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Sense of coherence and pain experience in older age

Published online by Cambridge University Press:  18 October 2013

Ulrich Wiesmann ,
Jessie Dezutter  and
Hans-Joachim Hannich
Ulrich Wiesmann*
Affiliation:
Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany
Jessie Dezutter
Affiliation:
Research Group Clinical Psychology, University of Leuven, Leuven, Belgium
Hans-Joachim Hannich
Affiliation:
Institute for Medical Psychology, University Medicine Greifswald, Greifswald, Germany
*
Correspondence should be addressed to: Ulrich Wiesmann, Institute for Medical Psychology, University Medicine Greifswald, Walther-Rathenau-Straße 48, D-17475 Greifswald, Germany. Phone: 49-3834-865603; Fax: 49-3834-865605. Email: wiesmann@uni-greifswald.de.
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Abstract

Background:

We investigate to what extent pain in older individuals is predicted by on the one hand chronic morbidity as a resistance deficit, and on the other hand psychological resistance resources and the sense of coherence. For the first time, we tested the salutogenic hypothesis that the sense of coherence mediates the relationship between resources/deficits and pain.

Methods:

In our questionnaire study, we assessed selected psychological resistance resources (self-esteem, generalized self-efficacy, optimism, and social support), the number of self-reported medical diagnoses of chronic illness, the sense of coherence, and pain (SF-36 Bodily Pain subscale) in a sample of 387 older persons (at the mean age of 73.8 years).

Results:

Using hierarchical regression, we found that morbidity and sense of coherence were the only significant predictors of pain, with morbidity showing the strongest effect. Using path analysis, the sense of coherence was a mediator of the relationship between resistance resources/deficits and pain.

Conclusions:

With respect to our analytical model, in which pain experience was the criterion variable, morbidity and the sense of coherence are important predictors of pain. Moreover, we found evidence for the salutogenic idea that the sense of coherence represents a mediator variable as it pools resistance/deficits influences on pain. We recommend a prospective design to explore these assumed causal chains in future research.

Keywords

sense of coherencepainsuccessful agingresilience
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 1 , January 2014 , pp. 123 - 133
Copyright
Copyright © International Psychogeriatric Association 2013 

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References

Antonovsky, A. (1987). Unraveling the Mystery of Health. How People Manage Stress and Stay Well. San Francisco: Jossey-Bass.Google Scholar
Antonovsky, A. (1992). Can attitudes contribute to health? Advances, The Journal of Mind-Body Health, 8, 33–49.Google Scholar
Antonovsky, A. (1996). The salutogenic model as a theory to guide health promotion. Health Promotion International, 11, 11–18.CrossRefGoogle Scholar
Arbuckle, J. L. (2012). Amos 21 Reference Guide. Meadville: Amos Development Corporation.Google Scholar
Baltes, P. B. and Baltes, M. M. (1990). Psychological perspectives on successful aging: the model of selective optimization with compensation. In Baltes, P. B. and Baltes, M. M. (eds.), Successful Aging: Perspectives from the Behavioral Sciences (pp. 1–34). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Bandura, A. (1997). Self-efficacy: The Exercise of Control. New York: Freeman.Google Scholar
Barlow, J. H., Williams, B. and Wright, C. (1996). The Generalized Self-Efficacy Scale in people with arthritis. Arthritis Care and Research, 9, 189–196.3.0.CO;2-#>CrossRefGoogle ScholarPubMed
Barthelsson, C., Nordstrom, G. and Norberg, A. (2011). Sense of coherence and other predictors of pain and health following laparoscopic cholecystectomy. Scandinavian Journal of Caring Sciences, 25, 143–150.CrossRefGoogle ScholarPubMed
Benz, T., Angst, F., Lehmann, S. and Aeschlimann, A. (2013). Association of the sense of coherence with physical and psychosocial health in the rehabilitation of osteoarthritis of the hip and knee: a prospective cohort study. BMC Musculoskeletal Disorders, 14, 159.CrossRefGoogle ScholarPubMed
Bode, C., van der Heij, A., Taal, E. and van de Laar, M. A. F. J. (2010). Body-self unity and self-esteem in patients with rheumatic diseases. Psychology, Health and Medicine, 15, 672–684.CrossRefGoogle ScholarPubMed
Bullinger, M. (1995). German translation and psychometric testing of the SF-36 Health Survey: preliminary results from the IQOLA project. Social Science and Medicine, 41, 1359–1366.CrossRefGoogle ScholarPubMed
Bullinger, M. and Kirchberger, I. (1998). Fragebogen zum Gesundheitszustand (SF-36) [The SF-36 Health Survey]. Göttingen: Hogrefe.Google Scholar
Callahan, L. F. and Pincus, T. (1995). The Sense of Coherence Scale in patients with rheumatoid arthritis. Arthritis Care and Research, 8, 28–35.CrossRefGoogle ScholarPubMed
Cannella, D. T. L., Lobel, M., Glass, P., Lokshina, I. and Graham, J. E. (2007). Factors associated with depressed mood in chronic pain patients: the role of intrapersonal coping resources. The Journal of Pain, 8, 256–262.CrossRefGoogle Scholar
Cederlund, R. I., Ramel, E., Rosberg, H. E. and Dahlin, L. B. (2010). Outcome and clinical changes in patients 3, 6, 12 months after a severe or major hand injury–can sense of coherence be an indicator for rehabilitation focus? BMC Musculoskeletal Disorders, 11, 286.CrossRefGoogle ScholarPubMed
Chamberlain, K., Petrie, K. and Azariah, R. (1992). The role of optimism and sense of coherence in predicting recovery following surgery. Psychology and Health, 7, 301–310.CrossRefGoogle Scholar
Chan, S., Hadjistavropoulos, T., Carleton, R. N. and Hadjistavropoulos, H. (2012). Predicting adjustment to chronic pain in older adults. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 44, 192–199.CrossRefGoogle Scholar
Cheung, G. W. and Lau, R. S. (2008). Testing mediation and suppression effects of latent variables. Bootstrapping with structural equation models. Organizational Research Methods, 11, 296–325.CrossRefGoogle Scholar
Cohen, M. Z., Musgrave, C. F., Munsell, M. F., Mendoza, T. R. and Gips, M. (2005). The cancer pain experience of israeli and american patients 65 years and older. Journal of Pain and Symptom Management, 30, 254–263.CrossRefGoogle ScholarPubMed
Denison, E., Åsenlöf, P. and Lindberg, P. (2004). Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care. Pain, 111, 245–252.CrossRefGoogle ScholarPubMed
Dezutter, J., Robertson, L. A., Luyckx, K. and Hutsebaut, D. (2010). Life satisfaction in chronic pain patients: the stress-buffering role of the centrality of religion. Journal for the Scientific Study of Religion, 49, 507–516.CrossRefGoogle Scholar
Drageset, J., Nygaard, H. A., Eide, G. E., Bondevik, M., Nortvedt, M. W. and Natvig, G. K. (2008). Sense of coherence as a resource in relation to health-related quality of life among mentally intact nursing home residents – a questionnaire study. Health and Quality of Life Outcomes, 6, 85.CrossRefGoogle ScholarPubMed
DuBois, D. L. and Flay, B. R. (2004). The healthy pursuit of self-esteem: comment on and alternative to the Crocker and Park (2004) formulation. Psychological Bulletin, 130, 415–420.CrossRefGoogle Scholar
Ekman, I., Fagerberg, B. and Lundman, B. (2002). Health-related quality of life and sense of coherence among elderly patients with severe chronic heart failure in comparison with healthy controls. Heart and Lung the Journal of Critical Care, 31, 94–101.CrossRefGoogle ScholarPubMed
Eriksson, M. and Lindström, B. (2006). Antonovsky's sense of coherence scale and the relation with health: a systematic review. Journal of Epidemiology and Community Health, 60, 376–381.CrossRefGoogle ScholarPubMed
Eriksson, M. and Lindström, B. (2007). Antonovsky's sense of coherence scale and its relation with quality of life: a systematic review. Journal of Epidemiology and Community Health, 61, 938–944.CrossRefGoogle ScholarPubMed
Evers, A. W. M., Kraaimaat, F. W., Geene, R., Jacobs, J. W. G. and Bijlsma, J. W. J. (2003). Pain coping and social support as predictors of long-term functional disability and pain in early rheumatoid arthritis. Behaviour Research and Therapy, 41, 1295–1310.CrossRefGoogle ScholarPubMed
Ferreira, V. M. and Sherman, A. M. (2007). The relationship of optimism, pain and social support to well-being in older adults with osteoarthritis. Aging and Mental Health, 11, 89–98.CrossRefGoogle ScholarPubMed
Fry, P. S. and Debats, D. L. (2010). Sources of human life-strengths, resilience, and health. In Fry, P. S. and Keyes, C. L. M. (eds.), New Frontiers in Resilient Aging: Life-Strengths and Well-Being in Late Life (pp. 15–59). New York, US: Cambridge University Press.CrossRefGoogle Scholar
Gibson, S. J. and Helme, R. D. (2000). Cognitive factors and the experience of pain and suffering in older persons. Pain, 85, 375–383.CrossRefGoogle ScholarPubMed
Goulia, P., Voulgari, P. V., Tsifetaki, N., Drosos, A. A. and Hyphantis, T. (2010). Comparison of health-related quality of life and associated psychological factors between younger and older patients with established rheumatic disorders. Aging and Mental Health, 14, 819–827.CrossRefGoogle ScholarPubMed
Hävermark, A.-M. and Langius-Eklöf, A. (2006). Long-term follow up of a physical therapy programme for patients with fibromyalgia syndrome. Scandinavian Journal of Caring Sciences, 20, 315–322.CrossRefGoogle ScholarPubMed
Helme, R. D. and Gibson, S. J. (2001). The epidemiology of pain in elderly people. Clinics in Geriatric Medicine, 17, 417–431.CrossRefGoogle ScholarPubMed
Hobfoll, S. E. (1989). Conservation of resources: a new attempt at conceptualizing stress. American Psychologist, 44, 513–524.CrossRefGoogle ScholarPubMed
Keefe, F. J., Rumble, M. E., Scipio, C. D., Giordano, L. A. and Perri, L. M. (2004). Psychological aspects of persistent pain: current state of the science. The Journal of Pain, 5, 195–211.Google ScholarPubMed
Kline, R. B. (2011). Principles and Practice of Structural Equation Modeling. New York, London: The Guilford Press.Google Scholar
Kurtz, M. E., Kurtz, J. C., Given, C. W. and Given, B. A. (2008). Patient optimism and mastery—Do they play a role in cancer patients’ management of pain and fatigue? Journal of Pain and Symptom Management, 36, 1–10.CrossRefGoogle ScholarPubMed
Lee, C. and Owens, R. G. (2002). The Psychology of Men's Health. Buckingham: Open University Press.Google ScholarPubMed
Lillefjell, M. and Jakobsen, K. (2007). Sense of coherence as a predictor of work reentry following multidisciplinary rehabilitation for individuals with chronic musculoskeletal pain. Journal of Occupational Health Psychology, 12, 222–231.CrossRefGoogle ScholarPubMed
Lindström, B. and Eriksson, M. (2005). Salutogenesis. Journal of Epidemiology and Community Health, 59, 440–442.CrossRefGoogle ScholarPubMed
Luger, T., Cotter, K. A. and Sherman, A. M. (2009). It's all in how you view it: pessimism, social relations, and life satisfaction in older adults with osteoarthritis. Aging and Mental Health, 13, 635–647.CrossRefGoogle ScholarPubMed
MacKinnon, D. P., Lockwood, C. M. and Williams, J. (2004). Confidence limits for the indirect effect: distribution of the product and resampling methods. Multivariate Behavioral Research, 39, 99–128.CrossRefGoogle ScholarPubMed
Malmgren Olsson, E. B. and Braenholm, I. B. (2002). A comparison between three physiotherapy approaches with regard to health-related factors in patients with non-specific musculoskeletal disorders. Disability and Rehabilitation: An International Multidisciplinary Journal, 24, 308–317.CrossRefGoogle ScholarPubMed
Maxwell, C. J.et al. (2008). The prevalence and management of current daily pain among older home care clients. Pain, 138, 208–216.CrossRefGoogle ScholarPubMed
Motl, R. W., McAuley, E., Snook, E. M. and Gliottoni, R. C. (2009). Physical activity and quality of life in multiple sclerosis: intermediary roles of disability, fatigue, mood, pain, self-efficacy and social support. Psychology, Health and Medicine, 14, 111–124.CrossRefGoogle ScholarPubMed
Motzer, S. A., Hertig, V., Jarrett, M. and Heitkemper, M. M. (2003). Sense of coherence and quality of life in women with and without irritable bowel syndrome. Nursing Research, 52, 329–337.CrossRefGoogle ScholarPubMed
Nagyova, I., Stewart, R. E., Macejova, Z., van Dijk, J. P. and van den Heuvel, W. J. A. (2005). The impact of pain on psychological well-being in rheumatoid arthritis: the mediating effects of self-esteem and adjustment to disease. Patient Education and Counseling, 58, 55–62.CrossRefGoogle ScholarPubMed
Nilsson, E. and Kristenson, M. (2010). Psychological factors related to physical, social, and mental dimensions of the SF-36: a population-based study of middle-aged women and men. Patient Related Outcome Measures, 1, 153–162.CrossRefGoogle ScholarPubMed
Norusis, M. J. (2011). IBM SPSS Statistics 19 Advanced Statistical Procedures Companion. New Jersey: Prentice Hall.Google Scholar
Preacher, K. J. and Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891.CrossRefGoogle ScholarPubMed
Rosenberg, M. (1965). Society and the Adolescent Self-image. New York: Princeton.CrossRefGoogle Scholar
Rosenberger, P. H., Kerns, R., Jokl, P. and Ickovics, J. R. (2009). Mood and attitude predict pain outcomes following arthroscopic knee surgery. Annals of Behavioral Medicine, 37, 70–76.CrossRefGoogle ScholarPubMed
Savolainen, J.et al. (2005). Sense of coherence as a determinant of the oral health-related quality of life: a national study in Finnish adults. European Journal of Oral Sciences, 113, 121–127.CrossRefGoogle ScholarPubMed
Scheier, M. F. and Carver, C. S. (1985). Optimism, coping, and health: assessment and implications of generalized outcome expectancies. Health Psychology, 4, 219–247.CrossRefGoogle ScholarPubMed
Scheier, M. F. and Carver, C. S. (1992). Effects of optimism on psychological and physical well-being: theoretical overview and empirical update. Cognitive Therapy and Research, 16, 201–228.CrossRefGoogle Scholar
Schrier, M.et al. (2012). Association of fibromyalgia characteristics in patients with non-metastatic breast cancer and the protective role of resilience. Rheumatology International, 32, 3017–3023.CrossRefGoogle ScholarPubMed
Schwarzer, R. (1993). Stress, Angst und Handlungsregulation [Stress, Anxiety and Action Regulation]. Stuttgart: Kohlhammer.Google Scholar
Schwarzer, R. and Jerusalem, M. (1995). Generalized self-efficacy scale. In Weinman, J., Wright, S. and Johnston, M. (eds.), Measures in Health Psychology: A User's Portfolio. Causal and Control Beliefs (pp. 35–37). Windsor, UK: NFER-NELSON.Google Scholar
Shrout, P. E. and Bolger, N. (2002). Mediation in experimental and nonexperimental studies: new procedures and recommendations. Psychological Methods, 7, 422–445.CrossRefGoogle ScholarPubMed
Steinhagen-Thiessen, E. and Borchelt, M. (1999). Morbidity, medication, and functional limitations in very old age. In Baltes, P. B. and Mayer, K. U. (eds.), The Berlin Aging Study: Aging from 70 to 100 (pp. 131–166). Cambridge: Cambridge University Press.Google Scholar
Svebak, S., Sondenaa, K., Hausken, T., Soreide, O., Hammar, A. and Berstad, A. (2000). The significance of personality in pain from gallbladder stones. Scandinavian Journal of Gastroenterology, 35, 759–764.CrossRefGoogle ScholarPubMed
Taylor, S. E. (2007). Social support. In Friedman, H. S. and Silver, R. C. (eds.), Foundations of Health Psychology (pp. 145–171). New York: Oxford University Press.Google Scholar
Taylor, S. E. and Stanton, A. L. (2007). Coping resources, coping processes, and mental health. Annual Review of Clinical Psychology, 3, 377–401.CrossRefGoogle ScholarPubMed
Turner, J. A., Holtzman, S. and Mancl, L. (2007). Mediators, moderators, and predictors of therapeutic change in cognitive–behavioral therapy for chronic pain. Pain, 127, 276–286.CrossRefGoogle ScholarPubMed
Veenstra, M., Moum, T. and Roysamb, E. (2005). Relationships between health domains and sense of coherence: a two-year cross-lagged study in patients with chronic illness. Quality of Life Research, 14, 1455–1465.CrossRefGoogle ScholarPubMed
Weiner, D. K. (2012). Pain in older adults. In Colvin, L. A. and Fallon, M. (eds.), ABC of Pain (pp. 65–68). Oxford: Wiley.Google Scholar
Wiesmann, U. and Hannich, H.-J. (2008). A salutogenic view on well-being in active elderly persons. Aging and Mental Health, 12, 56–65.CrossRefGoogle ScholarPubMed
Wiesmann, U. and Hannich, H.-J. (2010). A salutogenic analysis of healthy aging in active elderly persons. Research on Aging, 32, 349–371.CrossRefGoogle Scholar
Wiesmann, U. and Hannich, H.-J. (2011a). A salutogenic analysis of developmental tasks and ego integrity vs. despair. International Journal of Aging and Human Development, 73, 351–369.CrossRefGoogle ScholarPubMed
Wiesmann, U. and Hannich, H.-J. (2011b). Salutogenic perspectives on health maintenance: the role of resistance resources and meaningfulness. GeroPsych – The Journal of Gerontopsychology and Geriatric Psychiatry, 24 127–135.Google Scholar
Wiesmann, U. and Hannich, H.-J. (2013a). The contribution of resistance resources and sense of coherence to life satisfaction in older age. Journal of Happiness Studies, 14, 911–928.CrossRefGoogle Scholar
Wiesmann, U. and Hannich, H.-J. (2013b). A salutogenic analysis of the well-being paradox in older age. Journal of Happiness Studies, Online First, March 2013.CrossRefGoogle Scholar
Wiesmann, U., Niehörster, G. and Hannich, H.-J. (2009). Subjective health in old age from a salutogenic perspective. British Journal of Health Psychology, 14, 767–787.CrossRefGoogle ScholarPubMed
Wiesmann, U., Rölker, S. and Hannich, H.-J. (2004). Salutogenese im Alter [Salutogenesis in old age]. Zeitschrift für Gerontologie und Geriatrie, 37, 366–376.CrossRefGoogle Scholar
Wong, W. S. and Fielding, R. (2007). Quality of life and pain in Chinese lung cancer patients: is optimism a moderator or mediator? Quality of Life Research, 16, 53–63.CrossRefGoogle ScholarPubMed
Wright, L. J., Zautra, A. J. and Going, S. (2008). Adaptation to early knee osteoarthritis: the role of risk, resilience, and disease severity on pain and physical functioning. Annals of Behavioral Medicine, 36, 70–80.CrossRefGoogle ScholarPubMed
Yonan, C. A. and Wegener, S. T. (2003). Assessment and management of pain in the older adult. Rehabilitation Psychology, 48, 4–13.CrossRefGoogle Scholar