Is sense of coherence stable after multiple trauma?

Abstract

Objectives: To explore whether sense of coherence (SOC) is stable over time after multiple trauma. The associations between SOC and satisfaction with life as a whole, as well as aspects of psychological well-being, were explored. Finally, an overriding aim was to assess whether SOC has long-term prognostic value for global life satisfaction or psychological well-being.

Design: Prospective study.

Setting: Sunnaas Rehabilitation Hospital.

Subjects: Twenty-six subjects with severe multiple trauma, without neuropsychological deficits.

Main outcome measures: Questionnaires that were answered at admission, at discharge and at follow-up 1–3 years after trauma were: Sense of Coherence Scale 13 items (SOC-13), satisfaction with life as a whole, General Health Questionnaire 20 items (GHQ-20), Hospital Anxiety and Depression Scale (HAD).

Results: While median SOC scores were fairly stable, individual scores were not stable over time, and for some subjects showed large variations. SOC score had neither long-term prognostic value for satisfaction with life as a whole nor for psychological well-being, at least not in the first years after severe multiple trauma. However, SOC was closely associated with overall life satisfaction when measured simultaneously. Furthermore, a weak SOC correlated with scores on psychological distress, anxiety and depression. SOC scores were also significantly related to being or not being in a state of anxiety, but not to being or not being depressed. Global life satisfaction was considerably reduced from before trauma (reported at admission) to the time of follow-up.

Conclusion: SOC was not stable over time after severe multiple trauma. SOC measured at admission could neither predict future satisfaction with life as a whole nor future psychological well-being. Measured simultaneously, overall life satisfaction and occurrence of anxiety were significantly associated with SOC.