Sense of Coherence is a Predictor of Survival: A Prospective Study in Women Treated for Breast Cancer

Abstract

Objective

Sense of coherence (SOC) reflects a person´s overall orientation to life. SOC 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 (HR) were performed to identify significant independent predictors and their association with increase in SOC.

Results

Over a median follow-up time of ten years, patients with a higher SOC had 63% lower risk of BC progression (HR 0.63; 95% Cl, 0.11 to 0.85, p 0.03), 80% lower risk of BC mortality (HR 0.80; 95% Cl, 0.38 to 0.96, p 0.00) and 80% lower risk of all-cause mortality (HR 0.80; 95% Cl, 0.47 to 0.93, p 0.00) than patients with a lower SOC. The mortality risk declined by 2.3% for every one-unit increase in SOC, both for BC mortality (HR 0.98; 95% CI, 0.96 to 0.99, p 0.01) and for all-cause mortality (HR 0.98; 95% CI, 0.96 to 0.99, p 0.00). The risk of progression declined by 1.4% for every one-unit increase in SOC (HR 0.99; 95% CI, 0.97 to 1.00, p 0.03).

Conclusions

This study provides evidence of SOC´s predictive value for disease progression, BC caused and all-cause mortality. SOC provides a complement when designing individual plans that aims to support patients during their treatment.

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