title: The impact of a sense of coherence in employees with chronic pain.
abstract: 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.
authors.affiliation: Research Centre for Health Promotion and Resources HiST/NTNU, Department of Occupational Therapy, Faculty of Health Education and Social Work , Sør-Trøndelag University College, Trondheim, Norway Norwegian University of Science and Technology, NTNU, Department of Social Work and Health Science, Trondheim, Norway.
authors.forename: Monica
authors.initials: M
authors.lastname: Lillefjell
authors.affiliation: Research Centre for Health Promotion and Resources HiST/NTNU, Department of Occupational Therapy, Faculty of Health Education and Social Work , Sør-Trøndelag University College, Trondheim, Norway.
authors.forename: Klara
authors.initials: K
authors.lastname: Jakobsen
authors.affiliation: Faculty of Nursing, Sør-Trøndelag University College, Trondheim, Norway.
authors.forename: Linda
authors.initials: L
authors.lastname: Ernstsen
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000150:complications* / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health / Q000592:standards*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D060685:Sense of Coherence
keywords: Occupational disability; coping; multidisciplinary rehabilitation; negative emotions