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Determination and Evaluation of Sense of Coherence in Women in Semi-urban Nepal: A part of the Heart-health Associated Research, Dissemination, and Intervention in the Community (HARDIC) Trial

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Abstract

ABSTRACT Background Sense of coherence (SOC) is a core concept of salutogenesis which relates to individuals’ overall life orientation. Stronger SOC associates with better coping strategies, better health, and better quality of life. Although the SOC-questionnaire is validated in many cultures and languages, it has not, to date, been applied in Nepal. Objective To determine and evaluate women’s SOC before and after a health education intervention. Method This study was conducted as a part of the Heart-health Associated Research, Dissemination, and Intervention in the Community in the semi-urban Jhaukhel- Duwakot Health Demographic Surveillance Site in Nepal. Jhaukhel and Duwakot were selected as the control and intervention areas, respectively. Participants were women with children aged 1-7 years. Eight hundred and fifty-seven women before and 1,268 women after the health education intervention participated in the study. The statistical analysis was carried out with chi-square tests and one-way uni-variate ANOVA. Result Women’s total SOC mean values at baseline were 51.1-57.4 and at follow up 54.4-54.9 in the intervention and control area, respectively. At baseline, SOC was significantly weaker in the intervention area compared to the control area (p < 0.001). At follow- up three months later, SOC was significantly stronger in the intervention area than in the control area (p < 0.001). Conclusion Nepalese women had weaker SOC than women in high-income countries, but comparable to neighboring country India with similar cultural features. Empowerment of women through community participation and health education strengthened SOC. The SOC-13-questionnaire in its Nepali version is recommended to be further evaluated. KEY WORDS Health education, Health promotion, Non-communicable disease, Quality of life, Sense of coherence

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Thapa DR,1,2 Oli N,3 Vaidya A,3 Suominen S,4,5 Ekström-Bergström A,1,6 Areskoug Josefsson K,7-9 Krettek A4,10,11 1Department of Nursing and Reproductive, Perinatal and Sexual Health, School of Health Sciences, University of Skövde, Skövde, Sweden 2School of Health and Welfare, Jönköping University, Jönköping, Sweden. 3Department of Community Medicine, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal. 4Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden. 5Department of Public Health, University of Turku, Turku, Finland 6Department of Health Science, University West, Trollhättan, Sweden 7The Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping Sweden 8Department of Behavioural Sciences, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway 9Faculty of Health Sciences, VID Specialized University, Sandnes, Norway 10Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden 11Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway

Keywords

Health education, Health promotion, Non-communicable disease, Quality of life, Sense of coherence

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