Psy-chologie als Fundament [TRUST: Impulses for a treatment approach – salutogenesis, resilience and positive psychology as a foundation]. In C. Diegelmann & M. Isermann (Eds.), Ressourcenorientierte Psychoonkologie. Körper und Psyche ermutigen [Resource-oriented psycho-oncology. Encourage body and mind] (pp. 85–102). Kohlhammer.
13.
Dillman, D. A. (1978). Mail and telephone surveys: The total design method. Wiley.
14.
Dresen, A., Salm, S., Hagemeier, A., Hellmich, M., Kusch, M., Labouvie, H., Hallek, M., Scholten, N., Pfaff, H., Krieger, T., & Cecon-Stabel, N. (2024). Effectiveness of reducing anxiety and depression in newly diagnosed can-cer patients through psycho-oncology care – Evaluation results of a new integrated, cross-sectoral German care program (isPO). (Submitted and under review).
15.
Eriksson, M., & Lindström, B. (2005). Validity of Antonovsky’s sense of coherence scale: a systematic review. Journal of Epidemiology and Community Health, 59, 460–466. https://doi.org/10.1136/jech.2....
16.
Eriksson, M., & Lindström, B. (2006). Antonovsky’s Sense of Coherence Scale and the relation with health: a systematic review. Journal of Epidemiology and Community Health, 60, 376–381. https://doi.org/10.1136/jech.2....
17.
Eriksson, M., & Lindström, B. (2007). Antonovsky’s Sense of Coherence Scale and its relation with quality of life: a systematic review. Journal of Epidemiology and Community Health, 61, 938–944.
19.
Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: a meta-analytic synthesis. Psychotherapy, 55, 316–340. https://doi.org/10.1037/pst000....
20.
Gerasimčik-Pulko, V., Pileckaitė-Markovienė, M., Bulotienė, G. & Ostapenko, V. (2009). Relationship between sense of coherence and quality of life in early stage breast cancer patients. Acta Medica Lituanica, 16, 139–144. https://doi.org/10.2478/v10140....
21.
Graves, K. D. (2003). Social cognitive theory and cancer patients’ quality of life: a meta-analysis of psychosocial intervention components. Health Psychology, 22, 210–219. https://doi.org/10.1037/0278-6....
22.
Hakanen, J. J., Feldt, T., & Leskinen, E. (2007). Change and stability of sense of coherence in adulthood: Longitu-dinal evidence from the Healthy Child study. Journal of Research in Personality, 41, 602–617. https://doi.org/10.1016/j.jrp.....
23.
Hatcher, R. L., & Gillaspy, J. A. (2006). Development and validation of a revised short version of the Working Alli-ance Inventory. Psychotherapy Research, 16, 12–25. https://doi.org/10.1080/105033....
24.
Herrmann-Lingen, C., Buss, U., & Snaith, R. P. (2011). Hospital Anxiety and Depression Scale – German version (HADS-D) (3rd ed.). Verlag für Psychotherapie.
25.
Hiensch, A. E., Bolam, K. A., Mijwel, S., May, A. M., & Wengström, Y. (2020). Sense of coherence and its relation-ship to participation, cancer-related fatigue, symptom burden, and quality of life in women with breast cancer participating in the OptiTrain exercise trial. Supportive Care in Cancer, 28, 5371–5379. https://doi.org/10.1007/s00520....
26.
Hochwälder, J. (2022). Theoretical issues in the further development of the sense of coherence construct. In M. B. Mittelmark (Ed..), The handbook of salutogenesis (2nd ed., pp. 569–579). Springer International Publishing.
27.
Hojdahl, T., Magnus, J. H., Hagen, R., & Langeland, E. (2013). “VINN” – an accredited motivational program pro-moting convicted women’s sense of coherence and coping. EuroVista, 2, 177–190.
28.
Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psycho-therapy, 48, 9–16. https://doi.org/10.1037/a00221....
29.
Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 36, 223–233. https://doi.org/10.1037/0022-0....
30.
Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: a meta-analysis. Journal of Counseling Psychology, 38, 139–149. https://doi.org/10.1037/0022-0....
31.
Humboldt, S. von, & Leal, I. (2013). The promotion of older adults’ sense of coherence through Person-centered therapy: a randomized controlled pilot study. Interdisciplinaria, 30, 235–251. https://doi.org/10.16888/inter....
32.
Idan, O., Eriksson, M., & Al-Yagon, M. (2017). The salutogenic model: The role of generalized resistance re-sources. In M. B. Mittelmark, S. Sagy, M. Eriksson, G. F. Bauer, J. M. Pelikan, B. Lindström, & G. Arild Espnes (Eds.), The handbook of salutogenesis (pp. 57–69). Springer. https://doi.org/10.1007/978-3-....
33.
Jenniches, I., Lemmen, C., Cwik, J. C., Kusch, M., Labouvie, H., Scholten, N., Gerlach, A., Stock, S., Samel, C., Hagemeier, A., Hellmich, M., Haas, P., Hallek, M., Pfaff, H., & Dresen, A. (2020). Evaluation of a complex inte-grated, cross-sectoral psycho-oncological care program (isPO): a mixed-methods study protocol. BMJ Open, 10, e034141. https://doi.org/10.1136/bmjope....
34.
Katz, E. R., Kellerman, J. & Ellenberg, L. (1987). Hypnosis in the reduction of acute pain and distress in children with cancer. Journal of Pediatric Psychology, 12, 379–394. https://doi.org/10.1093/jpepsy....
35.
Kenne Sarenmalm, E., Browall, M., & Gaston-Johansson, F. (2014). Symptom burden clusters: a challenge for targeted symptom management. A longitudinal study examining symptom burden clusters in breast cancer. Journal of Pain and Symptom Management, 47, 731–741. https://doi.org/10.1016/j.jpai....
36.
Kenne Sarenmalm, E., Browall, M., Persson, L. O., Fall-Dickson, J., & Gaston-Johansson, F. (2013). Relationship of sense of coherence to stressful events, coping strategies, health status, and quality of life in women with breast cancer. Psycho-Oncology, 22, 20–27. https://doi.org/10.1002/pon.20....
37.
Kenne Sarenmalm, E., Mårtensson, L. B., Andersson, B. A., Karlsson, P., & Bergh, I. (2017). Mindfulness and its efficacy for psychological and biological responses in women with breast cancer. Cancer Medicine, 6, 1108–1122. https://doi.org/10.1002/cam4.1....
38.
Krieger, T., Cecon, N., Salm, S., Pfaff, H., & Dresen, A. (June 2022). Evaluationsbericht (EvalB): isPO – integrierte, sektorenübergreifende Psychoonkologie (01NVF17022) [Evaluation report: isPO – integrated cross-sectoral psy-cho-oncology (01NVF17022)]. University of Cologne.
39.
Krieger, T., Salm, S., Cecon, N., Pfaff, H., & Dresen, A. (2020). Ergebnisbericht der externen formativen Evaluation des Projekts isPO [Results report of the external formative evaluation of the isPO project]. University of Co-logne.
40.
Krieger, T., Salm, S., Cecon, N., Pfaff, H. & Dresen, A. (2021a). Ergebnisbericht der zweiten externen formativen Evaluation des Projekts isPO (FE 2.0) [Results report of the second external formative evaluation of the isPO project (FE 2.0). University of Cologne.
41.
Krieger, T., Salm, S., Cecon, N., Pfaff, H. & Dresen, A. (2021b). Vorläufige summative Evaluation des Projekts isPO (SE 1.0): Forschungsbericht 3-2021 [Preliminary summative evaluation of the isPO project (SE 1.0): Research report 3-2021]. University of Cologne.
42.
Kusch, M., Labouvie, H., Schiewer, V., Talalaev, N., Cwik, J. C., Bussmann, S., Vaganian, L., Gerlach, A. L., Dresen, A., Cecon, N., Salm, S., Krieger, T., Pfaff, H., Lemmen, C., Derendorf, L., Stock, S., Samel, C., Hagemeier, A., Hellmich, M., … Hallek, M. (2022). Integrated, cross-sectoral psycho-oncology (isPO): a new form of care for newly diagnosed cancer patients in Germany. BMC Health Services Research, 22, 543. https://doi.org/10.1186/s12913....
43.
Langeland, E., Riise, T., Hanestad, B. R., Nortvedt, M. W., Kristoffersen, K., & Wahl, A. K. (2006). The effect of salutogenic treatment principles on coping with mental health problems: a randomised controlled trial. Patient Education and Counseling, 62, 212–219. https://doi.org/10.1016/j.pec.....
44.
Langeland, E., Wahl, A. K., Kristoffersen, K., & Hanestad, B. R. (2007). Promoting coping: Salutogenesis among people with mental health problems. Issues in Mental Health Nursing, 28, 275–295. https://doi.org/10.1080/016128....
45.
Larsson, B. W., Larsson, G., & Starrin, B. (1999). Patients’ views on quality of care: a comparison of men and women. Journal of Nursing Management, 7, 133–139. https://doi.org/10.1046/j.1365....
46.
Leitlinienprogramm Onkologie (2014). Psychoonkologische Diagnostik, Beratung undBehandlung von erwachsenen Krebspatienten. Langfassung Version 1.1, AWMF-Nr. 032/051OL [Psycho-oncological diagnostics, advice and treatment of adult cancer patients. Long version 1.1, AWMF no. 032/051OL]. Leitlinienprogramm Onkologie.
47.
Leuteritz, K., Weißflog, G., Barthel, Y., Brähler, E., Zwerenz, R., Wiltink, J., & Beutel, M. E. (2017). Therapeutic alli-ance and treatment outcome in psychodynamic psychotherapy of depressed breast cancer patients: The same old story or different from other populations? Breast Cancer, 24, 765–773. https://doi.org/10.1007/s12282....
48.
Lindblad, C., Langius-Eklöf, A., Petersson, L. M., Sackey, H., Bottai, M., & Sandelin, K. (2018). Sense of coherence is a predictor of survival: a prospective study in women treated for breast cancer. Psycho-Oncology, 27, 1615–1621. https://doi.org/10.1002/pon.47....
49.
Mack, J. W., Block, S. D., Nilsson, M., Wright, A., Trice, E., Friedlander, R., Paulk, E., & Prigerson, H. G. (2009). Measuring therapeutic alliance between oncologists and patients with advanced cancer: The Human Connec-tion Scale. Cancer, 115, 3302–3311. https://doi.org/10.1002/cncr.2....
50.
Malin, A. J., & Pos, A. E. (2015). The impact of early empathy on alliance building, emotional processing, and out-come during experiential treatment of depression. Psychotherapy Research, 25, 445–459. https://doi.org/10.1080/105033....
51.
Manne, S., Winkel, G., Zaider, T., Rubin, S., Hernandez, E., & Bergman, C. (2010). Therapy processes and out-comes of psychological interventions for women diagnosed with gynecological cancers: a test of the generic process model of psychotherapy. Journal of Consulting and Clinical Psychology, 78, 236–248. https://doi.org/10.1037/a00182....
52.
Marmarosh, C. L., & Kivlighan, D. M. (2012). Relationships among client and counselor agreement about the working alliance, session evaluations, and change in client symptoms using response surface analysis. Journal of Counseling Psychology, 59, 352–367. https://doi.org/10.1037/a00289....
53.
Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other vari-ables: a meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438–450. https://doi.org/10.1037/0022-0....
54.
Mehnert, A. (2014). Psychoonkologie [Psycho-oncology]. Der Gynäkologe, 47, 427–434. https://doi.org/10.1007/s00129....
55.
Nienhuis, J. B., Owen, J., Valentine, J. C., Winkeljohn Black, S., Halford, T. C., Parazak, S. E., Budge, S., & Hilsenroth, M. (2018). Therapeutic alliance, empathy, and genuineness in individual adult psychotherapy: a meta-analytic review. Psychotherapy Research, 28, 593–605. https://doi.org/10.1080/105033....
56.
Nissim, R., Freeman, E., Lo, C., Zimmermann, C., Gagliese, L., Rydall, A., Hales, S., & Rodin, G. (2012). Managing cancer and living meaningfully (CALM): a qualitative study of a brief individual psychotherapy for individuals with advanced cancer. Palliative Medicine, 26, 713–721. https://doi.org/10.1177/026921....
57.
Norcross, J. C., & Lambert, M. J. (2011). Psychotherapy relationships that work II. Psychotherapy, 48, 4–8. https://doi.org/10.1037/a00221....
58.
Orlinski, D. E., Grawe, K., & Parks, B. K. (1994). Process and outcome in psychotherapy – noch einmal. In A. Bergin & J. S. Garfield (Eds.), Handbook of psychotherapy and behaviour change (4th ed., pp. 270–378). Wiley.
59.
Osborn, R. L., Demoncada, A. C., & Feuerstein, M. (2006). Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. International Journal of Psychiatry in Medicine, 36, 13–34. https://doi.org/10.2190/EUFN-R....
60.
Pelikan, J. M. (2017). The application of salutogenesis in healthcare settings. In M. B. Mittelmark, S. Sagy, M. Eriksson, G. F. Bauer, J. M. Pelikan, B. Lindström, & G. Arild Espnes (Eds.), The handbook of salutogenesis (pp. 261–266). Springer.
61.
Pfaff, H., & Schmitt, J. (2023). Reducing uncertainty in evidence-based health policy by integrating empirical and theoretical evidence: an EbM+theory approach. Journal of Evaluation in Clinical Practice, 29, 1279–1293. https://doi.org/10.1111/jep.13....
62.
Rehse, B., & Pukrop, R. (2003). Effects of psychosocial interventions on quality of life in adult cancer patients: meta-analysis of 37 published controlled outcome studies. Patient Education and Counseling, 50, 179–186. https://doi.org/10.1016/S0738-....
63.
Rohani, C., Abedi, H. A., Omranipour, R., & Langius-Eklöf, A. (2015a). Health-related quality of life and the predic-tive role of sense of coherence, spirituality and religious coping in a sample of Iranian women with breast can-cer: a prospective study with comparative design. Health and Quality of Life Outcomes, 13, 40. https://doi.org/10.1186/s12955....
64.
Rohani, C., Abedi, H. A., Sundberg, K., & Langius-Eklöf, A. (2015b). Sense of coherence as a mediator of health-related quality of life dimensions in patients with breast cancer: a longitudinal study with prospective design. Health and Quality of Life Outcomes, 13, 195. https://doi.org/10.1186/s12955....
65.
Rozmarin, E., Muran, J. C., Safran, J., Gorman, B., Nagy, J., & Winston, A. (2008). Subjective and intersubjective analyses of the therapeutic alliance in a brief relational therapy. American Journal of Psychotherapy, 62, 313–328. https://doi.org/10.1176/appi.p....
66.
Sammet, I., Staats, H., & Schauenburg, H. (2004). Beziehungserleben und Therapieergebnis in stationäer Psycho-therapie [Relationship experiences and therapeutic outcome in inpatient psychotherapy]. Zeitschrift fur Psy-chosomatische Medizin und Psychotherapie, 50, 376–393. https://doi.org/10.13109/zptm.....
67.
Schäfer, S. K., Schanz, C. G., Sopp, M. R., Lass-Hennemann, J., Käfer, M., & Michael, T. (2020). Pre-rehabilitation sense of coherence as a predictor of symptom change after rehabilitation. Stress and Health, 36, 546–554. https://doi.org/10.1002/smi.29....
68.
Schumacher, A. (2004). Stellenwert der Psychoonkologie im neuen deutschen Gesundheitssystem [Importance of psycho-oncology in the new German healthcare system]. Der Onkologe, 10, S98–S102. https://doi.org/10.1007/s00761....
69.
Schumacher, J., Gunzelmann, T., & Brähler, E. (2000). Deutsche Normierung der Sense of Coherence Scale von Antonovsky [German standardization of Antonovsky’s Sense of Coherence Scale]. Diagnostica, 46, 208–213.
70.
Shapiro, S. L., Lopez, A. M., Schwartz, G. E., Bootzin, R., Figueredo, A. J., Braden, C. J., & Kurker, S. F. (2001). Quality of life and breast cancer: Relationship to psychosocial variables. Journal of Clinical Psychology, 57, 501–519. https://doi.org/10.1002/jclp.1....
71.
Skärsäter, I., Rayens, M. K., Peden, A., Hall, L., Zhang, M., Agren, H., & Prochazka, H. (2009). Sense of coherence and recovery from major depression: a 4-year follow-up. Archives of Psychiatric Nursing, 23, 119–127. https://doi.org/10.1016/j.apnu....
72.
Sørensen, K., Pelikan, J. M., Röthlin, F., Ganahl, K., Slonska, Z., Doyle, G., Fullam, J., Kondilis, B., Agrafiotis, D., Uiters, E., Falcon, M., Mensing, M., Tchamov, K., van den Broucke, S., & Brand, H. (2015). Health literacy in Europe: Comparative results of the European health literacy survey (HLS-EU). European Journal of Public Health, 25, 1053–1058. https://doi.org/10.1093/eurpub....
73.
Sperner-Unterweger, B. (2011). Psychoonkologie – psychosoziale Onkologie : Integration in ein onkologisches Behandlungskonzept [Psycho-oncology – psychosocial oncology: Integration in a concept of oncological treatment]. Der Nervenarzt, 82, 371–380. https://doi.org/10.1007/s00115....
74.
Suominen, S., & Lindstrom, B. (2008). Salutogenesis. Scandinavian Journal of Public Health, 36, 337–339. https://doi.org/10.1177/140349....
75.
Szymona, K. (2005). Zmiany poczucia koherencji (SOC) po psychoterapii u pacjentów z zaburzeniami nerwico-wymi [Changes of sense of coherence (SOC) after psychotherapy in neurotic patients]. Psychiatria Polska, 39, 659–668.
76.
Tistad, M., Tham, K., von Koch, L., & Ytterberg, C. (2012). Unfulfilled rehabilitation needs and dissatisfaction with care 12 months after a stroke: an explorative observational study. BMC Neurology, 12, 40. https://doi.org/10.1186/1471-2....
77.
Vastamäki, J., Moser, K., & Paul, K. I. (2009). How stable is sense of coherence? Changes following an intervention for unemployed individuals. Scandinavian Journal of Psychology, 50, 161–171. https://doi.org/10.1111/j.1467....
78.
Vinje, H. F., Langeland, E., & Bull, T. (2022). Aaron Antonovsky’s development of salutogenesis, 1979–1994. In M. B. Mittelmark (Ed..), The handbook of salutogenesis (2nd ed., pp. 29–45). Springer International Publishing.
79.
Vitinius, F., Tieden, S., Hellmich, M., Pfaff, H., Albus, C., & Ommen, O. (2018). Perceived psychotherapist’s empa-thy and therapy motivation as determinants of long-term therapy success: Results of a cohort study of short term psychodynamic inpatient psychotherapy. Frontiers in Psychiatry, 9, 660. https://doi.org/10.3389/fpsyt.....
80.
Waddington, L. (2002). The therapy relationship in cognitive therapy: a review. Behavioural and Cognitive Psycho-therapy, 30, 179–191. https://doi.org/10.1017/S13524....
81.
Weis, J., Schumacher, A., Blettner, G., Determann, M., Reinert, E., Rüffer, J. U., Werner, A., & Weyland, P. (2007). Psychoonkologie [Psycho-oncology]. Der Onkologe, 13, 185–194. https://doi.org/10.1007/s00761....
82.
Weissbecker, I., Salmon, P., Studts, J. L., Floyd, A. R., Dedert, E. A., & Sephton, S. E. (2002). Mindfulness-based stress reduction and sense of coherence among women with fibromyalgia. Journal of Clinical Psychology in Medical Settings, 9, 297–307. https://doi.org/10.1023/A:1020....
83.
Wilmers, F., Munder, T., Leonhart, R., Herzog, T., Plassmann, R., Barth, J., & Linster, H. W. (2008). Die deutsch-sprachige Version des Working Alliance Inventory-short revised (WAI-SR): Ein schulenübergreifendes, öko-nomisches und empirisch validiertes Instrument zur Erfassung der therapeutischen Allianz [The German-language version of the Working Alliance Inventory-short revised (WAI-SR): a cross-school, economical and empirically validated instrument for recording the therapeutic alliance]. Klinische Diagnostik und Evaluation, 1, 343–358.
84.
Winger, J. G., Adams, R. N., & Mosher, C. E. (2016). Relations of meaning in life and sense of coherence to distress in cancer patients: a meta-analysis. Psycho-Oncology, 25, 2–10. https://doi.org/10.1002/pon.37....
85.
Zwerenz, R., Beutel, M. E., Imruck, B. H., Wiltink, J., Haselbacher, A., Ruckes, C., Schmidberger, H., Hoffmann, G., Schmidt, M., Köhler, U., Langanke, D., Kortmann, R. D., Kuhnt, S., Weissflog, G., Barthel, Y., Leuteritz, K., & Brähler, E. (2012). Efficacy of psychodynamic short-term psychotherapy for depressed breast cancer pa-tients: Study protocol for a randomized controlled trial. BMC Cancer, 12, 578. https://doi.org/10.1186/1471-2....
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