The promotion of older adults' sense of coherence through person-centered therapy: A randomized controlled pilot study

Abstract

Sense of Coherence (SOC) derived from the salutogenic approach and seems to be a health promoting resource, which strengthens resilience and develops a positive subjective state of health. Older adults' SOC is often challenged by specific issues in later adulthood such as grieving for losses, illness, feelings of worthless and solitude, retirement, disability and death, which require distinctive consideration. To our best knowledge, there are no previous studies that indicated the differences between the relation between a person-centered therapy (PCT)and older adults' SOC. Therefore, this study aimsto explore if a brief eight-session individual PCTintervention on older adults can promote theirSOC, as compared with a control group (waitinglist). Specifically, this is a randomized controlledpilot study designed to explore the promotion ofSOC through an individual-based PCT intervention. We posited that participants randomized toPCT would report improvements in SOC from thepre-to the post-intervention moments whencompared to those on the waiting list.The Orientation to Life Questionnaire (OtLQ)and demographics were assessed at the baseline(t1), post-treatment (t2) and at the 12-monthfollow-up (t3), in a group of 87 participantsbetween 65-86 years (M = 72.4; SD = 5.15), fromcommunity and health centers in the Great Lisbonarea, in Portugal. Participants were mostly women(59.8%), married (65.5%) and professionallyinactive (63.2%). The Cronbach's Alpha coefficients for SOCS were .878, .989, and .988, in thethree moments, respectively.Inclusion criteria determined their eligibility toparticipate in the study. No participant with acompromised cognitive function integrated thesample. All potential participants were given abrief description of the study and gave theirinformed consent. After the baseline assessment,participants were randomly assigned to one of thetwo groups. The eight-session intervention wasconducted in an adequate setting and with aweekly frequency. Comparisons between the threeassessments (t1, t2 and t3) for the two groups weredone using Repeated Measures ANOVA. Post-hocFisher's Least Significant Difference (LSD) testfor mean differences was used to compare thethree assessments for the SOC, in each group(PCT and waiting list).After the intervention, a significant increase of17.3% (M = 3.86, SD = .218) was observed in theparticipants who did the PCT. The SOC evidencedat follow-up (t3) (M = 3.84, SD = .219) by theseparticipants was significantly higher (16.7%) incomparison to the baseline score (M = 3.29,SD = .245). Conversely, participants in the controlgroup experienced a minor decrease betweenbaseline (M = 3.28, SD = .236) and follow-up(M = 3.19, SD =. 244) (-2.7%). The effect size inthe PCT group was high (@2p = .776). Significant intervention group and the control group were found at the post-intervention and follow-up. Findings also showed that partici-pants in PCT experienced an increment in the three dimensions of SOC. The highest increase was observed in the Comprehensibility dimension (71.2%). Manageability and Meaningfulness sub-scales showed an increase of 32.9% and 12.1%, respectively. Changes in SOC were positive and maintained, thus, findings suggest that PCT is favorable to enhancing SOC. In particular, for the participants who did PCT, the significant increase of their SOC was mainly due to the high increase of the comprehensibility of events. This study contribut-ed to filling a gap in gerontological literature and this intervention has the potential to offer a reasonably low-cost self-regulatory approach to the SOC. In this context, PCT is also a personal resource to promote SOC, in late adulthood. More-over, since SOC is associated with health-related well-being among older populations, SOC development in old age should be stressed.