Browsing by Subject "sense of coherence"

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  • Konttinen, Hanna (2006)
    Sosiologist Aaron Antonovsky was among the first who was interested in factors that maintain and enhance health instead of risk factors for different diseases. He developed the sense of coherence (SOC) construct, which is the core concept of his salutogenic theory, to explain how some individuals stay healthy despite the numerous stressful situations they encounter during their life. Sense of coherence is a global orientation towards life that characterizes the extent to which an individual appraises his or her internal and external environments as comprehensible, manageable and meaningful. In previous studies, there has been a strong inverse association between the SOC scale and the measures of depressive symptoms and anxiety. This is in accordance with Antonovsky's theory but the size of the correlations raises the question whether the SOC scale measures similar construct to depression and anxiety measures. The aim of this thesis was to investigate what is the relationship of the SOC scale (short form) with the measures of depressive symptoms (Beck Depression Inventory) and anxiety (Spielberger's State Anxiety Scale), and if they are similarly related to health and health behaviours. The participants of the present study were 25 – 74 years old Finnish men (n=2351) and women (n=2291) from the national cardiovascular risk factor survey (FINRISK) conducted in 1997. The SOC scale had strong and inverse correlations with the measures of depression (r=-0.62 among men and women) and anxiety (r=-0.57 among men and r=-0.54 among women). In addition, sense of coherence was similarly associated with health and health behaviours as depressive symptoms (cognitive and affective) and anxiety. These results suggest that the SOC scale overlaps with depression and anxiety measures. Nevertheless, there were also small differences between these measures: education was related only to sense of coherence, and in factor analysis, items of the each scale defined their own factors. The SOC scale was more normally distributed than the measure of depressive symptoms as depression measure did not create variation among those respondents who did not have depressive symptoms. However, the low end of the SOC distribution was more important in the prediction of different health variables than the high end of the SOC distribution. This finding questions the status of sense of coherence (as measured by the SOC scale) as a protective factor for health that is qualitatively different from risk factors. It is concluded that the items of the 13-item SOC scale should be reconstructed to reflect better the SOC construct and be less confounded with negative emotional states. Most important references: Antonovsky, A. (1987). Unraveling the mystery of health: How people manage stress and stay well. San Francisco: Jossey-Bass. Relevant articles from scientific peer reviewed journals.
  • Vähäaho, Niina (Helsingin yliopisto, 2018)
    Background and objectives: Currently in Finland, there are over 66 000 women living with breast cancer. The five-year survival rate is 90.6 %. Breast cancer and its treatments are known to impair patients’ health-related quality of life (HRQoL). The current study is a part of an open prospective randomized Breast cancer and exercise (BREX) -study in Finland conducted to investigate whether supervised exercise training shortly after the adjuvant treatments of breast cancer patients could prevent osteoporosis and improve patient’s quality of life. This master thesis examines cross-sectional and prospective associations between the sense of coherence (SOC) and the HRQoL of breast cancer survivors. Methods: 537 long-term breast cancer survivors and controls who participated in a prospective randomized physical exercise intervention with twelve months of supervised exercise training were followed up five years. 406 participants who finished the 5-year follow-up and filled the SOC questionnaire were included in the final analyzes. The SOC was measured by 13-item Finnish and Swedish short forms of Orientation to life Questionnaire (SOC-13) at 3 years. Cancer-specific HRQoL was measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) version 3 and general HRQoL by the 15D. Associations between the SOC and the HRQoL were studied by logistic regression analyze. Results and conclusion: The SOC was associated with the cancer-specific and the general HRQoL at the 3-year (p < .001) and at the 5-year follow-up (p < .001). The relationship was the most significant for the general HRQoL, global health / quality of life and emotional and cognitive functions. Weak SOC increases the risk of low cancer-specific and low general HRQoL after the adjuvant treatments of breast cancer. Strong SOC as an inner resource may serve as a protective psychological factor in the adaptation process of breast cancer survivors. The SOC-13 questionnaire might be useful in targeting patients vulnerable to decrease in the HRQoL and in planning psychosocial interventions.
  • Jaari, Aini (2000)
    The study is based on a measure of global self-esteem developed by Rosenberg (1965). The aims are (1) to investigate in an adult population the concept of self-esteem as defined by Rosenberg, (2) to develop measures for examining qualitative differences within this global concept, (3) to map out qualitative differences in self-esteem for the sample of adults involved in the study. Antonovsky (1979) provides the theoretical basis for measures to examine qualitative differences. These include a sense of coherence, machiavellism (Mach IV) and the 'Big Five' personality theories. Emerging qualitative factors (personality components) and their interrelationships are examined. Data was collected during 1995 through questionnares administered to course participants representing different work environments (n=368). Gender, age and education were independent variables. In methodological terms the study was quantitative. Results were examined first on the basis of percentages, averages and correlations. The predictors of the global concept of self-esteem were analysed by means of factor analysis and linear regression analysis. Analysis of variance examined whether, in terms of the predictors, there were differences between different professional groups. The following dimensions of coherence emerged: a sense of meaninglessness (a=.77), disappointment in interpersonal relationships (a=.74), anxiety (a=73). The components of machiavellism were: cynicism (a= .73) and honesty/moral respect (a=.65). The dimensions of a sense of competence were: a wish to please (a=.70), competence and success (a= .78) and success at school (a= .74). Other personality factors were: social competence and empathy (a=.78), willingness to experiment (a=.69), social and verbal influence (a=.78), a sense of shame (a=.70), a sense of guilt (a= .69) and conservatism (a= .67). Gender and age did not have an effect on global self-esteem (Rosenberg). However, level of education did. Those with more extensive education seemed to have higher levels of self-esteem. Weak sense of coherence, shame and guilt as predictors of low self-esteem were common to the whole sample. Education and age also contributed to qualitative predictors. Cynicism and disappointment in interpersonal relationships characterised low self-esteem in young men (aged below 31) who had less education. For employed young adults and women with more education, talkativeness, which was associated with low self-esteem, could be explained as a defence and compensatory mechanism. For women, low self-esteem was affected by aspects to do with a sense of life coherence, shame and guilt. Low self-esteem among educated men was explained by aspects of empathy and social competence. While for men success was the most important contributor, for women it was close interpersonal relationships, empathy and social interaction. The results are largely in agreement with the views expressed by Rosenberg, i.e. the importance of social, normative and institutional integration in affecting self-esteem. Rosenberg, M. (1965): Society and adolescent self-image. Rosenberg, M. (1979): Conceiving the self. Antonovsky, A. (1979): Health, stress and coping.
  • Kallio, Tarja (2005)
    In addiction treatment, it is important to develop clients' capacity to cope with high risk situations of substance use. Increase of clients' self-efficacy and sense of coherence and internalization of locus of control, and positive therapeutic alliance are considered important factors in treatment. These factors are, however, not much studied in Finland. This study is based on Social Learning Theory and cognitive-behavioral addiction treatment model. The general aim of the study was to open up new insights into the treatment of substance abusers. The dissertation is based on three studies. The specific aim of the Study 1 is to examine of the connection of drinking related self-efficacy and post-treatment substance use. The aim of the second study (Study II) is to study the connection of psychiatric symptoms, severity of alcohol dependence and use of primary care services. The third study (Study III) focused on the change of prisoners' sense of coherence, the change of prisoners' prison related and drug related locus of control during addiction treatment. The participants of the Study 1 were patients (N=100) of the Järvenpää addiction hospital. They were interviewed with Situational Confidence Questionnaire, General Self-Efficacy Questionnaire and Addiction Dependence Scale (ADS) at the beginning and at the end of cognitive-behavioral treatment. The follow-up information was gathered by mail after 6 and 12 months. The data was analyzed with logistic regression analysis. In the second study, the participants (N=40) were interviewed with ADS and General Health Questionnaire by the researcher in primary health care services, the participants of the third study (N=52) were prisoners in a cognitive-behavioral addiction treatment programme. The participants completed structured questionnaires with Sense of Coherence, Drug and Drinking Related Locus of Control and Prisoner's Locus of Control Scales at the beginning and at the end of treatment. According to the results, patients' drinking related self-efficacy and general self-efficacy improved significantly during addiction treatment, but no connection was found between in-treatment self-efficacy and post-treatment substance abuse. Those with most psychiatric symptoms also showed the most severe alcohol dependence and highest use of primary care services. Both prisoners' sense of coherence and drug related locus of control changed significantly during addiction treatment. There was no change in their prison related locus of control. The results gave new insights to substance abuse treatment, and showed the need of development of continuity of care and co-operation between in-patient and out-patient addiction treatment. The results are discussed from clinical point of view.
  • Jaari, Aini (2004)
    This study aimed to clarify underlying variables of global self-esteem in work-aged Finnish men and women as assessed on a measure developed by M. Rosenberg (1965). The study examined the relationship between self-esteem and (1) sense of coherence (Antonovsky, 1979) and sense of competence, (2) Machiavellism (Mach IV) and (3) personal values assessed through the Portraits measure (Schwartz, 2001) and completed in relation to work and spiritual values. Based on Eagly's (1987) theory of gender role differences, the self-esteem of young adults in further education or at work was compared. The study consisted of two data sets collected through questionnaires: the first in 1995 (n=368), the second in 2001 (n=1283). The central variables were gender, age, education and professional/occupational categories. The sets of data were also examined in relation to salary and type of occupational enterprise including farming. Results showed that neither gender nor age was related to level of self-esteem. However, the more educated the individuals the higher their self-esteem. Low self-esteem was best explained by a low sense of coherence and Machiavellian cynicism. Both can be considered related to weak social integration within society. Cynicism was highest among those men and women aged under 31 years with low levels of education and also those engaged in farming. Young people in further education had more problems with their sense of coherence than those in employment. Well-educated entrepreneurs achieved the highest scores on the self-esteem measure while those engaged in farming had the lowest scores. It seems that a proportion of the farming population perceive themselves deceived and marginalized within the Finnish society which, in turn, contributes to their low self-esteem, cynical attitude and conflicting values. Although this study showed that women were more social and emphatic than men, gender role differences at the workplace had narrowed. For both sexes, roles at the workplace were shaped by society's norms, expectations and demands. A sense of competence and success at the workplace was a very important correlate of self-esteem for both men and women. It can be concluded that work is an important route to social integration in society and work has a positive effect on the individual's sense of self-worth. According to the study, men and especially women at work appear to base their self-esteem on personal competence in the areas of knowledge, skills and social relations and on individual self-enhancement and values. The results of the study are in accordance with the views of Morris Rosenberg. Weak and problematic interpersonal relationships (integration between individuals) and weak institutional and norm-dependent behaviour are typical of persons with low self-esteem.
  • Selinheimo, Sanna; Vasankari, Tuula; Jokela, Markus; Kanervisto, Merja; Pirkola, Sami; Suvisaari, Jaana; Paunio, Tiina (2019)
    Background. We examined the prevalence of self-perceived respiratory symptoms (SRS) in the absence of any objective findings of respiratory pathology, and the association of such prevalence with psychological factors and healthcare use in the general population. Methods. The study was conducted among a nationally representative sample of Finnish adults (BRIF8901). Respiratory functioning was measured by a spirometry test. Structured questionnaires were used to measure SRS, physician visits and psychological factors of alexithymia, sense of coherence, illness worry and common mental disorders. Individuals with a diagnosed respiratory disease or a severe psychiatric disorder, determined in a diagnostic interview, were excluded, giving a sample comprising 4544 participants. Results. Twenty-six per cent of the general population and 36% of those with no diagnosed severe psychiatric disorder or respiratory disease experienced SRS despite a normal spirometry result. Psychological factors were associated with SRS (0.0001 <p <0.032), and on the number of physician visit explaining 42.7% of the difference in visits between individuals with and without SRS, respectively. Illness worry was associated most strongly with SRS [odds ratio (OR) 1.29, 95% confidence interval (CI) 1.19-1.41, p <0.0001] and higher numbers of physician visits (OR 1.35, CI 1.32-1.38, p <0.00001), even after several adjustments. Conclusions. Respiratory symptoms without objective findings are common in the general population. The study results underline the role of psychological factors in the reporting of respiratory symptoms and the associated medical burden, thereby indicating the functional nature of the symptomatology.