Open Access Debate

Integrating a sense of coherence into the neonatal environment

Gill Thomson1*, Victoria Hall Moran1, Anna Axelin2, Fiona Dykes1 and Renée Flacking13

Author Affiliations

1 Maternal and Infant Nutrition and Nurture (MAINN), University of Central Lancashire, Preston PR1 2HE, UK

2 Department of Nursing Science, University of Turku, Turku, FI 20014, Finland

3 School of Health and Social Studies, Dalarna University, Falun 791 88, Sweden

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BMC Pediatrics 2013, 13:84  doi:10.1186/1471-2431-13-84

Published: 22 May 2013



Family centred care (FCC) is currently a valued philosophy within neonatal care; an approach that places the parents at the heart of all decision-making and engagement in the care of their infant. However, to date, there is a lack of clarity regarding the definition of FCC and limited evidence of FCCs effectiveness in relation to parental, infant or staff outcomes.


In this paper we present a new perspective to neonatal care based on Aaron Antonovksy’s Sense of Coherence (SOC) theory of well-being and positive health. Whilst the SOC was originally conceptualised as a psychological-based construct, the SOCs three underpinning concepts of comprehensibility, manageability and meaningfulness provide a theoretical lens through which to consider and reflect upon meaningful care provision in this particular care environment. By drawing on available FCC research, we consider how the SOC concepts considered from both a parental and professional perspective need to be addressed. The debate offered in this paper is not presented to reduce the importance or significance of FCC within neonatal care, but, rather, how consideration of the SOC offers the basis through which meaningful and effective FCC may be delivered. Practice based implications contextualised within the SOC constructs are also detailed.


Consideration of the SOC constructs from both a parental and professional perspective need to be addressed in FCC provision. Service delivery and care practices need to be comprehensible, meaningful and manageable in order to achieve and promote positive well-being and health for all concerned.

Neonatal; NICU; Family centred care; Sense of coherence; Antonovsky; Service delivery; Parents; Staff