Yearbook on Journal of the Japan Society of Nursing Research 2013

The Reinforcement of Local Residents’ Sense of Coherence: A Longitudinal Study
Sayuri Tanaka 1), Taeko Masumoto 1), Setsuko Horii 2),
Miwa Mitsuhashi 2), Atsuko Tokushige 1), Megumi Fukumoto 3)
Key Words :sense of coherence
local residents
strengthening
longitudinal study

ABSTRACT
We conducted a longitudinal study by distributing self-administered questionnaires in 2003 and 2005 to
3,000 local residents aged 20 years or older, with the aim of clarifying factors affecting the developmentof Sense of Coherence (SOC). A total of 360 subjects who completed the questionnaires were analyzed.
The change in SOC was determined using the Japanese version of the 13-item SOC scale. To examine theassociation of “the change in SOC” with “gender”, “age”, “educational achievement”, “annual householdincome”, “social interaction”, “social support”, “early childhood experiences”, “adolescent experiences”,“financial status up to the age of 20”, “stressful life events”, and “successful tension management”, thePearson’s product-moment correlation coefficient was calculated, and a multiple regression analysis was
conducted using items for which a correlation was found. As the results, the “financial status up to the ageof 20” and “successful tension management” were extracted as factors related to the development of SOC.
A good financial status up to the age of 20 affected the development of a weak SOC, and successful tension
management affected the development of a strong SOC.

I. Introductionsocial health status and QOL, and the age, work, family status,
and annual household income are factors associated with SOC.
Based on these results, we investigated how an individual’s
SOC is improved and reinforced. Thus, we conducted alongitudinal study involving local residents aged 20 years orolder using the SOC-13 scale, with the aim of clarifying factors
affecting the development of a strong SOC. Since few studies
have focused on local residents’ SOC, this study serves as basic
data to maintain and promote health, and contributes to theaccumulation of empirical studies on SOC.

Stress is inevitable for most of us living in modern society.
However, there are some people who cope well and manage
stress while others break down. As the most fundamental
factor causing this difference, sense of coherence (SOC),
which is a concept regarding one’s ability to maintain health,is considered1). The SOC concept was put forward by the
Israeli sociologist Antonovsk to answer the question of how
some people manage to maintain health.
SOC can be measured by the SOC scale2). By around 2005,
approximately 500 empirical studies had been published in
the world. The SOC scale measures an individual’s internal
strength to cope with difficulties in life3). There are two typesof study on SOC: one examines health effects based on the SOC
levels, and the other examines how the environment affects
these levels2).
In Japan, after the introduction of the concept of SOC
by Oda4) in 1996, SOC research was developed mainly by
Yamazaki et al5.6). Recent SOC studies involved pregnant
and breastfeeding women7), working people8), patients9),and visiting nurses10) to examine the relationships of SOC
with stressful events, such as childbirth, work, and illness,and psychological aspects, such as a sense of burden andsatisfaction. Despite such challenges, there are still insufficient
data on how effective SOC is, whether an individual’s SOC
changes, and how the buffering effect differs according todependent variables.
Masumoto3) conducted an empirical study to investigate
the physical, psychological, and social health status and the
QOL of subjects aged 20 years or older using the Japaneseversion of the 13-item SOC scale (SOC-13)11), in order to apply
the concept of SOC in local nursing activities. As the results,
relationships of SOC with the psychological/social healthstatus and the QOL were identified. Her study also revealed
that a strong SOC contributes to enhance the psychological/

II. Methods

A longitudinal study approach which consisted ofquestionnaire surveys.
1. Conceptual framework

Figure 1 shows the conceptual framework of this study,
which was developed based on Antonovsky’s salutogenic
model partly modified by Yamazaki12). The salutogenic model
is composed of two main conceptual models: 1) A strong SOC
enables people to successfully manage tension; 2) SOC isshaped by positive life experiences, reinforced by successful
tension management, and influenced by generalized
resistance resources (GRRs) that affect its formation anddevelopment1). Our conceptual framework is based on thelatter model. Successful tension management is a positive
experience of overcoming one’s stressful life events.
To identify factors affecting the development of a strong
SOC, we evaluated the changes in SOC scores based on two
surveys, and investigated stressful life events and theirsuccessful tension management. We also investigated
the relationship between life experiences that shape SOC
and GRRs that affect the formation and development of
SOC. According to Antonovsky, GRRs can be classified into
psychosocial, genetic, and constitutional aspects. Material,knowledge/intelligence, social support/ties, cultural stability,
and religion were presented as psychosocial GRRs2). In
this study, we investigated educational achievements asknowledge/intelligence, the annual household income asmaterial, and social support as social ties.

1) School of Nursing Science, Meiji University of Integrative Medicine,
Kyoto, Japan
2) School of Nursing, Kyoto Prefectural University of Medicine
3) Former School of Nursing, Kyoto Prefectural University of Medicine

Corresponding author. Tel.: +81 771 72 1181; Fax: +81 771 72 0326.
E-mail address: sayutana@meiji-u.ac.jp (S. Tanaka)

75
This paper was published at “the Japan Society of Nursing Research” Vol.33 No.5 in 2010.

Yearbook on Journal of the Japan Society of Nursing Research 2013
Generalized resistance resources(GRRs) that affect the formationand development of SOC

Developed SOC

Development
Life experience

Undeveloped SOC

Educational achievement

Early childhood experiences

Annual household income

Adolescent experiences

Social interaction

Financial status up to the age of 20

Reinforcement

Stressful life events

Successful tension management

Social support

Figure 1. Conceptual framework of this study¥6,000,000-8,000,000, ¥8,000,000-10,000,000, ¥10,000,00013,000,000, ¥13,000,000-16,000,000, and ¥16,000,000 orover), family status (single elderly household, single nonelderly household, elderly married couple, non-elderly
married couple, elderly person(s) and non-elderly married
couple, married couple with unmarried children at home,married couple and parents, married couple with unmarried
children and parents at home, and single parent household).
The elderly are those aged 65 and older.

2. Subjects and Methods

One administrative region was selected from each ofnorthern, middle, and southern parts of City A, and a total of
3,000 people aged 20 years or older were randomly selectedfrom among the list of registered voters by obtaining support
from a commission on election administration. To selectsubjects, we followed predetermined procedures based on
regulations on access to the list of registered voters.
Prior to conducting surveys, we first sent a letter informing
them of the study purpose, methods, and privacy protection,and sought consent with the return of a stamped selfaddressed postcard. Self-administered questionnaire surveys
were conducted in 2003 (survey 1) and 2005 (survey 2)
involving subjects who consented to this study.

2) SOC (surveys 1, 2)

The Japanese version of the 13-item SOC scale was used in
the surveys. The content, construct, and criterion validity of
the SOC scale were confirmed by Antonovsky13). The factorial
and concurrent validity the Japanese version of the SOC scale
was confirmed by Yamazaki et al14). Scale items were rated on
a 7-point scale, ranging from “Strongly agree” (7 points) to“Strongly disagree” (1 point), with higher scores (total score
range: 13-91) indicating a higher level of SOC, i.e., greater
ability to maintain one’s health.
The concept of SOC consists of 3 key components:
comprehensibility, manageability, and meaningfulness2).
Other studies examined each element separately8); however,in this study, we supported the idea of Antonovsky:“Theoretically, three components can be separated, but they
are dynamically interrelated.”2).

3. Ethical considerations

This study was conducted with the approval of the ethics
committee of Kyoto Prefectural University of Medicine basedon ethics guidelines for epidemiological research (public
notice No. 2 announced by the Ministry of Education, Culture,
Sports, Science, and Technology, and Ministry of Health,Labour, and Welfare on June 17, 2002). The subjects were
informed of the purpose, methods, privacy protection, andpublication of the study results in written form at the time
the researchers sent their request for study participation.
Questionnaires were sent to those who gave consent. Data
were coded so as not to identify individuals.

3) Other variables

Subscales other than basic attributes are as follows:

4. Study period(1) Social interaction

April 2003 - March 2006

Antonovsky reported that social interactions at work havea strong impact on SOC during adulthood2). We, therefore,
investigated the interaction between individuals and society.
However, because there was no scale designed for local
residents, the 18-item social interaction scale which was
designed to investigate social well-being of people aged 60
or older was used15). The total score was calculated as the sumof all yes=1/no=0 scores.

5. Variables

Survey items were as follows:

1) Basic attributes (Surveys 1, 2)

The survey included gender, age group (20s, 30s, 40s, 50s,
60s, 70s, and 80s or older), occupation (self-employed, service
and sales workers, craft and related trade workers, clerical
workers/technicians, owners/managers, professionals/
freelance workers/other, full-time housewives, students, andunemployed), educational achievement (elementary school,
junior high school, high school, specialty school, junior college/
technical college, undergraduate/graduate school, and other),annual household income (¥0-1,000,000, ¥1,000,0002,000,000, ¥2,000,000-4,000,000, ¥4,000,000-6,000,000,(2) Social support

Active and effective stress-coping and the presenceof emotional support, i.e., social support, are closely
related16). Antonovsky also mentioned social support as
one of the psychosocial GRRs that affects the formation anddevelopment of a strong and weak SOC. To examine subjects’76This paper was published at “the Japan Society of Nursing Research” Vol.33 No.5 in 2010.

Yearbook on Journal of the Japan Society of Nursing Research 2013social support, the following 5 items on instrumental support
were also included other than the 10 items of the emotional
support network scale: “Is there anyone who financially
supports you when you have money problems?”, “Is there
anyone who takes care of you when you are sick?”, “Is there
anyone who helps you moving?”, “Is there anyone who gives
you advice?”, and “Is there anyone who helps you with yourhousework?”16). The total score was calculated as the sum of
all yes=1/no=0 scores.

two surveys, and Pearson’s product-moment correlation
coefficient between the survey items was calculated. To
examine the levels of impact of the survey items on thedevelopment of SOC, a multiple regression analysis was
conducted using items for which correlations were foundas independent variables, and the change in SOC scores as adependent variable. Statistical analyses were performed using
SPSS 15.0J for Windows.
III. Results(3) Life experience

Of the 3,000 people aged 20 years or older, 530 people
responded to the survey 1 (response rate: 17.7%). In survey
2, questionnaires were sent to subjects who responded tosurvey 1, and 422 subjects responded to survey 2 (response
rate: 14.1%). This study analyzed data of 360 subjects(12.0%) who completed the SOC scale. The subjects’ basic
attributes, results of SOC scores and other variables, andfactors affecting the development of a strong and weak SOC
are as follows:

The basis of a strong SOC is fostered up to the age of 20
by good life experiences1). We, therefore, investigated [earlychildhood experiences], [adolescent experiences], and the[financial status up to the age of 20] based on the processof building up SOC2), which was proposed by Antonovsky, inorder to understand people’s lives before the age of 20. [Early
childhood experiences] refer to those from infancy to early
elementary school. The following 6 questions were developed
and rated on a 5-point scale: “Did you think that you could
rely on people around you?”, “Do you think that you wereloved by your parents and friends?”, “When you wished tostart something: did your parents help shape your future/
did your parents motivate you/did your parents disregard
you/did your parents reject you?”. [Adolescent experiences]refer to those around the age of 20. The following 7 questions
were developed and rated on a 5-point scale: “Did you havea clear vision about your future when you were 20 years
old?”, “Did you find it easy to solve problems when you
faced difficulties?”, “Did you have a favorable environmentor the means to improve your job, academic performance,or everyday chores?”, “Did you have anyone who could help
you with your work, housework, or studies?”, “Did you comeacross a person or book that has influenced your philosophy
or sense of value?”, “Have you ever felt joy or pride in yourwork, housework, or studies?”, and “Do you think that yourthoughts were respected in your work, housework, andstudies?”. Concerning the [financial status up to the age of20], financial affluence before the age of 20 was rated on a
5-point scale.

1. Summary of the subjects

The subjects included 167 males (46.4%) and 193 females(53.6%). Their mean age was 55.4±15.3 years old (range:
20-91, male: 59.2±14.5, female: 52.2±15.3 years old). The
number of subjects in their 60s (27.8%) was the highest,
followed by those in their 50s (20.3%). Subjects aged 60 orolder accounted for 45.3% of the total subjects. Concerning
the occupation, the number of “unemployed” subjects (n=69,
19.9%) was the highest, followed by “clerical workers/
technicians” (n=64, 18.4%), and “full-time housewives” (n=63,
18.2%). Concerning the educational achievement, subjects
who graduated “high school” (n=139, 39.4%) were the largest
group, followed by “undergraduate/graduate school” (n=93,
26.3%), and “junior college” (n=38, 10.8%). Concerning
the annual household income, subjects with “¥2,000,0004,000,000” (n=94, 29.1%) were the largest group, followedby “¥4,000,000-6,000,000” (n=67, 20.7%). Concerning thefamily status, subjects who responded “married couple withunmarried children at home” (n=117, 32.8%) were the largest
group, followed by “elderly married couple” (n=52, 14.6%,
and “non-elderly married couple” (n=44, 12.3%).
The mean SOC scores of surveys 1 and 2 were 63.6±12.1(range: 27-91, male: 63.5±11.6, female: 63.6±12.5) and
63.8±12.7 (range: 28-90), respectively (Table 1). Although nosignificant differences were observed in SOC scores among theage groups, the score increased with age. Higher SOC scores
were observed in owners/managers and professionals/
freelance workers, as well as in elderly married couples. No
order regularity was observed in the educational achievement
and annual household income. Cronbach’s α was 0.839 insurvey 1 and 0.866 in survey 2. The mean social interaction
score, which was investigated using the social interaction
scale, was 14.4±2.7 (range: 3-18), with Cronbach’s α of 0.697.
Concerning social support, 10 (2.8%) and 55 (15.3%)
subjects answered 0 and all questions, respectively. The
mean social support score was 8.5±4.7. Cronbach’s α of theemotional support network scale and instrumental support
items was 0.897.
The results of the questions about life experiences showedthat 43.5-82.2 and 45.1-66.4% of the subjects had favorable
impressions about their [early childhood experiences] and(4) Stressful life eventsThe life event scale16) was used in survey 2 to investigate
stressful life events over the past 1 year. The total score wascalculated as the sum of all yes=1/no=0 scores.
(5) Successful tension management

The level of satisfaction with stress management was rated
on a 5-point rating scale.
6. Methods of analysis

The social interaction, social support, early childhood
experiences, adolescent experiences, and financial status
up to the age of 20 were scored, and their mean score wascalculated by the subjects’ basic attributes. The characteristicsof the subjects were subsequently examined using either thet-test or ANOVA.
To extract factors affecting the development of a strong
SOC, the change in SOC scores was calculated based on the77

This paper was published at “the Japan Society of Nursing Research” Vol.33 No.5 in 2010.

Yearbook on Journal of the Japan Society of Nursing Research 2013

Table 1. SOC scores according to basic attributesnTotal SOC scale

GenderAge group

M±SD

63.6±12.1

63.8±12.7

0.3± 8.6

64.6±12.120s

2256.4±13.055.8±15.6

30s

(6.1)

50 (13.9)40s

52 (14.4)50s

73 (20.3)60s

100 (27.8)

Self-employed43 (12.4)

Clerical workers/technicians

64 (18.4)

70s

Craft and related trade workers
Owners/managers

57 (15.8)
6

(1.7)

33

(9.5)

29
13

(8.4)
(3.7)

63.6±12.558.3±11.6

61.7±10.1
61.2±11.6

66.6±10.969.8±12.2

69.2±11.4

61.4±10.661.3±12.2

60.0±14.0

61.6±10.968.7±12.1

57.0±10.1-1.3± 7.4

61.9±12.2
62.0±11.7

67.2±11.1

70.3±12.8

71.7±11.6

63.0±10.761.5±13.1

60.1±13.060.2±11.9

71.6±10.3(7.8)

67.0±11.9

69.6±13.3

Unemployed69 (19.9)66.1±12.4

66.2±12.3

Single elderly household

63 (18.2)
6

14

23

(1.7)

(3.9)

(6.4)

65.3±11.4

52.5±10.965.6±17.5

54.7±12.764.6±12.3

69.8±12.3

Married couple with unmarried children at home

117 (32.8)

62.6±11.0

62.9±12.0

Non-elderly married couple
Married couple and parents

Married couple with unmarried children andparents at home
Single parent household
Other

Elementary school

Junior high school

44 (12.3)
17

(4.8)

24

(6.7)

5

(1.4)

42 (11.8)
9(2.5)

￥4,000,000-6,000,000￥6,000,000-8,000,000￥8,000,000-10,000,000￥10,000,000-13,000,000￥13,000,000-16,000,000￥16,000,000 or over

60.8± 8.964.8±18.0

1

5

23

(0.3)

(1.5)

(7.1)

61.0±12.864.0±12.0

67.0± -

66.0±10.855.2±13.4

13

(4.0)

62.5±11.7

65.3±13.8(4.3)

64.1±11.1
63.0±14.1

0.3± 8.464.9±12.1
61.6±12.6

63.4±12.8
63.8±13.9

78This paper was published at “the Japan Society of Nursing Research” Vol.33 No.5 in 2010.

.257-0.8± 8.7
7.0± 9.7

1.4± 7.70.1± 8.0
0.3± 9.4-2.8± 5.3

65.7±11.7(8.7)

3.7± 6.2-0.2± 6.7

63.2±15.1

55.7±15.6

65.1±11.3

140.0± 9.7-0.4± 9.1

(9.0)

28

1.4±10.3

63.6±13.0

68.0± -

.431

0.1± 9.2

2.0±10.12962.6±12.3-0.7± 7.3

63.0±12.464.3±12.4

65.6±11.8

64.7±12.0

2.6± 6.5-5.6±10.764.4±11.1

50 (15.5)

2.9±14.959.2±20.8

94 (29.1)

67 (20.7)

0.0± 7.5-1.4± 8.91.1± 7.967.8±12.7

63.1±12.664.2±12.1

1.6± 8.962.1±12.562.8±11.1

36 (10.2)￥0-1,000,000￥2,000,000-4,000,000

61.0±14.0

63.1±14.1.8500.2± 8.0-2.3± 8.3

38 (10.8)

93 (26.3)￥1,000,000-2,000,000

63.9±12.0.089

2.5± 5.2

62.7±12.0

64.2±13.0

Undergraduate/graduate school
Other

65.0± 9.7

63.9±10.062.9±11.9

139 (39.4)

Junior college

64.1±11.7

66.6±10.9

41 (11.6)

High school

Specialty school

62.9±10.3

0.5± 9.5-1.4±10.6

69.8±11.2(4.2)

0.9± 8.9

0.6± 8.764.3±15.0

52 (14.6)150.2± 8.3-2.8± 8.5

56.0±15.3

P-value-0.6± 9.649.7±11.0

Elderly married couple

Elderly person(s) and non-elderly married couple

1.1± 9.3-0.5± 8.0

27

Full-time housewives

Difference (B-A)

63.1±13.1

Professionals/freelance workers/otherSingle non-elderly household

Annual householdincomeM±SD

63.5±11.6

193 (53.6)

Students

Educational
achievement

Survey 2 (B)

M±SD

167 (46.4)

FemaleService and sales workers

Family status

Survey 1 (A)Male

80s or older

Occupation

360

(%)

.543

1.0± -

0.5±12.3
1.2± 9.00.2± 7.7-1.0± 9.2
0.6± 6.5-0.7± 6.5

0.8±10.0

2.8±11.0.841

Yearbook on Journal of the Japan Society of Nursing Research 2013[adolescent experiences], respectively. Cronbach’s α of [earlychildhood experiences] and [adolescent experiences] was
0.781 and 0.792, respectively.
The mean score for [financial status up to the age of20] was 2.7±0.9. One-hundred and sixty-eight subjects(46.7%) classified their financial status up to the age of 20
as “Average” and 65 subjects (18.1%) classified it as “Verywealthy/wealthy”. The number of subjects who classified
it as “wealthy” was greater in those in their 20s than malesubjects (p=0.000) and those in their 50s. Subjects who havecompleted education beyond high school also classified it
as “wealthy” compared with those who only completed
elementary (p<0.05) or junior high school (p<0.001).
The mean number of stressful life events identified using
the life event scale was 1.7±1.8. One-hundred and sevensubjects experienced no stressful life events, and 1 subject
experienced 9 stressful life events. The number of subjects
who were “Very satisfied/satisfied” and “Very dissatisfied/dissatisfied” with their stress-coping behaviors was 190(52.8%) and 36 (10.0%), respectively.

than the mean percentage, and that of those aged 50 or older
was 1.6 times higher than those younger than 49 years old,
indicating that the survey results reflect the characteristicsof the elderly population.
The mean SOC score of survey 1 was 63.6±12.1 (male:63.5±11.6, female: 63.6±12.5), and that investigated inanother SOC study9) involving postal workers (ranged in age
from 10s to 70s) was 57.4±11.2 (male: 57.3±11.1, female:57.2±11.4), showing that the mean SOC score for total
subjects, both sexes, and employed subjects was higher inour study, meaning that our subjects had a greater ability tomaintain health.
Although no significant difference was observed in SOC
scores among age groups, the score increased with age. Anotherstudy stated that “life experiences build up SOC ” 19), and our
results support this. However, a finding of Masumoto3): “thehigher the annual household income, the stronger the SOC”,
was not seen in our study, necessitating further examinations.
The social interaction scale was designed to investigate
people aged 60 or older. Since there was no scale designed
for local residents at the time of our surveys, we employed
this scale which was developed under the concept of: “Social
interaction should be measured by the presence or absenceof interpersonal relationships and the frequency of social
involvements within the community”15). However, further
examinations must be conducted with an appropriate scale.

2. Factors affecting the development of SOC

To identify factors affecting the development of SOC, we
calculated the change in SOC scores (0.3±8.6) based on thetwo surveys. We subsequently calculated Pearson’s productmoment correlation coefficient of “the change in SOC”
with “gender”, “age”, “educational achievement”, “annual
household income”, “social interaction”, “social support”,“early childhood experiences”, “adolescent experiences”,“financial status up to the age of 20”, “stressful life events”,
and “successful tension management” (Table 2). A significant
difference with “the change in SOC” was observed in “financial
status up to the age of 20” (-0.115, p=0.013) and “successful
tension management” (0.146, p=0.007). To examine the levelsof impact on the development of SOC, multiple regression
analysis was conducted using the “financial status up to the ageof 20” and “successful tension management” as independent
variables, and “the change in SOC” as a dependent variable.
As shown in Table 3, a significant difference was observedin both the “financial status up to the age of 20” (β=-0.134,
p=0.013) and “successful tension management” (β=0.160,
p=0.003) (R2=0.039, adjusted R2=0.033).

2. Examination of factors affecting the development of SOC

The “financial status up to the age of 20” (β=-0.134,
p=0.013) and “successful tension management” (β=0.160,
p=0.003) were extracted as factors affecting the development
of SOC, and “successful tension management” had a stronger
impact on the changes in SOC. As SOC has been reported tobe reinforced by “successful tension management”1), ourstudy also supports the theory of Antonovsky. In a study byMasumoto, “satisfaction with one’s own health status” and“satisfaction with one’s own life status” were identified asfactors reinforcing SOC20). She stated that people who aresatisfied with their own health and life status have highself-esteem, which shapes a strong SOC. Similar to a senseof satisfaction, we speculated that experiences of successful
stress coping, i.e., positive ways of thinking, may be an
important factor affecting the development of a strong SOC.
On the other hand, the “financial status up to the age of20” was extracted as a negative factor, and it was indicatedthat good financial status up to the age of 20 affects thedevelopment of a weak SOC. Approximately 50 and 18% of thesubjects responded “Average” and “Very wealthy/wealthy”,
respectively, regarding their “financial status up to the age of20”. The number of subjects who responded “wealthy” wasgreater in subjects in their 20s and those who had completed
education beyond high school than male subjects in their 50s,
and those who had only completed elementary or junior highschool. The results suggest a close association of the gender,
age, and educational achievement with the “financial status
up to the age of 20” that affects the development of SOC.
However, the social background of the subjects that affects
their “financial status up to the age of 20” was not consistentbecause it varies from the period of World War II, to rapid
postwar growth, to the economic bubble. The historicalbackground must be taken into account so that the “financial
status up to the age of 20” can be more clearly identified as aIV. Discussion

We conducted a longitudinal study involving local
residents using the SOC-13 scale, with the aim of clarifying
factors affecting the development of SOC. The total numberof respondents was 422 (14.1%) out of the 3,000 randomlyselected subjects aged 20 years or older. Since a bias would
be expected in responses of subjects with health concerns,
this was taken into account in the discussion.
1. Characteristics of the study subjects

A total of 360 subjects were analyzed (male: 46.4%, female:
53.6%). Their age distribution was: 20s (6.1%), 30s (13.9%),40s (14.4%), 50s (20.3%), 60s (27.8%), 70s (15.8%), and 80s
or older (1.7%). The male-female ratio and percentage ofsubjects in their 30s and 40s were similar to those of Japan17)
and A City18). However, the percentage of subjects in their 20s
accounted for only 6.1%, which is approximately 50% lower
79

This paper was published at “the Japan Society of Nursing Research” Vol.33 No.5 in 2010.

.174 **

.000

.006

.079

-.074

Annual household income

Social interaction

Social support

This paper was published at “the Japan Society of Nursing Research” Vol.33 No.5 in 2010.

80*p<.05**p<.01 ***p<.001

Successful tension
management

Stressful life events

Financial status up
to the age of 20

Adolescent experiences

Early childhood
experiences.233 ***-.023

Educational achievement

.034
.020

.146 **.192 ***-.115 *-.050

.143 **

-.025

.073

.149 **-.016-.233 ***

.070

Age

1.000

-.091

1.000

GenderGenderChange in SOC

Change in
SOC

.064

-.264 ***-.123 *

-.103

.001

-.187 ***

.116 *-.163 **-.275 ***

1.000

Age

.012

.019

.288 ***.312 ***.192 ***

.020

.048

.214 ***

1.000

Educational
achievement

.067

.049

.171 **.218 ***.144 **.204 ***

.072

1.000

Annualhouseholdincome.354 ***-.074.160 ***.302 ***.235 ***.357 ***

1.000

Socialinteraction.390 ***.021.234 ***.338 ***.299 ***

1.000

Socialsupport.183 **-.053.376 ***.510 ***

1.000.243 ***.019.429 ***

1.000.122 *

-.002

1.000

-.153 **

1.000
1.000

Financial
Early
Successful
AdolescentStressful life
status up to
childhoodtensionexperiences
eventsexperiences
the age of 20
management

Table 2. Matrix of Pearson’s product-moment correlation coefficients for factors related to the change in SOC (n=360)

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Yearbook on Journal of the Japan Society of Nursing Research 2013

Table 3. The results of multiple regression analysis of factors related to the change in SOC (n=305)
Item

Financial status up to the age of 20 (→ high)Successful tension management
Adjusted R 2

Standardized partial
regression coefficient βt-value 1)
F-value 2)

P-value

-.134

.160

-2.481)

.033

2.96

.013

6.682).001(→ high)

1).003

References

factor affecting the development of SOC.
The results of multiple regression analysis showed R2 andadjusted R2 values of 0.039 and 0.033, respectively, indicatingthat approximately 4% of the variance in the change in SOC
scores can be explained by the two independent variables“financial status up to the age of 20” and “successful tension
management”. However, it was also verified that survey
items used in this study were not sufficient. A sampling of
the subjects (aged 20 years or older) is considered one of
the reasons.
Concerning the judgment of a low coefficient of determination,a value lower than 0.5 has been reported to be tolerable oncomparing the levels of impact of independent variables
on a dependent variable without using predictive values21).
However, the values obtained in this study were notsatisfactory. Although Antonovsky presented some examplesof GRRs that were stated in the conceptual framework sectionin this study, he did not specifically define them2), suggestingthat SOC is built upon multifactorial elements. Based on the
results of the present study, further investigations must be
conducted to establish a new framework that can be used toanalyze relevant factors more objectively.

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V. Conclusion

We conducted a longitudinal study involving local residents
aged 20 years or older using self-administered questionnaires,with the aim of clarifying factors affecting the development
of SOC, the ability to maintain health. As the results, the“financial status up to the age of 20” and “successful tension
management” were extracted as factors related to thedevelopment of SOC. A good financial status up to the age of
20 affected the development of a weak SOC, and successful
tension management affected the development of a strong
SOC.
Community nursing activities involve not only individuals
or families, but also groups and the entire community.
Therefore, it can be said that this study, which involved
community residents aged 20 years or older, suited the
purposes of everyday nursing activities. Not only theelimination of factors impeding health promotion, but also
reinforcement of the ability to maintain health is effective innursing activities aiming at the promotion and maintenanceof health. An effective method must be developed with further
investigations.
Acknowledgments

We are grateful to the local residents who agreed to andtook part in this study.

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This paper was published at “the Japan Society of Nursing Research” Vol.33 No.5 in 2010.

Yearbook on Journal of the Japan Society of Nursing Research 2013
salutogenic model, Ritsumeikan Review of Industrial Society,36(4), 53-73.
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20) Masumoto, T. (2001). Health status among residents based on

82
This paper was published at “the Japan Society of Nursing Research” Vol.33 No.5 in 2010.