Sense of coherence in Crete and Sweden: key findings and messages from a comparative study.

BACKGROUND/OBJECTIVE The concept of ''sense of coherence'' (SOC) was introduced in 1987 by Aaron Antonovsky to describe a dispositional orientation, ''a way of seeing the world'', which is presumed to enhance health. This study reports on the results of the first implementation of SOC in rural Crete and discusses the findings, with a view to the potential impact on primary care delivery in rural Crete. METHODS This study forms part of a follow-up project initially established in 1988 in the rural area of Spili, Crete. All participants of the initial study still living in the area (n = 248) were eligible. Data were obtained from 200 subjects (91 males and 109 females) aged 28-92 years, resulting in a second-phase participation rate of 80.7%. The SOC scales (both the SOC-29 and SOC-13 forms) were recorded for 175 (87.1%) of the participants. RESULTS Comparing the SOC scores among Cretan males and females, there is a statistically significant difference (p < 0.0001), with men reporting a higher sense of coherence than women, regardless of the form of the questionnaire used. Cretan women seem to score significantly lower than their Swedish counterparts (p < 0.0001), while Cretan men tend to report a higher SOC compared to their matched Swedish reference population (p = 0.07). DISCUSSION The study introduces other issues worthy of additional research, particularly with regard to the significantly lower SOC scores obtained by Cretan women, compared to Cretan men. These low SOC scores raise the issue of a potential increase of psychiatric morbidity in the area, leading to a high impact on primary care services. Future investigation into the health impact of SOC factors could be of value to primary care physicians located in rural Crete.