Artikel: Sense of coherence is a predictor of survival: A prospective study in women treated for breast cancer (2018)

Objective: Sense of coherence (SOC) reflects a person's overall orientation to life. Sense of coherence guides the person in finding and utilizing resources to maintain
health and manage stress. Previously, we demonstrated SOC's stability over time among breast cancer (BC) patients, and in the present article, SOC's predictive value
for survival is tested.

Methods: A cohort of 487 women underwent surgery for invasive BC and completed preoperatively the SOC‐13 within a multicenter trial. Hazard ratios (HRs) were
performed to identify significant independent predictors and their association with increase in SOC.

Results: Over a median follow‐up time of 10 years, patients with a higher SOC had 63% lower risk of BC progression (HR 0.63; 95% CI, 0.11 to 0.85, P.03), 80% lower risk
of BC mortality (HR 0.80; 95% CI, 0.38 to 0.96, P .00), and 80% lower risk of all‐cause mortality (HR 0.80; 95% CI, 0.47 to 0.93, P .00) than patients with a lower SOC. The
mortality risk declined by 2.3% for every 1‐unit increase in SOC, both for BC mortality (HR 0.98; 95% CI, 0.96 to 0.99, P .01) and for all‐cause mortality (HR 0.98; 95% CI,
0.96 to 0.99, P .00). The risk of progression declined by 1.4% for every 1‐unit increase in SOC (HR 0.99; 95% CI, 0.97 to 1.00, P .03).

Conclusions: This study provides evidence of SOC's predictive value for disease progression and BC‐caused and all‐cause mortality. Sense of coherence provides a
complement when designing individual plans that aims to support patients during their treatment.