Ten-year changes in the psychosocial well-being, psychopathology, substance use, suicidality, bullying, and sense of coherence of 18-year-old males: a Finnish population-based time-trend study.

We studied Finnish 18-year-old males attending obligatory military call-up assessments in 1999 (n = 2340) and 2009 (n = 4309) on time-trend changes in psychosocial well-being, psychopathology, substance use, suicidality, bullying, and sense of coherence. Subjects filled in questionnaires, including the Young Adult Self-Report (YASR) for psychopathology and the Orientation to Life Questionnaire (SOC-13) for sense of coherence. The prevalence of minor mental health problems in the last 6 months decreased from 22.3% in 1999 to 18.6% in 2009 (OR 0.8, 95% CI 0.7-0.9), whereas severe mental health problems remained stable. Suicidal thoughts decreased from 5.7 to 3.7% (OR 0.6, 95% CI 0.5-0.8). The use of illicit drugs decreased from 6.0 to 4.7% (OR 0.8, 95% CI 0.6-0.95), but being drunk at least once a week increased from 10.3 to 13.4% (OR 1.3, 95% CI 1.0-1.5). Attention problems increased in YASR syndrome domains (mean score 2.9 vs 3.2, p < 0.001) and so did somatic complains (mean score 1.7 vs 1.9, p = 0.005). The SOC-13 scores remained stable. The percentage of males who had studied during the past 6 months increased from 91.4 to 93.4% (OR 1.3, 95% CI 1.1-1.6), while being employed decreased from 64.9 to 49.4% (OR 0.5, 95% CI 0.5-0.6). The positive findings included reductions in the prevalence of suicidal thoughts and the use of illicit drugs, but being drunk at least once a week increased. Self-reported somatic problems and attention problems increased. Despite changes in society and family structures, there were only minor overall changes in psychopathology.

Consideration of sense of coherence in a structured communication approach with stage IV lung cancer patients and their informal caregivers: a qualitative interview study.

OBJECTIVE: Salutogenetic aspects are valuable for consideration in patient-centred care of advanced oncological diseases with a limited life expectancy. The Milestone Communication Approach (MCA), involving physician-nurse tandems, addresses specific challenges and needs over the disease trajectory of patients with stage IV lung cancer and their informal caregivers. This study aims to explore patients' and informal caregivers' salutogenetic experiences with the MCA concept. METHODS: This qualitative study used face-to-face semi-structured interviews with patients and informal caregivers. All generated data were audio-recorded, pseudonymised and transcribed verbatim. Data were structured using Qualitative Content Analysis. The material was coded deductively into themes related to the components of sense of coherence (Aaron Antonovsky) and emerging sub-themes. All data was managed and organised in MAXQDA. RESULTS: In 25 interviews, sense of coherence was referred to with all three components: "Comprehensibility" was supported by information conveyed suitably for the patients; "meaningfulness" was addressed as accepting the situation; and "manageability" led to advance care planning the patients were comfortable with. Patients and informal caregivers experienced the interprofessional tandem as an added value for patient care. CONCLUSIONS: Participants appreciate the MCA in its support for coping with a life-limiting disease. Considering salutogenetic aspects facilitates prognostic awareness and advance care planning. Nevertheless, individual needs of patients and informal caregivers require an individualised application of the MCA.

Primary healthcare utilisation and self-rated health among patients with Irritable Bowel Syndrome: What are the impacts of comorbidities, gastrointestinal symptom burden, sense of coherence and stress?

OBJECTIVES: Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disease associated with impaired quality of life and an increased use of healthcare services. Self-ratings of health have proven a powerful predictor of health outcomes. The aim of this study was to evaluate the unique impacts of comorbidities, gastrointestinal symptoms, perceived stress and sense of coherence on the number of healthcare contacts and self-rated health of IBS patients in Swedish primary care. METHODS: In this cross-sectional study, 186 primary-care IBS patients and 360 non-IBS patients (as a reference group) were administrated a test battery of validated questionnaires. Data on comorbidities and healthcare-seeking frequency were obtained from a registry. RESULTS: In the reduced multivariable logistic regression model, average days of abdominal pain/week (OR = 0.83, 95% CI = 0.72-0.96), age (OR = 0.95, 95% CI = 0.92-0.97) and sense of coherence (OR = 1.07, 95% CI = 1.03-1.11) remained independent, statistically significant predictors of IBS (and non-IBS) patients reporting good health. Only the number of comorbidities in general (OR = 1.22, 95% CI = 1.14-1.32) and sleep disorders in particular (OR = 5.40, 95% CI = 1.85-15.76) independently predicted high levels of primary healthcare utilisation among IBS patients. CONCLUSION: Lack of gastrointestinal symptoms, a high sense of coherence and younger age were associated with better self-rated health in both IBS and non-IBS patients. The number of comorbidities in general and sleep disorders in particular were associated with frequent PHC contacts in IBS patients. The association between frequent primary-care contacts and sleep disorders was not seen in the control group, indicating a unique association with IBS patients.

Does the Sense of Coherence modifies the relationship of oral clinical conditions and Oral Health-Related Quality of Life?

PURPOSE: This cross-sectional study aimed to evaluate the association of demographic and clinical characteristics, Sense of Coherence (SOC), clinical conditions (number of teeth, and use of and need for dental prostheses), and Oral Health-Related Quality of Life (OHRQoL); and if the SOC modifies the relationship of clinical conditions and OHRQoL in a sample of elders. METHODS: Trained dentists assessed the participants' oral health and conducted interviews (n = 110). Information on sociodemographic conditions (sex; age at time of data collection; educational level; household income), SOC, and OHRQoL were investigated. Clinical data included use of and need for dental prostheses; number of decayed, missing, and filled teeth; and number of teeth (categorized by median). OHRQoL was measured using the Oral Health Impact Profile (OHIP-14). Effect modification between SOC and each clinical oral condition on OHRQoL was tested in regression models. RESULTS: The findings of the present study showed that individuals with high SOC presented better OHRQoL, even after adjustment for sociodemographic and clinical conditions. CONCLUSION: SOC modifies the effect in the association between OHIP-14 scores and clinical conditions, and could be a protective factor in adverse conditions.

Stressor experience negatively affects life satisfaction in adolescents: the positive role of sense of coherence.

PURPOSE: The aim of the present study was to investigate the association between different normative stressors, sense of coherence and life satisfaction separately for gender in Norwegian adolescents. The interaction effect of stress by sense of coherence in relation to life satisfaction was also investigated. METHODS: The data are based on a cross-sectional sample of 1239 adolescents (13-18 years) from public elementary and secondary schools in Central Norway. Hierarchical multiple regression analysis was used to evaluate the association between stressors, sense of coherence and life satisfaction, separately for gender. RESULTS: The results showed significant differences between genders, where boys reported higher scores than girls on sense of coherence and life satisfaction, whereas girls scored higher than boys on five of seven stressor domains. All stressors were significantly and inversely associated with life satisfaction in both genders; however, all associations were stronger for girls compared to boys. Sense of coherence showed a significant strong and positive association with life satisfaction, controlled for age and each individual stressor. A significant although weak interaction effect of stress related to romantic relationships by sense of coherence was found in association with life satisfaction for boys; the other interaction effects were nonsignificant in both genders. CONCLUSION: The results give support for a significant unique role of stressor experience and sense of coherence in relation to life satisfaction in both genders during adolescence, where the associations were especially strong in girls.

El final de vida en la cultura islámica / The end of life in islamic culture

Objetivo: analizar las evidencias publicadas sobre los aspectos característicos de la cultura islámica, para poder describir aquellos que han de considerarse en los cuidados enfermeros de pacientes de dicha cultura, en el periodo de final de vida. Método: revisión narrativa en la que se lleva a cabo una búsqueda bibliográfica en las bases de datos Clinical Key, PubMed, ENFISPO y Cuiden, así como en las monografías y documentos institucionales del Catálogo de Bibliotecas de la Universitat Autònoma de Barcelona (UAB). Se revisó la bibliografía publicada entre 1993 y 2013 sobre aspectos relacionados con el final de vida de los pacientes de cultura islámica, tanto en inglés como en castellano, de corte empírico o teórico. Asimismo, se tuvo en cuenta que las fuentes estuvieran centradas en el cuidado de los pacientes y que fueran pertenecientes a las Ciencias de la Salud, Ciencias Sociales y Humanidades. Resultados y conclusiones: se seleccionaron 32 fuentes. Los resultados, relacionados con aspectos teóricos, simbólicos y con el cuidado de los enfermos, se agruparon en dos categorías de análisis: antes de la muerte y después de la muerte. Se concluye que para proporcionar un cuidado coherente y sensible a los pacientes de cultura islámica en el final de vida, las enfermeras deberían conocer los aspectos culturales que inciden en los cuidados, a fin de evitar el choque cultural mediante la comprensión de las distintas intervenciones y toma de decisiones de los pacientes y familias (AU)

Objective: to analyze the published evidence about characteristic aspects in islamic culture, in order to describe those which must be considered in nursing care for patients within said culture, in the end-of-life period. Method: narrative review, where a bibliographic search is conducted in the Clinical Key, PubMed, ENFISPO and Cuiden databases, as well as in monographs and institutional documents from the Library Catalogue of the Universitat Autònoma de Barcelona (UAB). The bibliography published between 1993 and 2013 about aspects regarding the end of life in patients from the islamic culture was reviewed, both in English and in Spanish, and empirical as well as theoretical. Additionally, it was taken into account that sources were focused on patient care, and belonged to Healthcare Sciences, Social Sciences, and Humanities. Results and conclusions: thirty-two (32) sources were selected. Results associated with theoretical and symbolic aspects, and with patient care, were classified into two categories of analysis: before death and after death. The conclusion was that in order to provide coherent and sensitive care for islamic culture patients at the end of their life, nurses should be aware of the cultural aspects which have an impact on care, in order to prevent a cultural clash through understanding the different interventions and decision making by patients and families (AU)