Sense of coherence and rehabilitation outcomes: a 3-year longitudinal study.

Abstract

Objectives To examine Sense of Coherence over a 3-year period and investigate whether baseline levels and changes in Sense of Coherence are associated with rehabilitation outcomes. Design Longitudinal cohort study. Participants Patients accepted for specialized rehabilitation (n = 601). Methods Sense of Coherence and rehabilitation outcomes, defined by health and functioning were assessed before rehabilitation and after 3 years after using the 13-item Sense of Coherence questionnaire, the EuroQol visual analogue scale, and the Medical Outcomes Study Short Form 36. Sense of Coherence was analysed descriptively, and associations with rehabilitation outcomes were examined using analysis of covariance, adjusted for age, sex, level of education, referral diagnosis, and multimorbidity. Results Participants reported lower Sense of Coherence, health, and functioning compared with reference populations. Mean change in Sense of Coherence over 3 years was small at the group level, at 0.7 (SD 9.7) points. Substantial variation was observed in both baseline Sense of Coherence and individual change over time. Both baseline Sense of Coherence and change in Sense of Coherence were independently associated with rehabilitation outcomes, with stronger associations observed for overall health and mental functioning than for physical functioning. Conclusion These findings suggest that interventions aimed at strengthening Sense of Coherence may improve rehabilitation outcomes across patient groups.