Moderating effect of sense of coherence on the relationship between symptom distress and health-related quality of life in patients receiving cancer chemotherapy.

PURPOSE: This study is aimed at examining the buffering effect of sense of coherence (SOC) on symptom distress during cancer drug therapy, which thereby affects health-related quality of life (QoL), and obtaining suggestions for promoting supportive care. METHODS: We investigated health-related QoL (SF-8), symptom distress (using the Symptom Distress Scale (SDS)), and SOC (the SOC 13-item Scale) in 66 patients receiving adjuvant chemotherapy for non-small cell lung cancer. We employed descriptive statistics to seek the correlation of each variable; then, a hierarchical multiple regression analysis was conducted with SF-8 score as the dependent variable. RESULTS: Results showed that significant changes in bodily pain showed a buffering effect on the SDS and sense of comprehensibility (ß = - 0.658, p < 0.01, ß = - 0.319, p < 0.05), sense of manageability (ß = - 0.658, p < 0.01, ß = 0.398, p < 0.01), and meaningfulness (ß = - 0.658, p < 0.01, ß = - 0.257, p < 0.05). Significant changes in general health perception showed a buffering effect on the SDS and sense of manageability (ß = - 0.406, p < 0.01, ß = 0.329, p < 0.05). As a result of the simple inclination test, SOC proved to be effective under high levels of symptom distress; the buffering effect of sense of manageability was reversed regarding bodily pain; and when meaningfulness was lower, it had a positive effect on QoL. CONCLUSION: This study revealed that SOC exerts a buffering effect in situations where symptoms are highly painful. It also revealed that the effect of SOC was reversed for bodily pain and that a high SOC had a negative effect on QoL.

Exploring the relationship between sexual function, sense of coherence, and well-being in a sample of Iranian breast cancer survivors.

PURPOSE: This study was aimed at exploring the type and role of relationships between sexual function, sense of coherence (SOC), and well-being in a sample of Iranian breast cancer survivors. METHODS: In this cross-sectional study with correlational design, data were collected from 181 survivors by consecutive sampling. They answered demographic and clinical information sheet, the SOC scale, the Female Sexual Function Index (FSFI), and the Health Index (HI). The data were analyzed using SPSS version 20. RESULTS: The mean age of survivors was 47.04 ± 9.05 years. Most survivors were menopausal (51.9%) and underwent mastectomy (69.1%), and 12 months or more had passed since their treatment ended (71.2%). Sexual function was positively correlated with the level of SOC (r = 0.20) and the HI (r = 0.33). Also, there was a positive correlation between the level of SOC and the HI (r = 0.51). The results of logistic regression analyses showed the protective role of the SOC (OR: 0.95; 95% CI: 0.92-0.97) and the HI (OR: 0.87; 95% CI: 0.79-0.96) for women's sexual function. According to these results, the mediating role of the SOC was assessed between the variables of the HI and the FSFI. The SOC revealed a complete mediating effect in this relationship. CONCLUSIONS: The mediator role of the SOC between survivors' well-being and their sexual function helps nurses and clinicians to understand how the SOC can be used as a screening test to detect survivors who are at risk of sexual problems and to plan for salutogenic interventions.

Association of Copeptin With Sense of Coherence in Individuals With Varying Degrees of Glucose Intolerance.

OBJECTIVE: This study aimed to examine the association of serum copeptin levels, a surrogate marker of arginine-vasopressin secretion with sense of coherence (SOC) among individuals with varying degrees of glucose intolerance. METHODS: The study was conducted in 120 age- and sex-matched individuals who were divided equally into three groups. Group A included individuals with normal glucose tolerance; group B, individuals with prediabetes (impaired glucose tolerance and/or impaired fasting glucose); and group C, individuals with newly detected diabetes mellitus (NDDM). SOC, perceived stress scale (PSS), copeptin, anthropometry, glycated hemoglobin, insulin, and salivary cortisol were measured in all study participants. RESULTS: The SOC score was found to be significantly lower in group C compared with group A (p < .001) and group B (p = .006). The PSS score was found to be significantly higher in group C compared with group A (p = .002). No significant difference was found between PSS scores of groups B and C (p = .25). Copeptin levels were found to be significantly higher in group C compared with group A (p = .016). Copeptin levels in group C did not differ significantly from those in group B (p = .056). There was a significant negative correlation between serum copeptin levels and SOC in the NDDM group C (r = 0.31, p = .048) and overall (r = 0.19, p = .037). In multiple regression analysis, SOC emerged as the variable with the strongest association with 2-hour postprandial plasma glucose and glycated hemoglobin. CONCLUSION: Individuals with NDDM displayed significantly higher serum copeptin levels that inversely correlated with SOC, a global measure of stress coping ability.

Sense of coherence and its relationship to participation, cancer-related fatigue, symptom burden, and quality of life in women with breast cancer participating in the OptiTrain exercise trial.

PURPOSE: This study examined the Sense of Coherence (SOC) of patients participating in the randomized controlled 'Optimal Training for Women with Breast Cancer' (OptiTrain) study and assessed how patient characteristics were associated with SOC. Secondary aims were to assess the association between SOC and patients' participation in this study and to determine whether SOC moderates the effect of the 16-week exercise intervention on fatigue, quality of life (QoL), and symptom burden in women with breast cancer undergoing chemotherapy. METHODS: Modified Poisson regression analyses were conducted to determine the relative risk of weak-normal SOC versus strong SOC in terms of exercise session attendance, study and intervention dropout, and long absence rates. Analyses of covariance were performed to assess whether SOC moderated the effect of the exercise intervention (pinteraction ≤ 0.10). RESULTS: Two hundred and forty women with early breast cancer (mean age 53 ± 10) participated in the OptiTrain study. Women with strong SOC reported less fatigue, lower symptom burden, and higher QoL. Women with weak-normal SOC were significantly more likely to drop out from the OptiTrain study and tended to have slightly poorer exercise session attendance. Women with breast cancer and weaker SOC benefitted as much from the exercise intervention, in terms of fatigue and QoL, as those with stronger SOC (pinteraction > 0.10). CONCLUSIONS: Strong SOC appears to be associated with a more positive subjective state of health. Women with weak-normal SOC may need additional support to encourage participation and adherence in exercise trials. Assessing SOC may assist clinicians to identify and provide extra support for participants with weak SOC, who may be less inclined to participate in exercise programs.

The journey of sensemaking and identity construction in the aftermath of trauma: Peer support as a vehicle for coconstruction.

Sensemaking is rooted in identity construction and it is a particularly interpersonal process. Moreover, traumatic experiences are known to cause people to engage in sensemaking processes and identity construction. However, knowledge of how this works in an interpersonal, community setting, is lacking. The aim of this study is to assess how peer support contributes to the sensemaking processes and identity construction in the aftermath of trauma. Data from an observational study of organised peer support groups for (co)victims of serious crimes and survivors of traumatic loss were analysed using inductive thematic analysis. Results show how participants of peer support groups move through several phases of sensemaking and identity construction in a fluid, dynamic, way. Identity work is collectively done. Through coconstruction of their identities, participants are able to make sense of a traumatic experience and progress towards a more self-aware and self-centred identity.

Sense of coherence is linked to post-traumatic growth after critical incidents in Austrian ambulance personnel.

BACKGROUND: Ambulance personnel, as well as other emergency services like fire-fighters or the police force, are regularly confronted with experiences of extreme psychological distress and potentially traumatizing events in the line of their daily duties. As a consequence, this occupational group is exposed to an elevated risk of developing symptoms of Post-Traumatic Stress (PTSS). Subsequently, symptoms of Post-Traumatic Stress have been observed as potentially co-occurring with Post-Traumatic Growth (PTG) in ambulance personnel as well. Therefore, in this study we hypothesized that Sense of Coherence (SOC) might play an important role as an underlying feature in enabling growth after stressful experiences in Austrian ambulance personnel. METHODS: In this study, voluntary and full-time ambulance personnel (n = 266) of the Austrian Red Cross ambulance service completed an online survey including the Sense of Coherence Scale (SOC-29), the Post-Traumatic Growth Inventory (PTGI) and the Impact of Event Scale Revised (IES-R) for the assessment of PTSS. In line with theoretical considerations, a two-step cluster analysis limited to four clusters and further ANOVAs were conducted. RESULTS: Four clusters were confirmed and labelled PTSS-low/PTG-low, PTSS-low/PTG-high, PTSS-high/PTG-high and PTSS-high/PTG-low. Further ANOVAs revealed substantial cluster differences in SOC, with higher SOC-levels in PTSS-high/PTG-high than in PTSS-high/PTG-low (p < .01), in PTSS-low/PTG-high than in PTSS-low/PTG-low (p < .01) and in PTSS-low/PTG-high than in PTSS-high/PTG-low (p < .01). CONCLUSIONS: Our findings point to a significant association between SOC and the development of PTG in ambulance personnel. Furthermore, the results suggest that growth and stress after critical incidents are independent from each other and can co-exist. Therefore, promoting SOC (e.g., meaningfulness) in ambulance personnel - e.g., through psychological interventions - might preserve and enhance psychological health after critical incidents.

Effects of a 9-month resistance training intervention on quality of life, sense of coherence, and depressive symptoms in older adults: randomized controlled trial.

PURPOSE: (1) To determine the effects of a 9-month resistance training intervention on quality of life, sense of coherence, and depressive symptoms in older adults, and (2) to compare effects between different training frequencies. METHODS: Men and women aged 65-75 (N = 106) were randomized to four groups according to training frequency: training groups RT1 (n = 26), RT2 (n = 27), and RT3 (n = 28) and non-training control group (n = 25). All training groups attended supervised resistance training twice a week for 3 months. For the following 6 months, they continued training with different frequencies (1, 2 or 3 times per week). Psychological functioning was measured by quality of life (WHOQOL-Bref), sense of coherence (Antonovsky's SOC-13), and depressive symptoms (Beck's Depression Inventory II). Measurements were conducted at baseline and 3 and 9 months after baseline. The effects of the intervention were analyzed using generalized estimating equations (GEE). RESULTS: After 3 months, there was an intervention effect on environmental quality of life (group × time p = .048). Between 3 and 9 months, environmental quality of life decreased among RT1 compared to RT2 and RT3 (group × time p = .025). Between baseline and 9 months, environmental quality of life increased in RT2 compared to all other groups (group × time p = .011). Sense of coherence increased in RT2 compared to the control group and RT3 (group × time p = .032). CONCLUSION: Resistance training is beneficial for environmental quality of life and sense of coherence. Attending resistance training twice a week seems to be the most advantageous for these aspects of psychological functioning.

Coping mediates the relationship between sense of coherence and mental quality of life in patients with chronic illness: a cross-sectional study.

PURPOSE: The aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus' and Folkman's stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status. METHODS: The study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided background data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS. RESULTS: The test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL. CONCLUSIONS: Self-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus' and Folkman's stress and coping theory.

The impact of self-perceived limitations, stigma and sense of coherence on quality of life in multiple sclerosis patients: results of a cross-sectional study.

OBJECTIVE: To examine the impact of perceived limitations, stigma and sense of coherence on quality of life in multiple sclerosis patients. DESIGN: Cross-sectional survey. SETTING: Department of Neurology, University Medical Center Groningen, the Netherlands. SUBJECTS: Multiple sclerosis patients. MAIN MEASURES: World Health Organization Quality of Life - abbreviated version, Stigma Scale for Chronic Illness, Sense of Coherence Scale, background and disease-related questions. RESULTS: In total, 185 patients (61% response rate) participated in the study with moderate to severe limitations. Stigma was highly prevalent but low in severity. Patients with a higher sense of coherence experienced a lower level of limitations ( B = -0.063, P < 0.01) and less stigma (enacted stigma B = -0.030, P < 0.01; self-stigma B = -0.037, P < 0.01). Patients with a higher level of limitations experienced more stigma (enacted stigma B = 0.044, P < 0.05; self-stigma B = 0.063, P < 0.01). Patients with a higher sense of coherence experienced better quality of life (physical health B = 0.059, P < 0.01; psychological health B = 0.062, P < 0.01; social relationships B = 0.052, P < 0.01; environmental aspects B = 0.030, P < 0.01). Patients with a higher level of limitations experienced poorer quality of life (physical health B = -0.364, P < 0.01; psychological health B = -0.089, P < 0.05) and patients with more stigma also experienced poorer quality of life (self-stigma: physical health B = -0.073, P < 0.01; psychological health B = -0.089, P < 0.01; social relationships B = -0.124, P < 0.01; environmental aspects B = -0.052, P < 0.01, and enacted stigma: physical health B = -0.085, P < 0.10). CONCLUSION: Patients with less perceived limitations and stigma and a higher level of sense of coherence experienced better quality of life. Patients with a higher sense of coherence experienced a lower level of limitations and less stigma.

Factors related to sense of coherence in adult patients with Type 2 diabetes.

The influence of a diabetic person's sense of burden and blood sugar control through sense of coherence (SOC) on self-management has yet to be sufficiently clarified. The purpose of this study was to examine the utility of salutogenesis, which has sense of coherence at its core, for the self-management of patients with type 2 diabetes. A total of 258 questionnaires were distributed to patients who were seen at one of three hospitals in an urban area in Japan, after obtaining consent from the patient. They were between 20 and 75 years old and regularly received care. Of the 185 responses, 177 were valid. The responses were analyzed by referring to the framework of salutogenesis, and the relationship between patient characteristics, SOC, the Problem Areas In Diabetes survey (PAID), and glycosylated hemoglobin (HbA1c) were studied with structural equation modeling (SEM). SOC had a main effect on PAID scores and an indirect effect on HbA1c. Moreover, age influenced SOC positively. The SOC of patients with type 2 diabetes in the present study was comparatively high. These observations suggest a direct effect of SOC on reducing the sense of burden from having diabetes and an indirect effect on decreasing HbA1c. This research suggested the possibility that diabetes can be controlled by improving SOC.

[Sense of Coherence Scale according to Antonovsky as a possible predictor for return to work for cardiac surgery intensive care patients]. / "Sense-of-coherence"-Skala nach Antonovsky als möglicher Prädiktor für den Wiedereinstieg in das Berufsleben für herzchirurgische Intensivpatienten.

BACKGROUND: For cardiac surgery patients who were employed prior to surgery, the return to their professional life is of special importance. In addition to medical reasons, such as pre-existing conditions, the success of the operation or postoperative course and patient-intrinsic reasons, which can be assessed with the Sense of Coherence (SOC) scale by Antonovsky, may also play a role in the question of a possible return into working life. METHODS: In this study 278 patients (invasive coronary artery bypass graft surgery and/or surgery on heart valves, age < 60 years, employed) were questioned postoperatively via post with the SOC questionnaire. The SOC questionnaire was used in addition to questions about return to work. The cohort was stratified according to the time of return to work. Subsequently, the point of maximum sensitivity and specificity was determined for the total SOC score and the prediction power was considered. RESULTS: Of the 278 patients, 61 questionnaires (22%) were considered as eligible and included in the analysis. Of these, 47 participants had returned to work after undergoing cardiac surgery and 14 participants had not. We observed significant differences in SOC values between both groups (146.07 ± 29.76 versus 124.29 ± 28.8, p = 0.020). Patients that returned to work within the first 6 months after surgery showed even higher SOC scores (148.56 ± 28.98, p = 0.034). CONCLUSION: Patients with an SOC score < 130 are at greater risk not to return to their professional life after cardiac surgery. The SOC is an easily obtainable score that reliably predicts the probability of return to work after cardiac surgery.

Using arts-based research to access sense of coherence in marginalised indigenous Bedouin youth.

The literature describes a mismatch between the core concepts of salutogenesis, or sense of coherence (SOC), meaning manageability and comprehensibility, as these concepts are manifested in research with Western populations, as compared to non-Western populations. The overall objective of this study is to explore this mismatch and to understand how the core concept of salutogenesis is manifested in youth ages 14-16 from the indigenous Bedouin ethnic minority culture of the Negev, Israel, in their own terms through arts-based qualitative methods. The research methods revolved 80 drawings and texts by youth who drew "a good day that went bad - and how [I] fixed it" as well as focus groups. All data, both verbal and visual, were analysed by dividing into themes and then socially contextualising the themes with a peer group. The findings reveal and concretize a mismatch in SOC between these youth and the predominant Western understandings of coping in terms of meanings, manageability and comprehensibility of coping methods. This study's theoretical recommendations are the need to take steps in the direction of closing the gap or mismatch between a universal versus culturally specific body of literature about culture and SOC. Its practical recommendations are to suggest such a methodology.

The relationship between internalized stigma and quality of life among people with mental illness: are self-esteem and sense of coherence sequential mediators?

PURPOSE: To elucidate the mechanism through which internalized stigma reduces the quality of life (QoL) of people with mental illness by exploring the mediating roles of self-esteem and sense of coherence (SOC). METHODS: A cross-sectional analysis of 229 patients diagnosed with schizophrenia or affective disorders was undertaken to test a sequential mediation model assuming that more severe internalized stigma is related to lower self-esteem, which is associated with weaker SOC, which in turn relates to worse QoL. RESULTS: The proposed model was supported by the data. A sequential indirect effect from internalized stigma to QoL via self-esteem and SOC turned out to be significant [beta = -0.06, SE = 0.02; 95% CI (-0.11, -0.03)]. Support was also found for simple mediation models with either self-esteem or SOC as single mediators between internalized stigma and QoL. CONCLUSIONS: Self-esteem and SOC are personal resources that should be considered as potential targets of interventions aiming to prevent the harmful consequences of internalized stigma for the QoL of people receiving psychiatric treatment.

The Elasticity of Preferences.

We explore how preferences for attributes are constructed when people choose between multiattribute options. As found in prior research, we observed that while people make decisions, their preferences for the attributes in question shift to support the emerging choice, thus enabling confident decisions. The novelty of the studies reported here is that participants repeated the same task 6 to 8 weeks later. We found that between tasks, preferences returned to near their original levels, only to shift again to support the second choice, regardless of which choice participants made. Similar patterns were observed in a free-choice task (Study 1) and when the favorableness of options was manipulated (Study 2). It follows that preferences behave in an elastic manner: In the absence of situational pressures, they rest at baseline levels, but during the process of reaching a decision, they morph to support the chosen options. This elasticity appears to facilitate confident decision making in the face of decisional conflict.

Does depression matter in neuropsychological performances in anorexia nervosa? A descriptive review.

OBJECTIVE: This review aims to examine the impact of depressive symptoms on the assessment of cognitive flexibility, central coherence, and decision-making in individuals with anorexia nervosa (AN). METHOD: An online search was carried out using PubMed and PsycInfo. Articles were selected for review if they were published in English between 1990 and 2014 and used the Wisconsin Card Sorting Test, the Trail Making Task parts A and B, the Brixton Test, the Rey-Osterrieth Complex Figure Test, and/or the Iowa Gambling Task. RESULTS: Sixty-two studies were included. Thirty (48%) of the studies statistically assessed the association between depression and neurocognition in AN versus healthy controls. Where significant correlations were found, it became clear that the more serious the depression, the greater the neuropsychological impairment. Only six (10%) studies examined whether increased depressive symptoms were able to eliminate the differences between individuals with AN and healthy controls, and one study found that depressive symptoms did eliminate group differences in cognitive flexibility and decision-making. DISCUSSION: Only a subgroup of articles on neuropsychology in AN adjusted for depression. However, given the role of depression that some articles suggest, future studies should pay closer attention to the evaluation of this potential confounder.

Predictors of sense of coherence in typically developing adolescent siblings of individuals with autism spectrum disorder.

BACKGROUND: Children with autism spectrum disorder (ASD) may be a stressor for family members yet there is little published research on the impact of having a child with ASD on their typically developing (TD) adolescent siblings. According to Antonovsky's salutogenic model, a strong sense of coherence leads to the view that the stressor is a manageable challenge rather than a burden and promotes healthier adaptation. This study examines the relationship between stress, TD sibling resources and the sense of coherence in TD siblings. METHOD: This quantitative mail-based study uses a survey methodology, analysing the responses of TD adolescent siblings (n = 96) of individuals with autism, Asperger's syndrome, or pervasive developmental disorder - not otherwise specified to several rating scales. Adolescent siblings, ages 11 to 18 years, completed the Adolescent Coping Orientation for Problem Experience (ACOPE), Network of Relationship Inventory - Social Provision Version (NRI-SPV), Youth Self Report (YSR), and Sense of Coherence (SOC) instruments; parents completed the Child Autism Rating Scale - 2nd Edition (CARS-2). RESULTS: The salutogenesis model was used to guide and inform this research. Findings suggested the following: (a) the stress of ASD severity and resource of adjustment are related in TD adolescent siblings; (b) TD sibling adjustment has a strong relationship with sense of coherence levels; and (c) a greater number of positive coping strategies buffer TD sibling coherence levels when ASD severity scores are high. CONCLUSIONS: ASD severity and TD adolescent sibling resources influence sense of coherence in adolescent TD siblings of individuals with ASD.

Test of Antonovsky's postulate: high sense of coherence helps people avoid negative life events.

This study tested Antonovsky's postulate that a high sense of coherence (SOC) helps people avoid negative life events. It was assumed that negative life events that were uncontrollable would not show this effect, while those events that potentially could be controlled would show a significant relationship with SOC. 1,012 female nurses (M age=46.9 yr.; SD=8.9) participated in this longitudinal study and were divided into groups with low, moderate, and high SOC. Sixteen negative life events were categorized into uncontrollable and controllable events, with the controllable events divided into three sub-categories. Five one-way analyses of variance (ANOVAs) for independent measures followed up with post hoc tests were performed, with the number of experienced events in a given category by each participant (at Time 2) as the dependent variable and the three SOC groups (formed at Time 1) as the independent variable. The results indicated that the high SOC group reported fewer controllable negative life events, while there was no significant relationship between the SOC level and uncontrollable negative life events. The findings support the postulate in Antonovsky's model, with the distinction between controllable and uncontrollable negative life events.

Sense of coherence and gender as a predictor of the effect of laboratory induced stress on cognitive performance.

The current experimental study examined sense of coherence (SOC) as a predictor of the effect of induced stress (time limit and posing a threat) on the level of overall cognitive performance (based on three subscales: mathematics, shapes, and analogies). Results indicated the following: (a) induced stress (experimental group, n = 80) scored lower on the overall cognitive score, compared to the no-stress (control group, n = 81); (b) subjects in the stress group with higher SOC performed better on the overall cognitive score, compared to subjects with lower SOC; however, in the no-stress group there was no significant effect of SOC on cognitive performance;

The sense-of-coherence predicts health-related quality of life and emotional distress but not disability in Parkinson's disease.

BACKGROUND: Personality traits are deemed important in many fields of Medicine. The present study aimed at evaluating i) the presence of Sense-of-Coherence (SOC) in patients suffering from Parkinson's Disease (PD) in comparison with an age-matched general control population, ii) the influence of SOC on health-related variables, such as depression and anxiety, quality of life (Qol), and activities of daily living (ADL). METHODS: SOC was measured in 50 PD patients and in 50 matched controls enrolled in cross-sectional study. The other clinical measures included: Mini Mental State Examination (MMSE), Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Well-being Index (WHO-5), Hospital Anxiety and Depression Scale (HADS) and the Barthel Index of ADL (BI). Data were analysed with univariate statistics and loglinear adjusted regression models. RESULTS: No difference emerged between PD and controls on socio-demographic and SOC. A statistically significant positive correlation was found between SOC and Qol (0.40, p < 0.004) and a negative significant correlation between SOC and emotional distress (-0.37, p < 0.008). The multivariate regression analysis confirmed the negative effect of SOC on total emotional distress (-3%, p = 0.01) and positive effect on Qol (2%, p = 0.01). SOC and BI were uncorrelated. CONCLUSIONS: SOC is predictive of QoL and emotional distress in PD, whereas no evidence of a predictive effect for disability could be found. These results support only partially, the Salutogenic Theory in PD, i.e. a strong SOC positively influences psychosocial health, but does not influence physical health.

Sense of coherence among cognitively intact nursing home residents--a five-year longitudinal study.

AIM AND OBJECTIVES: To examine how stable the sense of coherence (SOC) is over a five-year period among residents of nursing homes (NH) who are not cognitively impaired and whether components of social support influence SOC. BACKGROUND: Many studies have investigated the stability of SOC, and the findings have been inconsistent. Social support is a crucial resource in developing SOC. Few researchers have studied the stability of SOC and how various social support dimensions influence changes in SOC among older NH residents who are cognitively intact. DESIGN: The study was prospective and included baseline assessment and five-year follow-up. METHODS: The sample comprised 52 cognitively intact NH residents (Clinical Dementia Rating score ≤0.5). We obtained data through direct interviews using the Social Provisions Scale and Sense of Coherence Scale. RESULTS: SOC increased statistically significantly from baseline to follow-up. The social support subdimension reassurance of worth predicted change in SOC after adjustment for sociodemographic factors. When controlled for baseline SOC, attachment was associated with change in SOC, but reassurance of worth was not. CONCLUSIONS: The study indicates that the change in SOC over time during the 5 years of follow-up and the social support dimension attachment appear to be important components of change in SOC. Nursing personnel should be aware of the residents' individual needs for attachment and the importance of emotional support for personal strength and ability to cope.