Exploring the Link Between Sense of Coherence, Cognitive Flexibility, and Well-Being in Patients With Schizophrenia: A Cross-Sectional Study

West J Nurs Res. 2026 Mar;48(3):274-281. doi: 10.1177/01939459251400481. Epub 2025 Dec 15.

Abstract

Background: Schizophrenia is a chronic and severe mental health condition that adversely affects individuals' sense of coherence, cognitive flexibility, and overall well-being.

Objectives: This study aimed to examine the association between sense of coherence, cognitive flexibility, and well-being in people with schizophrenia.

Methods: This cross-sectional and correlational study was conducted with 104 patients diagnosed with schizophrenia in a community mental health center in Western Turkey. Data were collected through a personal information form, the Sense of Coherence (SOC) Scale, the Cognitive Flexibility Inventory (CFI), and the Flourishing Scale (FS).

Results: The mean (± SD) scores obtained by participants were 52.8 ± 11.4 for the SOC Scale, 57.0 ± 16.5 for the CFI, and 37.4 ± 11.8 for the FS. Analyses revealed positive and significant correlations between the total scores of the SOC Scale, the CFI, and the FS, as well as their respective subdimensions (P < .05). Moreover, CFI and FS scores accounted for 63% of the variance in SOC scores among patients (adjusted R2 = 0.63; F = 88.43).

Conclusion: Intervention programs that enhance sense of coherence, cognitive flexibility, and well-being should be developed and implemented for individuals with schizophrenia. These findings highlight the role of mental health nurses in implementing psychosocial interventions to increase cognitive flexibility and well-being in people diagnosed with schizophrenia.

Keywords: cognitive flexibility; psychiatric nursing; schizophrenia; sense of coherence; well-being.

MeSH terms

  • Adult
  • Cognition*
  • Cognitive Flexibility
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychometrics / instrumentation
  • Psychometrics / methods
  • Schizophrenia* / complications
  • Schizophrenic Psychology*
  • Sense of Coherence*
  • Surveys and Questionnaires
  • Turkey