Sense of coherence in stroke: A concept analysis with Rodger's evolutionary approach

Sense of coherence (SoC) refers to how individuals cope with stress and maintain health, yet its concept remains no consensus about how it is defined and applied in the context of stroke care. This study aims to clarify the concept of SoC by reviewing its applications in various stroke populations and its changes across different stages of stroke. The adapted steps of Rodger's evolutionary approach of concept analysis were used to explore the attributes, surrogate or related terms, antecedents, and consequences of SoC in stroke. Twenty-five articles were included after evaluating 1065 records and 80 full-text articles. The SoC's attributes, characterized with dynamicity of comprehensibility, manageability, and meaningfulness in stroke, lie within the different stroke phases (acute, sub-acute and chronic). There is no surrogate term to SoC. Related terms included coping, resistance resources, resilience, hardiness, and readiness. Antecedents related to stroke survivors and informal caregivers included sociodemographic factors, body functioning factors, social factors, stroke-related factors, and caring factors. Consequences for stroke survivors, informal caregivers, and dyads included psychological status, health behavior, marital satisfaction, care provision, and perception of rehabilitation needs. The findings of the concept analysis of SoC in stroke reveal that this concept extends beyond survivors experienced stroke, and its comprehensive understanding needs considering various aspects including the SoC of informal caregivers, dyads, and family. This paper serves as a novel perspective for future stroke care, focusing on the needs for dynamic monitoring and adaptations to changes of SoC at different stages of stroke care. A proper understanding of SoC can also contribute to developing assessment tools and theoretical models in stroke care with some emphasis on the phases of strokes (attributes), demographic and functional characteristics (antecedents), and both stroke survivor-caregiver-related outcomes sensitive to SoC.

Sense of coherence and religion/spirituality: A systematic review and meta-analysis based on a methodical classification of instruments measuring religion/spirituality

The coherence hypothesis assumes that sense of coherence (SOC) explains the positive link between religion/spirituality (R/S) and mental health. The aim of our meta-analysis is to evaluate the evidence for the association between SOC (sensu Antonovsky) and different aspects of R/S and thus to contribute to the verification of the coherence hypothesis. Eighty-nine English- and German-language primarily cross-sectional studies with 67,913 participants met the inclusion criteria. The R/S scales of all included studies were subjected to item-by-item qualitative content analysis in order to determine whether scales do actually measure religion or spirituality and which R/S aspects dominated the instrument. Based on this classification, overall and subgroup meta-analyses were conducted using a random effects model. The adjusted effect size between SOC and all positive R/S measures was r+ = .120, 95% CI [.092, .149]. Particularly significant (r+ < -.180 or > .180) were correlations with negative R/S scales (r+ = -.405, 95% CI [-.476, -.333]), R/S instruments measuring primarily positive emotions (r+ = .212, 95% CI [.170, .253]) or meaning-making (r+ = .196, 95% CI [.126, .265]). Both sample characteristics (age, culture, gender, health status, religious affiliation) and study characteristics (e.g., publication year) had a moderating effect on the R/S-SOC connection. The correlation was particularly high in studies from Southern Asia (r+ = .226, 95% CI [.156, .297]), the African Islamic cultural value zone (r+ = .196, 95% CI [.106, .285]), and in a small subgroup of Iranian studies (r+ = .194, 95% CI [.117, .271]). The results confirm that R/S and SOC are clearly associated and suggest that there are different religious/spiritual pathways to a strong SOC. The strength of the associations presumably depends not only on individual differences, but also on cultural embeddedness and social plausibility of R/S. Trial registration. PROSPERO registration number: CRD42021240380. https://www.crd.york.ac.uk/prospero/display_record.php?ID = CRD42021240380.

Strength of Sense of Coherence among Nurses and the Relationship between Socio-Demographic and Work-Related Factors

Sense of coherence (SOC) occupies the central place within the salutogenic model. It is an important contributor to the development and maintenance of people's health. This study aimed to assess the strength of sense of coherence (SOC) among nurses and the relationship between the strength of SOC and socio-demographic and work-related factors. A cross-sectional study was conducted in 2018. Linear regression was used to describe strength of association between SOC and socio-demographic and work-related factors. A total of 713/1300 nurses completed an SOC-29-item questionnaire for the assessment of SOC. The mean value for total SOC score (SOCS) was 145.0 points (SD 22.1, range 81-200). The results of the multivariate linear regression revealed statistically significant positive associations between SOCS and age (>40 years), level of education (master of nursing and bachelor of nursing), and transportation mode by car. Our study suggested SOC as an important and influential health-promoting personal resource of nurses which might offer protection regarding work-related stress.

Male graduates transitioning into the workplace: managing stress through the sense of coherence components

Male graduates are faced with many challenges when transitioning into work life after graduation. This transition from university to the workplace is one of the most important developmental stages in a young adult's life. It has an important impact on their careers and causes increased stress levels. Often, young men are suffering from mental health challenges and feel as though they cannot seek the appropriate help. Thus, it is necessary to determine how young male graduates cope with the changes experienced in this period, especially relating to their sense of coherence and salutogenesis. The aim of the study is to investigate the transition from university to the workplace and to understand their stress and well-being experiences in terms of activating the three sense of coherence components for coping. A qualitative approach is employed through the use of semi-structured interviews with 10 male South African university graduates. A content analysis technique was used to analyse the qualitative data. The findings indicate that most of the young male graduates understand the transition from university to the workplace and the challenges that come with it (comprehensibility). They also have the necessary personal resources to cope with the stress (manageability) while experiencing this life phase as meaningful (meaningfulness). To understand the transition into the workforce was the most important aspect to stay health during the transition. However, male graduates mainly coped by applying their personal coping strategies and mechanisms and thereby managed their transition mainly by themselves, not based on organizational structures or integrative processes. Meaning applied to the transitional process mainly derived from their personal concepts of creating a meaningful life, not as such from the meaning applied to the work or position they held. The findings provide insights which can be used by higher education institutions to prepare graduates for the transition into the workforce and for organizations to develop programmes for graduates to improve their transition into the organization.

An Observational Study to Assess the Impact of COVID-19 on the Factors Affecting the Mental Well-being of Doctoral Students

The effects of SARS-CoV-2 on mental health far extend its effects on physical well-being. Long before the onset of COVID-19, there have been concerns related to the mental well-being of graduate students, especially doctoral students. This study evaluated the factors associated with the mental well-being of doctoral students since the onset of the pandemic using data collected from early career researchers in the UK in April 2020. The results show that the characteristics of mental well-being associated with social connection, loneliness, and anxiety have remained consistent during the lockdowns. Furthermore, everyday stressors related to lifestyle, finances, and caregiving responsibilities, alongside supervisors and university support, influenced the mental well-being of the doctoral students during the pandemic.

Sense of coherence among Bedouin women in polygamous marriages compared to women in monogamous marriages

We compared sense of coherence (SOC) among Bedouin women in polygamous with those in monogamous marriages. SOC is a global orientation toward life as comprehensible, manageable, and meaningful, and is derived from generalized resistance resources that promote effective coping in stressful life situations. Strong SOC may be a resource for strengthening resilience and promoting health. We administered questionnaires to 464 Indigenous Arab Bedouin women (ages 18-49 years) in 2008-2009 using the 13-item SOC questionnaire. Contrary to our hypothesis, SOC was higher among women in polygamous compared to monogamous marriages. Husband's education, husband's abandonment of the household, living in unrecognized villages, and low mastery (perception of one's ability to control life situations) were associated with higher SOC. These results might suggest that polygamy may provoke new coping mechanisms among women as they reappraise life amidst low mastery, accept cultural norms, and marshal new resources, thereby increasing key elements of SOC, including comprehensibility, manageability, and meaningfulness. Interventions and services seeking to empower women in polygamous marriages should build on their resilience.