Relationship of sense of coherence to stressful events, coping strategies, health status, and quality of life in women with breast cancer

Authors

  • Elisabeth Kenne Sarenmalm,

    Corresponding author
    1. Research and Development Centre, Skaraborg Hospital, Skövde, Sweden
    2. Institute of Health and Caring Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
    • Johns Hopkins School of Nursing, Baltimore, MD, USA
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  • Maria Browall,

    1. Johns Hopkins School of Nursing, Baltimore, MD, USA
    2. Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
    3. School of Life Sciences, University of Skövde, Skövde, Sweden
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  • L.-O. Persson,

    1. Institute of Health and Caring Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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  • J. Fall-Dickson,

    1. National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
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  • Fanny Gaston-Johansson

    1. Johns Hopkins School of Nursing, Baltimore, MD, USA
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Research and Development Centre, Skaraborg Hospital, SE 541 85 Skövde, Sweden. E-mail: elisabeth.kenne.sarenmalm@vgregion.se

Abstract

Objective

To test the hypothesis that Antonovsky's concept of sense of coherence (SOC) predicts stressful events, coping strategies, health status, and quality of life (QoL) in a cohort of postmenopausal women (n = 131) with newly diagnosed primary or recurrent breast cancer.

Methods

Regression analyses of longitudinal data at baseline through 6 months following breast cancer diagnosis examined the relationships between SOC (13-item version), daily assessment of coping with stressful events, health status, and QoL (EORTC QLQ-30).

Results

The findings support Antonovsky's concept of SOC. Women with strong SOC reported fewer stressful events and more days without stressful events. They used more coping strategies and more frequently used distraction, situation redefinition, direct action, and relaxation, but seldom religion, to cope with stressful events, and reported better health status and QoL. Women with weak SOC experienced more distress and used fewer coping strategies, and they more frequently used coping strategies such as catharsis and seeking social and spiritual support, but seldom acceptance of the situation. They reported worse health status and QoL, regardless of disease stage or treatment. The relationships between SOC and health status and QoL were linear.

Conclusions

Sense of coherence significantly predicts distress, number and type of coping strategies such as direct action and relaxation, health status, and QoL in women with breast cancer. Our data suggest that the SOC scale may be a useful screening tool to identify individuals particularly vulnerable to distress and unable to cope adequately. Assessing SOC strength may assist health care providers to provide individualized patient interventions. Copyright © 2011 John Wiley & Sons, Ltd.

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