Sense of coherence and physical health–related quality of life in Italian chronic patients: the mediating role of the mental component

Objective To examine the relationship between sense of coherence (SOC) and physical health–related quality of life in patients with chronic illnesses by focusing on the mediating role of the mental component of quality of life.Design Cross-sectional survey design.Setting Secondary care; three depart...

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Main Authors: Maura Galletta, Manuela Cherchi, Alice Cocco, Giacomo Lai, Valentina Manca, Martina Pau, Federica Tatti, Giorgia Zambon, Simona Deidda, Pierangelo Origa, Elena Massa, Efisio Cossu, Francesco Boi, Paolo Contu
Format: Article
Language:English
Published: BMJ Publishing Group 2019-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/9/e030001.full
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author Maura Galletta
Manuela Cherchi
Alice Cocco
Giacomo Lai
Valentina Manca
Martina Pau
Federica Tatti
Giorgia Zambon
Simona Deidda
Pierangelo Origa
Elena Massa
Efisio Cossu
Francesco Boi
Paolo Contu
author_facet Maura Galletta
Manuela Cherchi
Alice Cocco
Giacomo Lai
Valentina Manca
Martina Pau
Federica Tatti
Giorgia Zambon
Simona Deidda
Pierangelo Origa
Elena Massa
Efisio Cossu
Francesco Boi
Paolo Contu
author_sort Maura Galletta
collection DOAJ
description Objective To examine the relationship between sense of coherence (SOC) and physical health–related quality of life in patients with chronic illnesses by focusing on the mediating role of the mental component of quality of life.Design Cross-sectional survey design.Setting Secondary care; three departments of an Italian university hospital.Methods The participants (n=209) in the study were adult (≥18 years) outpatients with a chronic pathology (eg, diabetes, thyroid disorders or cancer) at any phase in the care trajectory (eg, pre-treatment, undergoing treatment, follow-up care). They agreed to participate in the study after providing their informed consent. Data were collected using a structured self-reporting questionnaire. Data analysis was carried out using SPSS, and mediation analysis was performed via PROCESS macro.Results The SOC score of the study sample was equivalent to that of the general population (mean difference=−2.50, 95% CI −4.57 to 0.00). Correlation analysis showed that SOC was mainly correlated to the mental component (MCS) (r=0.51, p<0.01) of quality of life and then to the physical component (PCS) (r=0.35, p<0.01). Mediation analysis showed that SOC was directly related to MCS (p<0.001, 95% CI 0.62 to 0.99) but not to PCS (p=0.42, 95% CI −0.27 to 0.12). In turn, MCS was directly related to PCS (p<0.001, 95% CI 0.76 to 1.01). The indirect effect of SOC on PCS through MCS was significant (0.71, p<0.001, bootstrap 95% CI 0.54 to 0.91), thus supporting the mediating role of the mental component of quality of life.Conclusion The indirect effect suggests that SOC is a marker of quality of life, especially of the mental component. The findings show that SOC is a psychological process that impacts patients’ mental health status, which in turn affects physical health. Better knowledge of a person’s SOC and how it affects his/her quality of life may help to plan tailoring interventions to strengthen SOC and improve health-related quality of life.
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spelling doaj-art-7fccbe2a262142d2966dc0b08cfd82372025-08-20T02:49:22ZengBMJ Publishing GroupBMJ Open2044-60552019-09-019910.1136/bmjopen-2019-030001Sense of coherence and physical health–related quality of life in Italian chronic patients: the mediating role of the mental componentMaura Galletta0Manuela Cherchi1Alice Cocco2Giacomo Lai3Valentina Manca4Martina Pau5Federica Tatti6Giorgia Zambon7Simona Deidda8Pierangelo Origa9Elena Massa10Efisio Cossu11Francesco Boi12Paolo Contu131 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy2 Department of Surgical Sciences, Colorectal Surgery Unit, University of Cagliari, Cagliari, Italy1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy3 Department of Medical Sciences and Public Health, Medical Oncology Unit, University of Cagliari, Cagliari, Italy4 Department of Medical Sciences and Public Health, Endocrinology and Diabetes Unit, University of Cagliari, Cagliari, Italy5 Department of Medical Sciences and Public Health, Endocrinology Unit, University of Cagliari, Cagliari, Italy1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, ItalyObjective To examine the relationship between sense of coherence (SOC) and physical health–related quality of life in patients with chronic illnesses by focusing on the mediating role of the mental component of quality of life.Design Cross-sectional survey design.Setting Secondary care; three departments of an Italian university hospital.Methods The participants (n=209) in the study were adult (≥18 years) outpatients with a chronic pathology (eg, diabetes, thyroid disorders or cancer) at any phase in the care trajectory (eg, pre-treatment, undergoing treatment, follow-up care). They agreed to participate in the study after providing their informed consent. Data were collected using a structured self-reporting questionnaire. Data analysis was carried out using SPSS, and mediation analysis was performed via PROCESS macro.Results The SOC score of the study sample was equivalent to that of the general population (mean difference=−2.50, 95% CI −4.57 to 0.00). Correlation analysis showed that SOC was mainly correlated to the mental component (MCS) (r=0.51, p<0.01) of quality of life and then to the physical component (PCS) (r=0.35, p<0.01). Mediation analysis showed that SOC was directly related to MCS (p<0.001, 95% CI 0.62 to 0.99) but not to PCS (p=0.42, 95% CI −0.27 to 0.12). In turn, MCS was directly related to PCS (p<0.001, 95% CI 0.76 to 1.01). The indirect effect of SOC on PCS through MCS was significant (0.71, p<0.001, bootstrap 95% CI 0.54 to 0.91), thus supporting the mediating role of the mental component of quality of life.Conclusion The indirect effect suggests that SOC is a marker of quality of life, especially of the mental component. The findings show that SOC is a psychological process that impacts patients’ mental health status, which in turn affects physical health. Better knowledge of a person’s SOC and how it affects his/her quality of life may help to plan tailoring interventions to strengthen SOC and improve health-related quality of life.https://bmjopen.bmj.com/content/9/9/e030001.full
spellingShingle Maura Galletta
Manuela Cherchi
Alice Cocco
Giacomo Lai
Valentina Manca
Martina Pau
Federica Tatti
Giorgia Zambon
Simona Deidda
Pierangelo Origa
Elena Massa
Efisio Cossu
Francesco Boi
Paolo Contu
Sense of coherence and physical health–related quality of life in Italian chronic patients: the mediating role of the mental component
BMJ Open
title Sense of coherence and physical health–related quality of life in Italian chronic patients: the mediating role of the mental component
title_full Sense of coherence and physical health–related quality of life in Italian chronic patients: the mediating role of the mental component
title_fullStr Sense of coherence and physical health–related quality of life in Italian chronic patients: the mediating role of the mental component
title_full_unstemmed Sense of coherence and physical health–related quality of life in Italian chronic patients: the mediating role of the mental component
title_short Sense of coherence and physical health–related quality of life in Italian chronic patients: the mediating role of the mental component
title_sort sense of coherence and physical health related quality of life in italian chronic patients the mediating role of the mental component
url https://bmjopen.bmj.com/content/9/9/e030001.full
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