Abstract
BackgroundResearch has consistently found that favourable exchange with one’s proximal social environment has positive effects on both mental health and wellbeing. Adults with physical disabilities may have fewer opportunities of favourable exchange, and therefore the effects on mental health and wellbeing may be less advantageous. The aim of this study is to systematically review quantitative studies exploring associations of social relationships with mental health and wellbeing in persons with physical disabilities.MethodsThe databases PubMed, PsycINFO and Scopus were searched for relevant studies published between 1995 and 2016. Data was extracted on study and participants’ characteristics, independent and dependent variables, used measures and effects sizes of associations between social relationships and mental health or wellbeing. A narrative review was performed to synthesize findings along the constructs social support, social networks, negative social interactions, family functioning and relationship quality.ResultsOf the 63 included studies, 47 were cross-sectional and 16 longitudinal. Most studies included a measure of social support (n = 58), while other concepts were less often studied (social networks n = 6; negative social interaction n = 3; family functioning n = 2; relationship quality n = 1). Over half of studies included depression as outcome (n = 33), followed by wellbeing (n = 14), composite mental health measures (n = 10), anxiety (n = 8), psychological distress (n = 7), posttraumatic stress disorder (n = 3), and hopelessness (n = 1). Although trends for associations of social support with mental health and wellbeing were consistent, around a quarter of studies failed to report significant associations. Social networks were related to depression, but not to other mental health or wellbeing measures. Family functioning, negative social interactions and relationship quality showed consistent associations with mental health and wellbeing, however, only few studies were available.ConclusionsThis review indicates that social relationships play an important role in mental health and wellbeing in persons with disabilities, although findings are less consistent than in general populations and strength of associations vary between constructs. Integrating persons with disabilities into social networks seems not sufficient and rehabilitation professionals together with affected persons and their peers should ensure that high quality relationships and tailored support are available.
Highlights
Research has consistently found that favourable exchange with one’s proximal social environment has positive effects on both mental health and wellbeing
The vast majority of the 63 included studies focussed on social support (n = 58), with relatively few other constructs being identified: Social networks were assessed in six studies, negative social interaction in three studies, family functioning in two studies, and relationship quality in one study
Concerning mental health and wellbeing constructs, depression was the most heavily studied construct being reported by 33 studies, a composite mental health score was reported by ten studies, followed by anxiety (n = 8), psychological distress (n = 7), posttraumatic stress disorder (n = 3), and hopelessness (n = 1)
Summary
Research has consistently found that favourable exchange with one’s proximal social environment has positive effects on both mental health and wellbeing. People with functional limitations or bodily impairments are generally disadvantaged in their opportunities to participate in social life [2] These restrictions contradict basic human rights [3], but may affect people’s health and wellbeing. There is consistent evidence that continued favourable exchange with one’s proximate social environment (e.g. family, friends and work life) exerts beneficial effects on health and wellbeing [4]. Social isolation or lack of close social ties is associated with poor health and increased mortality risk [5]. These associations hold true for the general population but are relevant for persons with physical disabilities, due to their restricted social participation [6]. Reduced mental health in terms of psychiatric disorders is one of the major burdens of disease worldwide [7] and in particular in populations with disabilities [8]
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