Is sense of coherence a mediator or moderator of relationships between violence at work and stress reactions?

The Effects of Burnout, Team Support, and Perceived Leader Effectiveness on Career Intentions Among JAG Corps Personnel

INTRODUCTION

Destructive interpersonal relationships at work may result in negative feelings among employees that hinder personal and organizational productivity, which may also result in high levels of job disengagement and subsequent career turnover intentions. Leaders play a key role in creating work environments conducive to optimizing employee performance, organizational culture, and workplace well-being. Social support, which may include support from one's supervisor, colleagues, and loved ones, has been shown to reduce strains and perceived stressors at work. In the Army, the Judge Advocate General's Corps (JAGC) personnel have a unique position as lawyers and legal staff and have been shown to have high rates of burnout. To promote soldier health, well-being, and career longevity, it is important to understand the impact interpersonal relationships have on career intentions. The current study assesses the relationship between perceived leadership effectiveness and career intentions as moderated by burnout measured by job disengagement and team care activities in JAGC personnel.

MATERIALS AND METHODS

The Walter Reed Army Institute of Research conducted a survey to understand factors affecting the well-being of the JAGC's soldier and civilian personnel as requested by the JAGC. JAGC personnel were administered several questionnaires covering a range of work and mental health topics. Job disengagement, career intentions, team care activities, and general leadership were assessed. A total of 831 JAGC personnel completed the survey, the majority (92%) of which were soldiers. Among soldiers, first lieutenants and captains (∼49%) were the majority. The sample largely consisted of men (∼63%), White individuals (∼76%), married individuals, (70%), and individuals with graduate degrees (∼81%).

RESULTS

One in four participants (∼29%) experienced high levels of disengagement, with their work. Over two-thirds of participants agreed that their immediate supervisor is an effective leader. When asked about career intentions, the majority of JAGC participants (54%) indicated that they would probably or definitely stay in the JAGC until retirement. Ordinal logistic regressions were conducted to assess the relationship between perceived leader effectiveness and career intentions, assessing the main effects of job disengagement and team care activities, and the interactions between those variables. No interaction effects were found to be significant, but main effects for perceived leader effectiveness were significant.

CONCLUSIONS

JAGC personnel reported higher levels of job disengagement for those with career intentions that were undecided or definitely leaving the JAGC after their current obligation. Those who were engaged in more team care activities had lower levels of disengagement. While the majority of the JAGC participants indicated career intentions to stay in the JAGC until retirement, increasing perceived effectiveness of leaders could help increase attrition and career intentions to stay in the JAGC beyond one's current obligation.

Positive mental health and sense of coherence among emergency medical service professionals

Background

Positive mental health (PMH) is a construct used to define and evaluate health from a positive perspective. Healthcare professionals in the emergency ambulance service are more likely to experience mental health disorders than the overall population. The demographic and occupational variables and Sense of Coherence (SOC) can act as predictors of PMH and can serve as protective elements against stress and demanding situations in the work environment.

Objective

This study aimed to evaluate PMH and its relationship with demographic and occupational variables and determine if SOC is a predictive variable for PMH in health professionals working in the emergency ambulance service.

Methods

A descriptive, cross-sectional, and correlational study was conducted with a sample of 406 healthcare professionals from the emergency ambulance service in eight health regions of Catalonia, Spain. The following variables were analyzed: Age, biological sex, household members, dependents family members, professional category, type of contract, job satisfaction and sense of collaboration with other institutions. The following assessment instruments were used: Positive Mental Health Questionnaire and Sense of Coherence scale.

Results

High scores were obtained in Positive Mental Health (PMH). Study participants who reported feeling completely satisfied in their work also showed a significant relationship with all PMH factors: greater satisfaction with their personal life, in their helpful prosocial attitude toward others, in their capability to deal effectively with stress and navigate conflict scenarios, in their ability to solve problems and self-realization, greater empathy and ability to understand the feelings of others, greater ability to establish interpersonal relationships. Comprehensibility, as a dimension of SOC, was identified as a predictor for some factors of PMH: a greater personal satisfaction, self-control, autonomy, interpersonal skills and total PMHQ. More than 43% of positive mental health in health professionals is explained by higher Meaningfulness and Comprehensibility values of the SOC, the absence of dependent family members and having a non-graduate background.

Conclusion

Healthcare workers in the emergency ambulance service had high PMH. Meaningfulness (ME) and Comprehensibility (C), dimensions of SOC, were identified as model predictors of greater PMH, showing higher scores in most of PMH factors. To enhance SOC as a mental health promotion measure, resilience programs should be implemented to help professionals develop skills to face and overcome adverse situations. Educating in stress management thought networks are key elements to strengthen SOC. Managers in emergency medical services play a key role in transforming healthcare work environments to promote positive outcomes in the mental health of their healthcare workers.

Workplace violence and burnout among Chinese nurses during the COVID-19 pandemic: does the sense of coherence mediate the relationship?

BACKGROUND

Workplace violence has always been a critical issue worldwide before and after the COVID-19 pandemic, which can lead to burnout and turnover. In addition, the burnout and mental stress of nurses during the COVID-19 period have been widely described. To our knowledge, no studies have examined the mediating effect of the sense of coherence on the relationship between workplace violence and burnout among Chinese nurses over time. Therefore, this study aimed to explore the relationship between workplace violence and burnout among Chinese nurses and how the sense of coherence mediates the association.

METHODS

Using a convenience sampling method, 1190 nurses from 4 tertiary grade-A comprehensive hospitals were investigated between September 2021 and December 2021 in 3 provinces of China. The Workplace Violence Scale, Burnout Inventory, and Sense of Coherence scale were used to collect data. Data analysis was conducted using descriptive statistics, Pearson correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis.

RESULTS

The mean total scores for workplace violence and burnout were 1.67 ± 1.08 and 47.36 ± 18.39, respectively. Workplace violence was significantly negatively correlated with the sense of coherence (r = -0.25) and positively correlated with burnout (r = 0.27). Additionally, a higher level of workplace violence was associated with higher burnout (β = 1.13, 95% CI: 0.68 ~ 1.56). A higher sense of coherence was also associated with lower burnout (β = -0.98, 95% CI: -1.03 ~ -0.92). Workplace violence showed an effect on burnout through a sense of coherence. The direct, indirect and total effects were 1.13, 1.88 and 3.01, respectively. The mediating effect of the sense of coherence accounted for 62.45% of the relationship between workplace violence and burnout.

CONCLUSION

We found that the sense of coherence mediated most workplace violence on burnout. It is imperative for hospital managers to improve nurses' sense of coherence to reduce the occurrence of burnout during COVID-19. Future intervention studies should be designed to strengthen nurses' sense of coherence.

Fear of COVID-19 and Life Satisfaction: The Role of the Health-Related Hardiness and Sense of Coherence

Introduction: The COVID-19 pandemic is contributing to increased fear and anxiety throughout society, which may affect life satisfaction. Health-related hardiness and sense of coherence (SOC) are personal resources that help people adapt to difficult circumstances. The purpose of this study was to investigate the relationship between fear of COVID-19, SOC, health-related hardiness, and life satisfaction. Methods: A total of 907 Polish people (522 women and 385 men) participated in this study. The Fear of COVID-19 Scale (FOC-6), the Health-Related Hardiness Scale, the Sense of Coherence Scale (SOC-29), and the Satisfaction with Life Scale were used. Results: Correlation showed that fear of COVID-19 was negatively related to health-related hardiness, SOC, and life satisfaction. Health-related hardiness and SOC were positively related to life satisfaction. Both SOC and hardiness were mediators between fear of COVID-19 and life satisfaction during the current pandemic. Conclusion: SOC and health-related hardiness are personal resources that are important for dealing with the effects of the COVID-19 pandemic. According to our study, SOC and hardiness can mediate between fear of COVID-19 and life satisfaction. Presented cross-sectional results have to be verified in future longitudinal studies in order to strengthen the conclusions presented in this manuscript. This study verified the role of only two personal resources, so more research is needed on the role of other personal resources during COVID-19 pandemic.

The relationship between resourceful working conditions, work-related and general sense of coherence

Sense of coherence (SoC) has been identified as an important health resource and is associated with various health-related outcomes, especially perceived health and mental health. SoC has also been found to be relevant in the work context. Our study examined whether job resources, such as autonomy or social support, can contribute to the development of SoC. We also examined the role of the setting-specific work-related sense of coherence (Work-SoC) as well as reciprocal relationships between the three variables. Participants (941) from Germany, Switzerland and Austria completed our questionnaires at three waves of data collection. Structural equation modeling was used to identify the best fitting model and interpret the relationships between variables. Our first hypothesis that job resources predict Work-SoC and that Work-SoC predicts SoC was confirmed. We also found support for our second hypothesis that SoC predicts Work-SoC and that Work-SoC predicts job resources. The indirect effects through Work-SoC were only marginally significant in both directions. Our findings illustrate complex and multidirectional relationships between the variables. Job resources seem to contribute to the strengthening of Work-SoC, which seems to set in motion a gain cycle of improved job resources, which again contribute to a higher Work-SoC. Over time, this might contribute to strengthening general SoC. However, our findings showed that SoC was highly stable over the observed 3-month interval, limiting the effect any other variable could exert on it. Future research should further examine the mechanisms and timeframes over which a setting-specific SoC contributes to the development of overall SoC.

Lifetime prevalence of polyvictimization among older adults in Sweden, associations with ill-heath, and the mediating effect of sense of coherence

Background

Experiences of violence and abuse is a prominent part of the life history of many older adults and is known to have negative health effects. However, the importance of multiple victimization over the life course, e.g., lifetime polyvictimization, is not well investigated in this age group. The objective of this study was to investigate the prevalence of lifetime physical, emotional, and sexual victimization as well as polyvictimization among older adults in Sweden. We explored background characteristics associated with polyvictimization and hypothesized that violence victimization and especially polyvictimization would be associated with lower health status. To better understand factors that promote health in the aftermath of victimization, we also explored the effect of two resilience factors, sense of coherence (SOC) and social support, on the association between victimization and ill-health.

Method

Cross-sectional data from a random population sample in Sweden (women n = 270, men n = 337) aged 60–85 was used. Respondents answered questions about exposure to violence, health status, social support, and SOC. Conditional process analysis was used to test if SOC mediates the association between victimization and health outcome, and if social support moderates the association.

Results

Overall, 24.8% of the women and 27.6% of the men reported some form of lifetime victimization and 82.1% of the female and 62.4% of the male victims were classified as polyvictims, i.e., reported experiences of more than one episode of violence. As hypothesized, we found a negative association between victimization and health status and the association was most prominent for polyvictims. We found moderated mediation for the association between polyvictimization and health status, i.e., polyvictimization was associated with lower SOC and SOC had a positive correlation with health status. Social support moderated the association, i.e., victims without social support had lower health scores.

Conclusions

Lifetime polyvictimization was common among older adults and associated with lower health status. To help victims of violence recover, or preferably never develop ill-health, a better understanding of what fosters resilience is warranted. This study implies that social support, and especially SOC may be factors to consider in future interventions concerning older adults subjected to violence.

What Protects Youth Residential Caregivers from Burning Out? A Longitudinal Analysis of Individual Resilience

Background: Professional caregivers are exposed to multiple stressors and have high burnout rates; however, not all individuals are equally susceptible. We investigated the association between resilience and burnout in a Swiss population of professional caregivers working in youth residential care. Methods: Using a prospective longitudinal study design, participants (n = 159; 57.9% women) reported on burnout symptoms and sense of coherence (SOC), self-efficacy and self-care at four annual sampling points. The associations of individual resilience measures and sociodemographic variables, work-related and personal stressors, and burnout symptoms were assessed. Cox proportional hazards regressions were calculated to compute hazard ratios over the course of three years. Results: Higher SOC, self-efficacy and self-care were related to lower burnout symptoms in work-related and personal domains. Higher SOC and self-efficacy were reported by older caregivers and by those with children. All three resilience measures were highly correlated. A combined model analysis weakened the protective effect of self-efficacy, leaving only SOC and self-care negatively associated with burnout. Conclusion: This longitudinal analysis suggests that SOC and self-caring behaviour in particular protect against burnout. Our findings could have implications for promoting self-care practices, as well as cultivating a meaningful, comprehensible and manageable professional climate in all facets of institutional care.

Employees exposed to work-related threats and violence in human services sectors: Are any employees members particularly exposed to violence and threats and what role do supervisors play?

BACKGROUND

The frequency of being exposed to work-related violence and threats is high in employees working in the human service sector. The question is whether certain employees are particularly exposed to violence and threats than others.

OBJECTIVE

This study examined whether particular employees were especially exposed to work-related violence and threats due to personal characteristics, coping styles, attitudes or participating in violence prevention training. We also examined the role played by supervisors.

METHODS

Questionnaire data were collected in 2010 and 2011. In all, 3584 employees from special schools, psychiatric wards, eldercare and the Prison and Probation Service participated. We used multivariate logistic regression analyses.

RESULTS

We found persons high on the extroversion and introversion scales were associated with statistical significant increased risk for work-related threats. Furthermore, accepting attitudes concerning work-related violence were also statistical significant associated with increased the risk for both work-related threats and violence. Associations between coping styles and work-related threats and violence were very small and statistically non-significant and we found no effect of violence prevention training. The risk for work-related threats for persons high on the extroversion scale was decreased if supervisor violence prevention behaviour was high. Furthermore, if supervisor prevention behaviour was high, prevention training decreased the risk for work-related violence. However, these associations weren't statistically significant.

CONCLUSION

The results stress that effective prevention requires involvement of both employees and supervisors.

Chronic stress, sense of coherence and risk of type 2 diabetes mellitus

AIMS

The study was conducted to ascertain whether chronic stress and sense of coherence are associated with risk of type 2 diabetes mellitus.

METHODS

Stress questionnaires - Presumptive Stressful Life Events Scale (PSLES), Perceived Stress Scale (PSS) and Sense of Coherence (SOC) - were administered to 500 Newly Detected Diabetes Mellitus (NDDM) cases and 500 Normal Glucose Tolerance (NGT) controls recruited following 75 g OGTT. Assessment of stress was completed before the diagnosis of diabetes was revealed to them.

RESULTS

PSLES and PSS scores were significantly higher and SOC score was significantly lower in NDDM subjects compared to those with NGT. PSLES and PSS correlated positively with anthropometric parameters (waist circumference, BMI), glycemic parameters (FPG, 2 hPG, A1C) and HOMA-IR and inversely with HOMA-β whereas SOC correlated inversely with glycemic parameters (FPG, 2 hPG, A1C) and HOMA-IR and positively with HOMA-β. In stepwise logistic regression analysis, SOC emerged as the strongest independent predictor of diabetes (OR: 0.774) after HOMA-IR (OR: 1.621) and BMI (OR: 1.288). Other significant predictors included PSS (OR:1.153), PSLES-LT (OR: 1.005) and HOMA-β (OR: 0.894).

CONCLUSION

Chronic stress and low sense of coherence are associated with a higher risk of type 2 diabetes mellitus.

Relationship Between Changes in Workplace Bullying Status and the Reporting of Personality Characteristics

OBJECTIVE

To examine whether a shift in work-related bullying status, from being non-bullied to being bullied or vice versa, was associated with changes in reporting of personality characteristics.

METHODS

Data on bullying and personality (neuroticism, extraversion, and sense of coherence) were collected in three waves approximately 2 years apart (N = 4947). Using a within-subjects design, personality change scores that followed altered bullying status were evaluated with one-sample t tests. Sensitivity analyses targeted depressive symptoms.

RESULTS

Shifts from non-bullied to frequently bullied were associated with increased neuroticism or decreased sense of coherence manageability scores. Shifts from bullied to non-bullied were associated with decreasing neuroticism and increasing extraversion scores, or increasing sense of coherence meaningfulness and comprehensibility scores. Excluding depressive cases had minor effects.

CONCLUSIONS

Bullying seems to some extent to affect personality scale scores, which thus seem sensitive to environmental and social circumstances.

Youth from Fundamentalist Societies: What are Their Attitudes Toward War and Peace and Their Relations with Anxiety Reactions?

The present study was conducted during "Protective Edge," a long-lasting military operation between the State of Israel and Hamas in Gaza, during which hundreds of rockets were fired from Gaza into various regions across the country. At the same time, Israeli forces bombed Gaza and sent in ground forces. The military operation ended after 50 days of fighting, with a cease-fire between the warring sides. The aim of this study was to compare attitudes and perceptions of youth from different religious fundamentalist societies, toward the war and their readiness for peace during this specific violent struggle, and attitudes toward the Israeli-Palestinian (I-P) conflict in general. Furthermore, we wanted to examine the links between these attitudes, personal sense of coherence and state anxiety. We compared two groups of adolescents who belong to religious minorities in Israel: ultra-Orthodox and national religious. The sample included a total of 107 subjects from both groups. The young people responded to a questionnaire, distributed during the military operation, while they were still under rocket fire from the Gaza Strip. The questionnaire included: socio-demographic characteristics; attitudes toward the military operation; ways to resolve the Israeli-Palestinian conflict; sense of coherence and state anxiety. Results indicate that both groups thought that the I-P conflict would not be resolved peacefully and that there were more wars to come. Furthermore, both national religious and ultra-Orthodox adolescents thought that this operation would have limited success for only a limited time. Regarding the differences between the groups, sense of coherence was higher among the ultra-Orthodox and this group also believed more than their counterparts that everything was in God's hands. Interesting results emerged with peaceful resolution being linked to more anxiety among the national religious group, while among the ultra-Orthodox group no relationships were indicated on these two variables. The results of the study underscore the implications of ongoing political conflicts, alongside the growing global power of religion, which minimizes opportunities for world peace.

Job crafting and motivation to continue working beyond retirement age

Purpose

The purpose of this paper is to examine how promotion- and prevention-focussed job crafting impacts the motivation of older employees to continue working beyond retirement age. The authors hypothesized that promotion-focussed job crafting (i.e. increasing social and structural job resources, and challenging job demands) relates positively and prevention-focussed job crafting (i.e. decreasing hindering job demands) relates negatively with motivation to continue working after reaching the official retirement age, and that these relationships are sequential mediated by work sense of coherence and burnout.

Design/methodology/approach

Data from 229 older employees (mean age=55.77) were analyzed using structural equation modeling.

Findings

Promotion-focussed job crafting was positively and prevention-focussed job crafting was negatively related with employees’ work sense of coherence, which was predictive of employees’ burnout, which in turn was predictive of motivation to continue working beyond retirement age.

Research limitations/implications

Despite the cross-sectional study design, the results unfold how promotion- and prevention-focussed job crafting are related with motivation to continue working beyond retirement age through work sense of coherence and burnout.

Practical implications

Given today’s aging and shrinking workforce, older employees working beyond their official retirement age are a necessity for organizations’ functional capability. The results suggest that organizations should encourage employees’ promotion-focussed job crafting and limit prevention-focussed job crafting. Promotion-focussed job crafting facilitates employees’ work sense of coherence, which keeps them healthy and motivates older employees to continue working beyond retirement age.

Originality/value

This study adds to the literatures on job crafting and motivation to continue working beyond retirement age and explicates intervening processes in this relationship.

Post-traumatic Recovery to Distress Symptoms Ratio Mediates Relations of Resilience Fostering Resources and Their Predictors

A large-scale study investigated the direct and indirect effects of demographic predictors and traumatic experiences on resilience fostering resources following a war. The sample consisted of 829 Israeli adults, living in a border town, 1 year after experiencing the 2006 war with Lebanon. Resilience was assessed by measures of individual and public resilience and low sense of danger. Results show that as hypothesized the proportion of post-traumatic recovery to post-war distress symptoms predicts these indices of resilience and partly mediates the direct links between these indices and demographic predictors (age, gender and economic condition) and exposure to war. Research of resilience has proposed several prototypical trajectories that characterize responses to potentially traumatic events. Our discussion suggests that these trajectories and their changes over time can be accounted for by the balance of post-war recovery to symptoms level. Copyright © 2014 John Wiley & Sons, Ltd.

Youth Exposed to Terrorism: the Moderating Role of Ideology

The present review examines the moderating role of ideology on the effects of war, armed conflict, and terrorism on youth. Ideology is an important factor given the central role played by religio-political ideology and nationalism in present-day conflicts. Ideologies or worldviews represent cognitive frameworks that imbue the traumatic situation with meaning and order. Analysis of the pool of studies identified three categories of ideologically based moderating factors, each representing an aspect of social construction of traumatic events, namely, religion, political ideology, and self-concept. The two closely related categories of religion and politico-religious beliefs showed both positive and negative effects on psychological and psychiatric outcomes among youth. The third category of different aspects of self-concept yielded consistently positive moderating effects. The mechanisms by which each category of ideology moderates effects of exposure to war, armed conflict, and terrorism are discussed, and research and clinical implications are presented.

Community Resilience of Civilians at War: A New Perspective

A new concept of community resilience pertaining to the community's post adversity strength to vulnerability ratio was associated with five determinants: individual resilience, national resilience, well-being, community size, and sense of coherence. The data was collected four months after Israel's war in the Gaza Strip in 2014. Participants were 251 adult civilians living in southern Israel who have recently been threatened by massive missile attacks, and 259 adults living in northern Israel, which has not been under missile fire recently. The investigated variables predicted community resilience, and their effects were mediated by sense of coherence. Results which were similar for both samples were discussed in terms of the nature of resilience and in terms of proximal and distal exposure to war.

Sense of coherence as a mediator of health-related quality of life dimensions in patients with breast cancer: a longitudinal study with prospective design

BACKGROUND

In our previous study, we found that the degree of sense of coherence (SOC) and baseline ratings of several dimensions of health-related quality of life (HRQoL) were the most important predictors of HRQoL changes 6 months after the pre-diagnosis period of breast cancer. To find a way to explain these findings, the aim of this study was to explore the mediating effect of the SOC between ratings of HRQoL dimensions before final diagnosis, and ratings of the same dimensions at the 6 months follow up, within a sample of women with breast cancer.

METHODS

A longitudinal study with a prospective design at baseline (T1) and 6 months later (T2) was conducted on 162 women with breast cancer. To measure HRQoL dimensions three different questionnaires, the European Organization for Research and Treatment of Cancer QLQ-30, the SF-12 Health Survey version 2 and the Health Index were applied at T1 and T2 to cover both diagnostic-specific and generic dimensions. Measurement of the SOC as a mediator was done by the SOC-13 scale.

RESULTS

Mediational analyses on eight significant pairs of HRQoL dimensions showed that the degree of SOC totally mediated variations of global quality of life (p < 0.001) as well as cognitive and social functioning (p <0.05) scores between T1 to T2. Changes in the scores of emotional functioning (p < 0.01), fatigue (p < 0.05), financial difficulties (p < 0.05), well-being (p < 0.001), and mental health component (p < 0.001) were partially mediated. The degree of SOC explained 16% to 45% of the variances in HRQoL dimensions at T2.

CONCLUSIONS

The mediating pathway of the SOC in the context of this study appears to be the key to understanding how a higher sense of coherence as an inner resource may serve as a protective psychological factor in the adaptation process of the patients. Clinicians might consider coherence-oriented structure of the SOC and the connection between the SOC and HRQoL data in intervention plans from the first visit onwards. It may assist the identification of women who are at greater risk for maladaptation to the breast cancer trajectory.

Bullied at school, bullied at work: a prospective study

BACKGROUND

The consequences of childhood bullying victimisation are serious. Much previous research on risk factors for being bullied has used a cross-sectional design, impeding the possibility to draw conclusions on causality, and has not considered simultaneous effects of multiple risk factors. Paying closer attention to multiple risk factors for being bullying can provide a basis for designing intervention programmes to prevent or reduce bullying among children and adolescents.

METHODS

Risk factors for bullying were examined by using questionnaire data collected in 2004 and 2007. In 2004, the participants were aged 14-15 years and 17-18 years in 2007. The baseline questionnaire was answered by 3054 individuals in 2004, and 2181 individuals participated in both rounds. We analysed risk factors for being bullied at the individual and societal level. Information on the social background of the participants was derived from a national register at Statistics Denmark.

RESULTS

Several risk factors were identified. Being obese, low self-assessed position in school class, overprotective parents, low self-esteem, low sense of coherence and low socioeconomic status were risk factors for being bullied at school. Being overweight, smoking, low self-assessed position in class, low sense of coherence and low socioeconomic status were risk factors for being bullied at work. However, most associations between risk factors in 2004 and being bullied in 2007 disappeared after adjustment for being bullied in 2004.

CONCLUSIONS

The strongest risk factor for being bullied was being previously bullied. Our results stress the importance of early prevention of bullying at schools. In addition, attention should be drawn to the role of overprotective parents.

Posttraumatic recovery to distress symptoms ratio: a mediator of the links between gender, exposure to fire, economic condition, and three indices of resilience to fire disaster

This study investigated the direct and indirect effects of demographic predictors on level of resilience following a potentially traumatic event. We hypothesized that the direct effects of three variables (exposure to fire hazards, gender, and economic condition) on resilience following a fire disaster would be mediated by the proportion of posttraumatic recovery to post-fire distress symptoms. The sample consisted of 234 Israeli Druze youth whose hometown was endangered and damaged by the Mount Carmel fire disaster in December 2010. Results partially supported the research hypotheses.

Bullying victimization prevalence and its effects on psychosomatic complaints: can sense of coherence make a difference?

BACKGROUND

The aim of this study was to examine the prevalence of bullying victimization and its impact on physical and psychological complaints in a representative sample of adolescents and to explore the role of sense of coherence (SOC) in victimization prevalence and consequences.

METHODS

A representative sample of Spanish adolescents (N = 7580, mean age = 15.41) was selected as part of the Health Behaviour in School-aged Children study. Bullying victimization, physical and psychological symptoms, and SOC were measured, and comparisons were made between strong- and weak-SOC adolescents regarding their likelihood of being a victim of bullying and the negative effects of bullying victimization on their health.

RESULTS

Weak-SOC adolescents were significantly more likely to suffer from bullying victimization regardless of type (nonphysical vs physical and nonphysical) or means (traditional vs cyberbullying). In addition, bullying victimization showed significant increasing effects on weak-SOC adolescents' physical and psychological symptoms whereas in strong-SOC adolescents it was not significantly associated with increases in physical complaints and its effects on psychological complaints seemed to be weaker.

CONCLUSIONS

Weak-SOC adolescents seem to be at higher risk of becoming bullying victims and victimization experiences appear to have increased negative effects on them when compared to strong-SOC students.

Psychosocial working conditions and cognitive complaints among Swedish employees

BACKGROUND

Cognitive complaints involving problems with concentration, memory, decision-making and thinking are relatively common in the work force. The sensitivity of both subjective and objective cognitive functioning to common psychiatric conditions, stress levels and to cognitive load makes it plausible that psychosocial working conditions play a role in cognitive complaints. Thus, this study aimed to test the associations between psychosocial work factors and cognitive complaints in nationally representative samples of the Swedish work force. Cross-sectional (n = 9751) and prospective (n = 3644; two time points two years apart) sequential multiple regression analyses were run, adjusting for general confounders, depressive- and sleeping problems. Additional prospective analyses were run adjusting for baseline cognitive complaints.

CROSS/SECTIONAL RESULTS

High quantitative demands, information and communication technology (ICT) demands, under qualification and conflicts were positively associated with cognitive complaints, while social support, good resources at work and over qualification were negatively associated with cognitive complaints in all models. Skill discretion and decision authority were weakly associated with cognitive complaints. Conflicts were more strongly associated with cognitive complaints in women than in men, after adjustment for general confounders.

PROSPECTIVE RESULTS

Quantitative job demands, ICT demands and under qualification were positively associated with future cognitive complaints in all models, including when adjusted for baseline cognitive complaints. Decision authority was weakly positively associated with future cognitive complaints, only after adjustment for depressive- and sleeping problems respectively. Social support was negatively associated with future cognitive complaints after adjustment for general confounders and baseline cognitive complaints. Skill discretion and resources were negatively associated with future cognitive complaints after adjustment for general confounders. The associations between quantitative demands and future cognitive complaints were stronger in women.

DISCUSSION/CONCLUSIONS

The findings indicate that psychosocial working conditions should be taken into account when considering cognitive complaints among employees.

Comprehensibility, manageability and meaningfulness at work: Construct validity of a scale measuring work-related sense of coherence

Orientation: Work-related sense of coherence (Work-SoC) is defined as the perceived comprehensibility, manageability and meaningfulness of an individual’s current work situation.Research purpose: The aim of the present study was to investigate the factorial invariance and the construct validity of a scale that measures Work-SoC.Motivation for the study: It might be useful to specifically apply the concept of sense of coherence to the work context.Research design, approach and method: Statistical analysis was performed on crosssectional (n = 3412) and longitudinal (n = 1286) questionnaire data collected in eight medium to large Swiss companies from diverse economic sectors (four industrialproduction companies, one food-processing company, one public-administration service and two hospitals). The dataset therefore covers a broad range of different occupational groups.Main findings: Multiple-group analyses indicated that the scale’s factor structure remains invariant across different employee groups and across time. High values in job resources were related to high values in Work-SoC whereas high values in job demands were related to low values in Work-SoC. Furthermore, Work-SoC acted as a partial mediator between job resources and work engagement.Practical/managerial implications: It can be concluded that Work-SoC might serve as a practical screening instrument for assessing an employee’s perception of the potential health-promoting qualities of his or her current work situation.Contribution/value-add: The study advances both the salutogenic theory and the field of positive occupational health psychology by redefining sense of coherence as an interactional and context-specific construct that is useful for intervention research.

Coping resources as explanatory factors of stress reactions during missile attacks: comparing Jewish and Arab adolescents in Israel

The aim of this study was to explore coping resources as explanatory factors in reducing emotional distress of adolescents in an acute stress situation. We compared two ethnic groups-Jewish and Arab-Bedouin Israelis-during intensive missile attacks in January 2009. Data were gathered from 138 Israeli-Jews and 84 Israeli-Arab Bedouins, 12-18 years old, who filled out self reported questionnaires among which state anxiety, state anger, and psychological distress (SPD) were measures of emotional distress, and sense of coherence (SOC) and hope index served as measures of coping resources. Findings indicated no differences between the two groups on state anxiety, SPD and hope levels. Arab Bedouins reported higher levels of state anger and lower levels of sense of coherence. The coping resources, however, explained the stress reactions differently among the two groups. While SOC made a major contribution in explaining stress reactions among Jewish adolescents, hope index explained stress reactions only for the Arab group. The findings are discussed against the background of the salutogenic theory and the cultural differences between the two ethnic groups.

Brief report: adolescents under missile attacks: sense of coherence as a mediator between exposure and stress-related reactions

Employing the salutogenic approach (Antonovsky, 1987), this pilot study aimed at exploring the mediation effect of Sense of Coherence (SOC) on the relationships between exposure to missile attacks and stress-related reactions among adolescents. A strong SOC means a tendency to see the world as more comprehensible, manageable and meaningful. Data were gathered during August 2006 (Second Lebanon War) from 230 Israeli adolescents, 12-18 years old. Adolescents filled out self-reported questionnaires, including demographics, level of physical exposure, SOC, Scale of Psychological Distress (SPD), State Anxiety and State Anger. Exposure to missile attacks was found to be significantly positively linked to stress reactions; exposure was negatively linked to SOC which was also negatively linked to stress reactions. The mediation hypothesis was supported, with SOC mediating the effect of exposure to missile attacks on stress reactions. It seems that SOC may have a protective effect against stress reactions among adolescents exposed to political violence. This should be further studied in a longitudinal research.

The effect of the work environment and performance-based self-esteem on cognitive stress symptoms among Danish knowledge workers

AIMS

Interpersonal relations at work as well as individual factors seem to play prominent roles in the modern labour market, and arguably also for the change in stress symptoms. The aim was to examine whether exposures in the psychosocial work environment predicted symptoms of cognitive stress in a sample of Danish knowledge workers (i.e. employees working with sign, communication or exchange of knowledge) and whether performance-based self-esteem had a main effect, over and above the work environmental factors.

METHODS

349 knowledge workers, selected from a national, representative cohort study, were followed up with two data collections, 12 months apart. We used data on psychosocial work environment factors and cognitive stress symptoms measured with the Copenhagen Psychosocial Questionnaire (COPSOQ), and a measurement of performance-based self-esteem. Effects on cognitive stress symptoms were analyzed with a GLM procedure with and without adjustment for baseline level.

RESULTS

Measures at baseline of quantitative demands, role conflicts, lack of role clarity, recognition, predictability, influence and social support from management were positively associated with cognitive stress symptoms 12 months later. After adjustment for baseline level of cognitive stress symptoms, follow-up level was only predicted by lack of predictability. Performance-based self-esteem was prospectively associated with cognitive stress symptoms and had an independent effect above the psychosocial work environment factors on the level of and changes in cognitive stress symptoms.

CONCLUSIONS

The results suggest that both work environmental and individual characteristics should be taken into account in order to capture sources of stress in modern working life.

The effects of positive cognitions on the relationship between alienation and resourcefulness in nursing students in Egypt

Alienation is a subjective state, a feeling of being a stranger, as if one were not one's normal self. It is also a sense of homelessness; a feeling of uneasiness or discomfort, which signifies the person's exclusion from social or cultural participation. Alienation can adversely affect healthy functioning of nursing students. Nursing students are the adolescents of today and the nurses of tomorrow who will deal with human behavior, and their psychological well-being will be important in managing their clients' conditions. Healthy nursing students are likely to become healthy nurses who can then model and promote healthy lifestyles for their patients. This study looked at whether the effects of alienation on adolescents' resourcefulness are influenced by positive cognitions. Zauszniewski's theory of resourcefulness, which is based on the conceptualization of two forms of resourcefulness: personal (self-help) and social (help-seeking) resourcefulness, served as the theoretical framework for the study. A descriptive, correlational, cross-sectional design was used to examine hypothesized relationships among the study variables in a convenience sample of 170 first-year nursing students aged 17 to 20 years. Results showed that positive cognitions had a moderating and a partial mediating effect on the relationship between alienation and resourcefulness. It is imperative for nurse educators to generate interventions to enhance positive cognitions among nursing students.

A Salutogenic Analysis of Healthy Aging in Active Elderly Persons

The authors systematically explore relationships between generalized resistance resources (GRRs), the sense of coherence (SOC), and the healthease/dis-ease (HE-DE) continuum. A sample of 170 active older adults at the mean age of 67 years filled out a comprehensive questionnaire. The results indicate that 11 GRRs significantly predicted SOC (56% of variance accounted for) and that GRRs significantly predicted the HE-DE continuum (38%). Holding GRRs constant, SOC significantly accounted for 3% additional variance in health. Finally, SOC mediated GRRs’ effects on health. SOC proved to be a complete mediator for autonomy/identity resource gains, social external health locus of control, self-efficacy, and self-esteem, and a partial mediator for activity level and social support. The findings suggest that SOC plays a central role for health maintenance and health promotion in the third age because it pools resource influences on health. The authors recommend the application of salutogenic theory to intervention.

The association of sense of coherence and coping profile with stress among research park city workers in Japan

Via a large scale cross-sectional study among Japanese white color workers, the authors aimed to elucidate: (1) the distributions of Sense of Coherence (SOC), which reflect stress coping abilities, (2) the distributions of the Brief Scale for Coping Profile (BSCP) which reflect coping profiles for stressors; (3) and the association between SOC and BSCP. Anonymous self-administered questionnaires were sent to 20,742 employees at educational and research institutions in Tsukuba Research Park City. A total of 12,009 (57.9%) workers completed and returned the questionnaire; 10,317 workers without missing data were analyzed. SOC scale scores and BSCP subscale scores differed by gender, age, and other demographic features. Among the BSCP subscales, workers whose SOC scale scores were higher tended to adopt a problem-focused coping profile, whereas workers whose SOC scale scores were lower adopted an emotion-focused coping profile. The coping profile that workers adopted depended on their background and demographic characteristics. Stronger SOC allowed one to adopt a problem-focused coping profile that allows for better coping with work-related stressors.

Sense of coherence moderates late effects of early childhood Holocaust exposure

This study evaluated child Holocaust survivors with an emphasis on potential protective factors facilitating participants' adaptation to post-Holocaust life. We examined Antonovsky's (1979, 1987) salutogenic paradigm, testing the mediating and moderating effect of participants' sense of coherence (SOC) on the association between early childhood deprivation due to Holocaust persecution and posttraumatic stress later in life. The nonclinical sample, composed of 203 child Holocaust survivors born between 1935 and 1944 completed questionnaires on Holocaust survival exposure, inventories on current health, posttraumatic stress, and SOC. The results indicated that SOC moderates the association between traumatic experiences during the war and posttraumatic stress, and SOC acts as a protective factor, buffering the impact of traumatic Holocaust experiences on child survivors in old age. Survivors with a less coherent perspective on the meaning of their life showed greater vulnerability for posttraumatic complaints. The moderating role of the SOC may suggest promising avenues of therapeutic interventions for child Holocaust survivors and other adults with early childhood trauma.

Subjective health in old age from a salutogenic perspective

OBJECTIVE

We applied Antonovsky's salutogenic model to healthy ageing. Basically, salutogenic theory states that generalized resistance resources build-up the sense of coherence which in turn determines an individual's health level. Specifically, we explored the status of the sense of coherence as a mediator variable.

DESIGN AND METHOD

We conducted a cross-sectional questionnaire study with 387 volunteering elders (73.4% women and 22.2% nursing home residents) at the mean age of 74 (SD=7.58) years. We assessed 19 bio-psychosocial resources, the sense of coherence, and three subjective health measures - psychological health, symptom reporting, and physical health. As nursing home residents were generally inferior, our study controlled for dependent living.

RESULTS

Resources, sense of coherence, and subjective health were significantly inter-related. A regression showed that optimism, self-esteem, low depressive mood, self-efficacy, and social support predicted the sense of coherence significantly. Predicting psychological health and symptom reporting, the sense of coherence remained significant when resources were added in the final step of the regression. This pattern was not found for physical health. Mediator analyses using Preacher and Hayes' paradigm showed that every eligible resource influenced both psychological health and symptom reporting, but not physical health, indirectly via the sense of coherence.

CONCLUSION

The sense of coherence is largely shaped by individual difference variables. As a mediator variable, it strongly accounts for the relation between resources and psychogenic aspects of health, whereas its relative significance for physical health is not corroborated. Our findings emphasize the importance of resource-oriented health care for elders.

Incidence and recurrent work-related violence towards healthcare workers and subsequent health effects. A one-year follow-up study

AIMS

The aim of the present study was to analyse the incidence of violence and threats of violence during the first year at work after graduating as a healthcare worker, the risk of re-exposure and health effects among respondents previously exposed to violence or threats.

METHODS

We analysed baseline data from 5,696 healthcare students and conducted prospective multinomial regression analyses following 2,847 respondents during their first year of employment.

RESULTS

At baseline we found that nearly a third of the respondents had been exposed to violence or threats of violence, 8.7% during trainee periods. At follow-up, we found that 24.6% of the healthcare workers had been exposed to violence and 33.4% to threats during the first year at work after graduation. Exposure to violence or threats during trainee periods was a strong predictor of violence (Odds ratio (OR)=3.3) and threats (OR=4.2) at follow-up. The results showed that violence or threats in previous jobs or at other places had a significant impact on the health of the victims at follow-up independent of gender, age, sense of coherence, self-efficacy and health at baseline. Exposure during trainee periods had a small but not quite significant (p=0.06) impact on the health of the victims at follow-up.

CONCLUSIONS

The study shows a high risk of violence and threats of violence among healthcare workers during training and the first year at work after graduation, indicating a need for violence prevention planning involving both college and workplaces.

Sense of coherence and quality of life in women family members of the seriously mentally ill

Providing care to a family member with serious mental illness (SMI) can reduce a family's quality of life. Quality of life, however, can be positively influenced by the caregiver's sense of coherence (SOC). Antonovsky's Salutogenic Health Model was examined in this secondary analysis of data from 60 women family members of adults with SMI. The results indicated that greater perceived stress decreased SOC and QoL, greater SOC enhanced QoL, and SOC partially mediated the effects of perceived stress on QoL. The findings suggest the need for reducing stress and strengthening SOC to promote optimal QoL for family members of adults with SMI.

Negative life events and stability of sense of coherence: A five-year follow-up study of Finnish women and men

A strong sense of coherence (SOC) is found to be associated with good mental health. This study investigated (1) whether negative life events affect level of SOC, (2) whether initial level of SOC modifies the effect of negative life events on SOC, and (3) whether stability of SOC differs between genders. The data were derived from the 15-year Health and Social Support study (N= 17,271). Ordinary linear regression analysis was used. Negative life events decreased the level of SOC among both genders irrespective of the timing of the event. The more recent the life event, the lower the SOC. A strong SOC in 1998 did not protect SOC from declining during follow-up. Specific gender differences were not discovered. SOC was related to negative changes in people's environment. Initially strong SOC was not more stable than initially mediocre or weak SOC. Men and women reacted quite similarly to negative life events.

Work related violence and threats and the risk of depression and stress disorders

OBJECTIVE

To examine the risk of depression and stress related disorders as a function of occupational exposure to violence and threats.

DESIGN

Population based nested case-control study.

SETTING

All gainfully employed Danes. Cases and controls: 14 166 hospital inpatients and outpatients, aged 18-65, treated for affective or stress related disorders during 1995-1998 selected from The Danish Psychiatric Central Research Register and 58 060 controls matched for age, sex, and time, drawn from Statistics Denmark's Integrated Database for Labour Market Research.

MAIN OUTCOME MEASURE

Clinical psychiatric diagnosis (WHO ICD-10) of affective (F30-39) or stress related (F40-48) disorders compared with controls by the occupation held the year before treatment. The occupation held the year before treatment was used as exposure proxy.

RESULTS

Potential exposure to occupational violence is associated with significantly increased relative risks of both disorders in either sex (women: depression RR 1.45 CI 1.27 to 1.65, stress RR 1.32 CI 1.19 to 1.46; men: depression RR 1.48 CI 1.18 to 1.86, stress RR 1.55 CI 1.29 to 1.84). Work related threats are associated with increase in the risk of depression in women (RR 1.48 CI 1.23 to 1.79) and the risk of stress related disorders in men (RR 1.59 CI 1.32 to 1.91). Risks rose with increasing prevalence of violence and threats. The results remain significant and only slightly attenuated after controlling for extent of professional contact with people other than colleagues.

CONCLUSIONS

Employment in occupations involving exposure to work related threats and violence is a risk factor for depression and stress related disorders in both sexes. These findings have implications for health and safety at work policies.

A 5-year follow-up study of aggression at work and psychological health

In a longitudinal cohort study, organizational climate and long-term effects of exposure to nasty teasing (aggression) at work were investigated. The baseline consisted of a representative sample of Danish employees in 1995 with a response rate of 80% (N = 5,652). Of these, 4,647 participated in the follow-up in 2000 (response rate 84%). In 1995, 6.3% were subjected to nasty teasing with no significant gender difference. At baseline, we found significant associations among nasty teasing, a negative organizational climate, and psychological health effects. In the follow-up analyses, associations were found between exposure to nasty teasing at baseline and psychological health problems at follow-up, even when controlled for organizational climate and psychological health at baseline and nasty teasing at follow-up. Stratified for gender, the follow-up associations were significant for women but not for men. Low coworker support and conflicts at baseline and teasing at follow-up mediated the effects on men.