School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Nurs Health Sci. 2024 Sep;26(3):e13151. doi: 10.1111/nhs.13151.
Sense of coherence (SoC) refers to how individuals cope with stress and maintain health, yet its concept remains no consensus about how it is defined and applied in the context of stroke care. This study aims to clarify the concept of SoC by reviewing its applications in various stroke populations and its changes across different stages of stroke. The adapted steps of Rodger's evolutionary approach of concept analysis were used to explore the attributes, surrogate or related terms, antecedents, and consequences of SoC in stroke. Twenty-five articles were included after evaluating 1065 records and 80 full-text articles. The SoC's attributes, characterized with dynamicity of comprehensibility, manageability, and meaningfulness in stroke, lie within the different stroke phases (acute, sub-acute and chronic). There is no surrogate term to SoC. Related terms included coping, resistance resources, resilience, hardiness, and readiness. Antecedents related to stroke survivors and informal caregivers included sociodemographic factors, body functioning factors, social factors, stroke-related factors, and caring factors. Consequences for stroke survivors, informal caregivers, and dyads included psychological status, health behavior, marital satisfaction, care provision, and perception of rehabilitation needs. The findings of the concept analysis of SoC in stroke reveal that this concept extends beyond survivors experienced stroke, and its comprehensive understanding needs considering various aspects including the SoC of informal caregivers, dyads, and family. This paper serves as a novel perspective for future stroke care, focusing on the needs for dynamic monitoring and adaptations to changes of SoC at different stages of stroke care. A proper understanding of SoC can also contribute to developing assessment tools and theoretical models in stroke care with some emphasis on the phases of strokes (attributes), demographic and functional characteristics (antecedents), and both stroke survivor-caregiver-related outcomes sensitive to SoC.
意义感（SoC）是指个体如何应对压力和保持健康，但它的概念在中风护理背景下的定义和应用仍没有达成共识。本研究旨在通过回顾 SoC 在各种中风人群中的应用及其在中风不同阶段的变化来澄清 SoC 的概念。采用罗格进化概念分析方法的改编步骤，探讨了中风中 SoC 的属性、替代或相关术语、前因和后果。在评估了 1065 条记录和 80 篇全文文章后，共纳入了 25 篇文章。SoC 的属性具有中风中可理解性、可管理性和意义的动态性，存在于不同的中风阶段（急性、亚急性和慢性）中。SoC 没有替代术语。相关术语包括应对、抵抗资源、韧性、坚韧和准备就绪。与中风幸存者和非正式照顾者相关的前因包括社会人口因素、身体功能因素、社会因素、中风相关因素和照顾因素。中风幸存者、非正式照顾者和二人组的后果包括心理状态、健康行为、婚姻满意度、照顾提供和对康复需求的感知。中风中 SoC 的概念分析结果表明，这个概念不仅限于经历过中风的幸存者，对其全面理解需要考虑包括非正式照顾者、二人组和家庭在内的各个方面的 SoC。本文为未来的中风护理提供了一个新的视角，侧重于在中风护理的不同阶段动态监测和适应 SoC 的变化的需求。对 SoC 的适当理解也有助于开发中风护理中的评估工具和理论模型，重点关注中风阶段（属性）、人口统计学和功能特征（前因）以及对 SoC 敏感的中风幸存者-照顾者相关结果。
