Functional Social Support Research Articles

ELDER ABUSE BY FAMILY CAREGIVER: DOES COGNITIVE IMPAIRMENT REALLY MATTER?

Previous research suggested that cognitive impairment is a risk factor for elder abuse. Persons with dementia experience elevated risk of abuse as compared to the general aging population. The present study compared rates of abuse reported by family caregivers of older persons with and without dementia. A total of 693 family caregivers participated, among which 592 were providing care older persons with dementia and 101 were providing care to older persons without. Participants provided information on their demographic characteristics, care recipient physical functioning (Instrumental Activities of Daily Living), behavioral problems (Cohen Mansfield Agitation Inventory), caregiver stress (Zarit Burden Interview), emotional and instrumental social support, and abusive behaviors directed at the care recipients (Conflict Tactics Scale and Potentially Harmful Behaviors). Abuse is common in this sample: 46.8% reported potentially harmful behaviors, 52.7% reported psychological aggression, 11% physical assault, and 1.3% injury. No significant difference was observed between caregivers providing care to older persons with or without dementia (p>.05). A series of logistic regression was conducted to determine factors associated with abuse. Care recipient behavioral problems and caregiver burden were two prominent factors associated with potentially harmful behaviors and all forms of abuse. Behavioral problems are common in persons with cognitive impairment and many caregivers feel stressful managing them. It is plausible that cognitive impairments per sec do not increases risk of abuse, but the associated characteristics do. Helping family caregivers manage the caregiving situation and their expectation, positive appraisal and cognitive restructuring may help prevent elder abuse.

A 20-YEAR COHORT STUDY OF LIVING ARRANGEMENTS AND COGNITIVE DECLINE IN THE MEXICAN AMERICAN POPULATION

Backgrounds/Objectives: The prevalence of dementia in the elderly Latino population is expected to significantly increase from around 200,000 cases in 2000 to as many as 1.3 million cases in 2050. This demographic trend has important consequences for options in care and living arrangements. Very little is known about how of cognitive impairment trajectories co-vary with support available to Mexican Americans. We examine the relationship between living arrangements and the social support of individuals with dementia. Methods: Using data from nine waves from the 23 years of the Hispanic EPESE (n=3,952), we examine trajectories of cognitive functioning and family and social support. We first describe the change in Mini Mental Status Examination (MMSE) scores for survivors from Wave 1 (1993/1994) to Wave 9 (2015/2016), n=255. Growth Mixture Modeling (GMM) is then used to assess how changes in MMSE scores are distributed among living arrangements for individuals living independently compared to household extension (living with others) using the full sample. Results: Analyses reveal different trajectories in MMSE score. 12% (n=27) of the sample had no decrease, while the remaining (88%) were split between moderate decline (60% n=136, 1-10 point decline in MMSE) and severe decline (28% n=62 >10 point decline In MMSE). Changes in living arrangement over the same period show that 89% of individuals who move from independent living into extended household experienced cognitive decline. Conclusions: This study provides new information on how cognitive trajectories are associated with living arrangements. We discuss implications for improving community-based interventions for Latino family caregivers.

THE PROTECTIVE ROLE OF SOCIAL SUPPORT ON DEPRESSIVE SYMPTOMS AMONG AGING SEXUAL MINORITY CANADIANS

Sexual minority older adults face minority stressors that are associated with higher rates of mental illness. The stress buffering effects of social support within majority populations are well documented. Using a large population-based sample of aging Canadians, we sought to examine the relationship between sexual orientation and depressive symptoms, and determine whether this relationship is moderated by social support and sex. Baseline data from the Canadian Longitudinal Study on Aging (CLSA) were used (n = 46147). Participants were between the ages of 45-85 years at time of recruitment (mean age = 62.46, SD = 10.27), and self-reported their sexual orientation as heterosexual or lesbian, gay, or bisexual (LGB) (2.1%). Social support and depressive symptoms were measured using validated instruments. Four functional social support subscales were derived: tangible, positive social interaction, affectionate, and emotional/informational. Multiple linear regression models adjusted for relevant covariates were conducted. LGB identification was associated with greater depressive symptoms when compared to heterosexual participants (p = 0.032). As evidenced by a significant 3-way interaction (p = 0.030), increasing tangible social support was associated with a corresponding decrease in the risk of depressive symptoms; this relationship was most pronounced for lesbian and bisexual women. A significant 2-way interaction (p = 0.040) revealed that as emotional/informational social support increased, depressive symptoms decreased, with greater disparity between LGB and heterosexual participants at lower levels of social support. The results highlight the importance of social support in promoting mental health, especially among sexual minority older adults.

Psychosocial health of patients receiving orthopaedic treatment in northern Tanzania: A cross-sectional study.

BackgroundPatients with musculoskeletal injuries in Sub-Saharan Africa often receive prolonged inpatient treatment due to limited access to surgical care. Little is known regarding the psychosocial impact of prolonged conservative treatment for orthopaedic injuries, which may add to disability and preclude rehabilitation.MethodsA cross-sectional, questionnaire study was conducted to characterize the psychosocial health of orthopaedic inpatients at a tertiary hospital in Moshi, Tanzania. Three validated surveys assessing coping strategies, functional social support, and symptoms of depression were orally administered to all orthopaedic patients with a length of stay (LOS) ≥ 6 days by a Tanzanian orthopaedic specialist.ResultsFifty-nine patient surveys were completed, and revealed 92% (54) of patients were more likely to utilize more adaptive than maladaptive coping strategies. Patients with chest or spinal column injuries were more likely to use maladaptive coping strategies (p = 0·027). Patients with head injuries had more social support compared to others (p = 0·009). Lack of insurance, limited education, and rural origins were associated with less functional social support, although this finding did not reach statistical significance. 23·7% (14) of patients had symptoms consistent with mild depression, 33·9% (20) with moderate depression, and 3·4% (2) with moderately-severe depression. LOS was the only significant predictor for depression severity.Conclusions61% (36) of orthopaedic inpatients exhibited depressive symptoms, indicating that the psychosocial health in this population is sub-optimal. Mental health is a crucial element of successful orthopaedic care. Access to timely surgical care would greatly decrease LOS, the most prominent predictor of depressive symptom severity.

Social Support as a Predictor of Community Participation After Stroke.

Participation is a primary goal of neurorehabilitation; however, most individuals post stroke experience significant restrictions in participation as they attempt to resume their everyday roles and routines. Despite this emphasis on participation, there is a paucity of evidence-based interventions for optimizing this outcome and a limited understanding of factors that contribute to poor participation outcomes. Caregiver support at discharge from inpatient rehabilitation positively influences physical and psychological outcomes after stroke but more research is needed to understand the association between social support and participation. This study aimed to examine the independent contribution of perceived social support to participation 3 months post discharge from inpatient stroke rehabilitation. This study was a secondary analysis of the Stroke Recovery in Underserved Populations 2005–2006 data. Participants were adults ≥55 years old, living in the community 3 months post discharge from inpatient rehabilitation for ischemic stroke (n = 422). Hierarchical linear regressions were performed. The primary variables of interest were the PAR-PRO Measure of Home and Community Participation and the Duke–University of North Carolina Functional Social Support Questionnaire. Perceived social support at discharge from inpatient rehabilitation for ischemic stroke contributed uniquely to the variance in participation 3 months later (β = 0.396, P < 0.001) after controlling for race, sex, age, years of education, comorbidities, stroke symptoms, depression, FIM Motor, and FIM Cognitive. Social support accounted for 12.2% of the variance in participation and was the strongest predictor of participation relative to the other independently significant predictors in the model including FIM Motor and depression. There is already a focus on caregiver training during inpatient rehabilitation related to basic self-care, transfers, and medical management. These findings suggest the need for rehabilitation professionals to also address social support during discharge planning in the context of promoting participation. Given the findings, expanding caregiver training is necessary but novel interventions and programs must be carefully developed to avoid increasing caregiver burden.

Interrelationship between depression, anxiety, pain, and treatment adherence in hemophilia: results from a US cross-sectional survey.

PurposeDepression, anxiety, pain, and treatment adherence have reciprocal effects not characterized extensively in hemophilia. This study explored the relationships between depression, anxiety, chronic pain, and treatment adherence in adults with hemophilia.Patients and methodsAdults with self-reported hemophilia A or B completed the cross-sectional IMPACT QoL II survey. Depression (9-item Patient Health Questionnaire [PHQ-9]), anxiety (7-item Generalized Anxiety Disorder scale [GAD-7]), chronic pain (Faces Pain Scale–Revised [FPS-R]), social support (Duke UNC Functional Social Support questionnaire), level of pain control, clotting factor treatment adherence (VERITAS-Pro or -PRN), and previous depression/anxiety were analyzed.ResultsAmong 200 participants (male, 77.3%; female, 22.8%), 54% had PHQ-9 and 52% had GAD-7 scores indicating moderate to severe depression or anxiety without diagnosis of either disorder. Participants with PHQ-9 scores ≥10 (moderate to severe depression) were more likely to have lower treatment adherence than those with PHQ-9 scores <10 (P<0.05). Participants with PHQ-9 or GAD-7 scores ≥10 were more likely to report uncontrolled pain and less social support versus PHQ-9 or GAD-7 scores <10 (χ2 P<0.05). Significant correlations were found between PHQ-9 and GAD-7 (P<0.0001), PHQ-9 and FPS-R (P=0.0004), PHQ-9 and VERITAS (P=0.01), GAD-7 and FPS-R (P=0.02), and GAD-7 and VERITAS (P=0.001).ConclusionDepression and anxiety are underdiagnosed in hemophilia. Depression is associated with anxiety, pain, and lower treatment adherence. While treatment providers play an important role in diagnosis, social workers may play a pivotal role in depression and anxiety screening. This study highlights the importance of regular screening and treatment for these disorders.

The Relationship among Functional Health Literacy, Self-Rated Health, and Social Support among Younger and Older Adults in Ghana.

It is well established that health literacy positively affects health outcomes, and social support influences this association. What remains unclear is which aspect of social support (instrumental, informational, and emotional support) is responsible for this effect and whether the influence differs from one population group to another. This study addresses these lacunae. It examines the impact each type of support makes on the relation between functional health literacy (FHL) and self-rated health status among younger and older adults in Ghana. Data were pooled from two cross-sectional surveys, together comprising 521 participants in the Ashanti Region. The results indicated that young adults were more likely to possess sufficient FHL and perceive their health more positively than older adults. While FHL was positively associated with health status, the relation was stronger when young adults received a high level of emotional support. Among older persons, informational support substantially moderated the association between FHL and health status. Thus, social support modifies the relations between FHL and health status among younger and older adults in different ways and to different degrees. Therefore, interventions to improve FHL and health amongst younger and older adults should pay due regard to relevant aspects of social support.

Perceptions of a Father's Role during a Couple's First Pregnancy

The objective of this study was to explore the first‐time pregnant couples’ perception of the father's role in relation to a pregnant woman's food and activity behavior during pregnancy. Eleven first‐time pregnant, cohabitating couples across the United States completed a one‐on‐one semi‐structured phone interview for the study. Couples shared similar expectations of a father's role during pregnancy. Fathers were also important in setting and achieving health behavior goals of the pregnant mother. Family and Consumer Sciences professionals might consider including fathers in programs for expecting mothers. Maintaining functional social support from an equally as motivated partner might improve health during pregnancy and after pregnancy as well.

Perceived social support functions as a resilience in buffering the impact of trauma exposure on PTSD symptoms via intrusive rumination and entrapment in firefighters.

Resilience has been highlighted as a pivotal factor in overcoming the detrimental impact of trauma. The present study tests a resilience model of trauma using risk (rumination, emotion regulation, and entrapment) and protective (perceived social support) factors in a sample of firefighters who are at heightened risk for post-traumatic stress disorder, using a cross-sectional design. Specifically, the present study focuses on perceived social support as a resilience factor against PTSD symptoms, in response to trauma exposure. The sample included 545 firefighters from six large cities in Korea, who completed the following self-report questionnaires: Life Event Checklist, Event-related Rumination Inventory, Emotion Regulation Questionnaire, Entrapment scale, Impact of Event Scale-Revised, and Duke-UNC Functional Social Support Questionnaire. Exposure to traumatic events indirectly affected PTSD symptoms via intrusive rumination, emotional regulation, and perceptions of entrapment. Additionally, the mediating effects of intrusive rumination and perceptions of entrapment were moderated by perceived social support. That is, firefighters with high levels of perceived social support reported lower severity of rumination and PTSD symptoms. These findings suggest that perceptions of social support may operate as a resilience factor in buffering the effects of trauma on PTSD symptoms. Perceived social support interacts with intrusive rumination and perceptions of entrapment, thereby resisting the development of PTSD symptoms.

Functional capacity and social support to people affected by cerebrovascular accident.

To investigate the functional capacity and its relationship with the level of social support to people affected by cerebrovascular accident. Cross-sectional and quantitative research, conducted with 108 individuals with sequelae of cerebrovascular accident in João Pessoa/PB. Data were collected through interviews, using a sociodemographic instrument - the Barthel Index and the Social Support Scale. We observed the prevalence of functional dependency in 93.5%, and the mild dependency stood out in 40.7%. Medium social support was the most found, with 48.2%. The predominant dimensions of social support were the material dimension, followed by the emotional. There was a significant association (p ≤ 0.05) between very serious dependency and high social support. The results found allow us to reflect on the need for involvement of health professionals in strengthening the social support of patients with disabling diseases, such as the cerebrovascular accident.

Psychometric evaluation of the Portuguese Satisfaction with Family Life Scale

The purpose of this study is to examine the psychometric properties of the Satisfaction with Family Life Scale (SWFLS) among Portuguese adolescents. This scale assesses a person’s global evaluation of family satisfaction. The participants were 252 high school students from public schools in Lisbon, aged 15–19 years (M = 16.87; SD = 1.21). Confirmatory factor analysis confirmed a one-factor model of the SWFLS among Portuguese adolescents. The SWFLS showed adequate psychometric properties, with good internal consistency. Subsequent analyses indicated that the SWFLS scores were related to a measure of family satisfaction, as well as wellbeing (life satisfaction, self-esteem) and current interpersonal functioning (social support and loneliness). These findings are interpreted as supporting the validity of the SWFLS. The findings of this research indicate that the Portuguese version of the SWFLS is a brief, psychometrically sound instrument to assess family life satisfaction.

Association of functional and structural social support with chronic kidney disease among African Americans: the Jackson Heart Study

BackgroundThere is limited evidence on the relationship between social support and renal outcomes in African Americans. We sought to determine the association of social support with prevalent chronic kidney disease (CKD) and kidney function decline in an African American cohort. We also examined whether age modifies the association between social support and kidney function decline.MethodsWe identified Jackson Heart Study (JHS) participants with baseline (Exam in 2000–2004) functional and structural social support data via the Interpersonal Support Evaluation List (ISEL) and social network size questions, respectively. With ISEL as our primary exposure variable, we performed multivariable regression models to evaluate the association between social support and prevalent CKD [estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 or urine albumin-creatinine ratio (ACR) ≥30 mg/g], eGFR decline, and rapid renal function decline (RRFD) (> 30% decrease in eGFR over approximately 10 years). All models were adjusted for baseline sociodemographics, diabetes, hypertension, smoking status, and body mass index; models for eGFR decline and RRFD were additionally adjusted for eGFR and ACR. In models for eGFR decline, we assessed for interaction between age and social support. For secondary analyses, we replaced ISEL with its individual domains (appraisal, belonging, self-esteem, and tangible) and social network size in separate models as exposure variables.ResultsOf 5301 JHS participants, 4015 (76%) completed the ISEL at baseline. 843 (21%) had low functional social support (ISEL score < 32). Participants with low (vs. higher) functional social support were more likely to have lower income (47% vs. 28%), be current or former tobacco users (39% vs. 30%), have diabetes (25% vs. 21%) or CKD (14% vs. 12%). After multivariable adjustment, neither ISEL or social network size were independently associated with prevalent CKD, eGFR decline, or RRFD. Of the ISEL domains, only higher self-esteem was associated with lower odds of prevalent CKD [OR 0.94 (95% CI 0.89–0.99)]. The associations between social support measures and eGFR decline were not modified by age.ConclusionsIn this African-American cohort, social support was not associated with prevalent CKD or kidney function decline. Further inquiry of self-esteem’s role in CKD self-management and renal outcomes is warranted.

Psychosocial stress and bone loss among postmenopausal women: results from the Women’s Health Initiative

BackgroundBone loss is a major public health concern with large proportions of older women experiencing osteoporotic fractures. Previous research has established a relationship between psychosocial stressors and fractures. However, few...

Cultural Distance, Acculturative Stress, Functional Social Support, and Psychological Adaptation of International Students

This study examined how cultural distance, acculturative stress, and social support interacted to influence emotional responses among international students studying in the northern part of Cyprus. Acculturation models and the stress-buffering hypothesis served as theoretical frameworks. The research questions involved understanding whether international students experienced more negative emotional responses compared to students from the home culture and whether social support moderated acculturative stress and reactions to being in the northern part of Cyprus. An analysis of variance (ANOVA) examined differences in emotional reactions between home and international students while hierarchical multiple regression was used to examine the moderation hypotheses. ANOVA results indicated that Turkish-Cypriots had more positive emotional responses than international students to being in the host culture. Results did not support social support as a moderator for either international students’ acculturative stress or their emotional reactions. However, results suggested that unmet expectations, less financial satisfaction, and less social support predicted acculturative stress, while being in a relationship, higher Turkish proficiency, unmet expectations, and higher acculturative stress predicted more negative emotional responses. These results may help universities design programs to support psychological adaptation among international students, which could ultimately facilitate student retention.

Apoyo social y resiliencia: factores protectores en cuidadores principales de pacientes en hemodiálisis

Introducción: Garantizar el cuidado del paciente en hemodiálisis se reconoce como una actividad compleja, exigente y estresante a la cual se expone de manera reiterada el cuidador. El apoyo social y la resiliencia constituyen factores protectores que permiten amortiguar el impacto del estrés en la salud mental de los cuidadores. Objetivo: Analizar el apoyo social y la resiliencia como factores protectores en los cuidadores de pacientes en hemodiálisis. Material y Método: Estudio mixto secuencial con alcance descriptivo. La selección muestral se realizó de forma intencional-no probabilística para una muestra de 67 cuidadores de pacientes en hemodiálisis asistentes al Servicio de tratamiento sustitutivo durante el 2018. Se emplearon como instrumentos un Cuestionario de variables sociodemográficas, el Cuestionario de apoyo social funcional Duke-UNK-11 y la Escala reducida de Resiliencia Connor-Davidson. Se desarrollaron entrevistas grupales para la recogida de información cualitativa. Resultados: La percepción de apoyo social así como las dimensiones de apoyo afectivo y confidencial se expresan en niveles medios y bajos, distinguiéndose la familia como la principal red de apoyo para los cuidadores. La resiliencia alcanza niveles medio y alto siendo el optimismo, el sentido del humor y el establecimiento de relaciones sociales los principales mecanismos resilientes para enfrentar la actividad de cuidado. Conclusiones: El apoyo social y la resiliencia se comportan como factores protectores en los cuidadores estudiados. Se constituyen como los principales recursos psicológicos amortiguadores del estrés que ofrecen una perspectiva diferente y enriquecedora para enfrentar situaciones adversas de manera efectiva en los cuidadores.

Predictive model for quality of life in patients with recurrent coronary artery disease.

The aims of this study were to construct and verify a model that explains the quality of life in patients with recurrent coronary artery disease. Participants were 212 patients with recurrent coronary artery disease undergoing percutaneous coronary intervention. Data were collected through structured questionnaires from 21 December 2016-30 April 2017, and were analyzed using SPSS 23.0 and AMOS 23.0. The model's fit indices were adequate. Type D personality, symptom experience, and resilience had a direct effect on quality of life, while type D personality, cardiac function status, social support, and resilience had an indirect effect on quality of life. Type D personality, cardiac function status, social support, symptom experience, and resilience explained 55% of the total variance in quality of life. Thus, type D personality, cardiac function status, social support, symptom experience, and resilience affected the quality of life in patients with recurrent coronary artery disease. Systematic and integrated intervention programs considering factors related to quality of life may be useful for improving quality of life for patients with recurrent coronary artery disease.

Sosyal Destek ve Sosyal Desteğin Psikolojik İyi Oluşa Etkisi

The aim of this paper is to give introductory information regarding social support. A brief literature review regarding social support was performed. Using the review, background information, definitions of social support, different aspects of social support, the relationship between social support and self-efficacy, social support models (i.e. main effect model, and stress buffering effect model) and the effect of social support on recipient and provider are explained. The literature indicated there are two dimensions of social support: structure social support and functional social support. Structural social support refers to existence, quantity, and density of social relationships, whereas functional social support refers to quality of social relationships and type and functionality of resources provided to recipient (Chronister, 2009). In addition to it, social support is divided into two categories: perceived versus received social support. Research shows that social support has positive effect on psychological well-being. Overall, social support has potential beneficial effects on mental and physical health. The paper can be a useful tool for someone who aims to have a general overview of those constructs.

The Support for New Mums Project: A protocol for a pilot randomized controlled trial designed to test a postnatal psychoeducation smartphone application.

To report a pilot trial protocol for testing the effectiveness of the Support for New Mums smartphone application in a cohort of first-time mothers. A pilot/feasibility randomized controlled trial using a two-group pre-test and repeated post-test design. This protocol follows the Standard Protocol Items: Recommendations for Intervention Trials (SPIRIT) guidelines. The Intervention group will receive access to the smartphone application for 6weeks post birth. Both Intervention and control groups will receive standardized institutional postnatal care services. Trial funding was gained from respective grant sponsors in May and November 2016. The Support for New Mums smartphone application could be a novel method for addressing the gap in provision of postpartum care services providing psychoeducation and improving maternal parental self-efficacy for Australian childbearing women. Australian New Zealand Clinical Trials Registry ACTRN12618001580268.

Loneliness and social support: Differential predictive power on depression and satisfaction in senior citizens.

The lack of social support and the feelings of loneliness among older adults are associated with physical and mental health negative outcomes. This study attempts to test for their differential predictive power on depression and satisfaction in seniors. Data were drawn from a sample of 335 older adults ranging from 55 to 80 years old, with a mean age of 63.97 years (standard deviation = 5.56) attending a learning program at the University of Valencia during the academic year 2014-2015. In addition to health and wellbeing outcomes, we used the Functional Social Support Questionnaire DUKE-UNC, and two scales of loneliness, the de Jong Gierveld Loneliness Scale and the University of California Loneliness Scale version 3. Using structural equations models with Mplus, two models were proposed to assess the predictive power of social support and loneliness on wellbeing outcomes, specifically life satisfaction and depression, while controlling for health. Results confirm the negative association between loneliness and satisfaction with life and the positive one with depression.

The relationship between perceived social support and depressive symptoms in informal caregivers of community-dwelling older persons in Chile.

AIMDepression among caregivers of older persons is a serious concern, but it is often overlooked and neglected in developing countries. The aim of this study was to examine the relationship between perceived social support and depression in informal caregivers of community‐dwelling older persons in Chile.MethodsWe analyzed cross‐sectional secondary data on 377 dyads of community‐dwelling older persons and their informal caregivers from a nationwide survey in Chile. The Duke‐UNC Functional Social Support Questionnaire (FSSQ) was used to measure caregivers’ perceived social support, and the Center for Epidemiologic Studies Depression Scale assessed their depression.ResultsIn this study, 76.9% of the caregivers perceived a high level of social support, and 46.9% were assessed as having depression. Based on multivariable analysis, factors that decrease the likelihood of being depressed are a high level of social support (odds ratio (OR) = 0.311, 95% confidence interval (CI): 0.167–0.579) and having taken holidays in the past 12 months (OR = 0.513, 95%CI: 0.270–0.975). Factors that increase the likelihood of being depressed are being a female caregiver (OR = 2.296, 95%CI: 1.119–4.707), being uninsured (OR = 4.321, 95%CI: 1.750–10.672), being the partner or spouse of the care recipient (OR = 3.832, 95%CI: 1.546–9.493), and the number of hours of care (OR = 1.053, 95%CI: 1.021–1.085).ConclusionHigher levels of perceived social support and holidays were associated with lower levels of depression. However, being female, being the care recipient's partner or spouse, being uninsured, and having long care periods had detrimental effects. Interventions to preserve and enhance perceived social support could help improve depressive symptoms in informal caregivers. Additionally, support should be available to caregivers who are women, uninsured, and the care recipient's partner or spouse, as well as those who provide care for long hours, to ensure they have respite from their caregiving role.