AccScience Publishing / HPR / Online First / DOI: 10.36922/hpr.0329
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RESEARCH ARTICLE

A mixed-methods exploration of psychological challenges and sense of coherence in individuals with chronic illnesses

Arben Hysenaj1 ,  Uvejs Hyseni2 ,  Driton Maljichi3 ,  Bernard Tahirbegolli1,4*
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1 Department of Psychology, Faculty of Social and Psychological Science, Heimerer College, Prishtina 10 000, Kosovo
2 Department of Nursing, Faculty of Health and Nursing Sciences, Heimerer College, Prishtina 10 000, Kosovo
3 Institute of Sociological, Political, and Juridical Research, SS. Cyril and Methodius University, Skopje 1000, North Macedonia
4 Department of Advanced Nursing Practice, Faculty of Health and Nursing Sciences, Heimerer College, Prishtina 10 000, Kosovo
HPR 2026, 14(2), 0329 https://doi.org/10.36922/hpr.0329
Received: 12 October 2025 | Revised: 1 February 2026 | Accepted: 5 February 2026 | Published online: 5 May 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background: Although a multidisciplinary approach is essential for addressing complex physical and mental health problems, it remains underutilized in managing chronic illness, mental health, and sense of coherence (SOC).

Objective: This study examines the psychological difficulties of individuals with chronic illnesses in Kosovo and explores the relationship between their SOC and coping capacity.

Methods: This study employed a mixed-methods design to capture both the scope and depth of the phenomena under investigation. The quantitative component included 799 participants, who completed a demographic questionnaire, the General Health Questionnaire (GHQ-28), and the SOC scale. The qualitative component consisted of semi-structured interviews with 32 participants living with chronic illnesses, focusing on their experiences of coping, meaning-making, and perceived resources.

Results: Participants with chronic illnesses reported significantly higher SOC scores compared to those without chronic conditions (p = 0.04). At the same time, they exhibited significantly higher levels of psychological distress (p = 0.0001), including somatization (p = 0.0001), anxiety and insomnia (p = 0.0001), social dysfunction (p = 0.0001), and severe depression (p = 0.0001). Qualitative findings provided explanatory depth, indicating that the higher SOC observed among chronically ill individuals was largely attributed to the spiritual or religious engagement and a strong sense of responsibility toward caring for family and future generations.

Conclusion: These findings highlight the complexity of SOC among individuals with chronic illnesses, where cultural, social, and religious factors may simultaneously sustain coherence and contribute to psychological burden.

Keywords
Sense of coherence
Psychological problems
Chronic non-infectious diseases
Spiritual activities
Funding
None.
Conflict of interest
The authors declare they have no competing interests.
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