Sense of coherence and rehabilitation outcomes: a 3-year longitudinal study

Authors

  • Anne Mette Berget Centre of Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway
  • Øystein Hetlevik Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  • Merethe Hustoft Centre of Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway; Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
  • Jörg Assmus Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
  • Vegard Pihl Moen Centre of Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway; Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway

DOI:

https://doi.org/10.2340/jrm.v58.46229

Keywords:

Functional Rehabilitation, Sense of Coherence, PROMs, Health, physical and mental functioning, Coping resources

Abstract

Objectives: To examine Sense of Coherence over a 3-year period and investigate whether baseline levels and changes in Sense of Coherence are associated with rehabilitation outcomes.

Design: Longitudinal cohort study.

Participants: Patients accepted for specialized rehabilitation (n = 601).

Methods: Sense of Coherence and rehabilitation outcomes, defined by health and functioning were assessed before rehabilitation and after 3 years after using the 13-item Sense of Coherence questionnaire, the EuroQol visual analogue scale, and the Medical Outcomes Study Short Form 36. Sense of Coherence was analysed descriptively, and associations with rehabilitation outcomes were examined using analysis of covariance, adjusted for age, sex, level of education, referral diagnosis, and multimorbidity.

Results: Participants reported lower Sense of Coherence, health, and functioning compared with reference populations. Mean change in Sense of Coherence over 3 years was small at the group level, at 0.7 (SD 9.7) points. Substantial variation was observed in both baseline Sense of Coherence and individual change over time. Both baseline Sense of Coherence and change in Sense of Coherence were independently associated with rehabilitation outcomes, with stronger associations observed for overall health and mental functioning than for physical functioning.

Conclusion: These findings suggest that interventions aimed at strengthening Sense of Coherence may improve rehabilitation outcomes across patient groups.

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Author Biographies

Anne Mette Berget, Centre of Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway

PhD

Øystein Hetlevik, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway

PhD. Professor

Jörg Assmus, Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway

PhD

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Published

2026-09-29

How to Cite

Berget, A. M., Hetlevik, Øystein, Hustoft, M., Assmus, J., & Moen, V. P. (2026). Sense of coherence and rehabilitation outcomes: a 3-year longitudinal study. Journal of Rehabilitation Medicine, 58, jrm46229. https://doi.org/10.2340/jrm.v58.46229

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