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Yıl:1997; Cilt: 8; Sayı: 3>> Özet
Türk Psikiyatri Dergisi; 1997;8(3):183-189
Sağlık Oluşumu (Salutogenez) ve Tutarlılık Duygusu (Sense of Coherence)
G KOPTAGEL-İLAL
Yaşam, birbirleriyle etkileşim halinde bir bütünü oluşturan çeşitli sistemler arasındaki sistemik ilişkiye dayanır. Her canlı organizma, dolayısıyla insan da bu sistemin bir parçası olduğu gibi, aynı zamanda kendisi de, bir birey olarak, sistemik ilişkilerden kurulu biyo-psiko-sosyal bir bütündür. Hastalık ve sağlık, süreklilik ilişkisi içindeki bu sistemin birbirene karşıt kutuplarıdır. Hekimlikte, genellikle dikkatler hastalık üzerine toplamış olup, patognetik yöne ağırlık veren bir tutum ile davranılır. Oysa, sağlık oluşturucu, sağlığı geliştirici bir tutum olan salutogenez ilkesi benimsenip, ona uygun bir tutum ile davranılırsa, sağlıklı kalmada ve hastalıklarla başetmede daha etkili ve anlamlı bir yaklaşım elde edilir. Salutogenez’de “tutarlılık duygusunun” oluşması önemlidir. Anlayabilme, yönetebilme ve anlam verebilme, tutarlılık duygusun oluşturan temel öğeler olup, bunlar insanın kendi özgüçlerini sağlık oluşturucu (salutogen) yolda kullanmasını ve her türden yaşam olayı ile daha kolay başedebilmesini olanaklı kılarlar. Hekim-hasta ilişkisinde salutogenetik tutumu benimseyerek ve hastayı biyo-psiko-sosyal bütünlüğü ile kavrayarak tutarlılık duygusu ile hareket edildiğinde, etkileşimde gerekli olan olumlu “içeren-içerilmiş” ilişkisi de kurulur ve böylece daha başarılı sonuçlara ulaşılabilir. Üç olgu örneği ile kavramlara daha da açıklık getirilmeye çalışılmıştır.

Salutogenesis and Sense of Coherence
Life is based upon the systemic relationship of various systems which build up a whole. Like all living organisms, the human being is a also part of this system, but is at the same time, itself a system based upon the interaction of other systems which build up a bio-psycho-social unity. Health and disease are the opposite poles of this system and are parts of a continuity. The medical approach to illness is generally pathogenetic, facusing the attention merely upon the illness. The salutogenic approach, on the other hand, is directed to the preservation and promotion of health. The development of the “sense of coherence” is based upon comprehensivity, manageability and meaningfulness. With the adoption of the salutognetic approach, it becomes easier to cope with life situations in health and in disease. The salutogenic approach in medical practice makes it easier possible to activate the veriy forces of the patient for coping up with his life or health problems and, at the same time, enables the establishment of a positive “container-contained” relationship in doctor-patient interaction that can possibly lead to more successful results. Three case examples have been given to further clarify the concepts defined.

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