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The impact of a sense of coherence in employees with chronic pain


BACKGROUND: Although a strong sense of coherence, described as the dimensions of a person's response to a stressful situation, improves the prospects of coping with health problems, more knowledge is required about the association between initial anxiety levels and physical functioning after rehabilitation in relation to individuals' own experiences of their health-resources.

OBJECTIVE: To investigate if the associations between anxiety, pain, and functional health status differ with a strong and weak sense of coherence in employees with chronic musculoskeletal pain in rehabilitation.

METHODS: One thousand six hundred and sixty-five employees (mean age=45.2/SD=9.1) were included in the study. Self-reported sense of coherence (SOC), personal characteristics, anxiety, functional status, and pain were collected at the start (T1) and at the end of the rehabilitation period (12 weeks) (T2). Based on validated cut-off values the employees were divided into strong (> 75) (n=280) and weak (< 57) (n =433) SOC samples.

RESULTS: The strong SOC sample reported lower levels of anxiety (p < 0.001) and higher levels on functional health status (p < 0.001) at T1 and T2, compared to the weak SOC sample. Baseline anxiety predicted low functional health status in the weak SOC sample at T2. Anxiety had less negative consequences for function after rehabilitation in the strong SOC compared to the weak SOC sample.

CONCLUSIONS: The data suggest that appropriate interventions would strengthen the level of SOC in the most vulnerable, as well as resources that encourage SOC.