Harnessing psychological resilience in hip fracture recovery: The overlooked role of sense of coherence

Table 1 Observational evidence linking sense of coherence to recovery-relevant outcomes in hip-fracture and older-adult cohorts

Ref.	Population and setting	Design and SOC measure	Outcome(s)	Key finding (direction)	Notes
Wu et al[1], 2025	Intertrochanteric femoral fracture; postoperative inpatients	Cross-sectional; SOC (instrument per paper)	PTG; Hospital Anxiety and Depression Scale-A/D	Conversion between higher SOC and higher PTG; anxiety/depression inversely related to PTG	Positions psychological coherence on the recovery axis
Chen et al[11], 2022	Community-dwelling older adults (China)	Cross-sectional; 13-item SOC	Frailty (multidimensional)	Conversion between lower SOC and higher frailty	Signals broader vulnerability processes
Portegijs et al[12], 2014	Older adults with hip-fracture history undergoing progressive resistance training	Prospective training cohort; SOC (baseline)	Adherence; gains in strength, mobility, balance	Higher SOC transform into better adherence and larger functional gains	Behavioral relevance for day-to-day rehab
Gadhvi et al[2], 2023	Hip-fracture survivors (systematic review)	Systematic review	Fear of falling and related constructs	Fear of falling common; associated with worse function	Companion risk aligned with low coherence patterns
Hikichi et al[8], 2023	Older disaster survivors (Japan)	Prospective outcome-wide study; SOC baseline	Multiple health and well-being outcomes	Higher pre-event SOC buffered adverse impacts	External validity for resilience role of SOC
Taylor et al[4], 2024	Hip fracture (qualitative synthesis)	Systematic review of qualitative studies	Psychosocial impacts	Psychological distress affects participation and recovery	Context for early psychosocial assessment

PTG: Post-traumatic growth; SOC: Sense of coherence.