Cancer patients' sense of coherence - psycho-oncological consultations and therapeutic alliance as salutogenic factors

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 (beta = .34, t = 2.26, p = .026) and manageability (beta = .47, t =3.02, p = .003). The num-ber of consultations predicted overall SoC (beta = .16, t = 2.05, p = .043), meaningfulness (beta = .21, t = 2.51, p = .014) and man-ageability (beta = .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.