Quality of Life Research

, Volume 18, Issue 5, pp 629–636 | Cite as

Structure of the sense of coherence scale in a nationally representative sample: the Finnish Health 2000 survey

  • Eduardo Bernabé
  • Georgios Tsakos
  • Richard G. Watt
  • Anna L. Suominen-Taipale
  • Antti Uutela
  • Jussi Vahtera
  • Mika Kivimäki



To examine the structure of the sense of coherence (SOC) scale in a general population.


This study analysed the responses of 6,217 subjects aged 30 years and over who participated in the Finnish Health 2000 survey (response rate 77.4%). Participants completed an abbreviated 12-item version of the SOC scale. Two alternative structures were tested using confirmatory factor analysis: a one-factor model, with all scale items loaded onto a single latent factor representing the SOC construct, versus a second-order factor model, with scale items loaded onto their corresponding latent factors representing the three SOC components (comprehensibility, manageability and meaningfulness), which are, in turn, dependent on one single higher-order SOC construct.


The one-factor model was fitted to the data after allowing the errors of comprehensibility item 5 and manageability item 6 to correlate, as was done in previous studies among Finnish adults. The comparative fit index (CFI), Tucker–Lewis index (TLI) and root mean square error of approximation (RMSEA) for the one-factor model were, respectively, 0.97–0.98, 0.96–0.97 and 0.05–0.09 across both sexes and three age groups. The second-order factor model had correlations between latent factors higher than 1, even after alternative model modifications, casting doubts on this more complex structure.


These data suggest that the components of comprehensibility, manageability and meaningfulness should be merged when measuring SOC with the 12-item SOC scale in the Finnish general population.


Sense of coherence Construct validity Confirmatory factor analysis Adults Finland 



Eduardo Bernabé was supported by the Programme Alβan, the European Union Programme of High Level Scholarships for Latin America, Scholarship No. E06D1000352PE. Mika Kivimäki and Jussi Vahtera are supported by the Academy of Finland (projects 117604, 124327 and 124332).


  1. 1.
    Antonovsky, A. (1987). Unraveling the mystery of health: How people manage stress and stay well. California: Jossey-Bass Inc.Google Scholar
  2. 2.
    Antonovsky, A. (1984). The sense of coherence as a determinant of health. In J. D. Matarazzo, S. M. Weiss, J. A. Herd, N. E. Miller (Ed.), Behavioral health: A handbook of health enhancement and disease prevention (pp. 114–129). New York: Wiley.Google Scholar
  3. 3.
    Antonovsky, A. (1993). The structure and properties of the sense of coherence scale. Social Science and Medicine, 36, 725–733. doi: 10.1016/0277-9536(93)90033-Z.PubMedCrossRefGoogle Scholar
  4. 4.
    Eriksson, M., & Lindström, B. (2006). Antonovsky’s sense of coherence scale and the relation with health: A systematic review. Journal of Epidemiology and Community Health, 60, 376–381. doi: 10.1136/jech.2005.041616.PubMedCrossRefGoogle Scholar
  5. 5.
    Wainwright, N. W., Surtees, P. G., Welch, A. A., Luben, R. N., Khaw, K. T., & Bingham, S. A. (2007). Healthy lifestyle choices: Could sense of coherence aid health promotion? Journal of Epidemiology and Community Health, 61, 871–876. doi: 10.1136/jech.2006.056275.PubMedCrossRefGoogle Scholar
  6. 6.
    Eriksson, M., & Lindström, B. (2008). A salutogenic interpretation of the Ottawa Charter. Health Promotion International, 23, 190–199. doi: 10.1093/heapro/dan014.PubMedCrossRefGoogle Scholar
  7. 7.
    Eriksson, M., & Lindström, B. (2005). Validity of Antonovsky’s sense of coherence scale: A systematic review. Journal of Epidemiology and Community Health, 59, 460–466. doi: 10.1136/jech.2003.018085.PubMedCrossRefGoogle Scholar
  8. 8.
    Hittner, J. B. (2007). Factorial invariance of the 13-item sense of coherence scale across gender. Journal of Health Psychology, 12, 273–280. doi: 10.1177/1359105307074256.PubMedCrossRefGoogle Scholar
  9. 9.
    Klepp, O. M., Mastekaasa, A., Sørensen, T., Sandanger, I., & Kleiner, R. (2007). Structure analysis of Antonovsky’s sense of coherence from an epidemiological mental health survey with a brief nine-item sense of coherence scale. International Journal of Methods in Psychiatric Research, 16, 11–22. doi: 10.1002/mpr.197.PubMedCrossRefGoogle Scholar
  10. 10.
    Feldt, T., & Rasku, A. (1998). The structure of Antonovsky’s orientation to life questionnaire. Personality and Individual Differences, 25, 505–516. doi: 10.1016/S0191-8869(98)00077-4.CrossRefGoogle Scholar
  11. 11.
    Feldt, T., Leskinen, E., Kinnunen, U., & Mauno, S. (2000). Longitudinal factor analysis models in the assessment of the stability of sense of coherence. Personality and Individual Differences, 28, 239–257. doi: 10.1016/S0191-8869(99)00094-X.CrossRefGoogle Scholar
  12. 12.
    Gana, K., & Garnier, S. (2001). Latent structure of the sense of coherence scale in a French sample. Personality and Individual Differences, 31, 1079–1090. doi: 10.1016/S0191-8869(00)00205-1.CrossRefGoogle Scholar
  13. 13.
    Feldt, T., Leskinen, E., Kinnunen, U., & Ruoppila, I. (2003). The stability of sense of coherence: Comparing two age groups in a 5-year follow-up study. Personality and Individual Differences, 35, 1151–1165. doi: 10.1016/S0191-8869(02)00325-2.CrossRefGoogle Scholar
  14. 14.
    Feldt, T., Lintula, H., Suominen, S., Koskenvuo, M., Vahtera, J., & Kivimäki, M. (2007). Structural validity and temporal stability of the 13-item sense of coherence scale: Prospective evidence from the population-based HeSSup study. Quality of Life Research, 16, 483–493. doi: 10.1007/s11136-006-9130-z.PubMedCrossRefGoogle Scholar
  15. 15.
    Larsson, G., & Kallenberg, K. (1999). Dimensional analysis of sense of coherence using structural equation modelling. European Journal of Personality, 13, 51–61. doi: 10.1002/(SICI)1099-0984(199901/02)13:1<51::AID-PER321>3.0.CO;2-P.CrossRefGoogle Scholar
  16. 16.
    Richardson, C. G., Ratner, P. A., & Zumbo, B. D. (2007). A test of the age-based measurement invariance and temporal stability of Antonovsky’s sense of coherence scale. Educational and Psychological Measurement, 67, 679–696. doi: 10.1177/0013164406292089.CrossRefGoogle Scholar
  17. 17.
    Aromaa, A., & Koskinen, S. (Eds.). (2004). Health and functional capacity in Finland. Baseline results of the Health 2000 health examination survey. Helsinki: National Public Health Institute. http://www.terveys2000.fi/julkaisut/baseline.pdf
  18. 18.
    Savolainen, J., Knuuttila, M., Suominen-Taipale, L., Martelin, T., Nordblad, A., Niskanen, M., et al. (2004). A strong sense of coherence promotes regular dental attendance in adults. Community Dental Health, 21, 271–276.PubMedGoogle Scholar
  19. 19.
    Savolainen, J., Suominen-Taipale, A. L., Hausen, H., Harju, P., Uutela, A., Martelin, T., et al. (2005). Sense of coherence as a determinant of the oral health-related quality of life: A national study in Finnish adults. European Journal of Oral Sciences, 113, 121–127. doi: 10.1111/j.1600-0722.2005.00201.x.PubMedCrossRefGoogle Scholar
  20. 20.
    Savolainen, J., Suominen-Taipale, A. L., Uutela, A. K., Martelin, T. P., Niskanen, M. C., & Knuuttila, M. L. (2005). Sense of coherence as a determinant of toothbrushing frequency and level of oral hygiene. Journal of Periodontology, 76, 1006–1012. doi: 10.1902/jop.2005.76.6.1006.PubMedCrossRefGoogle Scholar
  21. 21.
    Savolainen, J., Suominen-Taipale, A. L., Uutela, A. U., Aromaa, A., Härkänen, T. & Knuuttila, M. (2008). Sense of coherence associates with oral and general health behaviours. Community Dental Health (in press).Google Scholar
  22. 22.
    Muthén, L. K., & Muthén, B. O. (2007). Mplus. Statistical analysis with latent variables. User’s guide. Los Angeles: Muthén & Muthén.Google Scholar
  23. 23.
    Kline, R. B. (2005). Principles and practice of structural equation modeling. London: The Guilford Press.Google Scholar
  24. 24.
    Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238–246. doi: 10.1037/0033-2909.107.2.238.PubMedCrossRefGoogle Scholar
  25. 25.
    Hu, L.-T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.CrossRefGoogle Scholar
  26. 26.
    Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural models (pp. 131–162). Newbury Park: Sage Publications Inc.Google Scholar
  27. 27.
    Byrne, B. M. (2005). Factor analytic models: Viewing the structure of an assessment instrument from three perspectives. Journal of Personality Assessment, 85, 17–32. doi: 10.1207/s15327752jpa8501_02.PubMedCrossRefGoogle Scholar
  28. 28.
    Ullman, J. B. (2006). Structural equation modeling: Reviewing the basics and moving forward. Journal of Personality Assessment, 87, 35–50. doi: 10.1207/s15327752jpa8701_03.PubMedCrossRefGoogle Scholar
  29. 29.
    Bowling, A. (2005). Mode of questionnaire administration can have serious effects on data quality. Journal of Public Health (Oxford, England), 27, 281–291. doi: 10.1093/pubmed/fdi031.CrossRefGoogle Scholar
  30. 30.
    Streiner, D. L., & Norman, G. R. (2003). Health measurement scales. A practical guide to their development and use. New York: Oxford University Press.Google Scholar
  31. 31.
    Söderhamn, O., & Holmgren, L. (2004). Testing Antonovsky’s sense of coherence (SOC) scale among Swedish physically active older people. Scandinavian Journal of Psychology, 45, 215–221. doi: 10.1111/j.1467-9450.2004.00397.x.PubMedCrossRefGoogle Scholar
  32. 32.
    Kivimäki, M., Feldt, T., Vahtera, J., & Nurmi, J. E. (2000). Sense of coherence and health: Evidence from two cross-lagged longitudinal samples. Social Science and Medicine, 50, 583–597. doi: 10.1016/S0277-9536(99)00326-3.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Eduardo Bernabé
    • 1
  • Georgios Tsakos
    • 1
  • Richard G. Watt
    • 1
  • Anna L. Suominen-Taipale
    • 2
  • Antti Uutela
    • 2
  • Jussi Vahtera
    • 3
  • Mika Kivimäki
    • 1
    • 3
  1. 1.Department of Epidemiology and Public HealthUniversity College LondonLondonUK
  2. 2.National Institute for Health and WelfareHelsinkiFinland
  3. 3.Finnish Institute of Occupational HealthHelsinkiFinland

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