Salutogenic approach in the study of the self-esteem of the elderly


Salutogenic approach in the study of the self-esteem of the elderly

Enfoque salutogénico en el estudio de la autoestima del adulto mayor


Nerely de Armas Ramírez1*
Lucía del Carmen Alba Pérez2
Jesús Yasoda Endo Milán3


1Physical Culture Faculty. "Marta Abreu" Central University of Las Villas. Villa Clara. Cuba.
2 Medicine Faculty. Villa Clara University of Medical Sciences. Cuba.
3 Postgraduate Direction. Villa Clara University of Medical Sciences. Cuba.


*Author for correspondence. E-mail:




Professionals who care for the elderly need scientific training on the salutogenic approach in the treatment of low self-esteem to diagnose and reduce the effect this attitude can have on the lives of the elderly. An analysis was made about the importance of the aforementioned approach, with the aim of socializing the need for their knowledge among those who are in the undergraduate training process, or in the period of scientific-professional advanced training in the health field, pedagogical training and physical culture, for its application in therapeutic, rehabilitation, sports and recreational activities.

MeSH: comprehensive health care; aging; education, medical.


Los profesionales que atienden adultos mayores necesitan preparación científica sobre el enfoque salutogénico en el tratamiento de la baja autoestima para diagnosticar y disminuir la afectación que puede ocasionar esta actitud en la vida de las personas de la tercera edad. Se realizó un análisis acerca de la importancia del mencionado enfoque, con el objetivo de socializar la necesidad de su conocimiento entre los que se encuentran en proceso formativo de pregrado, o en el periodo de perfeccionamiento científico-profesional de posgrado en el campo de la salud, la formación pedagógica y la cultura física, por su aplicación en actividades terapéuticas, de rehabilitación, deportivas y recreativas.

DeSC: atención integral de salud; envejecimiento; educación médica.



Submitted: 29/01/2019
Accepted: 21/06/2019



Currently specialties such as Comprehensive General Medicine, Clinical Psychology, Medical Psychology, Health Psychology and several sectors of society, show interest in care for the elderly people due to its population increase. It aims to achieve health, well-being, a positive assessment of their possibilities and greater personal satisfaction in them, which requires trained professionals, competent to address the psychological well-being of the elderly, which results in a higher life quality.

Barros, referenced by Ortiz Arriagada et al.(1) considers well-being as: "... the subjective perception or appreciation of feeling or being well, being in good spirits, feeling satisfied. It is argued that the welfare state experienced by individuals depends on social and personal conditions, and on how individuals face them. Bearing in mind that this happens within the context of a society and that individuals coexist or are interacting with other members of it".

According to Antonovsky's postulates, referenced by Rivera de los Santos et al.(2), health is understood as a health-disease continuum. Its salutogenic model constitutes a relevant theory in the new conceptualization of human health by its explanation of the factors that form its bases. This author(2) criticized the traditional health-disease model as opposed areas and understood health as a continuum in which two poles were identified: well-being (health) and malaise (illness).

Psychological well-being is an indicator of health that reflects a positive feeling of satisfaction with oneself and with the environment. In the elderly, their lack is characterized by personal, family and social losses, which determines difficult situations of isolation and depression, which can generate a health problem. According to Rivera de los Santos, et al.(2) there is neither perfect health nor the complete state of illness.

Health can be conceptualized in terms of life quality, understood in its psychological dimension as the perception of the satisfaction of the needs and the opportunities that are offered to persons or human groups to reach the state of happiness and personal fulfillment, in correspondence with subjective well-being.(3)

Self-esteem is an important indicator of health and well-being, generally defined as a feeling that can be positive or negative, manifested as a result of the assessment of one's own characteristics and potentialities, which determines feelings of satisfaction or dissatisfaction with the personality.

In the elderly, assertive self-esteem is important to achieve a balanced emotional state present in healthy behaviors to face challenges and counteract stress; it is evident in their active participation in tasks that provide welfare and health status, so that the responsibility to assume them does not become a source of distress, equivalent to harmful stress; but represent the necessary euutrés to face the obligations and duties raised by life. Thus the beginning of a pathological process is postponed, many times in advance when the distress interacts with other risk factors, declared as determinants of health, in which the biological, psychological, cultural, spiritual and social plays its role.(4)

Adequate self-esteem means a good emotional, cognitive and practical adjustment that positively influences all areas of life. In the elderly this condition is affected by changes in their physical characteristics, capacities, abilities, appearance of chronic diseases and other conflictive situations: retirement, loss of family members, the independence-dependency dilemma, family overprotection, the invisibility of the elderly by family, work and social groups, separation of children, and personal management for the sake of their economic well-being and emotional independence, only modified when the elderly has economic solvency.(4)

Generally, a negative social appreciation is experienced due to a greater appreciation of the values associated with the beauty of the youthful age, and the lack of a fair evaluation of the experience and wisdom of the elderly, which is accentuated by the apparent affection and care shown by some people, sometimes even health and education professionals , who treat older adults with the terms: grandmother, aunt and others of the populace regardless of whether people are or are not grandmothers, aunts, if they can be or not, and without evaluating their academic, cultural, social training and occupation. Some elderly people have had or keep work, professional, cultural, sports, and political responsibilities, among others; they have performed satisfactorily and have achieved relevant social prestige.(1)

These realities can give rise to harmful reactions such as depression, distimias and other expressions of affective states, which sometimes appear as anxiety and frustration, and have an affective feeling that affects self-esteem; Hence, decompensated states can constitute risk factors for health and emotional balance, and are associated with chronic diseases, decreased mental, cognitive, affective and behavioral functions, and sensory related to loss of visual and auditory acuity. These limitations are significant for the elderly because they affect their social competence, especially in those in which their transcendence and the defense of their legacy is distinguished for new generations. It is necessary to investigate personal strengths and resources to help them cope with disturbing stimuli that favor positive emotional states and the development of a construct called self-esteem.(5) It must be recognized that negative affective states and low self-esteem are not characteristic of aging, but rather there is a belief rooted in the social culture towards the elderly, considered as not accepted by the loss of skills that make them inefficient for certain tasks they performed in their previous life and limitations for the mastery of technological innovations, typical of contemporaneity.

Social acceptance is one of the most important needs of the human being and directly influences self-esteem; this can cause negative feelings and generate low self-esteem due to all the functional and physiological limitations of the normal aging process; aspects that coexist with the salutogenic vision.(6)

Self-esteem can be dealt with in the field of topics that require the preparation of human resources to carry out educational health promotion actions, evaluation and diagnosis in the context of prevention, in early care and rehabilitation in the elderly. It is a matter of interest for professionals of pedagogical training and physical culture for their involvement in therapeutic, rehabilitation, sports and recreational activities.

Professionals who care for the elderly need scientific training on the salutogenic approach in the treatment of low self-esteem to diagnose and reduce the impact that this attitude can cause in the life of the elderly, in order to achieve health promotion in favor of raising self-efficacy, self-knowledge, optimism, family support and the increase of social relations.


1. Ortiz Arriagada JB, Castro Salas M. Bienestar psicológico de los adultos mayores, su relación con la autoestima y la autoeficacia: contribución de enfermería. Ciencia y Enfermería. 2009;15:25-31.

2. Rivera de los Santos F, Moreno Rodríguez C, Hernán García M. Análisis del modelo salutogénico en España: aplicación en salud pública e implicaciones para el modelo de activos en salud. Rev Esp Salud Pública. 2011;85(2):129-39.

3. Talabera Díaz Y. Estrategia como vía para gestionar la formación salutogénica de estudiantes de Medicina. Rev Pertinencia Académica 2017;(5):24-38.

4. Mazadiego Infante TJ, Solares Mejía C, Zárate Moreno M, Torres Vargas L, Coto Sampayo ÁJ. Incremento de la autoestima en los adultos mayores de un hogar de jubilados. Enseñanza e Investigación en Psicología. 2011;16(1):175-82.

5. de los Santos PV. Prevalencia de depresión en hombres y mujeres mayores en México y factores de riesgo. Población y Salud en Mesoamérica. 2018;15(2):38-44.

6. Orosco C. Depresión y autoestima en adultos mayores institucionalizados y no institucionalizados en la ciudad de Lima. Persona [Internet]. 2015 [citado 29/01/2019];(18):[aprox. 15 p.]. Disponible en:



Declaration of interests

The authors declare no conflict of interest.



Contribution of the authors

Nerely de Armas Ramírez and Lucía del Carmen Alba Pérez: wrote the researching report.
Jesús Yasoda Endo Milán: carried out the bibliographic review and participated in the writing of the research paper.



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