{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T19:18:17Z","timestamp":1784315897057,"version":"3.55.0"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sense of coherence (SoC) is a core concept of \u2018salutogenesis\u2019 in positive psychology, correlated with emotional distress and disease development in adults with chronic disease and older adults. A diversity of non\u2010pharmacological interventions (NPIs) has been developed to enhance SoC, but research findings are conflicting and the adequacy of sample sizes is uncertainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This paper aimed to explore appropriate interventions, evaluate the effectiveness of these SoC interventions and verify the statistical robustness and reliability of pooled results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Search terms including \u2018sense of coherence\u2019 and \u2018randomised controlled trial (RCT)\u2019 were performed in nine electronic databases. Publications were written in English from January 1979 to February 2024. A narrative synthesis was performed to determine intervention details, and classical meta\u2010analysis was used to analyse available data on SoC using RevMan. Besides, trial sequential analysis (TSA) was conducted to verify the robustness of pooled effect size.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Meta\u2010analysis was carried out with 27 RCTs involving 2178 patients. It showed significant effects on SoC compared to usual care among this population for all NPIs at post\u2010intervention and 3\u2010month follow\u2010up. Of these follow\u2010up durations, the effective NPIs were salutogenic\u2010based intervention, self\u2010management intervention, while no significant difference was observed at 6\u2010month or\u2009&gt;\u20096\u2010month follow\u2010up. TSA showed that the significant finding of meta\u2010analysis in salutogenic\u2010based intervention was stable and reliable, while the pooled sample size on self\u2010management intervention was insufficient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Non\u2010pharmacological (salutogenic\u2010based) interventions could improve SoC among older adults and adults with chronic conditions within 3\u2009months after\u2010intervention. However, its effects were not sustained over a longer period, which further studies will need larger sample sizes to draw definitive conclusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Practice<\/jats:title>\n                    <jats:p>This meta\u2010analysis provided the evidence that salutogenic\u2010based interventions could improve SoC among the target population within 3\u2009months after\u2010intervention, providing a solid foundation for healthcare professionals to base their therapeutic strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>The searching results were reported in accordance with the Preferred Reporting Items for Systematic Review and Meta\u2010analysis checklist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>No Patient or Public Contribution<\/jats:title>\n                    <jats:p>This study is a systematic review with meta\u2010analysis and trial sequential analysis, and the aforementioned details are not applicable to our research.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      PROSPERO: CRD42023401215\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.16558","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T07:19:47Z","timestamp":1735888787000},"page":"2165-2198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Non\u2010Pharmacological Interventions Targeting Sense of Coherence Among Older Adults and Adults With Chronic Conditions: A Meta\u2010Analysis With Trial Sequential Analysis"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0897-0725","authenticated-orcid":false,"given":"Yaqian","family":"Liu","sequence":"first","affiliation":[{"name":"School of Nursing The Hong Kong Polytechnic University  Hong Kong SAR China"},{"name":"Research Institute for Smart Ageing, The Hong Kong Polytechnic University  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2165-9424","authenticated-orcid":false,"given":"Bohan","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Nursing The Hong Kong Polytechnic University  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2435-8061","authenticated-orcid":false,"given":"Jed","family":"Montayre","sequence":"additional","affiliation":[{"name":"School of Nursing The Hong Kong Polytechnic University  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adwoa Owusuaa","family":"Koduah","sequence":"additional","affiliation":[{"name":"School of Nursing The Hong Kong Polytechnic University  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9836-1925","authenticated-orcid":false,"given":"Angela Y. 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