Sense of Coherence as Predictor of Quality of Life in Early Breast Cancer Patients.

BACKGROUND/AIM: To examine the association between sense of coherence (SOC) and health-related quality of life (HRQoL) in early breast cancer patients. PATIENTS AND METHODS: The study population included 406 disease-free breast cancer survivors who participated in 3-year and 5-year follow-ups of a randomized exercise intervention. SOC was assessed using the short version of the Orientation to life questionnaire (SOC-13) in the 3-year follow-up. HRQoL was self-reported using the EORTC QLQC30 questionnaire in both 3-year and 5-year follow-ups. The association between SOC and HRQoL was analyzed using the Spearman's rank correlation coefficient. RESULTS: SOC had a strong positive correlation with global HRQoL in both 3-year (rs=0.57, p<0.01) and 5-year (rs=0.51, p<0.01) follow-ups. CONCLUSION: This study provides evidence of SOC's predictive value for HRQoL in early breast cancer patients. SOC might be used for identifying patients who will profit most from psychosocial support and intervention during the rehabilitation period.

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.

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.

Personal values in adolescence and sense of coherence in adulthood: A cross-sectional study based on a retrospective recall.

AIMS: The purpose of this study is to retrospectively examine the association between personal values in adolescence and sense of coherence (SOC) in adulthood. METHODS: J-SHINE data from wave 1 (2010) and wave 3 (2017) were used in this study. We retrospectively measured personal values at age 15 in 2017 in two ways: (a) value priorities developed from Schwartz's theory of basic values; and (b) the commitment to values measured by Personal Values Questionnaire II (PVQ-II). Multiple regression analysis was used to estimate the association. RESULTS: Having a value priority of belief, pursuing one's interest, enduring active challenges, cherishing family and friends, and having a commitment to values in adolescence were significantly and positively associated, while avoiding causing trouble was significantly and negatively associated with SOC in adulthood. CONCLUSIONS: Personal values in adolescence may be associated with SOC in adulthood. Research of personal values in adolescence could contribute to the understanding the development of SOC.

Basic self-disturbances are associated with Sense of Coherence in patients with psychotic disorders.

BACKGROUND: The Sense of Coherence (SOC) theory gives a possible explanation of how people can experience subjective good health despite severe illness. Basic self-disturbances (BSDs) are subtle non-psychotic disturbances that may destabilize the person's sense of self, identity, corporeality, and the overall 'grip' of the world. AIM: Our objective was to investigate associations between BSDs and SOC in patients with psychotic disorders. DESIGN: This is a cross-sectional study of 56 patients diagnosed with psychotic disorders inside and outside the schizophrenia spectrum (35 schizophrenia, 13 bipolar, and eight other psychoses). SOC was measured using Antonovsky's 13-item SOC questionnaire, and BSDs were assessed using the Examination of Anomalous Self-Experience (EASE) manual. Diagnosis, symptoms, and social and occupational performance were assessed using standardized clinical instruments. RESULTS: We found a statistically significant correlation (r = ) between high levels of BSDs and low levels of SOC (r = -0.64/p<0.001). This association was not influenced by diagnostics, clinical symptoms or level of functioning in follow-up multivariate analyses. CONCLUSION: A statistically significant association between BSDs and SOC indicates that the presence and level of self-disturbances may influence the person's ability to experience life as comprehensive, manageable and meaningful. However, the cross-sectional nature of the study precludes conclusions regarding the direction of this association.

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.

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 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.

Association between religiosity and happiness in patients with chronic kidney disease on hemodialysis / Associação entre religiosidade e felicidade em pacientes com doença renal crônica em hemodiálise

Abstract Objectives: Religiosity/spirituality (R/S) seems to be a relevant factor in chronic diseases adaptation, but there is a lack of studies involving chronic kidney disease (CKD). This study aimed to investigate the association between R/S and happiness among CKD patients on hemodialysis and whether Sense of Coherence (SC) mediates this possible association. Methods: This was a cross-sectional study in two renal replacement therapy centers in Brazil, involving 161 adults on hemodialysis. Linear regressions were performed to evaluate the association between R/S (predicting variable measured with Duke Religious Index - DUREL) and happiness (outcome variable), adjusted for sociodemographic, clinical, and some laboratory variables. Later, SC was added to the model to test the possible mediating effect. Results: Most patients (91.20%) reported some religious affiliation. Private Religiosity (PR) (β = 0.53; 95% CI = 0.01 a 1.06), Intrinsic Religiosity (IR) (β = 0.48; 95% CI = 0.18 a 0.79), and SC (β = 0.11; 95% CI = -0.09 a 0.15) correlated with higher levels of happiness, controlling for clinical and sociodemographic variables. When SC was included in the model, IR (β = 0.34; 95% CI = 0.07 to 0.60) and SC (β = 0.11; 95% CI = 0.08 to 0.14) remained significantly. No clinical or sociodemographic variable correlated with happiness. Conclusions: Patients on hemodialysis showed high levels of R/S, which correlated with higher happiness levels. Clinical and sociodemographic variables were not correlated with patients' happiness. Psychosocial variables such as R/S and SC are potential key targets for interventions to promote better survival quality among CKD patients.

Resumo Objetivos: Religiosidade/espiritualidade (R/E) parecem ser fatores relevantes na adaptação a doenças crônicas, mas faltam estudos nessa área envolvendo pacientes com doença renal crônica (DRC). O presente estudo teve como objetivo investigar a associação entre R/E e felicidade em pacientes com DRC em hemodiálise e se o senso de coerência (SC) faz a mediação dessa possível associação. Métodos: Estudo transversal realizado em dois centros de terapia renal substitutiva no Brasil com 161 adultos em hemodiálise. Regressões lineares foram utilizadas para avaliar a associação entre R/E (variável preditora medida pelo Índice de Religiosidade de Duke - DUREL) e felicidade (variável de desfecho), ajustadas para variáveis sociodemográficas, clínicas e algumas variáveis laboratoriais. Posteriormente, o SC foi acrescentado ao modelo para testar seu possível efeito mediador. Resultados: A maioria dos pacientes (91,20%) relatou alguma afiliação religiosa. Religiosidade Privada (RP) (β = 0,53; IC 95% = 0,01 a 1,06) e Religiosidade Intrínseca (RI) (β = 0,48; IC 95% = 0,18 a 0,79) e SC (β = 0,11; IC 95% = -0,09 a 0,15) foram correlacionadas a níveis mais elevados de felicidade após controle para variáveis clínicas e sociodemográficas. Quando SC foi incluído no modelo, IR (β = 0.34; 95% IC = 0.07 a 0.60) and SC (β = 0.11; 95% IC = 0.08 a 0.14) continuaram se correlacionando significativamente com felicidade. Nenhuma variável clínica ou sociodemográfica apresentou correlação com felicidade. Conclusões: Os pacientes em hemodiálise apresentaram altos níveis de R/E, que por sua vez foi correlacionada com elevados níveis de felicidade. As variáveis clínicas e sociodemográficas não exibiram correlação com a felicidade dos pacientes. Variáveis psicossociais como R/E e SC são possíveis alvos para intervenções destinadas a promover a melhora da qualidade de sobrevida dos pacientes com DRC.

Relationships between menopausal symptoms, sense of coherence, coping strategies, and quality of life.

OBJECTIVES: The aims of this study were to examine the relationships between menopausal symptoms, sense of coherence (SOC), coping strategies, and quality of life, and to test the mediating effects of SOC and coping strategies on the relationships between menopausal symptoms and quality of life among Chinese women during menopausal transition. METHODS: Two hundred one women aged 40 to 60 years and currently undergoing menopausal transition were recruited at community centers between June and August 2017. Menopausal symptoms, SOC, coping strategies, and quality of life were assessed by the Menopause Rating Scale, the Sense of Coherence Scale, the Brief COPE Inventory, and the Medical Outcomes Study Short-Form-36, respectively. Data were analyzed by path analysis. RESULTS: Menopausal symptoms were associated with poorer quality of life, and both SOC and maladaptive coping were found to mediate the effects of menopausal symptoms on quality of life. The results suggest that SOC might alleviate the adverse effects of menopausal symptoms on quality of life, whereas maladaptive coping strategies might aggravate the adverse effects of menopausal symptoms on quality of life. CONCLUSIONS: The results provide new insights into the importance of considering SOC and coping strategies and their interactions with menopausal symptoms and quality of life in the situation of menopausal transition.

Storytelling as Adaptive Collective Sensemaking.

Storytelling represents a key element in the creation and propagation of culture. Three main accounts of the adaptive function of storytelling include (a) manipulating the behavior of the audience to enhance the fitness of the narrator, (b) transmitting survival-relevant information while avoiding the costs involved in the first-hand acquisition of that information, and (c) maintaining social bonds or group-level cooperation. We assess the substantial evidence collected in experimental and ethnographic studies for each account. These accounts do not always appeal to the specific features of storytelling above and beyond language use in general. We propose that the specific adaptive value of storytelling lies in making sense of non-routine, uncertain, or novel situations, thereby enabling the collaborative development of previously acquired skills and knowledge, but also promoting social cohesion by strengthening intragroup identity and clarifying intergroup relations.

Analysis of EEG Characteristics and Coherence in Patients Diagnosed as Borderline Personality.

Borderline personality disorder is a clinically important psychiatric diagnosis that is distinct from major depressive, bipolar and posttraumatic stress disorders, despite the overlapping symptoms. The diagnosis is mainly clinical and must follow the DMS 5 (or ICD 10) characteristics. The most common age at first presentation is in late adolescence, but the disorder frequently can be stay as misdiagnosed. Our study is concerned to QEEG characteristics, as well as coherence in borderline patients compared with healthy group, matched by number, gender and age and selected randomly. Our obtained results showed that electrophysiological characteristics for borderlines are fairly without statistical differences, except in low bands (delta and theta), which showed significantly lower frequencies and coherence compared to a healthy group. Future research in this filed with more patients is highly recommended.

Sense of coherence, burden and mental health in caregiving: A systematic review and meta-analysis.

BACKGROUND: Informal caregiving is associated with a number of negative effects on carers' physical and psychological well-being. The salutogenic theory argues that sense of coherence (SOC) is an important factor in psychological adjustment to stress. The main aim of this study was to systematically review current evidence on the association between SOC, burden and mental health outcomes in informal carers. METHOD: A systematic search was carried out up to September 2017 in the following databases: PubMed, CINAHL (EBSCO), PsychInfo (OVID) and Scopus. Studies were included if they evaluated the relationship between sense of coherence and subjective caregiver burden and/or mental health outcomes, specifically symptoms of depression and anxiety. Meta-analyses were performed and subgroup analyses were carried out to explore if methodological factors influenced findings. RESULTS: Thirty-five studies were included in the meta-analysis, which provided 40 independent samples with 22 independent comparisons for subjective caregiver burden, 26 for symptoms of depression and 7 for symptoms of anxiety. Higher levels of SOC were associated with lower levels of subjective caregiver burden and better mental health outcomes. Publication bias did not change the estimate of the effect. LIMITATIONS: Most of the studies included in this review were cross-sectional. CONCLUSIONS: Findings suggest that SOC is an important determinant of carer well-being and may protect carers from high levels of psychological distress and caregiver burden.

Association between religiosity and happiness in patients with chronic kidney disease on hemodialysis.

OBJECTIVES: Religiosity/spirituality (R/S) seems to be a relevant factor in chronic diseases adaptation, but there is a lack of studies involving chronic kidney disease (CKD). This study aimed to investigate the association between R/S and happiness among CKD patients on hemodialysis and whether Sense of Coherence (SC) mediates this possible association. METHODS: This was a cross-sectional study in two renal replacement therapy centers in Brazil, involving 161 adults on hemodialysis. Linear regressions were performed to evaluate the association between R/S (predicting variable measured with Duke Religious Index - DUREL) and happiness (outcome variable), adjusted for sociodemographic, clinical, and some laboratory variables. Later, SC was added to the model to test the possible mediating effect. RESULTS: Most patients (91.20%) reported some religious affiliation. Private Religiosity (PR) (ß = 0.53; 95% CI = 0.01 a 1.06), Intrinsic Religiosity (IR) (ß = 0.48; 95% CI = 0.18 a 0.79), and SC (ß = 0.11; 95% CI = -0.09 a 0.15) correlated with higher levels of happiness, controlling for clinical and sociodemographic variables. When SC was included in the model, IR (ß = 0.34; 95% CI = 0.07 to 0.60) and SC (ß = 0.11; 95% CI = 0.08 to 0.14) remained significantly. No clinical or sociodemographic variable correlated with happiness. CONCLUSIONS: Patients on hemodialysis showed high levels of R/S, which correlated with higher happiness levels. Clinical and sociodemographic variables were not correlated with patients' happiness. Psychosocial variables such as R/S and SC are potential key targets for interventions to promote better survival quality among CKD patients.

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.

Finding Meaning With Creativity in the Past, Present, and Future.

Being creative is considered a desirable trait, yet most empirical studies emphasize how to increase creativity rather than explore its possible benefits. A natural connection is how creativity can enhance life's meaning. Many of the core concepts in work on the meaning of life, such as the needs for coherence, significance, and purpose or the desire for symbolic immortality, can be reached through creative activity. The synthesis of these two constructs-creativity and the meaning of life-is discussed with a temporal model encompassing past, present, and future pathways to creativity. The past pathway can help one understand and reflect on life. The present pathway can remind one of life's joy and the many possible connections with humanity. Finally, the future pathway strives to ensure some type of legacy that may resonate with younger generations.

The Relationship between Disordered Eating Pathology, Sense of Coherence and Body Image among Adolescent Boys in Israel.

BACKGROUND: Disordered eating pathology (DEP) and body dissatisfaction are well-documented risk factors for eating disorders and have become more prevalent among adolescent males. METHOD: The sample consisted of 256 Israeli boys, in grades 8-12. Participants completed questionnaires measuring, Sense of Coherence (SOC), Body Shape (BSQ), Eating attitudes (EAT-26), and the Eating Disorder Inventory (EDI-2). RESULTS: Findings revealed low levels of DEP among adolescent boys. Younger adolescents (grade 8-9) had higher levels of clinically relevant DEP than older adolescents (grade 10-12). SOC was negatively associated with DEP and a significant interaction for age and SOC emerged with younger age being associated with both lower levels of SOC and higher DEP. CONCLUSION: These results demonstrate a low overall prevalence rate of DEP among adolescent boys and is consistent with the developmental literature relating to SOC and mental health and in contrast with a similar population of girls documented in Israel and the US.