It is not easy to point to the exact moment in time when Polish academics and practitioners got acquainted with the theory of salutogenesis. It is quite likely that it was during one of the international conferences of psychology or during the bilateral research meetings in the 1980s. Since that moment, the theory of salutogenesis and its core concept—sense of coherence—started their journey through academic textbooks, journal articles, and conference presentations, and became recognized as important theoretical inputs, mostly in health psychology and studies on stress and coping.

Professor Aaron Antonovsky visited Poland in 1993 upon the invitation from the Institute of Occupational Medicine in Łódź, and many Polish academics and practitioners got a chance to discuss with him personally his theoretical concepts and their application in research and practice. Antonovsky encouraged the preparation and publication of the Polish edition of his book Unraveling the Mystery of Health. How People Manage Stress and Stay Well, that was finally published in 1995 under the title Rozwikłanie tajemnicy zdrowia. Jak sobie radzić ze stresem i nie zachorować.

Unfortunately, it was too late for Antonovsky to write his planned preface to this edition of the book. In 1997, the Institute of Psychiatry and Neurology, in cooperation with the University of Warsaw and the Polish Section of the European Health Psychology Society, organized the International Conference on Sense of Coherence, Coping, and Health that attracted participants from several European countries and several Polish scientific centers. The selected papers from that conference were published in English in the special issue of the Polish Psychological Bulletin in 1999. Salutogenesis and sense of coherence were also major topics of scientific symposia during national conferences. One good example is the session Poczucie koherencji—uwarunkowania, korelaty, związki ze zdrowiem (Sense of coherence—determinants, correlates, relations to health) organized in 2005 during the XXXII Congress of the Polish Psychological Association.

To identify the works by Polish authors who use salutogenesis and sense of coherence as their theoretical framework, a literature search was conducted using a national database (Bazy Biblioteki Narodowej) and international databases (Academic Search Complete, MEDLINE, SCOPUS, CEJSH). The terms “salutogenesis” and “sense of coherence” were used as keywords with Polish language as the only limitation for the searches. The publications identified are presented in this chapter. Master’s theses and doctoral dissertations are not included as most of them are unpublished.

Salutogenesis and Sense of Coherence in Textbooks

The analysis of contents of academic textbooks indicates that salutogenesis is discussed quite extensively, and the most typical context in which it is introduced is health, stress, and coping. The recent book edited by Strelau and Doliński (2008) is the good example. In more specialized textbooks, such as those on clinical or health psychology, salutogenesis is discussed in more detail. In clinical psychology textbooks, salutogenesis with its general question related to the origins of health, is introduced in contrast to theories that aim to explain the origins of disease and/or mental health problems (Sęk, 2001, 2005). Such contrast helps to explain the importance of the “change of paradigm” (Piotrowicz & Cianciara, 2011; Sęk, 2005, p. 44). Although proposed as the new approach to health, salutogenesis was also analyzed from the perspective of its possible integration with theories of pathology (Cierpiałkowska & Sęk, 2006).

In health psychology textbooks , salutogenesis and sense of coherence are presented as the framework for studies on health and its determinants (Heszen & Sęk, 2007). Polish textbooks conclude that the theory of salutogenesis has received sound empirical support, while calling for more research on the development and deterioration of the sense of coherence (Heszen & Sęk, 2007). In a recent textbook on stress, the sense of coherence is presented in the context of personal resources that affect coping (Heszen, 2013).

Salutogenesis and Sense of Coherence in Research

While salutogenesis is in focus in Polish theoretical analyses, research studies more often concentrate on its core concept—the sense of coherence. The relationship of the sense of coherence to health has been studied extensively. One example is the book edited by Sęk and Pasikowski (2001) with a selection of studies on the sense of coherence related to physical and mental health . Contributions to this book indicate that the sense of coherence has been analyzed in a variety of health contexts and considered either a predictor or a correlate of better adaptation to a disease and its treatment.

The salutogenic approach has been applied to the study of mental health and sense of coherence in patients with a variety of mental problems, such as depression (Mroziak, Czabała, & Wójtowicz, 1997; Zboralski, Florkowski, & Gałecki, 2006), postnatal depression (Kroemeke & Mateusiak, 2006), schizophrenia (Badura-Brzoza et al., 2012), bipolar disorder (Sariusz-Skąpska, Czabała, Dudek, & Zięba, 2003), panic and anxiety disorders (Kurowska & Ciesielska, 2013; Potoczek, 2010), suicide attempt (Polewka et al., 2001), and alcohol addiction (Badura, Gorczyca, Tomalczyk, & Matysiakiewicz, 2000; Piegza et al., 2005). Such studies were mostly cross-sectional and the sense of coherence scores for patient groups were compared with healthy controls. The longitudinal approach has been applied when the effects of psychotherapy have been analyzed; increases in sense of coherence scores were observed in the follow-up of treated neurotic (Szymona, 2005) and alcohol-dependent patients (Mroziak, 2002). Sense of coherence was found to promote posttraumatic growth in children and adolescents after their placement in children’s home (Ogińska-Bulik, 2013).

Somatic diseases have been analyzed in the salutogenic perspective as well, with the sense of coherence usually conceptualized as the factor that improved adjustment to a disease or affected health-related quality of life. Such studies were conducted in arterial hypertension (Kurowska & Dąbrowska, 2008; Kurowska & Prus, 2010), other heart diseases (Kurowska 2009b), cancer (Kurowska & Bartoszek, 2008; Kurowska, Dahms, Głowacka, & Haor, 2010), asthma (Potoczek, 2011; Potoczek, Niżankowska-Mogilnicka, Bochenek, & Szczeklik, 2006), rheumatic diseases (Kurowska et al., 2009c), dermatologic problems (Ogłodek et al., 2009; Zboralski, Gernand, Orzechowska, & Talarowska, 2010), type 2 diabetes (Kurowska et al., 2009a), hearing impairment (Kurowska & Wieczór-Klein, 2011), physical disability (Fidler, 2008), and transsexualism (Cysarz, Piwowarczyk, Czernikiewicz, Dulko, & Kokoszka, 2008). Patients who underwent surgery benefited from higher sense of coherence, for example better adaptation after hysterectomy (Jawor, Dimler, Kuleta, & Dudek, 2002) and after hip replacement (Badura-Brzoza et al., 2008).

The salutogenic perspective has also been applied in the analysis of adaptation to health problems within families (Bażyńska, Bronowska, Namysłowska, & Żechowski, 2002; Kasperek-Zimowska & Chądzyńska, 2011; Osuchowska-Kościjańska et al., 2014). Sense of coherence has also been considered within the context of care, especially for terminally ill cancer patients (Kurowska & Piechowska, 2008), children with developmental disabilities, such as cerebral palsy (Dąbrowska, 2007) and Down’s syndrome (Bobkowicz-Lewartowska, 2013). Such studies observed differences in coping styles related to high/low sense of coherence, and a relationship between sense of coherence and life satisfaction.

Some authors have advocated for salutogenic approach to be used within medical professions, to increase doctors’ capabilities, develop understanding of patients’ health behavior and improve doctor–patient communication (Zboralski et al., 2008). Others used this approach to discuss the risk of burnout among doctors (Świderski et al., 1999), motivation for voluntary work in hospices (Szulc & Parchem, 2014), and the experiences of medical students (Szymczak, 2005).

Studies that analyzed the effect of the sense of coherence on stress and coping were conducted with young and adult participants alike, and confirmed a link between high sense of coherence and task-oriented coping (Kosinska-Dec & Jelonkiewicz, 1997; Kurowska et al., 2009a, 2009b, 2009c; Kurowska & Zachulska, 2013). Findings indicated as well that persons with a high sense of coherence more often use contact-seeking than distraction coping (Jelonkiewicz & Kosińska-Dec, 2001). Gender effects have been observed i.e., women report lower sense of coherence, and for women but not for men, a particular coping style (contact-seeking) affected the sense of coherence in prospective analyses (Jelonkiewicz & Kosińska-Dec, 2001).

The concept of the sense of coherence has been applied to analyses of occupational stress, including the perception of job stressors and emotions experienced in workplaces, most often those of police and military forces, firefighters, and paramedics (Ogińska-Bulik, 2003). For example, sense of coherence affected coping with stress among officers (Piórowski, 2008) and the intensity of PTSD after traumatic experiences related to professional activity (Dudek, 2003).

Teachers are another professional group included in studies on the role of the sense of coherence at work. The same pattern was found—sense of coherence was protective against job stress (Zubrzycka-Maciag, 2013) and professional burnout (Świętochowski, 2004).

The demographic situation in Poland has stimulated the growing interest of the role of sense of coherence in healthy aging , with some research observing a significant relationship between the sense of coherence and life satisfaction of the elderly (Pasik, 2007; Kurowska, Rudewicz, Głowacka, & Felsmann, 2008; Zielińska-Więczkowska, Ciemnoczołowski, & Kędziora-Kornatowska, 2009).

Finally and quite compellingly, the salutogenic approach has also been used in analyses of consequences of political persecution (Czaja, 2001) and adaptation to political transformation (Pasikowski & Sęk, 2004).

Measures of Sense of Coherence

The measure of sense of coherence—Antonovsky’s Orientation to Life Questionnaire (SOC-29) —was adapted in Poland in 1993 as a joint effort of three research centers: the Institute of Psychiatry and Neurology (Warsaw), the Institute of Psychology at Adam Mickiewicz University (Poznań), and the Institute of Occupational Medicine in Łódź (Koniarek, Dudek, & Makowska, 1993). Another questionnaire that measures the sense of coherence—SOC-13—was also adapted and used in studies with young persons (Zwoliński, 2001).

Final Comments

Publications in the Polish language, reviewed in this chapter, are either theoretical analyses or research reports. In the former case salutogenesis is applied in a conceptual way, discussed in a variety of contexts, and related to other theoretical concepts. In research, the quantitative empirical approach is used and the sense of coherence is measured with validated tools. Findings of such studies provide data on correlates of the sense of coherence and its effect on many aspects of human health and behavior.