“Hope” Makes Sense in Eritrean Sense of Coherence, but “Loser” Does Not

Sense of coherence can predict hope in older adults: a cross-lagged analysis

OBJECTIVES

This study examined the relationship between sense of coherence (SOC) and hope in older adults from a longitudinal perspective.

METHOD

271 older adults completed self-reported questionnaires assessing hope and SOC at 3 time points: at intake, at a 6-month follow-up, and at a 12-month follow-up. A cross-lagged panel model was used to examine the relationship between SOC and hope.

RESULTS

The results showed that SOC was significantly associated with the level of hope in the older adults at all three time points. The cross-lagged analysis showed that the lagged effect of SOC on hope was significant, whereas the lagged effect of the level of hope on SOC was nonsignificant.

CONCLUSION

These results indicated that SOC predicted the level of hope 6 months later and may be helpful for guiding older adults to increase their hope for the future through strategies aimed at improving their SOC.

Construct validity and factor structure of sense of coherence (SoC-13) scale as a measure of resilience in Eritrean refugees living in Ethiopia

Background

There is a scarcity of adapted measures to study resilience and mental health of people in humanitarian settings in Africa. The aim of this study was to identify the factor structure and other psychometric properties of the Sense of Coherence (SoC-13) scale in Eritrean refugees living in Ethiopia.

Methods

In a cross-sectional survey, 562 adults were selected randomly from Eritrean refugees living in Mai Aini camp, Ethiopia. The SoC-13, the Center for Epidemiologic Studies Depression scale (CES-D), the Pre and Post-Migration Living Difficulties checklist, the Primary Care Post-Traumatic Stress Disorder screener (PC-PTSD), the Oslo Social Support Scale (OSS-3), the Coping Style scale and the Fast Alcohol Screening Test (FAST) were administered concurrently. Confirmatory Factor Analysis (CFA) was used to investigate the factor structure of the SoC-13 using IBM SPSS Amos, version 21.

Result

A one factor model of the SoC with twelve items had the best fit to the current data (CFA = 0.982, RMSEA = 0.035 [90%CI = 0.018, 0.050]), with good internal consistency (Cronbach’s Alpha = 0.75). When all 13 items of the Tigrigna version were considered, there was an inverse association of SoC-13 with PC-PTSD(r = − 0.433, p < 0.001), CES-D (r = − 0.597, p < 0.001), Pre and post-migration living difficulties checklist (r = − 0.265, p < .001and r = − 0.249, p < 0.001 respectively), and FAST (r = − 0.105, p < 0.001), providing support for the divergent validity of the scale. The SoC-13 was associated positively with the Oslo Social Support scale (OSS-3)(r = 0.363 p < 0.001) and task-oriented coping (r = 0.089, p < 0.001), demonstrating convergent validity. The four items, specifically item-1, item-2, item-3 and item-12 have shown relatively weaker item loadings (β<0.40); but item-2 demonstrated non-significant loading (β = 0.06, p>0.05) in a one factor model of SoC-13.

Conclusions

Although the 13-items of the Tigrigna version of the SoC scale loaded significantly onto their respective factors in the three factor model, only 12 items loaded significantly onto the one factor model, which demonstrated superior fit to the current data. Keeping in mind that future research should examine the conceptualizations of the four items demonstrating poor convergent validity in this Eritrean sample, the reduced Tigrigna version of SoC-12 is a reasonable measure of sense of coherence in this community.

Electronic supplementary material

The online version of this article (10.1186/s13031-019-0185-1) contains supplementary material, which is available to authorized users.

Health facility or home delivery? Factors influencing the choice of delivery place among mothers living in rural communities of Eritrea

BACKGROUND

In Eritrea, despite high antenatal care (ANC) use, utilization of health facilities for child birth is still low and with marked variations between urban and rural areas. Understanding the reasons behind the poor use of these services in a rural setting is important to design targeted strategies and address the challenge contextually. This study aimed to determine factors that influence women's choice of delivery place in selected rural communities in Eritrea.

METHODS

A cross-sectional survey of 309 women aged 15-49 years with a delivery in the last 1-2 years prior to the survey was conducted in a randomly selected villages of Hadish Adi, Serea, Genseba, Kelay Bealtat, Dirko, Mai Leham, Kudo Abour, Adi Koho, and Leayten. Data were collected using an interviewer administered questionnaire. Chi-square tests were used to explore association between variables. Using odds ratios with 95% confidence intervals with p < 0.05 taken as statically significant association, bivariate and multivariate logistic regression analysis were used to identify factors that affect the choice of delivery place.

RESULTS

Overall, 75.4% of the respondents delivered their last child at home while 24.6% delivered in health facility. Women whose husband's had no formal education were less likely [AOR = 0.02; 95% CI 0.01-0.54] to deliver in health facility. Women who had joint decision-making with husbands on delivery place [AOR = 5.42; 95% CI 1.78-16.49] and women whose husbands choose health facility delivery [AOR = 2.32; 95% CI 1.24-5.11] were more likely to have health facility delivery. Respondents who had medium wealth status [AOR = 3.78; 95% CI 1.38-10.37] have access to health facility within 2 km distance [AOR = 14.67; 95% CI 2.30-93.45] and women with traditional means of transport [AOR = 9.78; 95% CI 1.23-77.26] were also more likely to deliver in health facility. Women who read newspaper daily or infrequently had three [AOR = 3.77; 95% CI 1.12-4.04] and almost three times [AOR = 2.95; 95% CI 1.01-8.59] higher odds of delivering in health facility. Similarly, women who have knowledge about complications during delivery [AOR = 4.39; 95% CI 1.63-11.83], good perception on the quality of care they received [AOR = 9.52; 95% CI 1.91-47.50], had previous facility delivery [AOR = 2.69; 95% CI 0.94-7.68], have negative experiences of delivery outcomes in her community [AOR = 1.31; 95% CI 1.00-4.96], and women who perceive home delivery as life threatening [AOR = 1.84; 95% CI 1.46-3.38] were more likely to deliver in health facility.

CONCLUSION

To increase health facility delivery, raising women's awareness on the benefits of delivering in health facility, male involvement in the use of maternal health services, increasing women decision-making power, addressing common barriers of lack of transport, and compensations for transport expenses to alleviate the cost of transport are recommended. Efforts to shorten distance to reach health facility and health education focusing on the potential threats of delivering at home at the individual and community level can have substantial contribution to increase health facility delivery in rural communities of Eritrea.