Sense of Coherence and Quality of Life in Women With and Without Irritable Bowel Syndrome

Nurs Res. Sep-Oct 2003;52(5):329-37. doi: 10.1097/00006199-200309000-00007.


Background: Despite ongoing physical and psychological distress, little is known about sense of coherence (SOC) and holistic quality of life (QOL) in women with irritable bowel syndrome (IBS).

Objectives: The purposes of this study were to (a) describe and compare SOC and holistic QOL of women with and without IBS, and (b) examine the relationships among SOC, holistic QOL, and gastrointestinal (GI) and psychological distress symptoms.

Method: A two-group comparison design was used to test the study hypotheses that women with IBS would have lower SOC and holistic QOL than control women without IBS, and that SOC and holistic QOL would be inversely related to GI and psychological distress. A total of 324 women were studied (n= 235 with IBS, n= 89 controls). Measures included the 13-item SOC Questionnaire, Modified Flanagan QOL Scale, Bowel Disease Questionnaire, and Symptom-Checklist-90-R.

Results: Both SOC and holistic QOL were lower in women with IBS (p <.001). Correlations between SOC and global distress, depression, anxiety, and somatization without GI symptoms were moderately and inversely related (r= -.64, -.64, -.53, and -.31, respectively; p <.001) in the total sample. Relationships between holistic QOL and psychological distress indicators were universally of lower magnitude (r= -.56 to -.27, p <.001). The only GI symptom indicator significantly related to SOC and holistic QOL was alternating constipation and diarrhea (tau= -.21 and -.17, respectively; p <.001).

Discussion: Women with IBS have a reduced SOC and holistic QOL when compared to women without IBS. It remains to be determined whether interventions targeted at enhancing SOC and holistic QOL can impact the psychological distress associated with IBS.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Abdominal Pain / etiology
  • Activities of Daily Living
  • Adaptation, Psychological*
  • Adolescent
  • Adult
  • Anxiety / etiology
  • Attitude to Health*
  • Case-Control Studies
  • Colonic Diseases, Functional / complications
  • Colonic Diseases, Functional / psychology*
  • Depression / etiology
  • Family / psychology
  • Female
  • Health Status
  • Holistic Health
  • Humans
  • Internal-External Control
  • Middle Aged
  • Personal Satisfaction
  • Quality of Life*
  • Severity of Illness Index
  • Sick Role
  • Sickness Impact Profile
  • Somatoform Disorders / etiology
  • Stress, Psychological / etiology
  • Surveys and Questionnaires