The impact of social support and sense of coherence on health-related quality of life among nursing home residents-A questionnaire survey in Bergen, Norway

Background and objectives: Few studies have examined the association between social Support and health-related quality of life (HRQOL) among nursing home residents and whether the sense of coherence (SOC) modifies the effect of social support on health-related quality of life. The main aims of this study were to determine the relationship between social support and HRQOL and to investigate whether the SOC modifies the effect of social support on HRQOL. Design: A cross-sectional, descriptive, correlational design. Settings: All 30 nursing homes in Bergen in western Norway. Participants: Two hundred and twenty-seven mentally intact long-term nursing home residents 65 years and older. Methods: Data were obtained through face-to-face interviews using the SF-36 Health Survey, Social Provisions Scale and Sense of Coherence Scale. Possible relationships between the Social Provisions Scale and the eight SF-36 subdimensions were analysed using multiple linear regression while controlling for age, sex, marital status, education and comorbid illness. Interactions between the Sense of Coherence Scale and Social Provisions Scale were investigated. Results: Attachment affected the mental health subdimension (p = 0.001), opportunity for nurturance affected social functioning (p = 0.003) and reassurance of worth affected vitality (P = 0.001) after adjustment for demographic variables and comorbid illness. After the analysis included the sense of coherence, nurturance still significantly affected social functioning and reassurance of worth still significantly affected vitality. No interaction with sense of coherence was found, and sense of coherence significantly affected all SF-36 subdimensions. Conclusions: The opportunity to provide nurturance for others appears to be important for social functioning, and sense of competence and sense of self-esteem appear to be important for vitality. Further, the residents' relationships with significant others comprise an important component of mental health. Finally, independent of the level of sense of coherence, social support is an important resource for better health-related quality of life. Clinical nurses should recognize that social support is associated with health-related quality of life and pay attention to the importance of social support for the residents in daily practice. (C) 2008 Elsevier Ltd. All rights reserved.