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The predictive relationship of quality of life domains to sense of coherence subdomains

Joel Alcantara, DC and Andrew Whetten

Objective: To assess the predictive relationship between quality of life (QoL) domains with the subdomains of sense of coherence (SOC).

Methods: We measured the SOC and QoL of patients using the SOC-29 and the PROMIS-29/PROMIS global health measures, respectively. The SOC subdomains are comprehensibility, manageability and meaning. The measured PROMIS-29 QoL domains are physical function, anxiety, depression, fatigue, sleep disturbance, ability to participate in social roles and activities, pain interference and intensity while PROMIS global health are global physical health (GPH) and global mental health (GMH). Predictive relationships utilized random forest regression analysis based on variable importance.

Results: Our convenience sample consisted of 1980 responders (average age=40.72 years; 1494 females). Based on variable importance outcomes, the SOC subdomains were strong predictors for each other such that comprehensibility strongly predicted manageability and manageability strongly predicted meaning. The mental health domains (i.e., GMH, anxiety, depression) and age were also strong predictors for the SOC subdomains while the physical domains (i.e., physical function, pain interference) were the least predictive. Educational level predicted comprehensibility and meaning, while sleep disturbance predicted manageability.

Conclusion: The subdomains of SOC were strongly predictive for each other along with mental health QoL domains.


  • Patients presenting for chiropractic care have compromised quality of life and relatively low sense of coherence (i.e., global orientation to life)
  • The SOC subdomain of comprehensibility predicts well unto the SOC subdomain of manageability and manageability predict well unto the SOC subdomain of meaning. Clinical implications are that if patients comprehend chiropractic care and what it is (i.e., spinal adjustments), they are more likely able to understand and experience the meaning of full expression of life.
  • The mental health domains (i.e., depression and anxiety) are more important in predicting the SOC domains than the physical health domains.
  • Age and level of education are stronger predictors for SOC and its subdomains.

Presented at ACC-RAC 2019: Baltimore, MD Mar 14-16, 2019