Liu Yaqian, Zhang Bohan, Montayre Jed, Koduah Adwoa Owusuaa, Leung Angela Y M
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.
J Adv Nurs. 2025 Apr;81(4):2165-2198. doi: 10.1111/jan.16558. Epub 2025 Jan 3.
Sense of coherence (SoC) is a core concept of 'salutogenesis' in positive psychology, correlated with emotional distress and disease development in adults with chronic disease and older adults. A diversity of non-pharmacological interventions (NPIs) has been developed to enhance SoC, but research findings are conflicting and the adequacy of sample sizes is uncertainty.
This paper aimed to explore appropriate interventions, evaluate the effectiveness of these SoC interventions and verify the statistical robustness and reliability of pooled results.
Search terms including 'sense of coherence' and 'randomised controlled trial (RCT)' were performed in nine electronic databases. Publications were written in English from January 1979 to February 2024. A narrative synthesis was performed to determine intervention details, and classical meta-analysis was used to analyse available data on SoC using RevMan. Besides, trial sequential analysis (TSA) was conducted to verify the robustness of pooled effect size.
Meta-analysis was carried out with 27 RCTs involving 2178 patients. It showed significant effects on SoC compared to usual care among this population for all NPIs at post-intervention and 3-month follow-up. Of these follow-up durations, the effective NPIs were salutogenic-based intervention, self-management intervention, while no significant difference was observed at 6-month or > 6-month follow-up. TSA showed that the significant finding of meta-analysis in salutogenic-based intervention was stable and reliable, while the pooled sample size on self-management intervention was insufficient.
Non-pharmacological (salutogenic-based) interventions could improve SoC among older adults and adults with chronic conditions within 3 months after-intervention. However, its effects were not sustained over a longer period, which further studies will need larger sample sizes to draw definitive conclusions.
This meta-analysis provided the evidence that salutogenic-based interventions could improve SoC among the target population within 3 months after-intervention, providing a solid foundation for healthcare professionals to base their therapeutic strategies.
The searching results were reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis checklist.
This study is a systematic review with meta-analysis and trial sequential analysis, and the aforementioned details are not applicable to our research.
PROSPERO: CRD42023401215.
连贯感（SoC）是积极心理学中“健康生成学”的核心概念，与患有慢性病的成年人和老年人的情绪困扰及疾病发展相关。已开发出多种非药物干预措施（NPIs）来增强连贯感，但研究结果相互矛盾，且样本量是否充足尚不确定。
本文旨在探索合适的干预措施，评估这些增强连贯感干预措施的有效性，并验证汇总结果的统计稳健性和可靠性。
在九个电子数据库中检索了包括“连贯感”和“随机对照试验（RCT）”在内的检索词。纳入1979年1月至2024年2月期间发表的英文文献。进行叙述性综合分析以确定干预细节，并使用RevMan软件对关于连贯感的现有数据进行经典荟萃分析。此外，进行试验序贯分析（TSA）以验证汇总效应量的稳健性。
对27项随机对照试验（涉及2178名患者）进行了荟萃分析。结果显示，在干预后及3个月随访时，与常规护理相比，所有非药物干预措施对该人群的连贯感均有显著影响。在这些随访期间，有效的非药物干预措施是基于健康生成学的干预和自我管理干预，而在6个月或>6个月随访时未观察到显著差异。试验序贯分析表明，基于健康生成学的干预措施的荟萃分析显著结果稳定可靠，而自我管理干预措施的汇总样本量不足。
非药物（基于健康生成学）干预措施可在干预后3个月内改善老年人和慢性病成年人的连贯感。然而，其效果在较长时间内无法持续，进一步的研究需要更大的样本量才能得出明确结论。
这项荟萃分析提供了证据，表明基于健康生成学的干预措施可在干预后3个月内改善目标人群的连贯感，为医疗保健专业人员制定治疗策略提供了坚实基础。
检索结果按照系统评价和荟萃分析的首选报告项目清单进行报告。
本研究是一项包含荟萃分析和试验序贯分析的系统评价，上述细节不适用于我们的研究。
国际前瞻性系统评价注册库（PROSPERO）：CRD42023401215。
