Validation of the Slovenian Version of Short Sense of Coherence Questionnaire (SOC-13) in Multiple Sclerosis Patients

The sense of coherence scale: psychometric properties in a representative sample of the Czech adult population

BACKGROUND

Sense of coherence (SOC) is a personal resource that reflects the extent to which one perceives the world as comprehensible, manageable, and meaningful. Decades of empirical research consistently show that SOC is an important protective resource for health and well-being. Despite the extensive use of the 13-item measure of SOC, there remains uncertainty regarding its factorial structure. Additionally, a valid and reliable Czech version of the scale is lacking. Therefore, the present study aims to examine the psychometric properties of the SOC-13 scale in a representative sample of Czech adults.

METHODS

An online survey was completed by 498 Czech adults (18-86 years old) between November 2021 and December 2021. We used confirmatory factor analysis to examine the factorial structure of the scale. Further, we examined the variations in SOC based on age and gender, and we tested the criterion validity of the scale using the short form of the Mental Health Continuum (MHC) scale and the Generalized Anxiety Disorder (GAD) scale as mental health outcomes.

RESULTS

SOC-13 showed an acceptable one- and three-factor fit only with specified residual covariance between items 2 and 3. We tested alternative short versions by systematically removing poorly performing items. The fit significantly improved for all shorter versions with SOC-9 having the best psychometric properties with a clear one-factorialstructure. We found that SOC increases with age and males score higher than females. SOC showed a moderately strong positive correlation with MHC, and a moderately strong negative correlation with GAD. These findings were similar for all tested versions supporting the criterion validity of the SOC scale.

CONCLUSION

Our findings suggest that shortened versions of the SOC-13 scale have better psychometric properties than the original 13-item version in the Czech adult population. Particularly, SOC-9 emerges as a viable alternative, showing comparable reliability and validity as the 13-item version and a clear one-factorial structure in our sample.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Analysis of the psychometric properties of the Sense of Coherence scale (SOC-13) in patients with cardiovascular risk factors: a study of the method effects associated with negatively worded items

Purpose

The objectives of this study were to analyze the psychometric properties of the Sense of Coherence scale (SOC-13), determine the role of the method effect in the performance of the instrument, and identify the relationship with health perception, quality of life, and sleep quality in patients at cardiovascular risk.

Methods

The final sample consisted of 293 patients at cardiovascular risk, with a mean age of 61.9 years (SD = 8.8), 49.8% of whom were women. The SOC-13, the Patient Health Questionnaire (PHQ-9), and the Medical Outcomes Study-Sleep Scale (MOS-Sleep) were administered. In addition, the participant's self-perceived health and quality of life were also evaluated. All analyses were carried out with SPSS 26.0 and EQS 6.1 statistical software.

Results

The results showed adequate reliability for the SOC-13, with a Cronbach's alpha of .789. The fit of the structures was not adequate in any of the cases (.26 to .62 for one factor, .26 to.73 for three factors, .20 to .54 for one second-order factor, and .25, .42, and .54 for three first-order factors). The three structure models showed an improved fit when adding a latent factor resulting from the method effect (.6 to .85 for one factor, .11 to.90 for three factors, and .11 to .96 for one second-order factor). Moreover, positive correlations were found with health perception, perceived quality of life, and perceived sleep quality.

Conclusion

The SOC-13 is a suitable instrument for patients with cardiovascular risk in Spain, and it is also an indicator of health perception, quality of life, and perceived quality of sleep. Control of the method effect improves the fit of the instrument’s structure. As a future direction, it is recommended to conduct new studies in this and other samples and using different versions of the SOC.

Trial registration

International Standard Randomized Controlled Trial Number: ISRCTN76069254, 08/04/2015 retrospectively registered.

Measurement Invariance of the SOC-13 Sense of Coherence Scale Across Gender and Age Groups

Abstract. Sense of coherence (SOC) describes an individual’s ability to deal with life challenges (manageability), comprehend the environment (comprehensibility), and perceive life and its challenges as meaningful (meaningfulness). We examine measurement invariance (MI) of the SOC-13 scale across gender and age groups in a matched sample of N = 1,816 (50% females; age range 16–83 years). A two-factor model, with a common factor for manageability/comprehensibility items and a second factor for meaningfulness items, best represented the SOC-13 in all groups. Full metric, partial scalar, and full strict invariance held across gender groups. Across age groups, full metric, partial scalar, and partial strict invariance could be established. We conclude that SOC-13 is a reliable and valid measure. Measurement is comparable across gender and age.

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.

Psychometric Characteristics of the Croatian and the Serbian Versions of the Oral Health Impact Profile for Edentulous Subjects, with a Pilot Study on the Dimensionality

Introduction

The aim was to adapt the Croatian and the Serbian versions of the Oral Health Impact Profile for the edentulous population (OHIP-EDENT-CRO and OHIP-EDENT-SRB).

Methods

The translation and cross-cultural adaptation were carried out in accordance with accepted international standards. A total of 95 and 177 removable denture wearers were recruited in Croatia and Serbia respectively. The reliability was evaluated by calculating Cronbach’s alpha coefficient and by test-retest (30 participants in each country). The concurrent validity was determined by calculating the Spearman’s rank coefficient between the OHIP-EDENT summary scores and one question related to removable denture satisfaction. Construct validity was determined by exploratory factor analysis (EFA). Responsiveness was determined by comparison of the OHIP-EDENT summary scores before and after dental implant placement to support mandibular overdentures (23 patients in Croatia, 21 in Serbia).

Results

Cronbach’s alpha coefficient was 0.92 in Croatia and 0.87 in Serbia. The intraclass correlation coefficient was 0.98 in Croatia and 0.94 in Serbia. In Croatia the Spearman’s correlation coefficient was -0.71 (p<0.001) and in Serbia -0.74 (p<0.001). Both confirmed concurrent validity. Construct validity was tested by EFA, which extracted four factors in each country, accounting for 66.59% of the variance in Croatia and 59.33% in Serbia. Responsiveness was confirmed in both countries by a significant OHIP-EDENT summary score reduction and a high standardised effect size (3.9 in Croatia, 1.53 in Serbia).

Conclusion

The results prove that both instruments, the OHIP-EDENT-CRO and the OHIP-EDENT-SRB, have very good psychometric properties for assessing OHRQoL in the edentulous population.

Physical Activity, Resilience, Sense of Coherence and Coping in People with Multiple Sclerosis in the Situation Derived from COVID-19

The confinement forced by COVID-19 can have repercussions on the health of people diagnosed with multiple sclerosis. The objective of this study is to analyze the relationships between physical activity, a sense of coherence, resilience and coping among people diagnosed with Multiple Sclerosis during the health emergency situation. To achieve this goal, this transversal descriptive study included 84 patients that belonged to multiple sclerosis associations during the period of confinement. Participants filled out the Physical Activity (IPAQ-SF), Sense of Coherence (SOC-13), Resilience Scale (ER-14) and coping (COPE-28) questionnaires. The results showed that the average age was 46.9 and that 67.9% had Relapsing Remittent Multiple Sclerosis diagnosed on average 13.9 years ago. They had a high degree (33.3%) and moderate degree (34.5%) of physical activity, high levels of resilience, while the level of a sense of coherence was average and the most commonly used strategies for coping were active confrontation and religion. Physical activity was not related to the rest of the studied variables, but there were correlations between the other variables. The people with multiple sclerosis who belong to patient associations have remained physically active during the obligatory confinement period and have elevated degrees of resilience and an average sense of coherence, as well as using suitable coping strategies, which is why the social-health resource of belonging to a patient association could be boosting these variables that are beneficial to their health.

Validation of the Croatian Version of the Sense of Coherence 29-Item Scale in Croatian Nurses

Introduction

The aim of the study was to validate the Croatian version of the Sense of Coherence 29-item instrument (SOC-29) within a nursing population.

Methods

The cross-sectional study was conducted between December 2017 and June 2018 at the University Hospital Centre Sisters of Mercy (UHCSM) in Zagreb, Croatia. A total of 711 nurses participated in this study. Internal consistency reliability was evaluated using Cronbach’s alpha coefficient (α), while the structure of the questionnaire was verified by exploratory factor analysis (EFA) (method of extraction: principal component analysis (PCA)) and confirmatory factor analysis (CFA).

Results

The instrument demonstrated high internal consistency (α=0.885). PCA analysis has identified five factors that together account for 48% of the variance. However, the observed factors could not be interpreted. In the CFA, none of the models fitted well, although the fit of the three-factor model (CMIN/DF=4.786, CFI=0.767, RMSEA=0.073) was slightly better in comparison with the one-factor model (CMIN/DF=6.072, CFI=0.685, RMSEA=0.084). As the three-factor model in PCA has been shown to be uninterpretable, and all three factors were mutually positive and significantly correlated (correlation coefficients: 0.365–0.521), this indicated a single factor in the background. All items also showed saturation with the first factor (accounting for 25.7% of the variance).

Conclusions

The Croatian version of the SOC-29 instrument successfully fulfilled the necessary psychometric criteria for being used on the population of Croatian nurses. The study proposes that potential users use the single-factor structure.

Impact of sense of coherence on quality of life in patients with multiple sclerosis

AIM

Aiming at finding an effective way of empowering patients with multiple sclerosis (MS) to cope with their disease, the objective of the study was to explore the impact of sense of coherence (SOC) on their health-related quality of life (HRQoL).

METHODS

A total of 134/150 eligible MS patients followed-up at the Department of Neurology of the University Medical Centre Maribor, Slovenia, completed a multiple sclerosis quality of life 54 questionnaire (MSQoL-54) for assessment of HRQoL, and SOC-13-item questionnaire for assessment of SOC in 2013. Multiple linear regression was used to analyze the association between the SOC score and mental and physical subscores of MSQoL-54 adjusted to disease-related and sociodemographic characteristics as potential confounders.

RESULTS

In a univariate analysis SOC score proved to be the strongest predictor of mental subscore of MSQoL-54 (b = 0.834; p < 0.001) explaining 35.6% of its variance. When adjusted for confounders, it retained its position as the most important predictor (b = 0.758; p < 0.001). On the other hand, SOC score was a slightly less important predictor of physical subscore of MSQoL-54, being the fourth strongest factor (b = 0.582; p < 0.001) in univariate analysis explaining 19.1% of the variance; however, when adjusted for confounders, its importance slightly increased by becoming the third most important predictor (b = 0.508; p < 0.001).

CONCLUSION

Based on the results of the present study, we can propose SOC as an important and suitable intervention targeted outcome to consider in managing both aspects of MS difficulties.

Association Between Oral Health-Related and Health-Related Quality of Life

OBJECTIVES

To investigate the correlation between the four dimensions of Oral Health-Related Quality of Life (OHRQoL) and Health-Related Quality of Life (HRQoL) constructs in a dental patient population.

METHODS

A cross-sectional study carried out at HealthPartners, Minnesota, USA. This study is a secondary data analysis of available adult dental patients' data. The instruments used to assess the OHRQoL and HRQoL constructs were the Oral Health Impact Profile-version with 49 items (OHIP-49) and Patient-Reported Outcome Measures Information System (PROMIS) measures v.1.1 Global Health instruments Patient Reported Outcome Measures (PROMs), respectively. We used Structural Equation Modeling to determine the correlation between OHRQoL and HRQoL.

RESULTS

Two thousand and seventy-six dental patients participated in the study. OHRQoL and HRQoL scores correlated with 0.56 (95%CI:0.52-0.60). The OHRQoL and Physical Health dimension of HRQoL correlated with 0.55 (95%CI:0.51-0.59). The OHRQoL and Mental Health dimension of HRQoL correlated with 0.51 (95%CI:0.47-0.55). When adjusted for age, gender, and depression, the correlation coefficients changed only slightly and resulted in 0.52 between OHRQoL and HRQoL Physical Health, and 0.47 between OHRQoL and HRQoL Mental Health. Model fit statistics for all analyses were adequate and indicated a good fit.

CONCLUSIONS

OHRQoL and HRQoL overlap greatly. For dental practitioners, the OHRQoL score is informative for their patients' general health status and vice versa. Study results indicate that effective therapeutic interventions by dentists improve patients' OHRQoL as well as HRQoL.