title: Morbid obese adults increased their sense of coherence 1 year after a patient education course: a longitudinal study.
abstract: BACKGROUND
  Personal factors are key elements to understand peoples' health behavior. Studies of such factors are important to develop targeted interventions to improve health. The main purpose of this study is to explore sense of coherence (SOC) in a sample of persons with morbid obesity before and after attending a patient education course and to explore the association between SOC and sociodemographic and other personal factors.
  
  
  METHODS
  In this longitudinal purposely sampled study, the participants completed questionnaires on the first day of the course and 12 months after course completion. Sixty-eight participants had valid scores on the selected variables at follow-up: SOC, self-esteem, and self-efficacy. Relationships were assessed with correlation analyses and paired and independent samples t-tests and predictors with linear regression analyses.
  
  
  RESULTS
  From baseline to follow-up, the total SOC score and the subdimension scores comprehensibility, manageability, and meaningfulness all increased significantly. At both time points, the SOC scores were low compared to the general population but similar to scores in other chronically ill. At baseline, a multivariate analysis showed that older age, having paid work, and higher self-esteem were directly related to higher total SOC score after controlling for other sociodemographic factors and the participants' level of self-efficacy. Multivariate analyses of the relationship between baseline predictors of SOC at 12-month follow-up, controlling for baseline SOC scores or sociodemographic or personal factors, revealed that none of these variables independently predicted SOC scores at follow-up.
  
  
  CONCLUSIONS
  The total SOC score and its subdimensions increased significantly at follow-up. SOC may be a useful outcome measure for lifestyle interventions in people with morbid obesity and possibly other health care problems. Subdimension scores may give an indication of what is poorly developed and needs strengthening. This might guide choices for targeted cognitive and psychosocial interventions. Further studies are needed to explore this issue with larger samples.
authors.affiliation: Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway.
authors.forename: May Solveig
authors.initials: MS
authors.lastname: Fagermoen
authors.affiliation: GAH Consulting, Boston, MA, USA.
authors.forename: Glenys
authors.initials: G
authors.lastname: Hamilton
authors.affiliation: Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway ; Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway.
authors.forename: Anners
authors.initials: A
authors.lastname: Lerdal
keywords: health behavior; health promotion; obesity; self-efficacy; self-esteem
references.citation: J Epidemiol Community Health. 2010 Apr;64(4):347-52
references.pmid: 19692734
references.citation: Patient Educ Couns. 2006 Aug;62(2):212-9
references.pmid: 16242903
references.citation: J Adv Nurs. 2000 Jun;31(6):1383-92
references.pmid: 10849150
references.citation: Mol Cell Endocrinol. 2010 Mar 25;316(2):104-8
references.pmid: 19628019
references.citation: J Epidemiol Community Health. 2005 Jun;59(6):460-6
references.pmid: 15911640
references.citation: BMC Public Health. 2011 Sep 19;11:708
references.pmid: 21929805
references.citation: Arch Psychiatr Nurs. 2009 Apr;23(2):119-27
references.pmid: 19327554
references.citation: Obes Surg. 2010 Feb;20(2):161-7
references.pmid: 18958537
references.citation: Psychol Bull. 1992 Jul;112(1):155-9
references.pmid: 19565683
references.citation: J Epidemiol Community Health. 2006 May;60(5):376-81
references.pmid: 16614325
references.citation: Eur J Cardiovasc Nurs. 2014 Aug;13(4):345-56
references.pmid: 23828020
references.citation: J Occup Health Psychol. 2007 Jul;12(3):222-31
references.pmid: 17638489
references.citation: Med Care. 2003 Apr;41(4):490-9
references.pmid: 12665713
references.citation: Qual Life Res. 2005 Aug;14(6):1455-65
references.pmid: 16110926
references.citation: Complement Ther Clin Pract. 2008 Feb;14(1):8-16
references.pmid: 18243937
references.citation: Soc Sci Med. 1993 Mar;36(6):725-33
references.pmid: 8480217
references.citation: Qual Life Res. 2011 Oct;20(8):1187-96
references.pmid: 21336658
references.citation: J Clin Nurs. 2010 Jun;19(11-12):1519-28
references.pmid: 20384660
references.citation: BMJ. 2008 Feb 2;336(7638):245
references.pmid: 18244993
references.citation: J Epidemiol Community Health. 2007 Nov;61(11):938-44
references.pmid: 17933950
references.citation: Scand J Public Health. 2010 Feb;38(1):1-8
references.pmid: 19843629
references.citation: Heart Lung. 2009 Mar-Apr;38(2):129-40
references.pmid: 19254631
references.citation: Psychosom Med. 2004 Sep-Oct;66(5):776-82
references.pmid: 15385706
references.citation: BMC Psychol. 2013 Jun 21;1(1):11
references.pmid: 25566363