The role of sense of coherence in the relationship between posttraumatic stress, depression and anxiety among nurses in South Africa

Nurses experience high levels of occupational stress and trauma exposure, placing them at risk for adverse mental-health outcomes. This study examined the relationships between posttraumatic stress symptoms (PTS), Sense of Coherence (SOC), anxiety, and depression among South African nurses. A cross-sectional survey design was employed with 264 nurses from 4 hospitals in the Western Cape province. Participants completed a demographic questionnaire and four self-report measures: the SOC Scale, PTSD Checklist for DSM-5, Beck Anxiety Inventory, and Centre for Epidemiological Studies Depression Scale-Revised. Structural equation modelling assessed whether SOC mediated the effects of PTS on anxiety and depression. Results indicated that SOC partially mediated the relationship between PTS and both anxiety and depression, suggesting that part of the impact of PTS on psychological distress operates through nurses' SOC levels. These findings highlight the importance of trauma-informed approaches and SOC-enhancing interventions to strengthen nurses' mental health in high-stress, low-resource, healthcare environments.