Sense Of Coherence Concept Research Articles

How do international humanitarian aid workers stay healthy in the face of adversity?

International humanitarian aid workers (iHAWs) are motivated strongly to travel abroad to help communities affected by war, famine, disaster and disease. They expose themselves to dangers and hardships during their field assignments. Despite working under such challenging circumstances, most workers remain healthy. The objective of the present study was to unravel the mechanism that enables workers to remain healthy under the same circumstances that affect these communities. We hypothesised that the different components of the Sense of Coherence (SOC) health mechanism mediate the relationship between field stressors and post-assignment health. The stress-health model was tested among 465 international aid workers using a longitudinal pre-post assignment study design and structural equation modelling for path analyses. The (health) outcome variables were PTSD, anxiety, depression, emotional exhaustion, and work engagement. Our findings highlight the importance of being healthy before aid assignment and the negative health impact of field stressors that were not potentially traumatic. The SOC components mediated the relationship between field stress and post-assignment health, with males and females using different SOC components to alleviate stress. Males are more likely trying to understand the nature of the stressor, whereas females mobilise their resources to manage stressors. In both groups, a high level of meaningfulness of the work was an important component in maintaining health. Regarding using the SOC concept for understanding the process of maintaining health, our findings indicated that SOC is best considered context-specific and multidimensional. In addition to good pre-mission health, the SOC components help prevent field assignment-related negative health effects in iHAWs. Our findings support the idea to compose gender-balanced teams of iHAWs to maintain and promote health. The findings can be used to develop or refine health conversation tools and SOC based health interventions to promote health and wellbeing and prevent ill-health among aid workers and other stress-exposed populations.

The Sense of Coherence and Health Behavior of Men with Alcohol Addiction.

Introduction: Alcohol dependence is one of the world’s major health challenges. The salutogenic concept of health developed by Antonovsky focuses on the search for resources and factors supporting health. Its basic concept of the sense of coherence (SOC) focuses on strengthening the global orientation of the patient, and creating permanent internal resources that translate into the improvement of pro-health behavior, including the fight against alcoholism. Objective: The objective of this study was to determine the correlation between individual factors and the SOC as well as the influence of the SOC concept on pro-health behavior of people addicted to alcohol. Materials and methods: The study group consisted of 110 men undergoing treatment in an addiction treatment ward. To check the level of the SOC, two standardized questionnaires, Antonovsky’s “SOC-29 Life Orientation Questionnaire” and Juczyński’s “Health Behaviour Inventory”, were used. The correlation coefficient between the sociodemographic variables was checked using the Pearson’s r test. Results: A positive correlation was found with the intensity of pro-health behaviors for three sociodemographic variables. In people aged 43–65 (r = 0.299; p = 0.030), people with primary/vocational education (r = 0.276; p = 0.015), and respondents living in rural areas (r = 0.303; p = 0.028) a greater SOC was associated with pro-health behaviors. Conclusions: Individuals addicted to alcohol are characterized by a low SOC and a low level of pro-health behaviors. Strengthening the internal level of the SOC can constitute an element of addiction therapy when introducing health education to prepare the patient for independent life in sobriety.

Small business managers and Covid-19-The role of a sense of coherence and general resistance resources in coping with stressors.

BackgroundThe response of small business managers to an external event such as the pandemic can have a profound effect on the work environment, health and well-being for themselves and their employees. Previous research on small business managers during the pandemic has mainly focused on traditional pathogenic effects, and there is a lack of studies looking at the issue from a salutogenic health promotion perspective. The aim of this study is to explore whether a sense of coherence and general resistance resources were experienced by small business managers in Sweden and Norway during the Covid-19 pandemic.MethodsA qualitative design was applied through exploratory interviews with 16 managers of small businesses in Sweden and Norway. A content analysis of the interviews was conducted using the sense of coherence concept by Aaron Antonovsky, with the three main components of comprehensibility, meaningfulness and manageability acting as a conceptual framework for the analysis process.ResultsWithin the three main sense-of-coherence categories, six general resistance resources were identified as being important for the managers to handle uncertainty during the pandemic. These were understanding rules and regulations, social support, optimism, proactivity, problem-solving and flexibility and cooperation.ConclusionsThe small business managers handled the pandemic in a way that worked well in their contexts, and the pandemic generally did not have a negative effect on their businesses or themselves. A salutogenic approach, through which the managers focused on identifying and using resources, was an important factor for managing stressors and adversity during the pandemic. Hence, the concept of salutogenesis may be used as an intervention to foster better health in small businesses, both at a personal and organisational level in order to handle future challenges effectively.

Self-perceived oral health-related salutogenic factors in orally healthy older Swedes. A qualitative interview study

Objective This study aimed to explore oral health-related salutogenic factors in orally healthy older Swedish people, applying the three components of Antonovsky’s Sense of Coherence (SOC) concept: comprehensibility, manageability and meaningfulness. Material and method Interviews were conducted with 12 orally healthy patients, aged 75 years and older, enrolled at public dental clinics. The interviews were subjected to qualitative content analysis, applying the SOC concept as the theoretical framework. Results Three themes were formulated under the predefined SOC components, describing the central meaning of the informants’ perception of factors favourable to their good oral health. The theme ‘comprehension of cause and effect’ consisted of three categories, for example importance of oral hygiene, and reflected the component comprehensibility. The theme ‘living in confidence and trust in supporting society’ consisted of five categories, for example self-esteem, and reflected the component manageability. The theme ‘good oral health as a basis for satisfaction and social confidence’ consisted of two categories, for example social norms, and reflected the component meaningfulness. Conclusion This study discloses how orally healthy elderly Swedish people perceive the lifelong impact of salutogenic factors in response to lifelong stressors on their oral health and highlights the important roles of their internal resources, dental professionals, family and society in supporting and reinforcing lifelong oral health.

Future directions for the concept of salutogenesis: a position article.

Aaron Antonovsky advanced the concept of salutogenesis almost four decades ago (Antonovsky, Health, Stress and Coping. Jossey-Bass, San Francisco, CA, 1979; Unravelling the Mystery of Health. Jossey-Bass, San Francisco, CA, 1987). Salutogenesis posits that life experiences shape the sense of coherence (SOC) that helps to mobilize resources to cope with stressors and manage tension successfully (determining one's movement on the health Ease/Dis-ease continuum). Antonovsky considered the three-dimensional SOC (i.e. comprehensibility, manageability, meaningfulness) as the key answer to his question about the origin of health. The field of health promotion has adopted the concept of salutogenesis as reflected in the international Handbook of Salutogenesis (Mittelmark et al., The Handbook of Salutogenesis. Springer, New York, 2016). However, health promotion mostly builds on the more vague, general salutogenic orientation that implies the need to foster resources and capacities to promote health and wellbeing. To strengthen the knowledge base of salutogenesis, the Global Working Group on Salutogenesis (GWG-Sal) of the International Union of Health Promotion and Education produced the Handbook of Salutogenesis. During the creation of the handbook and the regular meetings of the GWG-Sal, the working group identified four key conceptual issues to be advanced: (i) the overall salutogenic model of health; (ii) the SOC concept; (iii) the design of salutogenic interventions and change processes in complex systems; (iv) the application of salutogenesis beyond health sector. For each of these areas, we first highlight Antonovsky's original contribution and then present suggestions for future development. These ideas will help guide GWG-Sal's work to strengthen salutogenesis as a theory base for health promotion.

Reduced Sense of Coherence Due to Neuroticism: Are Transcendent Beliefs Protective Among Catholic Pastoral Workers?

In this study, we examined a third variable effect on the relationship of personality traits, especially neuroticism and the salutogenetic concept sense of coherence. Specifically, we were interested in the moderating role of religious trust (RT) and transcendence perception operationalized as daily spiritual experiences (DSE) on the aforementioned relationship among religious individuals. We applied a cross-sectional study among a sample of 8594 pastoral workers using standardized questionnaires. Multiple regression and moderator analysis displayed the relationships between big five personality variables and sense of coherence. Neuroticism was identified as a negative predictor to sense of coherence, indicating impairment on this psychological resource. RT and DSE appear to function as moderators that buffer the negative effects of neuroticism on sense of coherence among religious persons. This is an interesting finding because people with expressions of neurotic personality tendencies often struggle to find helpful methods of coping and may find a helpful resource in the concepts studied here.

Content Validity and Reliability of the 13-Item Sense of Coherence Scale among 13-15 Year Old School Children in Chennai City

Objective: To assess the content validity and reliability of the 13-item Sense of Coherence (SOC) scale among 13-15 year old school children in Chennai city. Participants: A total of 258, 13 – 15 year old ethnic Dravidian students from two randomly selected schools within Chennai city, present on both days of the study were included. Study design: A cross sectional study. Method: The 13-item Sense of Coherence questionnaire was translated to the vernacular, back translated and subjected to expert opinion to check its validity. The 13-item SOC questionnaire was used to assess the Sense of Coherence of the selected school students. The questionnaire was re-administered after one week to measure to measure Internal consistency reliability and Infraclass correlation co-efficient. Results: The Internal consistency reliability checked using Cronbach α was found to be 0.784. The intra class correlation co-efficient was 0.7 and remained the same with an item deleted. Conclusion: Our results suggest that the 13 item SOC questionnaire is a valid and reliable epidemiological tool among an adolescent Dravidian population in Chennai city. Further studies are recommended to assess the stability of SOC concept over a period of time.

Sense of coherence and chronic illnesses: Scope for research in India

AbstractThe theory of salutogenesis focusses on how individuals move in the direction of health rather than illness. Within this is the concept of sense of coherence (SOC) that refers to a stable disposition which creates coping resources and a sense of health preservation. With the help of a widely validated SOC scale, a range of studies evidenced that a strong SOC was associated with psychological well-being, healthy behaviors, and good health. Although the cross-cultural nature of SOC is supported, there is limited research exploring SOC in Asian cultures. Understanding how people orient themselves toward health and leveraging this in the development of health interventions within the unique cultural context of India is necessary. The current paper will review the theory of salutogensis and SOC concept, the measurement of SOC, the relationship between SOC, chronic illnesses, and culture, concluding with suggestions for possible areas of SOC research in India.

Sense of coherence and health among home-dwelling older people

Sense of coherence (SOC) is important for maintaining health. The aim of this study was to investigate if the SOC experience among home-dwelling physically active older people differs from that of hospital patients with the same age and sex. Data were collected with questionnaires and structured interviews containing Antonovsky's SOC scale in an age- and sex-matched study group (n=160). Non-parametric statistical analyses were performed. No differences were found in SOC between home-dwelling individuals and patients. Ninety-five percent of the home-dwelling individuals perceived themselves as being in good health and 42.5% among the patients (p<0.001). SOC and disease were predictors for health in the total study group. Among the home-dwelling individuals, SOC, disease and being single were predictors for health and among the patients solely SOC. When using the components of the SOC concept, comprehensibility and disease predicted health for the home-dwelling individuals and meaningfulness predicted health for the patients.

Normal birth, magical birth: the role of the 36-week birth talk in caseload midwifery practice

to obtain a detailed description of the 36-week birth talk, and how it is delivered to and perceived by women and their birth partners. two qualitative methods: ethnography and interpretative phenomenological analysis. Non-participant observation of five birth talks and in-depth semi-structured interviews with midwives, women and their birth partners. two caseload midwifery practices in an inner city area of England, and women's homes. five birth talks, five case-loading midwives, five childbearing women and five birth partners. a rich description of the content and conduct of the birth talk emerged from the data. In addition, three master themes were identified: a new philosophy for birth ('don't forget the magic'); the construction of authoritative midwifery knowledge ('they make you believe that you can have what you want'); and achieving a sense of coherence ('making sense of the birth'). IMPLICATIONS FOR PRACTICE, POLICY, EDUCATION AND RESEARCH: the majority of data from this study suggest that the effectiveness of a birth talk cannot be separated from the philosophy and continuity associated with caseload midwifery practice. The birth talk is therefore probably not transferable per se into different models of care in order to achieve higher rates of normal birth. Further evaluation of the effectiveness of the birth talk in clinical practice, and further research into alternative birth philosophies in different settings is now required. Caseload midwifery practice has been shown to benefit women and midwives. This study would seem to concur with these previous findings. The sense of coherence concept could prove to be a useful tool to measure outcomes in future midwifery research.

Sense of Coherence and Physical Health. A “Copenhagen Interpretation” of Antonovsky's SOC Concept

According to Antonovsky's (Aaron Antonovsky, 1923–1994) sense of coherence (SOC) model, persons with a high SOC have the ability to benefit from their general defense mechanisms in order to overcome stressful situations. In a health-disease continuum, this leads to the development towards health. However, Antonovsky's global hypothesis that the strength of the SOC may influence the physical health status of a person could not be proven.Flensborg-Madsen et al. from Copenhagen were able to provide a new access regarding SOC and health. They investigated the mixture of emotional aspects and mental constructions as a possible cause for fairly low correlation between SOC and physical health. Thus, in an empirical way, they described “emotional coherence” in relation to physical health, while “mental coherence” was linked to psychological health. These authors introduced the idea of applying a shortened version of the original 29-item SOC questionnaire, but have not yet developed or tested the shortened questionnaire. Backed by their important findings, it appears to be promising to consider the use of the SOC questionnaire as standardized by Antonovsky, but cleared of the items regarding “predictability”, i.e., Flensborg-Madsen et al. suggested that the items on “predictability” be excluded from the SOC scale when a correlation to physical health is to be investigated. Further investigations in this area of research will be of high impact, not only for health sciences, but also for medical practice.

Antonovsky’s sense of coherence scale and its relation with quality of life: a systematic review

The aim of this paper is to synthesise findings on the salutogenic concept, sense of coherence (SOC), and its correlation with quality of life (QoL). This study is descriptive and...

No Sense of Coherence

See related article, pages 1447–1453. When making a diagnosis of stroke, a physician should ask the patient how he experienced his deficit. Most patients, if not impaired by speech or memory, will give a straightforward account of their surprising and miserable experience of having felt a sudden motor or sensory loss, distressing weakness, or alarming loss of vision or of coordination. Interestingly enough, many patients also include in their story why they think this has happened to them. Often they report that they had recently endured much ‘stress’, and whatever their own personal definition for this might be, it will often be connected to a life-event, such as loss of job, loss of a spouse, or any other personal unhappy (or, much more rarely, happy) event. Although stroke physicians empathically listen to such explanations by the patient, they do not overtly take these subjective causalities as an indicator of a stroke risk. If stressful events persist, physicians might offer general advice enabling …

Sense of coherence in a Thai sample.

This is the first large epidemiological study of the Sense of Coherence concept carried out in a non-western culture. One adult from each of 456 families living in northern Thailand filled in the Sense of Coherence scale (SOC) and checklists measuring anxiety, depression and self-esteem. The mean value for SOC was comparable with western studies. High SOC was related to high self-esteem and low distress scores in the parents. The same associations were found between parental SOC and the perceived competence and behaviour problems of the children. High SOC acted as a protective factor in high socio-economic stress situations.

Sense of coherence: quality of life before and after coronary artery bypass surgery--a longitudinal study.

The attention to patient outcome has nowadays extended from morbidity and mortality to an aspect of patients' benefits in terms of quality of life. One factor crucial for quality of life is coping capacity, in this study represented by the sense of coherence concept. Physical status and emotional state (often measured by comprehensive instruments not always suitable for clinical use) are also additionally used to reflect quality of life. The purpose was therefore to study sense of coherence and emotional state as indirect measures of quality of life in relation to coronary artery bypass grafting surgery. One hundred and eleven patients were studied by a developed questionnaire on five occasions in relation to the surgery: the week before the angiography, the day before surgery and then at 3, 6, and 12 months post-operatively. The main findings were: (1) The sense of coherence was changed (more than +/-10%) from before to 1 year after surgery in 41% of the patients, which is contrary to the theory of sense of coherence as a stable personality characteristic in adults. (2) Experience of depressed mood, stress, and anxiety decreased significantly from before to after surgery. (3) Beneficial outcome with regard to sense of coherence was significantly related to less experience of loneliness, depressed mood, stress and anxiety, and to less experience of chest pain 1 year after surgery. In conclusion, sense of coherence and emotional state variables, are suggested to be valuable as measurements of quality of life in relation to coronary artery bypass grafting surgery.

Sense of Coherence – A Mediator between Disability and Handicap?

Background: The aim of this study was first to analyze the associations between disability and handicap and Antonovsky’s concept of sense of coherence (SOC); secondly, to find out how the SOC concept could be integrated in the WHO model of impairments, disabilities, and handicaps (ICIDH). Methods: Data from two studies were used: one on patients with rheumatoid arthritis, one on severely injured accident victims. Objective measures of the illness or the injury were conceptualized as indicator variables for disability, whereas variables related to the patients’ subjective judgement were conceptualized as indicator variables for handicap. Correlations were calculated between both sets of variables and the SOC scale total score. Results: SOC showed no significant correlation with ‘disability variables’ (rheumatoid arthritis: HAQ, SF36 physical functioning; accidental injuries: ISS, GCS). However, significant correlations were found between SOC and all ‘handicap variables’ (rheumatoid arthritis: HAD, SF36 social functioning; accidental injuries: CAPS-2, IES, SCL-90-R depression subscale). Conclusions: SOC is related to the psychosocial effects of health problems. It may be understood as a mediator between disability and handicap. Prospective studies are needed to clarify whether the SOC scale can be used as an outcome predictor with regard to psychosocial adaptation, in acute as well as in chronic health problems.

Dimensional analysis of sense of coherence using structural equation modelling

The sense of coherence (SOC) concept has been criticized on conceptual and psychometric grounds. The aim of this study was to develop the concept using structural equation modelling. The short 13-item version of the SOC questionnaire was used and data were collected from two different samples. Each sample consisted of about 2000 individuals, selected to be representative of the Swedish population. A model with a general factor and two subordinate specific factors yielded a satisfactory solution in both samples. The two factors were labelled Social Comprehension and Commitment and Unpleasant Emotions and Inner Tension respectively. It was concluded that the 13-item SOC scale could to a certain degree be regarded as a measure of negative affectivity and that the suggested model makes the SOC concept more theoretically coherent. Copyright © 1999 John Wiley & Sons, Ltd.

Antonovsky's sense of coherence concept: an instrument for primary prevention in social work services

Antonovsky's sense of coherence concept: an instrument for primary prevention in social work services

View of Life and Health

The quest for causes behind health and sickness proposes deeper causes like per- sonality and general view of life. Two such concepts have been shown to associate with health indicators in a systematic way, sense of coherence and view of life. Sense of coherence (SOC) is defined as the sum of three factors, comprehensibility, manage- ability, and meaningfulness. View of life (VOL) consists of three components, general theories of man and the world, a central value system, and a basic attitude. Two em- pirical studies are summarized where the concepts are related to bereavement and health, respectively. It is concluded that there are many similarities between the two concepts. They both emphasize integration and coherence and connote basic struc- tures in belief systems. They can be related to personality structure and the coping process. The concepts differ in scope and depth. SOC can be considered as part of the connotation of VOL. SOC is quantitatively measurable while VOL presumes qualitative methods of assessment. In studies of health, where factors pertaining to world view or sense of coherence are not in focus, but studied rather as possible confoun- ders, methodological simplicity points to use of the SOC concept. In studies of health where the deeper causal structures are in focus, VOL should also be used, since it per- mits greater depth of analysis. Ideally, both concepts should be applied for a full un- derstanding between man's inner processes and health.

Salutogenic model and utilization of the KASAM form (Sense of Coherence) in nursing research--a methodological report

This paper presents psychometrical properties of the Swedish version of the Sense of Coherence (SOC) scale. The concept sense of coherence is proposed to explain successful coping with stressors and as being a stable trait of the individual. The stronger the SOC, the more successful coping and the more likely one is to have better health and quality of life. The data in this study has been obtained from five groups of healthy individuals and eight patient groups. The scores of the SOC scale did not change over time when studied after two, 12 and 18 months respectively. Weaker sense coherence was correlated to more self-rated anxiety, functional limitations especially those of a psychosocial character, and severe perception of symptoms, and to worse self-rated general health, and less motivation. It is suggested that the SOC scale could be of clinical use in assessing the need for nursing care.