Sense of coherence and religion/spirituality: A systematic review and meta-analysis based on a methodical classification of instruments measuring religion/spirituality

Abstract

The coherence hypothesis assumes that sense of coherence (SOC) explains the positive link between religion/spirituality (R/S) and mental health. The aim of our meta-analysis is to evaluate the evidence for the association between SOC (sensu Antonovsky) and different aspects of R/S and thus to contribute to the verification of the coherence hypothesis. Eighty-nine English- and German-language primarily cross-sectional studies with 67,913 participants met the inclusion criteria. The R/S scales of all included studies were subjected to item-by-item qualitative content analysis in order to determine whether scales do actually measure religion or spirituality and which R/S aspects dominated the instrument. Based on this classification, overall and subgroup meta-analyses were conducted using a random effects model. The adjusted effect size between SOC and all positive R/S measures was r+ = .120, 95% CI [.092, .149]. Particularly significant (r+ < -.180 or > .180) were correlations with negative R/S scales (r+ = -.405, 95% CI [-.476, -.333]), R/S instruments measuring primarily positive emotions (r+ = .212, 95% CI [.170, .253]) or meaning-making (r+ = .196, 95% CI [.126, .265]). Both sample characteristics (age, culture, gender, health status, religious affiliation) and study characteristics (e.g., publication year) had a moderating effect on the R/S-SOC connection. The correlation was particularly high in studies from Southern Asia (r+ = .226, 95% CI [.156, .297]), the African Islamic cultural value zone (r+ = .196, 95% CI [.106, .285]), and in a small subgroup of Iranian studies (r+ = .194, 95% CI [.117, .271]). The results confirm that R/S and SOC are clearly associated and suggest that there are different religious/spiritual pathways to a strong SOC. The strength of the associations presumably depends not only on individual differences, but also on cultural embeddedness and social plausibility of R/S. Trial registration. PROSPERO registration number: CRD42021240380. https://www.crd.york.ac.uk/prospero/display_record.php?ID = CRD42021240380.

RETRACTED: Structural equation modeling to estimate treatment adherence based on the light triad of personality and sense of coherence in patients with type-2 diabetes: examining the mediating role of psychological well-being

“…The significant correlation between SOC and treatment adherence can be attributed to several underlying factors. First, individuals with a higher SOC tend to possess a stronger internal locus of control and a greater ability to make sense of and cope with various life stressors, including health-related challenges ( da-Silva-Domingues et al, 2022 ; Jeserich et al, 2023 ). This heightened psychological resilience translates into a more positive and proactive approach to managing their health, making them more likely to adhere to treatment plans.…”

Wellness or medicine? Use and perception of Ayurveda in Germany: data from an online-representative cross-sectional study

“…These relationships with a sense of coherence, which is an important indicator of the capacity of resilient coping with difficult situations (such as coping with illness), was stronger the more semantically open and non-institutional the spiritual belief system was. The results support the link between R/S and SOC and point to different religious/spiritual pathways to a strong SOC that are influenced by individual and cultural factors ( 64 ).…”

“…Also, in combination with yoga, Ayurveda has a long tradition in India of mind (−fullness) training, breath work or ethical-philosophical recommendations for everyday life, which also has found a “mainstream-compatible approach” e.g., into fitness- and yoga-studios ( 11 , 68 ). In a systematic review by Jeserich et al on the correlation between religion and spirituality (R/S) and the sense of coherence (SOC), a connection was found between R/S and mental health ( 64 ). Relevant effect sizes were found in relation to the potential resource of spirituality.…”

“…Previous publications explored the role of religion and spirituality in medical contexts, emphasizing that these elements may influence attitudes and choices regarding the use of Ayurvedic healthcare services. Spirituality plays a crucial role in how Ayurveda is perceived, and in India it coexists with modern medicine (63)(64)(65)(66). In a paper of our working group associations were identified between individuals' religious or spiritual affiliations and their choices to either provide or seek access to Ayurveda (67).…”

Utilizing spiritual intelligence and workplace spirituality in creating collective awareness: the U-journey perspective

“…While the present is indeed transcendentally interpreted, the reference system used to describe what has been experienced remains ambiguous (e.g., a higher power or an ethereal energy), may differ, and/or is not based on institutionalized traditions. In contrast, spirituality is characterized by a greater range of individual interpretation and greater ambiguity ( Jeserich et al, 2023 ).…”