Sense of coherence in different stages of health and disease in northern Sweden: Gender and psychosocial differences

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Abstract
Objective - To investigate ?Sense of Coherence? (SOC) and its relation to perceived health, different stages of disease, and different psychosocial factors in a population-based study. Design - Postal survey of a population-based sample, the MONICA study (1994). Setting - Norrbotten and Västerbotten, the two northernmost counties in Sweden, with a total population of 510,000 inhabitants. Subjects - 837 men and 882 women in three mutually-exclusive groups: stomach trouble of many years' standing, identified disease (stroke, cardiac infarction, diabetes, anti-hypertension treatment) and no reported disease. Main outcome measures - SOC scores in relation to sociodemographic variables and perceived health. Results - We found a relationship between low SOC scores and poor perceived health, low social support and low emotional support on a population level. When comparing persons with stomach trouble with those without disease, or with established diseases, we found similar relationships between low mean SOC scores in all strata for both women and men. ?Perceived health?, however, was only significantly correlated for women, and women had an overall stronger relationship. Conclusions - In a study in northern Sweden, female patients with stomach trouble comprise a vulnerable group. The concept of SOC introduces a new dimension for perceiving health and disease. In clinical practice, care providers can identify and elaborate on the relationship between SOC scores and sociodemographic data.