[Sense of coherence and adolescence: an integrative review of the literature]

Sense of coherence and health in adolescents: a longitudinal cohort study

OBJECTIVE

Several studies indicate an association between adolescents' sense of coherence (SOC) and health. However, a few longitudinal studies have been conducted. The aim of the study was to analyze the association between SOC and health among adolescents during secondary education.

METHODS

Participants of longitudinal cohort study were followed by questionnaires at the age of 15 (N = 441), and 17 (N = 354). The data were analyzed using the methods of descriptive and inferential statistics. We used hierarchical regression to examine significant predictors of health.

RESULTS

Adolescents' SOC was stable during the analyzed two-year period (128.84 ± 22.17; 129.24 ± 23.06). A strong significant positive correlation was found between SOC and mental health (r = 0.635, p<.001; r = 0.670, p<.001). A significant difference was found between adolescents with a low SOC and those with a high SOC in physical functioning (p<.018), general health (p<.001), vitality (p<.001), social functioning (p<.001), emotional role functioning (p<.013) and mental health (p<.001). Boys had higher SOC and most of the health dimensions. Having a stronger SOC, being male, and living with both parents were predictors of better mental health.

CONCLUSIONS

Sense of coherence was a significant and stable factor associated with mental health. Thus, salutogenic interventions for improving the sense of coherence during adolescence should be explored.

Relationships Between Sense of Coherence, Self-perception of Voice and Work Environment Among Teachers

OBJECTIVE

to analyze the relationship between sense of coherence and sociodemographic data, remote physical work environment, and self-perception of symptoms, vocal handicap and vocal fatigue in teachers.

METHODS

Seventy eight teachers pertaining to the municipal education network of a Brazilian capital city participated in the study, during the period of social isolation by COVID-19. An online questionnaire was applied with sociodemographic and physical remote work environment questions, the Sense of Coherence Scale (SOC-13), the Brazilian Dysphonia Screening Tool (Br-DST), the Vocal Fatigue Index (VFI), and the Vocal Handicap Index (VHI-10). Descriptive analysis, bivariate and multivariate Logistic regression models were performed to check the proportion of teachers with high and low SOC among the different categories of independent variables. Student's t test and Mann Whitney test were used to compare SOC, IDV, and VFI scores between the groups, and Hedge's g test was used to access the effect size. The total scores of SOC, VHI and VFI were correlated using Pearson's Correlation Coefficient. All tests adopted a 5% significance level.

RESULTS

Male teachers and those over 45 years old were, respectively, 6.79 (95%CI = 1.16-39.58) and 5.27 (95%CI = 1.40-19.76) times more likely to present a high SOC. The variables associated with a lower chance of presenting high SOC were vocal restriction (OR = 0.21; 95%CI = 0.06-0.79) and voice-related physical discomfort (OR = 0.13; 95%CI = 0.02-0.78). Regarding the remote work environment, in bivariate analysis, teachers who were dissatisfied with air quality (OR = 0.08; 95%CI = 0.01-0.65), temperature (OR = 0.11; 95%CI = 0.01-0.92), and noise (OR = 0.25; 95%CI = 0.61-0.99) were less likely to have high SOC. Higher values of SOC are associated with lower self-perception of vocal fatigue and voice handicap (P < 0,001).

CONCLUSION

The way individuals face stressful situations interferes with the self-perception of their voice and their work environment. The relationship between the sense of coherence and voice perception is relevant to favor programs to promote vocal health and stress management in teachers.

Sense of coherence and oral health-related quality of life among southern Brazilian male adolescents

This study evaluated the association between sense of coherence (SoC) and oral health-related quality of life (OHRQoL) among conscripts of the Brazilian Army, in two cities of southern Brazil. A cross-sectional study included all 18-19-year-old adolescents who joined the Brazilian Army as draftees for mandatory military service in the cities of Itaqui, RS, and Santiago, RS (n = 505). Data collection was conducted from 2019 to 2021, and included the application of questionnaires and a clinical oral examination to record gingivitis, malocclusion, and dental caries. OHRQoL was collected through the Brazilian short version of the Oral Health Impact Profile (OHIP), composed of 14 questions. The adolescents' SoC was assessed using the validated Brazilian version of the SOC-13 scale. The primary outcome of this study was OHRQoL, modeled as a discrete variable (OHIP-14 scores). The main predictor variable was SoC, categorized as low, moderate, or high. The association between predictor variables and OHRQoL was assessed by Poisson regression models using a hierarchical approach. Unadjusted and adjusted rate ratios (RR), and 95% confidence intervals (CI) were estimated. All the analyses were performed using STATA software version 14.2. Adolescents with a moderate and high SoC had 27% (RR = 0.73, 95%CI = 0.64-0.84) and 51% (RR = 0.49, 95%CI = 0.41-0.58) lower mean OHIP-14 scores, respectively, than those with a low SoC score, after the inclusion of behavioral and clinical variables. This study showed a significant association between SoC and OHRQoL among 18-19-year-old southern Brazilian adolescents. Strengthening the SoC as a psychosocial resource may improve the well-being and OHRQoL of adolescents.

Moderation modelling of COVID-19 digital health literacy and sense of coherence across subjective social class and age among university students in Ghana

BACKGROUND

The study assessed the moderation modelling of digital health literacy and sense of coherence across subjective social class and age among university students in Ghana during the COVID-19 pandemic.

METHODS

A total of 1160 students were conveniently sampled from two universities namely, the University of Education, Winneba and University of Cape Coast, using the descriptive cross-sectional survey design. Preliminary analysis was performed using descriptive statistics, whilst multivariate multiple regression and moderation analyses (Haye's Model) were employed to analyze the main data.

RESULTS

The study revealed that COVID-19 digital health literacy is directly and positively associated with sense of coherence among university students. Further, higher subjective social class positively and strongly moderated the relationship between COVID-19 digital health literacy and sense of coherence among university students. Additionally, the relationship between COVID-19 digital health literacy and sense of coherence was indirectly prominent among relatively older university students than younger ones.

CONCLUSIONS

The findings have implications for university management/authorities and public health agencies to organize effective orientation and self-management training programmes for university students.

Direct relations between sense of coherence and oral health-related quality of life in adolescents

OBJECTIVE

To verify the relations between sense of coherence (SOC) and dental caries on oral health-related quality of life (OHRQoL) of adolescents.

SUBJECT AND METHODS

A cross-sectional sample of 768 adolescents nested in a cohort study was evaluated. SOC was measured using Antonovsky's scale. Dental caries was collected considering the decayed, missing, and filled teeth index (DMFT). OHRQoL was collected through the Child Perception Questionnaire. Demographic, socioeconomic, and use of service variables were also collected. The mediation effects between variables were tested by structural equation modeling.

RESULTS

The average age of the individuals was 17.5 years. Individuals with high SOC scores had a positive impact on OHRQoL (β-coefficient = -0.573, p < 0.00). Individuals with high DMFT (β-coefficient = 0.080, p = 0.034) and dental pain (β-coefficient = 0.079, p = 0.039) negatively impacted OHRQoL. Still, adolescents who had dental pain (β-coefficient = 0.112, p = 0.005), mothers with lower education levels (β-coefficient = -0.114, p = 0.004), lower household income (β-coefficient = -0.131, p = 0.003), and those who visited the dentist (β-coefficient = 0.109, p = 0.005) exhibited a higher DMFT index.

CONCLUSIONS

SOC and dental caries had a direct effect on OHRQoL, indicating that oral conditions and psychosocial characteristics are important contributors to OHRQoL.

Sense of coherence mediates the relationship between digital health literacy and anxiety about the future in aging population during the COVID-19 pandemic: a path analysis

Objectives: During the COVID-19 pandemic, older adults experience various challenges, including information uncertainties, financial pressure, and visit restrictions, which may lead to anxiety about the future. As a protective factor, sense of coherence (SOC) may play a role to reduce some psychological discomfort. This study aimed to analyze the relationships of SOC with anxiety, digital health literacy (DHL), information, and financial satisfaction among older adults during the outbreak.Methods: This is part of a large-scale DHL study with a cross-sectional survey across 41 countries. This study extracted data from three Asian countries (China, the Philippines, and Singapore) and included people aged ≥60. Structural equation modeling with path analysis was utilized to examine the relationships of SOC with anxiety about the future and other variables.Results: A total of 266 older adults were included, with 43.2% expressed anxiety about the future. DHL (β=-0.13, p < 0.05) and SOC (β=-0.26, p = 0.01) were negatively associated with anxiety, while financial and information satisfaction were not. However, financial satisfaction (β = 0.34, p < 0.01) and DHL (β = 0.32, p = 0.01) were positively associated with SOC. Higher SOC further mediated the negative relationships of DHL (β= -0.11, p = 0.004) and financial satisfaction (β= -0.12, p = 0.004) on anxiety of older adults.Conclusions: SOC had direct negative effect on anxiety and mediated the relationships between anxiety and DHL/financial satisfaction. Strategies should be developed to enhance SOC and DHL among older adults, as these capacities may help to manage anxiety during the pandemic.

Association of sense of coherence with oral health behaviors and gingival bleeding among adolescents

Context:

Adolescents experience many types of gingival and periodontal diseases, including gingivitis, localized or generalized aggressive periodontitis, and periodontal complications of various systemic diseases. The occurrence of periodontal diseases is not only related to biotic factors but may also be affected by nonbiotic factors such as oral health behaviors and practices. Various factors that influence an individual's health-related behaviors include a psychosocial construct named sense of coherence (SOC).

Aim:

The aim of this study is to investigate the association of SOC with oral health behaviors and gingival bleeding.

Settings and Design:

This was a cross-sectional, analytical study that was done in the school setting.

Materials and Methods:

A random sample of 850 adolescents was selected from nine schools of the Faridabad block of Faridabad district (Haryana) through the multistage cluster sampling technique. Methods of data collection included a combination of questionnaire administration and clinical examination. The questionnaire comprised sociodemographic variables, questions related to oral health behaviors, and Antonovsky's SOC scale. The questionnaire was interviewer administered.

Statistical Analysis:

Unadjusted and adjusted rate ratios of gingival units having bleeding on probing were estimated by Poisson regression multilevel analysis in Statistical Package for the Social Sciences (SPSS) software for Microsoft Office.

Results:

Adolescents whose mothers had studied <8 years (relative risk [RR] 1.26; 95% confidence interval [CI] 1.04–1.38), who were males (RR 1.198; 95% CI 1.01–1.29), low SOC (RR 15.93; 95% CI 13.06–19.35), and toothbrushing frequency of less than once a day (RR 1.43; 95% CI 1.21–1.67) and children with plaque index >1 (RR 2.765; 95% CI 2.12–3.25) presented with the higher number of gingival units having bleeding.

Conclusion:

SOC is associated with gingival bleeding through oral health behaviors.

Sense of Coherence and Coping Strategies in Patients With Dysphonia

AIM

To analyze sense of coherence (SOC) of dysphonic individuals considering the type and degree of dysphonia, coping strategies, and sociodemographic variables.

METHODS

This cross-sectional study was performed with 50 dysphonic individuals under follow-up at a Brazilian Speech-Language Pathology Clinic. They answered a questionnaire with sociodemographic information, the PEED-10 (Brazilian Voice Disability Coping Questionnaire) and the Brazilian version of Sense of Coherence scale. The SOC was categorized as high or low using Cluster analysis. After descriptive analysis, data were analyzed through both the bivariate and multivariate logistic regression model method and the Spearman's correlation test (P< 0.05).

RESULTS

Most individuals presented a high SOC (60%). Individuals with mild dysphonia were 7.00 times more likely to present high SOC (95% CI = 1.24-39.38).  Individuals between 45 and 70 years old were 5.03 times more likely to present high SOC (95% CI = 1.25-20.28). In addition, the higher SOC, as well as the scores of manageability domain, the lower the use of strategies focused on emotion.

CONCLUSION

Patients with mild dysphonia are more likely to have a high SOC. The same goes for individuals over the fourth decade of life. Also, the greater the SOC, the fewer emotional strategies are used to cope with dysphonia.

Sense of Coherence and the fear of public speaking in university students

PURPOSE

To test the association between the Sense of Coherence (SOC) and the fear of public speaking in university students.

METHOD

Cross-sectional study was carried out with a sample of 1124 undergraduate students of a Brazilian public university. An online questionnaire was used divided into three blocks: the first evaluated the sociodemographic data and the somatic symptoms of the fear of public speaking; the second evaluated the SOC, through the SOC-13 questionnaire; and the third was composed by the Scale for Self-Assessment in Public Speaking (SSPS), with questions that point out cognitive aspects of this activity. The students were divided into two groups (high SOC and low SOC) through the Two-step Cluster analysis. Data were analyzed descriptively and by the Mann-Whitney test and bi and multivariate logistic regression models, with significance set at 5%.

RESULTS

The students who reported not being afraid to speak in public were more likely to belong to the high SOC group (OR = 3.19, 95% CI = 2.30-4.42). Students from the high SOC group self-assessed more positively on the SSPS scale (p <0.001).

CONCLUSION

College students over 30 years old, on the second half of graduation, with breathing discomfort, who do not report fear of public speaking and who perceive themselves more positively for public speaking, they have the highest SOC. Thus, it is observed the importance of considering the SOC as an important coping resource, given the great interference of emotional aspects in public speech.

The Association between Sense of Coherence and Dental Caries in Low Social Status Schoolchildren

The relationship between dental caries and sense of coherence (SOC) has not been substantiated in children and adolescents, particularly among those with a low socioeconomic status. The aim of this study was to investigate the association between SOC and dental caries in schoolchildren from a low socioeconomic background. A random sample of 356 8- to 14-year-old schoolchildren enrolled in public schools from the poorest region of Santa Maria, a southern city in Brazil, was selected. Dental examinations were performed to assess dental plaque and dental caries (DMF-S and dmf-s indexes). The children's SOC was assessed using a validated Brazilian version of the SOC-13 scale. Socioeconomic, demographic, and behavioral data were collected from parents using a questionnaire. Multilevel Poisson regression analysis was used following a hierarchical approach to investigate the association between the SOC and DMF-T + dmf-t mean. Children whose mothers had studied for 8 years or less (RR 1.30; 95% CI 1.08-1.57) and children with dental plaque (RR 1.29; 95% CI 1.06-1.58) presented with higher DMF-T scores than their counterparts (p < 0.05). A higher household income (RR 0.66; 95% CI 0.51-0.84) and greater SOC scores (RR 0.71, 95% CI 0.56-0.90) were associated with lower DMF-T in children (p < 0.05). Children's SOC seems to be a relevant protective psychosocial factor for dental caries experience in socially vulnerable children.

Self-reported physical inactivity and health complaints: a cross-sectional study of Lithuanian adolescent schoolgirls

The study aimed to investigate the associations between physical inactivity and health complaints in relation to posttraumatic stress (PTS) symptoms, behavioral and nutritional factors, and sense of coherence (SOC) in eighth-grade girls enrolled in secondary schools in Kaunas, Lithuania. A random sample of girls (N = 862) was interviewed anonymously on health complaints, physical activity level, PTS symptoms, Antonovsky's SOC scale, health behaviors, and dietary patterns. All health complaints were significantly associated with physical inactivity. Crude odds ratio (OR) for physical inactivity and health complaints was 1.67 (95%CI: 1.09-2.56); after adjusting for PTS symptoms, the OR decreased to 1.57 (95%CI: 0.95-2.45); further adjustment for smoking, daily alcohol intake, daily consumption of fresh vegetables, and SOC decreased the OR to 1.25 (95%CI: 0.76-2.04). The effect of PTS symptoms and sense of coherence remained stable after all adjustments. The significant association between physical inactivity and health complaints was mediated by PTS symptoms.