Higher sense of coherence is associated with better mental and physical health in emergency medical services: results from investigations on the revised sense of coherence scale (SOC-R) in rescue workers

Figures & data

Table 1. Results of confirmatory factor analyses.

	χ ^2 (df)	p	χ ^2/df	RMSEA	SRMR	CFI
One-factor solution	173.51 (65)	< .001	2.67	.126 [.103, .149]	.113	.591
Original three-factor solution^a	89.88 (62)	.012	1.45	.066 [.032, .095]	.081	.892
Modified three-factor solution^b	122.03 (62)	< .001	1.97	.098 [.072, .124]	.112	.763

RMSEA = robust root mean square error of approximation with a 90% confidence interval, SRMR = standardized root mean square residual, CFI = robust comparative fit index. ^aSee Figure 1 for details; ^bBachem and Maercker (2016) proposed a modified three-factor solution, in which the second and third item were counted to the balance scale instead of the reflection scale.

Table 2. Fornell-Larcker criteria of the preferred three-factor model.

	Model criteria				Interfactor correlations
	CR	AVE	√AVE	MSV	Balance	Reflection	Manageability
Balance	.730	.420^†	.648	.208	−
Reflection	.636^†	.309^†	.556^†	.318^†	.149	−
Manageability	.725	.348^†	.590	.318	.456	.564	−

A composite reliability of CR > .70 indicates a sufficient consistency of items within a factor (latent variable); an average variance extracted of AVE > .50 indicates sufficient convergent factor validity (i.e., more than 50% of the items’ variances converged on their common factor); satisfactory discriminant factor validity is given when the maximum shared variance MSV < AVE and when the square root of AVE is greater than the interfactor correlations (i.e., items within factors converge more on their common factor than on another factors). Values indicated with ^† violate the aforementioned criteria.

Figure 1. Three-factor solution of the Revised Sense of Coherence Scale (SOC-R; Bachem & Maercker, 2016). Values on paths indicate standardised regression coefficients (β) or correlations (r). Italic values on top of the items display the respective proportions of explained item variance, R ²

Table 3. Overview of linear regression predicting symptom severity (N = 102).

	Posttraumatic symptoms (PCL-5 sum score)		Somatic symptoms (PHQ-15 sum score)		Depressive symptoms (PHQ-9 sum score)		Transdiagnostic symptom composite score
Predictors	β (η^2 p )	β (η^2 p )	β (η^2 p )	β (η^2 p )	β (η^2 p )	β (η^2 p )	β (η^2 p )	β (η^2 p )
SOC-R
total score	−.09 (.011)		−.17* (.037)		−.26** (.088)		−.20* (.058)
Manageability		−.31** (.101)		−.36** (.131)		−.44*** (.196)		−.43** (.205)
Reflection		.13 (.021)		.16 (.032)		.06 (.004)		.13 (.027)
Balance		.12 (.019)		.04 (.002)		.09 (.011)		.10 (.015)
Occupational trauma exposure	.22** (.056)	.22** (.066)	.36** (.142)	.38*** (.166)	.27** (.093)	.28** (.109)	.33*** (.135)	.34*** (.165)
Private-life trauma exposure	.40*** (.172)	.39*** (.172)	.23* (.066)	.24** (.072)	.36*** (.157)	.34*** (.155)	.38*** (.180)	.37*** (.191)
Sex^†	.18 (.042)	.21* (.056)	.17 (.037)	.20* (.053)	−.05 (.003)	−.02 (.001)	.12 (.020)	.15 (.036)
Model statistics
R ^2	.269	.338	.260	.312	.401	.339	.350	.401
F(df1,df2)	8.93*** (4,97)	8.07*** (6,95)	8.50*** (4,97)	11.01*** (4,97)	10.61*** (6,95)	8.10*** (6,95)	6.56*** (4,97)	10.61*** (6,95)

* p < .05, ** p < .01, *** p < .001, two-tailed; standardised regression coefficient (β), explained variance (R², η² _p). ^† Positive coefficients indicate more symptoms for women. Detailed results are presented in the Supplementary Tables 3 and 4. All models were 5000 times nonparametrically BCa bootstrapped.

Figure 2. Partial scatter plots displaying the linear regressive associations of the Revised Sense of Coherence Scale (SOC-R; Bachem & Maercker, 2016) total scale with the rescue workers’ (a) post-traumatic symptoms as assessed with the PTSD Checklist for DSM-5 (PCL-5; Krüger-Gottschalk et al., 2017), (c) depressive symptoms as assessed with the Patient Health Questionnaire depression scale (PHQ-9; Löwe et al., 2002), (e) somatic symptoms as assessed with the Patient Health Questionnaire physical symptoms scale (PHQ-15 ; Löwe et al., 2002), and the transdiagnostic symptom composite score (g) as well as the associations of the SOC-R Manageability subscale with (b) post-traumatic symptoms, (d) depressive symptoms, (f) somatic symptoms, and the transdiagnostic symptom composite score (h). Influences of occupational and private-life trauma exposure and sex were considered as covariates. Grey areas indicate 95% confidence intervals.

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Data availability statement

Restrictions apply to the datasets: The datasets for this manuscript are not publicly available because the data may not be passed on or published to third parties outside the research project. The dataset contains sensitive personal and clinical information that might allow identifying individual participants. We do not have the consent of the ethics committee or our participants to grant access to or insight into the collected data.