Sense of coherence and physical health-related quality of life in Italian chronic patients: the mediating role of the mental component

Exploring the psychological burden in a pancreatic cancer surveillance programme based on high-risk individuals: a Swedish cross-sectional study

INTRODUCTION

Pancreatic cancer, an aggressive cancer that presents with few or unspecific symptoms, has a poor prognosis. Thus, diagnosis at an early stage is vital for survival and a chance for curative treatment. Therefore, surveillance programmes for high-risk individuals are of the utmost importance. However, data on the psychological burden among participants in these programmes are limited.

AIMS

This study aimed to investigate the psychological burden for participants in a pancreatic cancer surveillance programme and explore whether the psychological burden was related to the individual's risk level for pancreatic cancer.

METHODS

This single-centre cross-sectional study investigated cancer worry, anxiety, coping and perceived physical and mental health using a digital questionnaire, including the following instruments: Cancer Worry Scale (CWS), State-Trait Anxiety Inventory (STAI), 13-Item Sense of Coherence and 12-Item Short-Form Survey. The invited participants (n=413) were healthy individuals with an increased risk of pancreatic cancer enrolled in a pancreatic cancer surveillance programme.

RESULTS

The results indicated high cancer worry among respondents (n=78) with high scores on CWS (mean, 16.45). The majority (69.3%) had scores indicating high cancer worry (≥14). Anxiety was not equally high among respondents (mean STAI-T, 35.13; STAI-S, 35.9). Female sex and younger age were significantly correlated with higher cancer worry and anxiety (p < 0.001). Outcomes in coping and perceived health were similar to those of the normal population.

CONCLUSIONS

Cancer worry is particularly high among participants. No correlation was found between the risk level and psychological burden.

The impact of caregiver burden on sense of coherence in Chinese family caregivers of people with dementia: the mediating effect of family resilience

OBJECTIVES

The caregiver burden frequently experienced by family members tending to people with dementia significantly impacts their psychological well-being and family quality of life. Thus, the objective of this study is to examine the link between caregiver burden and sense of coherence (SOC) among Chinese caregivers of people with dementia, as well as to explore the mediating effect of family resilience on this relationship.

METHODS

This cross-sectional research took place from November 2023 to June 2024 across two public tertiary hospitals and a community setting in Hangzhou Province, China. In total, 326 family caregivers who cared for members with dementia were recruited. Data were collected using the Zarit Burden Interview (ZBI), the Family Resilience Rating Scale (FRAS), and the Sense of Coherence Scale (SOC- 13). The relationships between caregiver burden, family resilience, and sense of coherence (SOC) were analyzed using Pearson correlation techniques. Furthermore, the mediating effect of family resilience on the relationship between caregiver burden and SOC was assessed utilizing Amos 27.0.

RESULTS

In this study, the total scores of caregiver burden, family resilience, and SOC were 45.64 ± 17.04, 175.30 ± 34.38, and 52.29 ± 15.91 among family caregivers of people with dementia. Caregiver burden, family resilience, and SOC of family caregivers were at a moderate to high level. Caregiver burden was negatively correlated with family resilience and SOC (p < 0.05). The mediating effect of family resilience on the relationship between caregiver burden and SOC was found to be significant (p < 0.05), accounting for 45.9%.

CONCLUSIONS

In this research, caregiver burden and family resilience emerged as critical factors influencing SOC. Additionally, the family resilience served as an important mediator in the connection between caregiver burden and SOC. Healthcare professionals should pay attention to the family dynamics of people with dementia and adopt intervention programs that focus on reducing caregiver burden and improving family resilience to improve the SOC of family caregivers of people with dementia.

Salutogenic Architecture, Non-Therapeutic Environments and the Health of the Elderly: A Systematic Review

Background: Despite a lot of studies that have been conducted on the effects of the built environment on the health of the elderly and environmental salutogenic factors, a limited number of studies have investigated the architectural physical factors clearly. Purpose and Aim: This paper investigated the architectural elements in the non-therapeutic built environment that can achieve salutogenic goals for the elderly. It also aimed to provide an answer to the question of how architectural design might be used to physically bring salutogenic theory to life. Method: In this review study, data were collected systematically using the PRISMA checklist. The three lists of keywords used for the initial search were "built environment" or "architecture," "elderly," and "health," and were supplemented with synonyms for a second search in four databases: Scopus, Science Direct, Web of Science, and PubMed, in the period from 2000 to 2024. By applying inclusion and exclusion criteria, 26 articles were selected for review and data extraction. The data were then qualitatively analyzed, and two reviewers independently verified the analysis. Conclusions: This study found that architectural elements can be salutogenic by supporting the comprehensibility, manageability, and meaningfulness. Porches, Stoop, above-grade entrances, and balconies are key elements in the home that support the sense of coherence. In assisted living facilities, walls were recognized as the only physical factor supporting the sense of coherence due to the creation of a personal, distinct, meaningful, comprehensible, and manageable space.

Patient empowerment: a critical evaluation and prescription for a foundational definition

Introduction

The evolution of healthcare continues to display an incongruence between delivery and outcomes. Current healthcare paradigms for patient empowerment warrants analysis. A lacking operational application for and agree upon assessment of patient empowerment contributes to healthcare's incongruence. Interchangeable psychosocial concepts and specific patient contextual factors associated with health-related behavioral change have escaped an applicable definition of empowerment. The aim of this theoretical perspective review is to support a comprehensive and contextual understanding of patient empowerment that frames a definition for future consensus research.

Methods and mechanisms

A theoretical perspective review of patient empowerment including interchangeable concepts and patient contextual factors such as personal suffering and resilience; self-determined meaning and purpose; and autonomy, competence, and self-efficacy are critically analyzed. This analysis builds on adjacent concepts including therapeutic alliance, communication, motivation, and trust. The inclusion of specific patient contextual factors that relate to behavioral change elevate the need to reinforce coping and self-management skills as mechanism for patient empowerment. Practice gaps for those experiencing chronic disease, pain, and mental health disorders in rehabilitation setting are specific populations who benefit from healthcare providers unifying the variables associated with patient empowerment.

Results and discussion

The review of associated concepts synthesized an actionable definition of patient empowerment that serves as a foundation for future research. Behavior related changes occur through the evolution in one's identity, perceptions, and abilities. Interventions that inspire autonomy, competence, and relatedness with a renewed sense of purpose establish resilience and self-efficacy. The totality of this inspired self-determined plan of care establishes the mechanisms required for behavioral change and sustainable transformation. The cumulative experience becomes patient empowerment.

Unraveling the power of sense of coherence: a key predictor of symptom severity among depressive disorders clients

BACKGROUND

Despite advancements in therapies, the severity of depressive symptoms continues to challenge psychiatric nurses. However, research has indicated that a higher sense of coherence (SOC) can act as a protective factor against the development of diseases and promote faster recovery.

AIM

This study aimed to investigate whether SOC could serve as an indicator of depressive symptom severity among clients with depression.

DESIGN

The study employed a cross-sectional design and followed the STROBE checklist for reporting observational studies.

METHODS

A convenient sample of 169 clients with depression participated in the study. The researchers utilized the Antonovsky Sense of Coherence Scale-29 and the Beck Depression Inventory-II to assess SOC and depressive symptoms, respectively.

RESULTS

The study findings indicated that a substantial proportion of the participants (35.5%) had low Sense of Coherence (SOC) levels, associated with higher depressive symptoms. The severity of depression showed a significant negative correlation with difficulties in understanding and finding meaning in life and challenges in effectively coping with life's demands (r = -0.626, p < 0.001). The regression analysis revealed that for every one-unit increase in SOC, there was a corresponding decrease of 0.5 units in depressive symptoms. The SOC variable accounted for 39.1% of the variance in depressive symptoms severity.

CONCLUSION

Psychiatric nurses should consider implementing interventions to enhance SOC, such as Life Skills Training (LST), psychoeducation, cognitive-behavioral therapy, and mindfulness practices, particularly for depressive disorder clients with a poor sense of coherence.

Relationship Between Intimate Partner Violence and Quality of Life Among Women With Chronic Diseases: Mediating and Moderating Role of Sense of Coherence

This study examined the mediating and moderating roles of the sense of coherence (SOC) on the relationship between intimate partner violence (IPV) and quality of life (QOL) in women with chronic diseases. Structural equation modeling was conducted on data from 400 women with chronic diseases. The moderating effect was not statistically significant. The mediating model indicates that SOC partially mediates the relationship between IPV and both mental (direct effect = -0.313; indirect effect = -0.147) and physical (direct effect = -0.258; indirect effect = -0.100) QOL. IPV, both directly and indirectly through a negative impact on SOC, reduces QOL among women with chronic diseases.

A qualitative study of coping strategies and resilience in the aftermath of childhood adversity in first-episode psychosis

AIM

Exposure to adversity during childhood is associated with elevated risk for commonly occurring forms of psychopathology, especially psychotic disorders. Despite the noteworthy consequences associated with adverse childhood experiences, an inconsistent and unpredictable number of at-risk populations present with remarkably good physical and mental health outcomes that can be attributed to resilience. This study aimed to qualitatively explore the experience of childhood adverse events and coping strategies employed by individuals that promote resilience and better mental health outcomes.

METHODS

Fourteen individuals with a history of childhood adversity were recruited to participate using a case-study approach. A semi-structured interview guide was developed based on empirical evidence and theoretical background, and the interviews were analysed using a reflexive thematic approach.

RESULTS

Our findings showed that the type of adversity impacted the experience of trauma, for example, the death of a caregiver versus emotional abuse or witnessing violence at home. Five coping strategies were identified (social support, religious coping, problem or emotion-focused coping, and meaning-making), with healthy controls found to identify and use these resources more than the psychosis group to promote individual well-being and better mental health outcomes.

CONCLUSIONS

Our findings provide insights into experiences in the aftermath of childhood adversity, emphasising the need to assess the history of trauma systematically. They further underscore the importance of mental health prevention programmes bolstering individual-level coping strategies and the resources available within our environments to help them manage adversity, improve overall outcomes, and promote resilience.

6-Fold path to self-forgiveness: an interdisciplinary model for the treatment of moral injury with intervention strategies for clinicians

Conscience is the indestructible core of one's personal identity and their sense of agency in the world. When it passes judgment against them, it generates inner conflict (i.e., moral injury). At its core, moral injury is about trust and sacred relationships, particularly the loss of safe connection with self, society, God/Divine/a Higher Power, and the world. The clash between a person's conscience and overwhelming existential or psychospiritual experiences, which uniquely defines moral injury, alienates them from life-sustaining relationships. Healing requires more than reordering fractured belief systems. Reestablishing bonds of self-worth, trust, and life-sustaining relationships are essential. This paper presents the 6-Fold Path to Self-Forgiveness (6-FPSF), an interdisciplinary, narrative-based healing writing process for the treatment of moral injury, particularly self-induced moral injury. Self-forgiveness has been associated with psychospiritual and relational well-being. The protocol draws upon theoretical literature, evidence-based psychological interventions, spiritual-oriented practices, creative arts, and somatic exercises for mental health counseling and spiritual/religious ministration. In addition to describing the 6-component therapeutic model, the author offers intervention strategies for clinicians.

Association of sense of coherence and periodontal disease severity, in two cross-sectional studies

OBJECTIVES

To investigate the association between the individuals' level of sense of coherence (SOC) and periodontal disease severity.

METHODS

The study populations originated from two stratified cross-sectional random samples of residents in a medium-sized Swedish city in 2003 and 2013, respectively. The final samples constituted 491 individuals in 2003 and 538 individuals in 2013. The samples were classified into three groups according to the severity of periodontitis (no/minor, moderate and severe). The 13-item Swedish version of Antonovsky's "Orientation to life" questionnaire, measuring the individual's SOC, was filled out. Descriptive statistics were performed as well as multinomial logistic regression analysis. Dependent variable was the severity of periodontal disease and independent variables, age in years, presently smoking and education at university level.

RESULTS

In the multinomial regression analysis, smoking, age, and total SOC score were significantly associated with severe periodontitis at both examinations. The strongest predictor of severe periodontal disease was smoking. The total SOC score did not differ between the examinations, but there was a statistically significant difference in two of the SOC dimensions, manageability (lower), and comprehensibility (higher), over time.

CONCLUSIONS

Individuals with severe periodontitis had significantly lower SOC compared to subjects periodontally having no/minor periodontal disease. Smoking was the strongest overall predictor of having severe periodontitis.

The role of a mindful movement-based program (Movimento Biologico) in health promotion: results of a pre-post intervention study

Introduction

Mindful movement is a comprehensive approach that integrates various bodily, emotional and cognitive aspects into physical activity, promoting overall well-being. This study assessed the impact of a mindful movement program, known as Movimento Biologico (MB), on participants psychological well-being (PWB), positive mental health (PMH), sense of coherence (SOC), and interoceptive awareness.

Methods

MB program was conducted for students attending the bachelor's degree in Kinesiology and Sport Sciences of University of Perugia over 8 weeks (from October 16 to November 27, 2022). Participants were requested to fill in four questionnaires before and after the MB program: (1) 18-item PWB scale; (2) 9-item PMH scale; (3) 13-item SOC scale; (4) 32-item scale for Multidimensional Assessment of Interoceptive Awareness (MAIA). Wilcoxon signed-rank tests were used to assess changes, with significance set at p < 0.05.

Results

Thirty-eight students (mean age 21.2, 60.5% male) participated. Several MAIA subscales, including noticing (p = 0.003), attention management (p = 0.002), emotional awareness (p = 0.007), self-regulation (p < 0.001), body listening (p = 0.001), and trusting (p = 0.001), showed significant improvements. PMH increased significantly (p = 0.015), and there was a significant enhancement in the autonomy subscale of PWB (p = 0.036). SOC and overall PWB also improved, though not significantly.

Conclusion

The MB program significantly improved participants' positive mental health and interoceptive awareness. This likely resulted from better recognition and management of positive physiological sensations, a stronger link between physical sensations and emotions, enhanced confidence in one's body, and increased autonomy.

Evaluating variations in the barriers to colorectal cancer screening associated with telehealth use in rural U.S. Pacific Northwest

PURPOSE

The incidence and mortality rates of colorectal cancer (CRC) remain consistently high in rural populations. Telehealth can improve screening uptake by overcoming individual and environmental disadvantages in rural communities. The present study aimed to characterize varying barriers to CRC screening between rural individuals with and without experience in using telehealth.

METHOD

The cross-sectional study surveyed 250 adults aged 45-75 residing in rural U.S. states of Alaska, Idaho, Oregon, and Washington from June to September 2022. The associations between CRC screening and four sets of individual and environmental factors specific to rural populations (i.e., demographic characteristics, accessibility, patient-provider factors, and psychological factors) were assessed among respondents with and without past telehealth adoption.

RESULT

Respondents with past telehealth use were more likely to screen if they were married, had a better health status, had experienced discrimination in health care, and had perceived susceptibility, screening efficacy, and cancer fear, but less likely to screen when they worried about privacy or had feelings of embarrassment, pain, and discomfort. Among respondents without past telehealth use, the odds of CRC screening decreased with busy schedules, travel burden, discrimination in health care, and lower perceived needs.

CONCLUSION

Rural individuals with and without previous telehealth experience face different barriers to CRC screening. The finding suggests the potential efficacy of telehealth in mitigating critical barriers to CRC screening associated with social, health care, and built environments of rural communities.

The effect of physical exercises program on social functioning, alexithymia, and sense of coherence among patients with bipolar disorders: A randomized control trial

BACKGROUND

Despite evidence that physical exercises have been helpful in the treatment of various psychiatric disorders, it is unclear whether these data can be generalized to bipolar disorder. The use of physical exercises is challenging and hopeful among patients with bipolar disorders. Few studies have examined the efficacy of physical exercise for patients with bipolar disorders.

OBJECTIVE

Investigate the effect of applying physical exercises program on social functioning, alexithymia, and sense of coherence among patients with bipolar disorders.

METHODS

This study followed a randomized control trial design "pre and post-test." Patients were randomly allocated to intervention (n = 25) and control groups (Waiting list) (n = 25). The Social Functioning Scale, Toronto Alexithymia Scale, and Sense of Coherence scales were applied in the study. Pre-test and post-tests were administered to investigate the effect of applying the physical exercises program between December 2022 to March 2023.

RESULTS

A statistically significant increase in the mean sense of coherence and social functioning scores among the study group. Mean alexithymia scores were significantly decreased among the study group between pre, immediately after, and after a three-month follow-up period.

CONCLUSION

Physical exercises are an adjunctive treatment modality that is helpful for patients with bipolar disorders. Nurse educators and service providers should reconsider the physical health care requirements for patients with bipolar disorders to equip them to manage the common comorbidities in people with mental illness.

Association between Sense of Coherence, Disease-Specific Symptoms, and Health-Related Quality of Life among Japanese Patients with Ulcerative Colitis: A Cross-Sectional Study

INTRODUCTION

We examined the associations among disease-related symptoms, health-related quality of life (HRQOL), and sense of coherence (SOC) in Japanese patients with ulcerative colitis (UC).

METHODS

This cross-sectional survey involved patients and physicians at 23 hospitals specializing in UC treatment in Japan (December 2019-December 2020). Multiple linear regression analysis was performed using scores on the Mental Health and General Health subscales of the Medical Outcomes Study 36-Item Short-Form Health Survey as outcomes and SOC as the main independent variable. Scores on the Inflammatory Bowel Disease Questionnaire (IBDQ) and Fecal Incontinence Quality of Life Scale (FIQL) were used to measure the effect of disease-related symptoms. The moderating effect of symptoms on the association between HRQOL and SOC was also tested.

RESULTS

SOC was positively and independently associated with HRQOL (Mental Health: β = 0.43, 95% confidence interval [CI] = 0.24-0.61, p < 0.001; General Health: β = 0.41, 95% CI = 0.23-0.59, p < 0.001). The association of SOC with Mental Health scores did not differ by symptoms, whereas its association with General Health was attenuated by symptoms (interaction term of IBDQ by SOC: β = -0.0082, 95% CI = -0.017 to 0.00064, p = 0.07; that of FIQL by SOC: β = -0.0052, 95% CI = -0.011 to 0.0010, p = 0.10).

CONCLUSIONS

SOC affected mental health independently, and its protective association with general health perception was affected by symptoms. Further research is required to determine the most effective use of SOC in interventions to improve HRQOL in patients with UC.

Sense of Coherence as a Mediator Between Functional Status and Health-Related Quality of Life in Patients With Heart Failure

BACKGROUND

Poor functional status relating to heart failure (HF) negatively affects health-related quality of life (HRQOL). Patients with HF, especially those with New York Heart Association (NYHA) Class III or IV HF, often exhibit poor HRQOL because of physical limitations and HF-related symptoms. Although sense of coherence (SOC) has been reported to be a determinant of HRQOL, its role as a mediator between functional status and HRQOL remains unclear, and few studies have explored the prevalence of HF in patients in NYHA Classes I and II.

PURPOSE

This study was designed to investigate SOC as a mediator between different functional status classes and HRQOL in patients with HF.

METHODS

A cross-sectional study was conducted on patients with HF recruited from a hospital in northern Taiwan from April 2020 to September 2020. The Minnesota Living with Heart Failure Questionnaire and a questionnaire on sociodemographic characteristics; functional classification in terms of NYHA Classes I, II, and III; and SOC were administered. The PROCESS v3.5 (by Andrew F. Hayes) macro was applied to analyze the effects, and Model 4 was used to examine the mediating role of SOC on the relationship between NYHA functional class and HRQOL.

RESULTS

Of the 295 participants, SOC was found to mediate the effects of functional status on HRQOL more significantly in patients in Class II than those in Class III but not more significantly in patients in Class I than those in Class III. A weaker mediating effect of SOC was noted on the relationship between functional status and HRQOL in patients with HF in NYHA Class II than those in Class III.

CONCLUSIONS

In patients with HF, poor functional status often reduces HRQOL significantly. SOC mediates the relationship between functional status and HRQOL more significantly in those in NYHA Class II than those in Class III. Nursing staff should work to increase patients' SOC by strengthening their coping capacity and improving their functional status to improve their HRQOL.

The mediating effect of sense of coherence in the relationship between eating attitudes and self-esteem in adolescents

PURPOSE

This study aimed to examine the mediating effect of a sense of coherence (SOC) in the relationship between eating attitudes and self-esteem in adolescents.

METHODS

The study was conducted in a descriptive-correlational exploratory design. The sample of the study consisted of 1175 adolescents who met the inclusion criteria. Data were obtained by the researchers using personal information form, the Sense of Coherence Scale (SOC-13), the Eatıng Attitude Test (EAT-26), and the Rosenberg Self-Esteem Scale (RSES).

RESULTS

SOC-13 mean score was 50.21 ± 11.06, EAT-26 mean score was 14.53 ± 10.17, and RSES mean score was 4.17 ± 1.66. It was found that there was a statistically significant negative relationship between the mean scores of RSES and the EAT, a positive relationship between the mean scores of the RSES and SOC, and a negative relationship between the mean scores of EAT and SOC. Moreover, the mediating role of SOC was found to be moderate. Furthermore, 4.5% of adolescents' SOC scores are explained by eating attitude. On the other hand, 16.4% of self-esteem scores are explained by eating attitude and SOC.

CONCLUSION

As a result of this study, it was determined that students' SOC moderately mediated the relationship between eating attitude and self-esteem. At the same time, eating attitude had a direct predictive effect on self-esteem.

Effect of sense of coherence on long-term work participation among rehabilitation patients: a longitudinal study

OBJECTIVE

To investigate the causal effect of sense of coherence on long-term work participation after rehabilitation, including stratification by age and diagnoses.

DESIGN

Longitudinal cohort study.

PARTICIPANTS

Patients aged ≤ 60 years, employed and accepted for somatic interprofessional rehabilitation in 2015 (n = 192).

METHODS

Patients reported sense of coherence before rehabilitation in 2015 and mental and physical functioning in 2016. Register data were used to measure work participation during 2018 and days working without social security benefits during 2016-18. Regression models were used to explore the total effect of sense of coherence and the possible mediation of functioning. Results are reported as odds ratios (95% confidence intervals).

RESULTS

During 2018, 77% of the total study cohort participated in work activities. The subgroup with musculoskeletal diagnoses had the fewest days of working without social security benefits. A causal relationship was found between sense of coherence and long-term work participation. Some of the effect of sense of coherence was mediated by mental functioning. The total effect of sense of coherence was strongest for patients with musculo-skeletal diagnoses (work participation: 1.11 (1.05, 1.17), days working without social security benefits: 1.05 (0.01, 109)).

CONCLUSION

Improving coping resources may be beneficial to facilitate long-term work participation after injury or illness, especially for individuals with musculoskeletal diagnoses.

Transition practices of college students with a mental health disorder

Objective

To explore transition practices, mental health promotion, and psychological health among college students with a mental health disorder.

Participants

data were collected from college students attending a southwestern university.

Methods

a web-based survey of transition practices, mental health promotion activities, and psychological health (i.e., self-efficacy, life satisfaction, and loneliness). A semi-structured interview was offered to all participants.

Results

A total of 140 participants (M age = 20.67 [SD=1.88]) completed the survey and N=29 (M age = 20.24 [SD=1.84] completed a semi-structured interview. When preparing for the transition into college, participants frequently considered geographical distance from home, living in a dormitory setting, and the student orientation/integration process. After entering a university, the student counseling center was accessed by 20.2% while only 6.4% filed for 504 accommodations. All participants considered having a close friend as important for mental health promotion.

Conclusions

A formal process of transition planning as it related to optimizing mental health was not consistently undertaken. Proactive transition interventions for college-bound students with a mental health disorder are needed and could include planning for ways to become involved in campus life and filing 504 accommodations to support academic success.

Cognitive functions and sense of coherence in patients with carotid artery stenosis-Preliminary report

Background

There is scarcely any data in the available literature on the relationship between sense of coherence (SOC) and cognitive functioning, and no information on the relationship between SOC and cognitive parameters in patients with carotid atherosclerosis.

Aim

The aim of this paper was to determine the relationship of SOC measured prior to carotid artery stenting (CAS) with neurocognitive functioning in patients with carotid atherosclerosis 12 months after CAS.

Methods

A total of 35 patients with carotid atherosclerosis completed the SOC-29 Orientation to Life Questionnaire (SOC-29) and completed a cognitive test battery twice, i.e., before (baseline-T1) and 12 months after stent implantation (follow-up-T2). Selected cognitive functions such as memory, attention, perception, visuospatial and executive functions and non-verbal fluency were assessed.

Results

One year after the procedure, patients with a higher SOC and sense of manageability present better performance in visual memory. Higher SOC and sense of meaningfulness are positively related to the speed of understanding the changing rules of card sorting (WCST).

Conclusion

Higher overall SOC and a component of sense of meaningfulness and manageability may be related to better cognitive functioning 1 year after the procedure.

Early-life adversity and later-life mental health: a conditional process analysis of sense of coherence and resilience-related resources

Objective

While early-life adversity can have negative effects on health and wellbeing that persist across the lifespan, some individuals show indications of resilience. Resilience can be understood as a dynamic coping process involving the mobilization of resources in response to adversity exposure. Sense of coherence-revised (SOC-R), an ability linked to health maintenance in the face of adversity, may be influential in this process. However, research is lacking on the mechanisms underpinning SOC-R and resilience-related resources and their impact on the (mental) health of individuals exposed to early-life adversity. Therefore, this study examined the role of SOC-R and selected resilience-related resources in the relationship between early-life adversity and later-life health and wellbeing.

Method

Participants were N = 531 Irish (older) adults (58.2% female, mean age = 59.5 years, range = 50-86 years). Standardized questionnaires assessed retrospective reports of early-life adversity, as well as current physical and mental health, satisfaction with life, SOC-R, and resilience-related resources (self-efficacy, optimism, social support). A multiple mediation analysis tested the indirect effects of the resources and a moderated mediation tested for conditional dependence on SOC-R.

Results

For mental health and satisfaction with life, significant partial mediations were found for all three resources. Only optimism showed a significant partial mediation for physical health. In the moderated mediation, SOC-R significantly moderated the associations between early-life adversity and self-efficacy (b = .06, t = 3.65, p = .001), optimism (b = .04, t = 2.60, p = .009), and social support (b = .08, t = 3.75, p < .001). The indirect effects were larger at high rather than low SOC-R, indicating that the mediating effects of the resources were greater for individuals with a stronger SOC-R.

Conclusion

A strong SOC-R may have a beneficial influence on health and wellbeing by mitigating the detrimental effect of early-life adversity on the resources self-efficacy, optimism, and social support. Future avenues for research include the expanded assessment of resources and the potential role of SOC-R in successful ageing through the selection and adaptation of goals and resources into older age. SOC-R may represent a promising target for psychotherapeutic interventions promoting resilience in survivors of early-life adversity.

Sense of Coherence (SOC) of Italian healthcare workers during the COVID-19 pandemic: analysis of associated factors

Introduction

The COVID-19 pandemic has posed significant challenges for healthcare workers worldwide, potentially affecting their sense of coherence (SOC) and overall well-being. This study aimed to identify factors associated with different levels of SOC among healthcare workers, exploring demographic characteristics, work-related factors, changes in relationships and social habits, and the overall well-being.

Methods

A cross-sectional study was conducted among 628 healthcare workers. SOC scores were assessed using a standardized questionnaire. Statistical analyses were performed to identify associations between these factors and SOC.

Results

Healthcare workers had a lower average SOC score (mean: 57.1) compared to the national average in Italy (mean: 60.3). Younger age and shorter length of service were associated with a higher risk of low SOC (p < 0.0001). Healthcare workers in the northwestern regions of Italy had an increased risk of low SOC compared to their counterparts in the northeastern regions (p = 0.0336). Adverse pandemic-related experiences and worsening social relationships were also associated with a higher risk of low SOC (p < 0.0001).

Conclusions

This study highlights the unique challenges and stressors faced by healthcare workers during the COVID-19 pandemic and their impact on SOC. Age, length of service, geographic location, and social status were significant factors influencing SOC levels. Targeted interventions are needed to enhance SOC and well-being, particularly for younger and newly employed healthcare workers. Strategies promoting social connections, work-life balance, and psychological support services are crucial to support healthcare workers' resilience and coping abilities.

Sense of coherence or self-efficacy as predictors of health-related quality of life in sickle cell disease patients

Patients with sickle cell disease (SCD) suffer from impaired health-related quality of life (HRQoL). This study aimed to determine the level of HRQoL, sense of coherence (SOC), and self-efficacy (SE) in a sample of SCD patients, and to explore predictors of their physical and mental HRQoL. A cross-sectional descriptive study was conducted on 83 SCD patients of one university hospital. The data of the study was collected through Persian versions of the Short-Form Health Survey SF-36 (RAND 36-item), the Sense of Coherence Scale (SOC-13), and the Sickle Cell Self-Efficacy Scale (SCSES). The mean age of the patients was 26.34 ± 8.19 years old. Patients' mean scores for the Physical Component Summary (PCS), Mental Component Summary (MCS), SOC, and SCSES were 40.57 ± 17.18 (range: 0-100), 50.44 ± 17.95 (range: 0-100), 52.40 ± 15.35 (range: 13-91), 26.40 ± 6.96 (range: 9-45), respectively. Regression models showed that the level of the patients' SOC, was the main predictor of the MCS (β = 0.37, p < 0.001). However, the level of the patients' SE was the main predictor of the PCS (β = 0.30, p = 0.004). Also, "blood transfusion history" in patients was a common predictor for both the PCS (β =  - 0.28, p = 0.008) and the MCS (β =  - 0.29, p = 0.003). These results can assist nurses and clinicians to plan clinical interventions for SCD patients by focusing on increasing the level of the SOC and SE and improving SCD patients' HRQoL. Furthermore, measuring the level of the SOC and self-efficacy as screening tests are useful to find patients with a greater risk of impaired HRQoL.

Selected Personality Traits and Employment as the Predictors of the Intensity of Psychosocial Problems Experienced by Chronically Ill Patients

BACKGROUND

This study sought to determine the effect of being employed or unemployed on the relationships between selected personal variables (acceptance of one's illness, self-efficacy, and self-actualization) and the intensity of psychosocial problems experienced by chronically ill persons (ChIP).

PARTICIPANTS AND PROCEDURES

The PCH-R Scale, the Generalized Self-Efficacy Scale, the Acceptance-of-Illness Scale, and the Self-Actualization Scale were used to collect information from 236 employed and unemployed ChIP.

RESULTS

Acceptance of illness and self-efficacy predicted the intensity of general psychosocial problems and problems in the personal, family, social, and occupational spheres in both employed and unemployed ChIP.

CONCLUSIONS

The results can significantly contribute to increasing the effectiveness of treatment and support offered to ChIP. Continued employment or reemployment after a period of intense therapy can protect them from a rapid degradation of their personal-and frequently, socio-economic-resources, which are necessary for them to be able to adapt to new challenges and maintain a good quality of life, despite experiencing a chronic illness.

Development of Sense of Coherence Stability in the AGORA Healthy Ageing Study

Sense of coherence (SOC) is a psycho-social trait formed in childhood or adolescence, allowing individuals to be more resilient to daily life stressors, stay well, and improve their personal health. Although SOC remains stable after the age of thirty, only a few studies investigated its stability in adulthood. The aim was to investigate the development of SOC over time in 489 participants and its association with age, gender, educational level, or negative life events. The study was performed as part of the Healthy Ageing project of the Academic Collaborative Centre AGORA, a longitudinal study involving four municipalities of Eastern Netherlands. A self-administrated questionnaire was used to monitor the SOC of the elderly in 2008, 2010, and 2013, using the Orientation to Life Questionnaire (SOC-13). The analysis included repeated-measures ANOVA analysis and bivariate analysis using Pearson's chi square test. We found no statistically significant variation in SOC over time (F (2, 282) = 2.99, p = 0.052) and no significant association with age (F (2, 282) = 2.851, p = 0.06), gender (F (2, 282) = 0.845, p = 0.43), or educational level (F (2, 282) = 0.708, p = 0.49). SOC remained stable in the elderly population, even if they experienced negative events over their lifespan.

Early Mental Health and Quality of Life in Discharged Patients With COVID-19

Aim: This study aimed to analyze the early mental health (MH) and quality of life (QoL) of discharged patients with coronavirus disease 2019 (COVID-19), which can provide a scientific basis for the further development of intervention programs.

Methods: In total, 108 subjects participated in this study, including an experimental group (90 patients diagnosed with COVID-19 from March to April 2020 and hospitalized in Wuhan China Resources & WISCO General Hospital, Wuhan, China, 83.3%) and a control group (18 healthy participants, 16.7%). Their MH and QoL were measured through the 12-item Short Form Health Survey version 2 (SF-12v2), the Self-rating anxiety scale (SAS), the Self-rating depression scale (SDS), and the International Physical Activity Questionnaire (IPAQ). The results of questionnaires were compared between these two groups.

Results: (1) Comparison of anxiety status: among 90 discharged patients with COVID-19, 30 patients (33.3%) had a state of anxiety. Compared with healthy participants and the general population, patients with COVID-19 in the early stages of discharge had a higher incidence of anxiety and more severe anxiety symptoms (P < 0.05). (2) Comparison of depression status: among 90 discharged patients with COVID-19, 29 patients (32.2%) had a state of depression. Compared with healthy participants and the general population, patients with COVID-19 in the early stages of discharge had a higher incidence of depression and more severe depression symptoms (P < 0.05). (3) Comparison of QoL: 78 patients (86.7%) presented a decrease in physical health-related quality of life (HRQoL) and 73 patients (81.1%) presented a decrease in psychology-related QoL. The SF-12v2 physical component summary (PCS) and the SF-12v2 mental component summary (MCS) of patients were significantly lower than those of healthy people, especially in physical function (PF), vitality (VT), social function (SF), and mental health (MH) (all P < 0.05). (4) Gender differences in mental health and the QoL among patients with COVID-19: women had more severe anxiety/depression symptoms than men (P < 0.05). The scores of women in all dimensions of SF-12V2 were lower than those of men, and there were statistically significant differences between the two groups in PCS, PF, general health (GH), VT, and role-emotional (RE) (P < 0.05).

Conclusion: During the early phase after being discharged, patients with COVID-19 might experience negative emotions, such as anxiety or depression, and also problems with reduced QoL, especially among female patients. Therefore, an intervention plan should focus on strengthening psychological condition and improving physical function, and gender-specific rehabilitation programmes should be adapted to improve psychological status and QoL.

Psychometric Properties of the SOC-13 Scale in Colombian Adults

The aim of this study was to determine the psychometric properties of the Spanish version of the SOC-13 in Colombian adults. The SOC-13 questionnaire was administered to 489 individuals aged ≥18 years who were in lockdown from March to July 2020 in Nariño County, Colombia. Psychometric properties of the scale were examined using a cross-validation method via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Additionally, configural and metric invariance were tested. To determine the internal consistency of the questionnaire, McDonald’s omega (ω), Cronbach’s alpha (α), and composite reliability (CR) coefficients were estimated. The EFA determined that a three-factor structure best fit the data (comprehensibility, manageability, and meaningfulness) and CFA confirmed this three-factor model structure showing a good fit (χ²_S-B = 188.530, χ²_S-B/(62) = 3.615, p = 0.001; NNFI = 0.959; CFI = 0.968; RMSEA = 0.052 (90% CI [0.041–0.063]) and SRMR = 0.052).The invariance analysis indicated the same underlying theoretical structure between genders. Additionally, (ω), (α), and (CR) coefficients confirmed a high internal consistency of the instrument. The SOC-13 scale, reflecting comprehensibility, manageability, and meaningfulness, is a reliable and valid tool for assessing the sense of coherence in Colombian populations.

A mediating role for mental health in associations between COVID-19-related self-stigma, PTSD, quality of life, and insomnia among patients recovered from COVID-19

INTRODUCTION

Patients with COVID-19 often suffer from psychological problems such as post-traumatic stress disorder (PTSD) and self-stigmatization that may negatively impact their quality of life and sleep. This study examined mental health as a potential mediating factor linking self-stigmatization and PTSD to quality of life and sleep.

METHODS

Using a cross-sectional design, 844 people who had recovered from COVID-19 were called and interviewed. Data were collected using structured scales. Structural equation modeling was applied to assess fitness of a mediation model including self-stigma and PTSD as independent factors and quality of life and insomnia as dependent variables.

RESULTS

Mental health, COVID-19-related self-stigma, and mental quality of life were associated. Insomnia, PTSD, and COVID-19-related self-stigma displayed significant direct associations (r = .334 to 0.454; p < .01). A mediation model indicated satisfactory goodness of fit (CFI = 0.968, TLI = 0.950, SRMR = 0.071, RMSEA = 0.068). Mental health as a mediator had negative relationships with COVID-19-related self-stigma, PTSD, and insomnia and positive associations with quality of life.

CONCLUSION

Mental health may mediate effects of COVID-19-related self-stigma and PTSD on quality of life and insomnia. Designing programs to improve mental health among patients with COVID-19 may include efforts to reduce negative effects of PTSD and COVID-19-related self-stigma on quality of life and insomnia.

Sense of Coherence and Quality of Life in Patients Treated with Antivitamin K Oral Anticoagulants: A Cross-Sectional Study

The aim of this study was to analyze the correlation between the participants’ self-reported quality of life and their sense of coherence in a sample (n = 85) of patients on treatment with oral antivitamin K anticoagulants. A cross-sectional design was used. The measurement instruments included a questionnaire on sociodemographic variables, the Spanish version of the Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF), an oral-anticoagulant-treatment-specific quality-of-life questionnaire, and the sense-of-coherence (SOC) scale. We analyzed the correlations between the participants’ characteristics and the results from the quality-of-life and SOC scales. Age, level of education, employment status, living arrangement, and treatment length were the determinants of the quality of life in people treated with oral anticoagulants. We found a significant association between the four domains of the WHOQOL-BREF questionnaire and general treatment satisfaction (p < 0.01); no significant correlations were found between the SOC subscales and the oral-anticoagulant-treatment-specific quality of life in our sample. Women had a worse level of self-management than men. Nursing interventions should be tailored to the needs of the populations on treatment with oral anticoagulants in order to facilitate a higher level of self-management.