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assessment
care pathway
clinical skills
decision-making

Salutogenesis: the case for a holistic tool for paramedic assessment of wellness

02 October 2019
Features
02 October 2019
Volume 11 · Issue 10

Abstract

Sense of coherence (SOC), the capacity to muster, believe in and value resources to support resilience, is a central component of the salutogenic approach to wellness. Assessing patients' SOC in a salutogenic model may be useful to paramedics as an adjunct to effective referral to care pathways other than via the emergency department and for predicting patient engagement. A tool to help direct practitioners in the prehospital environment towards the most appropriate resources for each patient's unique situation appears to be lacking. This article examines the literature around salutogenic and SOC theories and provides an overview of how a salutogenic assessment tool could be used in paramedic practice. Taking a multifactorial approach to determining health status and predicating patient capacity for adaptive coping may make health professionals better able to assist patients in overcoming health events and build health resilience to improve their future health outcomes.

As paramedicine has advanced and become more patient-focused, paramedics are increasingly referring patients to pathways and services other than the traditional emergency department route (Tohira et al, 2014; Oosterwold et al 2018). Using alternative pathways has inherent risks. One of the indicators of the efficacy and safety of the use of alternative pathways is the number and frequency of related future health events. Studies suggest that the numbers of future events following traditional and alternative pathways in well-governed systems are similar (Snooks et al, 2017). However, in a number of presentation types, such as falls, chronic disease exacerbations, and chronic illness, the risk of future events is significant, and ensuring both the implementation of appropriate pathways and engagement with those pathways is complex and challenging (Snooks et al, 2012; Comans et al, 2013).

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Salutogenesis
Sense of coherence
Resilience
Prehospital
Paramedicine