Conceptual Clarification of Wellness and Sense of Coherence (SOC). : Rodgers' evolutionary concept analysis in health care settings

Background: Clarification of concepts is important in the process of developing theories and concepts. The concept of «wellness» is frequently used, but the content is still unclear. Is the content of «wellness» the same as «health»,«sense of coherence», «wellbeing», «spirituality», «quality oflife» or another content Objective: To conceptually explore the concept of«wellness» in health care settings, and relate the results to the salutogenic core concept SOC. Method: Rodger's evolutionary concept analysis is used for the theoretical analysis of the data. The focus has been on attributes, related concepts, consequences, antecedents,references, exemplars and implications. The literature search has been performed through manual review of reference lists and online search in databases for relevant papers. The abstracts has been examined to identify relevant studies for further review. The inclusion criteria was peer reviewed papers in English, published in scientific journals using the keywords wellness/health/health care/healthcare and wellness/sense of coherence/salutogenesis, discussing and/or defining the concept of wellness. The search was run in Cinahl and PubMed via EBSCO and in ProQuest. Results: Fifty studies met the inclusion criteria. Preliminary results confirm a multidimensional property of «wellness». It seems to be used interchangeable with related concepts such as «health», «SOC», «wellbeing», «spirituality» or«quality of life» without a deeper clarification of theoretical aspects. A general impression is that wellness is strongly related to individual lifestyle and health behavior.