The significance of a sense of coherence for subjective health in persons with insulin-dependent diabetes.

The strength of an insulin-dependent, diabetic (IDDM) person's sense of coherence (SOC), conceptualized according to Antonovsky's salutogenetic model, was related to patterns of problem-solving and to emotional coping strategies. These personal SOC scores were also related to reported positive experiences, problems in daily life, problems in relation to the environment, worries about long-term complications, tedium and well-being which had been measured 5 years earlier. In the entire IDDM group the mean score for the SOC was 143. There was a significant correlation between the SOC scores and coping patterns (Z--2.053, P < 0.04). The subgroup labelled 'experts' had the highest SOC scores. There were also significant correlations between the SOC scores and problems in relation to the environment (r--0.08, P 0.03), tedium (r--0.69 P 0.01) and well-being (r--0.64, P 0.02). There were no correlations between the SOC scores and metabolic control, reported experiences that the disease had positively influenced the diabetic person's life, problems in daily life, or worries about long-term complications. It was concluded that a sense of coherence seems an important factor which contributes to successful emotional coping with the demands of the disease. As subjective health is an important nursing goal the salutogenic model appears to have potential utility in the care for the person with IDDM.