Sense of coherence and coping strategies: How they influence quality of life in Iranian women with breast cancer.
Hadi Zamanian, Mohammadali Amini-Tehrani, Aliyeh Mahdavi Adeli and 4 others
PMID 33608988WHAT IT FOUND
Higher sense of coherence was associated with better quality of life in Iranian breast cancer outpatients.
Emotional support and positive reframing were more strongly associated with quality of life when coherence was lower, but the study did not test whether raising coherence improves outcomes.
Key findings
01Sense of coherence had a moderate positive association with health-related quality of life (r = .43, p < .001).
02Sense of coherence partially mediated the relationship between coping strategies and quality of life, but planning and acceptance did not show significant indirect effects.
03As sense of coherence increased, the effects of emotional support and positive reframing on quality of life decreased in magnitude and significance level.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design cannot show whether sense of coherence caused better quality of life or vice versa, or whether these relationships change over time. The sample was a convenience sample from three centres in Tehran, and several clinical and psychosocial conditions were excluded, so it may not represent all women with breast cancer. Most participants had less than a diploma, were unemployed, and had lower socioeconomic status, so findings may not apply to more educated or employed patients. The sample was women only, so it does not address men with breast cancer. Two participants lacked coping data and valid N varied from 219 to 221, so some analyses used fewer cases. The study did not test whether interventions aimed at sense of coherence or coping improve quality of life.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that nurses or other clinicians should coach positive reframing and emotional support to improve quality of life. This was a cross-sectional survey of 221 analysed women, not an intervention trial, so it cannot show that changing coping or sense of coherence changes quality of life.