**Giuseppe Michele Masanotti 1,\*, Silvia Paolucci 2, Elia Abbafati 2, Claudio Serratore <sup>2</sup> and Michela Caricato <sup>2</sup>**


Received: 11 February 2020; Accepted: 8 March 2020; Published: 13 March 2020

**Abstract:** *Background*: Nurses experience high levels of distress due to the nature of their work and workplaces; Antonovsky's salutogenic theory shows that individual and work-related factors can influence human health. The aim of this paper is to analyze the possible correlations with different work-related and individual variables, which influence or are influenced by Sense of Coherence (SOC) and verify the possible use of SOC scales to prevent negative health determinants in workplaces. *Methods*: Electronic databases were searched with selected studies compared for sample, sample size, study design and basic results. Cross-sectional studies were reviewed for correlations between individual physical and mental health, distress, burnout, job satisfaction and SOC, with intervention studies used to assess the possible impact of training on nurses' SOC. *Results*: The review found several correlations between SOC and different work-related variables; but also with several individual characteristics. *Conclusion*: The review found that SOC was predictor of depressive state, burnout, job dissatisfaction among female nurses; therefore, SOC could be a health promoting resource.

**Keywords:** nurses; salutogenesis; Antonovsky

#### **1. Introduction**

Nurses are in the front line in the psychologically demanding everyday-care of patients, which can often undermine their emotional balance, influencing both their physical and mental wellbeing [1]. Moreover formal caregivers are frequently burdened with an excessive workload, high working pressure and demands, spending more time at work than on other dimensions of their lives [2,3]. All together these factors may contribute to the creation of a stressful working environment, which requires great coping abilities.

According to the salutogenic theory [4], one of the most critical determinants of the capacity to cope successfully with distress is the Sense of Coherence (SOC), which shapes the individual experience of a stressful event and allows it to be perceived as meaningful, manageable and comprehensible. This can be achieved by mobilizing efficiently the so-called GRRs (generalized resistance resources), which include biological, material and psychosocial factors, triggering a virtuous cycle and in turn strengthening the personal SOC [5]. Similarly, the Conservation of Resources theory (COR) states that the stress can result from circumstances involving loss of valued resources, and that the desire to preserve the individual resources is the basis of the coping ability [6].

Transposing Antonovsky's theory on the working context, the SOC can be modified, in a positive or negative way, by the nature of the current working environment. This re-adaptation explains how "job resources" are an integral part of the GRRs and participate in the modeling of the worker's SOC, which consequently influences how the so-called job demands (hours and pattern of work, workload, relations among the colleagues and every organizational aspects of a job that require continuous physical and/or psychological effort) are perceived, appraised, faced and overcome [5].

The SOC scale, named initially by Antonovsky's "Orientation to Life Questionnaire", investigating the three dimensions of SOC (Meaningfulness, Manageability and Comprehensibility) is available, to date, in two versions: the original form of 29 items (SOC-29) and the shorter version of 13 items (SOC-13). Each item is scored on a 7-point Likert scale, ranging 29–203 and 13–91, respectively, with higher score corresponding to a more developed SOC.

The aim of this paper is to analyze the possible correlations with different work-related and individual variables, which influence or are influenced by SOC and verify the possible use of SOC-29 or SOC-13 to prevent negative health determinants in workplaces.
