Factors Related to Sense of Coherence Among Dental Students at Istanbul University

Association between Sense of Coherence and Caries Activity and Caries Experience among Male Adolescents from Southern Brazil: A Cross-Sectional Study

INTRODUCTION

This cross-sectional study assessed the association between sense of coherence (SoC) and caries activity (number of active caries lesions) and caries experience (DMFT index) among 18-19-year-old male adolescents who joined the Brazilian Army as draftees for mandatory military service (n = 507).

METHODS

Data collection included a questionnaire (level of education, family income, and tooth brushing frequency), the Brazilian short version of the SoC scale (SOC-13), and clinical caries examination (noncavitated/cavitated, inactive/active). The main predictor variable was SoC, categorized as low, moderate, or high. Poisson regression models were used for statistical analysis.

RESULTS

A high SoC was significantly associated with a lower number of active lesions (adjusted rate ratio = 0.85; 95% CI = 0.74-0.98). No association between SoC and DMFT was detected.

CONCLUSION

A high SoC was found to be a protective factor to caries activity in this population.

Understanding the Quality of Life and Its Related Factors in Orthodontics Postgraduate Students: A Mixed Methods Approach

This study analyzed the academic, sociodemographic, and labor conditions related to the quality of life (QOL) of orthodontics postgraduate students in Colombia. A mixed study (explanatory sequential design) was conducted. An online cross-sectional survey (n = 84; 64.3% females) was carried out with sociodemographic, academic, social support, health, labor, and QOL (WHOQOL-BREF) variables. Descriptive, bivariate analyses, and multivariate linear regression were performed. Focus groups (FGs) delved into aspects of relevance regarding QOL and determinants, through qualitative content analysis and triangulation of information. The median score in the four WHOQOL-BREF dimensions surpasses 50 points, with the highest score being in the psychological dimension (62.5 ± 16.7). According to the multivariate linear regression models, the variables significantly associated with QOL scores were playing sports, being married/living together, normal BMI, low social support, and medium/low socioeconomic status. The qualitative results explained the determinants of QOL in the personal, academic, and social dimensions of the participants. The discourses showed that the postgraduate course represents a resignification of their life, where their QOL is affected by the difficulties of their academic development, by the difficulty of reconciling the personal academic load with their affective, work, and social life, and by the stress they experience in their staff process. In conclusion, the participants' QOL was moderate and affected by different factors. The findings highlighted the importance of mental health promotion and well-being strategies in students of orthodontic postgraduate training programs in Colombia for improving QOL.

Evaluation of the predictors of oral health-related quality of life among 3-5-year-old children with dental trauma

This study evaluated the influence of socio-demographic, clinical, and parental psychological factors on oral health-related quality of life (OHRQoL) and determined their predictors in preschool-aged children with traumatic dental injury (TDI). The study sample consisted of 324 dyads of children and their parents attending the Clinics of Pediatric Dentistry at Istanbul University. After clinical examination, the Sense of Coherence (SOC), Generalized Self-Efficacy Scale, Early Childhood Oral Health Impact Scale, and Multidimensional Health Locus of Control Scale-MHLC questionnaires were administered to the parents. The statistical analyses included Spearman correlation coefficients, Mann-Whitney U tests, Kruskal-Wallis tests, multiple linear regression, and confirmatory factor analysis. Having mixed TDI, a non-nuclear family, fewer children, and weak parental SOC were important predictors of worse overall OHRQoL and its sections of child and family. Lower internal health locus of control and dental pain due to TDI were predictors of worse overall OHRQoL and child impact, respectively. Consideration of these predictors may help oral health professionals to develop prevention and treatment programs for TDI and oral health literacy programs for families.

The relationship of dental students’ characteristics to social support, psychosocial factors, lifestyle, and quality of life

Objective

To examine the relationships between sociodemographic characteristics, student academic information, social support, sense of coherence, anxiety, lifestyle, and quality of life among dental students.

Methods:

A cross-sectional study among 233 dental students in Brazil. We captured data on sociodemographic and socioeconomic characteristics, social support through Social Support Appraisal, psychosocial factors (sense of coherence and anxiety based on SOC-13 and Depression, Anxiety and Stress Scale-21 – anxiety subscale, respectively), lifestyle as per individual Lifestyle Profile and quality of life based on VERAS-Q. Data was analysed through Structural Equation Modelling.

Results:

Greater social support, higher sense of coherence, lower anxiety, better lifestyle directly predicted better quality of life. Male gender, city of origin did not differ from the city of the campus, higher social support and greater sense of coherence were indirectly linked with better quality of life via better lifestyle. Lower academic semester and higher social support indirectly predicted better quality of life via lower anxiety.

Conclusion:

Social support, sense of coherence, anxiety, and lifestyle were relevant factors directly associated with dental student’s quality of life. Indirect pathways were observed between gender, moved home to attend dental course, academic semester, social support, sense of coherence, and quality of life.

Salutogenesis, nutritional status and eating behaviour: a systematic review

OBJECTIVE

To assess the relationship between the sense of coherence (SOC), eating behaviour and nutritional status.

DESIGN

It is a systematic review.

SETTING

The following databases were searched: MEDLINE/PubMed, Science Direct/Elsevier, LILACS/Bireme, SciELO and Google Scholar, using the indexed terms 'salutogenesis', 'sense of coherence', 'nutritional status', 'nutrition', 'eating behavior' and 'healthy eating'. The indexed terms were used in Portuguese and English according to the database searched. The data were extracted in a standardised way and the quality of the studies was assessed using the Newcastle-Ottawa Scale.

PARTICIPANTS

Observational studies were included, with no limitations on the date of publication or language.

RESULTS

After reading the titles and abstracts of 1855 articles, 107 full texts were retrieved, of which 27 were included. Of these, twenty-five were cross-sectional and two were longitudinal. The average score for Newcastle-Ottawa studies was 6 and most studies were rated as moderate and low quality. The cumulative sample size of all included studies was 28 981 adults and the elderly, aged between 18 and 81 years. The studies were carried out in fifteen different countries. Fifteen articles assessed eating behaviour/habit and twelve assessed nutritional status. Studies have shown that SOC has a positive relationship with an appropriate eating behaviour/habit. On the other hand, the relationship between SOC and nutritional status was controversial among studies. The heterogeneity of the data resulting from the use of different methods of evaluation of the outcomes of interest (nutritional status and eating behaviour) made it impossible to perform a meta-analysis.

CONCLUSION

SOC was positively associated with adequate eating behaviour. However, it was not possible to establish a relationship between SOC and nutritional status.

Validation of the factor structure and psychometric characteristics of the Arabic adaptation of the sense of coherence SOC-13 scale: a confirmatory factor analysis

BACKGROUND

The sense of coherence is as focused on one's awareness of the level of pervasive, enduring, and dynamic feelings. Stronger sense of coherence leads to better physical and mental health and promotes recovery from life stressors. Sense of coherence-13 (SOC-13) is a 13-item valid and reliable measure for individual's healthy living. However, the factor structure of SOC-13 was criticized in several cultures and languages. The current study was set to explore the factor structure of an Arabic adaptation for SOC-13.

METHODS

This cross-sectional study of the SOC-13 included (n = 1235) Arabic speaking individuals. We used confirmatory factor analysis to contrast unidimensional, bidimensional, three-dimensional, and four-dimensional factor structure for the SOC-13. We carried out measurement invariance analysis across age and gender groups to examine the stability of fit indices among participants' subgroups.

RESULTS

We found the reliability coefficient to be 0.82, indicative of good internal consistency. The three-factor structure, after modification of items 1, 2, and 3 was the best-fitting factor model. However, measurement invariance was indicative of discrepancy for the three-factor model between genders and age classes. The mean overall SOC-13 total score in our sample was 52.1 (SD = 16.1).

CONCLUSIONS

The SOC-13 showed acceptable psychometric properties in terms of internal consistency and a modified three-factor structure in its Arabic version. However, the reliability of the three underlying dimensions was sub-optimum. Moreover, the three-factor structure requires modification by either removing the first three problematic items or allowing the residuals to correlate.

Relationship between sense of coherence and health-related behaviours in adolescents and young adults: a systematic review

Background

The sense of coherence is developed through the learning process and contributes to the positioning of individuals in the health-disease continuum, facilitating successful and adaptive personal outcomes. Health-related behaviours represent a health determinant of utmost importance for public health and the development of adolescent and youth health promotion policies, as they are related to the main risk factors and problems of morbidity and mortality in our society. Previous studies have analysed the relationship between sense of coherence and only some individual health outcomes such as oral health, the relationship of sense of coherence with smoking and alcohol consumption, concluding that salutogenic factors are related to quality of life and preventive behaviours. The aim of this systematic review was to describe the relationship of sense of coherence with different health-related behaviours investigated so far in the adolescent and youth population.

Methods

A systematic review was carried out in databases (PubMed, CINAHL, Scopus and PsycInfo) and in the bibliographies of the retrieved articles, without limitation of time or language. Associations between sense of coherence and health-related behaviours have been assessed.

Results

A total of 1214 investigations were reviewed and 21 of them were included in this systematic review. The relationship between sense of coherence and eight health-related behaviours were identified (alcohol use, physical activity, tobacco use, eating habits, rest periods, use of illegal substances, behaviours related to oral health and time spent in games on the computer).

Conclusions

Our results increase the available evidence and support the solid relationship of the sense of coherence with health behaviours both as a protective factor against risk behaviours and for its positive association with preventive and health promoting behaviours of adolescents, young adults and university students.

Association Between Sense of Coherence and Periodontal Outcomes: A Systematic Review and Meta-analysis

This systematic review and meta-analysis aimed to evaluate the association between sense of coherence (SOC) and periodontal outcomes. Electronic searches were performed in 6 databases. Seventeen studies that evaluated the association between SOC and periodontal outcomes were included. The included studies demonstrated that individuals with a stronger SOC were more likely to present improved periodontal outcomes. The meta-analysis showed that individuals with a lower SOC were 3.31 times more likely to present bleeding on probing. Sons/daughters of mothers with a lower SOC were 3.22 times more likely to present gingival bleeding. Individuals with a stronger SOC have better periodontal health.

Parental social-cognitive correlates of preschoolers' oral hygiene behavior: A systematic review and meta-analysis

BACKGROUND

Regular and consistent parental involvement in children's oral hygiene practices is crucial to prevent oral diseases in young children. This emphasizes the need for interventions targeting parental-supervised oral hygiene behavior. To inform the design of future interventions, this meta-analysis aimed to identify the parental social-cognitive factors associated with oral hygiene behavior of preschoolers.

METHOD

Five bibliographic databases were searched. A study was eligible for inclusion when it reported an association between a parental social-cognitive factor and an oral hygiene behavior in the targeted age cohort. Meta-analyses were performed when there were at least four independent effect sizes (k > 3).

RESULTS

Of the 5945 records identified, 25 studies contained eligible data to be included in four meta-analyses: attitude (k = 12); self-efficacy (k = 12); intention (k = 6), and sense of coherence (k = 5). The results showed that greater frequency of preschoolers' oral hygiene behavior is significantly associated with parental attitudes (r⁺ = 0.18), self-efficacy (r⁺ = 0.34), and intention (r⁺ = 0.29), and not significantly associated with parental sense of coherence (r⁺ = 0.08).

CONCLUSION

Self-efficacy, attitudes, and intention were identified as significant correlates of parental-supervised oral hygiene behavior. However, this is a limited evidence base and many social-cognitive factors, such as self-regulatory processes including planning and action control, have yet to be explored in this context. The significant social-cognitive correlates identified in this study, as well as potential other self-regulatory factors, should be targeted in future intervention studies aimed at improving this important preventive behavior.

Acculturative Stress among Arab Students in Israel: The Roles of Sense of Coherence and Coping Strategies

BACKGROUND

In Israeli colleges and universities, many Arab students experience acculturative stress. Such stress arises from the need to learn new cultural rules, manage the overarching conflict inherent in maintaining elements of their culture of origin (i.e., Arab culture) while incorporating elements of the host culture (i.e., Jewish academic culture), and deal with experiences of prejudice and discrimination present in the host culture.

METHODS

This study investigated the association between acculturative stress and depressive symptoms among 170 Arab undergraduates from northern and central Israel. It also explored the roles of sense of coherence and coping strategies in the relationship between acculturative stress and depressive symptoms. Participants completed questionnaires on acculturative stress, depressive symptoms, sense of coherence, coping strategies, and demographics.

RESULTS

The findings reveal gender differences in the use of different coping strategies and in levels of depressive symptoms. However, academic-year differences were found only in levels of sense of coherence and depressive symptoms. Specifically, female students expressed higher levels of both active and avoidant coping. Moreover, female students and those in their first and second years of university studies reported higher levels of depressive symptoms. Among the male students, acculturative stress was related to depressive symptoms indirectly via sense of coherence and active coping. In contrast, among the female students, acculturative stress was related to depressive symptoms both directly and indirectly via sense of coherence and avoidant coping. Among first- and second-year students, acculturative stress was related to depressive symptoms indirectly via sense of coherence and avoidant coping. However, among third- and fourth-year students, acculturative stress was related to depressive symptoms both directly and indirectly via sense of coherence.

CONCLUSIONS

This article underscores the significance of gender and academic-year differences in pathways involving acculturative stress.

Modeling the factors associating with health-related habits among Japanese students

The aim of the present study was to clarify the structural relationship between health-related habits and psychosocial factors during adolescence/early adulthood. An anonymous, self-administered questionnaire was provided to 1141 third- and fourth-year students at eight academic departments from six universities in regional Japanese cities. Surveys included items addressing participants' demographic characteristics, psychosocial factors (individual-level social capital, self-efficacy, mental health (from health-related quality of life SF-36v2), and sense of coherence (SOC)), and health-related habits. A multiple indicator analysis based on structural equation modeling was conducted to examine the structural relationship between health-related habits and these factors. Valid responses were obtained from 952 participants. The final model demonstrated a high level of goodness of fit. While the path from SOC to health-related habits was significant, those from self-efficacy to health-related habits and from mental health to health-related habits were not significant. The path coefficient from SOC to health-related habits was greater than the path coefficient from background characteristics. In the multiple population comparison that considered gender, a nearly identical model was supported for men and women. Psychosocial factors related to health-related habits were social capital, self-efficacy, mental health, and SOC. Furthermore, it was suggested that SOC functions as an intervening factor for maintaining a healthy lifestyle. It was observed that individual psychosocial factors influence health-related habits more than their background characteristics. Findings highlight that supporting the building of social relationships and social environments is essential to promote a healthy lifestyle among university students.

Sense of coherence and self reported health amongst medical students: A cross sectional study

Background

In late 70s, Antonovsky proposed a salutogenic theory. This theory was based on the assumption that the human environment causes stress, and sense of coherence could serve as a stress-resisting resource. This study examined association between sense of coherence and self rated health of medical students. The aim of this study was to determine the association between sense of coherence and self reported health among medical students.

Methods

This was a cross-sectional analytical study conducted among medical students. The study tool used was a pre-designed, pre-tested, structured and self administered questionnaire (SOC scale and the SF 12 version 2 self-rated health measure). 172 medical students participated in the study. The data collected was entered into Microsoft Excel and analyzed using SPSS 20. All students were educated about sense of coherence after the study.

Results

Among the respondents, there were 99 (57.6%) female students, and 73 (42.4%) were male. The mean age of the students was 20.8 + 1.20 years. The mean (±SD) SOC scale score was 56.15 (±7.83). The mean self rated health score was 53.52 (±7.11). Pearson's χ² test was used to determine the association and there was significant association between students SOC and self reported health (p < 0.000).

Conclusion

There is a significant association between score of sense of coherence scale and self rated health among medical students.

A motivational interview intervention delivered at home to improve the oral health literacy and reduce the morbidity of Chilean disadvantaged families: a study protocol for a community trial

INTRODUCTION

Oral health education/promotion interventions have been identified as cost-efficient tools to improve the oral health of the population. These interventions are regularly made in contexts where the target population is captive, for example, in health centres. In Chile, there are no oral health interventions delivered at home.

METHODS AND ANALYSIS

This community trial covers two disadvantaged urban areas in the province of Concepción. Both sectors have public preschool education coverage with a traditional programme (TP) to promote oral health. The intervention will comprise four to six visits by dental hygienists trained in the delivery of a standardised oral health promotion programme using motivational interviewing (MI) at home. The experimental group will receive TP and MI, while the control group will receive only TP. If a positive and significant effect of MI is found, this will be administered to the control group. For a 50% reduction in the incidence of caries, a sample size of 120 preschoolers per group is estimated. Data will be gathered on demographic and socioeconomic variables; oral health outcomes using WHO oral health indicators (the prevalence and severity of caries, periodontal disease, dentofacial anomalies and oral hygiene); the oral health literacy of caregivers, measured by the Rapid Estimation of Adult Literacy in Dentistry and the Oral Health Literacy Instrument, both validated for the Chilean population. Assessments will take place at baseline and at 12-month follow-up.

ETHICS AND DISSEMINATION

The university bioethics committee approved this study (EI/21/2014). We will submit the trial's results for presentation at international scientific meetings and to peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ACTRN12615000450516.

Factors promoting sense of coherence among university students in urban areas of Japan: individual-level social capital, self-efficacy, and mental health

OBJECTIVE

Sense of coherence (SOC) is a concept that helps to explain the relation between personal intentionality as psychosocial factors and health-related behaviors. Thus, it is essential to enhance SOC when encouraging a healthy lifestyle. However, the factors that promote SOC have not been fully investigated among university students. The objective of this study was to clarify the general resistance resources (GRRs) that may promote the development of the SOC among university students. Therefore, we examined the relationship between SOC and social capital (SC), self-efficacy, and mental health.

METHODS

Participants included 443 students from nine academic departments at eight universities in the Kanto or Kinki metropolitan areas of Japan. Participants completed an anonymous questionnaire. Individual-level cognitive and structural SC, generalized self-efficacy, mental health inventory (from SF-36v2), and SOC were measured. Confirmatory factor analysis using structural equation modeling was conducted to verify the factor structure of the SOC-13 scale. Stepwise multiple regression analysis and two-way layout analysis of variance were performed with SOC as the dependent variable.

RESULTS

The factor structure of SOC indicated the optimal model fit in the second-order three-factor model of the 12 items. SOC was predicted by five variables: age, cognitive SC, structural SC, mental health, and self-efficacy. For students from urban areas, SOC was predicted by the interaction between cognitive and structural SC.

CONCLUSION

SOC was significantly related to cognitive SC, structural SC, and self-efficacy as well as mental health in university students from urban areas. Furthermore, the combination of higher-level cognitive SC and higher-level structural SC exerted an inhibitory influence on SOC among students who previously and currently live in urban areas. Therefore, the findings indicated that both cognitive and structural SC as well as self-efficacy may act as GRRs that promote the development of SOC, and similarly, good mental health may promote a strong SOC.

Association between social participation and hypertension among older people in Japan: the JAGES Study

Hypertension is an important risk factor for cardiovascular disease, the leading cause of mortality in the world. Although previous studies have focused on individual-level behavioral risk factors associated with hypertension, there has been little research on how interacting with others, that is social participation, affects hypertension. To address this research gap, this study examined the association between social participation and hypertension in Japan, a country with a high prevalence of hypertension possibly linked to rapid population aging. Data were used from 4582 participants aged more than 65 years who participated in the Japan Gerontological Evaluation Survey (JAGES) with blood pressure data collected during a health check-up. The frequency of participation in vertical organizations (characterized by hierarchical relationships) and horizontal organizations (characterized by non-hierarchical, egalitarian relationships) was measured by a questionnaire. In a Poisson regression analysis, participation in vertical organizations was not associated with hypertension, whereas participation in horizontal organizations at least once a month was inversely associated with hypertension (prevalence ratio: 0.941). This association remained significant after adjusting for social support variables, although further adjustment for health behaviors attenuated the association. As the frequency of going out and average time spent walking were both associated with hypertension, physical activity may be a possible pathway that connects social participation and hypertension. The results of this study suggest that expanding social participation programs, especially those involving horizontal organizations, may be one way to promote better health among older people in Japan.

Sense of coherence and associated factors among university students in China: cross-sectional evidence

Background

Sense of Coherence (SOC) is considered as a health-promoting resource; it is mainly developed before the age of 30. The multiple demands university students face, such as study-related stress and financial difficulty, could challenge their SOC development. This study aimed to: 1) investigate the association between SOC, socio-demographic and lifestyle-related characteristics; 2) assess the effect of perceived stress on SOC controlling for other variables among the Chinese university students. Analyses were done to derive a better view on possible strategies to strengthen students’ SOC and with that to promote their health.

Methods

The data used were from a Chinese university student health survey (N = 1,853). Logistic regression analyses were used to explore the effects of varied socio-demographic, lifestyle-related variables on students’ level of SOC, as well as the association between perceived stress and SOC controlling for other variables in the analysis.

Results

Both social support (OR = 2.56 [1.87–3.50]) and better performance compared with peers (OR = 1.64 [1.15–2.34]) were associated with a stronger SOC. Not feeling isolated at university (OR = 1.60 [1.04–2.47]) and satisfaction with the political situation (OR = 2.05 [1.57–2.67]) were also associated with a stronger SOC. This counts also for high health awareness (OR = 1.40 [1.05–1.87]) and nutrition importance (OR = 1.67 [1.04–2.69]). Perceived stress (OR = 0.81 [0.79–0.83]) was negatively associated with a strong SOC when controlling for socio-demographic and lifestyle-related variables.

Conclusion

We suggest integrating stress coping, emotion management training programmes as well as measures promoting social integration for students and teachers at campus, promoting healthy behaviours, and creating a supportive learning environment as strategies for enhancing the SOC level of university students in China.

Impact of Sense of Coherence on Oral Health Behaviors: A Systematic Review

Objectives

The aim of this review was to critically analyze the empirical evidence on the association between Sense of Coherence (SOC) and oral health behaviors through a systematic approach.

Methods

A systematic search up to April 2015 was carried out using the following electronic bibliographic databases: PubMed, Ovid MEDLINE; ISI Web of Science; and Ovid PsychInfo. Studies were included if they evaluated the relationship between SOC and oral health behaviors including tooth cleaning, fluoride usage, dietary habits, dental attendance, and smoking. We excluded studies that only assessed the relationship between oral health status and SOC without evaluating oral health behaviors. The New Castle Ottawa (NOS) quality assessment checklist was employed to evaluate the methodological quality of included studies.

Results

Thirty-nine potential papers met the preliminary selection criteria and following a full-text review, 9 papers were finally selected for this systematic review. Results provided by the included studies indicated different levels of association between SOC and oral health behaviors. The most frequent behaviors investigated were tooth brushing and dental attendance pattern. The impact of SOC on performing positive oral health behaviors, to some extent, was related to demographic and socio-economic factors. In addition, mothers’ SOC influenced children’s oral health practices.

Conclusions

A more favorable oral health behavior was observed among those with a stronger SOC suggesting that the SOC can be a determinant of oral health-related behaviors including tooth brushing frequency, daily smoking, and dental attendance.