Sense of coherence contributes to physical and mental health in general hospital patients in China

Abstract

The sense of coherence (SOC) may explain why some people become ill under stress whereas others remain healthy. SOC is strongly related to perceived health, particularly mental health. Little is known about the physical and mental health statuses associated with SOC among general hospital outpatients in China. This multicentre cross-sectional study analysed 491 outpatients from four large Chinese general hospitals located in Beijing, Shanghai, Chengdu and Kunming. Patients completed questionnaires examining their SOC (SOC-9), somatic symptom severity (PHQ-15), depression (PHQ-9), generalised anxiety disorder (GAD), health anxiety (WI-7), quality of life (QoL; SF-12) and socio-demographic and clinical characteristics. SOC was negatively correlated with daily-life impairment, symptom duration, somatic symptom severity, depression, GAD and health anxiety, but was positively correlated with age as well as physical and mental QoL. Using a multiple linear regression model, the three strongest correlates of SOC were mental QoL, depression and age. These three variables explained 52% of the variance. SOC may be an important contributor to both mental and physical health in Chinese general hospital outpatients, which is consistent with the results obtained for primary care patients in Western countries. Longitudinal studies are needed to investigate how SOC predicts physical and mental health statuses over time and how these statuses respond to treatment for low SOC.