Main Effects Of Social Support Research Articles

#376 Self-efficacy, social support and hemodiafiltration are independently associated with better Self-Reported Health Status over time

Abstract Background and Aims Patients with kidney disease receiving dialysis are a highly vulnerable population. Psychosocial determinants of Self-Efficacy (SE) and Social Support (SS) have been suggested as potentially important outcomes for people with end stage kidney disease. We investigated whether these variables could explain differences in Health-Related Quality of Life (HRQL) outcome domains over time independently or in interaction with treatment modality of high-flux hemodialysis (HD) versus high-dose hemodiafiltration (HDF). Method HRQL in 1264 participants from the international multi-centre, prospective, randomized, open label, controlled CONVINCE trial were assessed, using screening and quarterly follow-up data up to 24 months. Measures included the MOS Social Support Scale, General Self-Efficacy Scale, and PROMIS short forms for fatigue, physical function, pain interference and intensity, sleep disturbance, anxiety, cognitive function, depression, ability to participate in social roles. SE, SS and interactions with modality were included as independent variables and HRQL domains as dependent variables in a linear mixed effects model with random intercept and slope for SE and SS. Results Participants were 20-92 (M=62.33, SD=13.50) years old, 62.9% were male. Linear mixed effect regression models showed significant main effects for self-efficacy (β = −0.15-1.09, all p < .0001) on all HRQL domains. Significant SE × time interactions were found for all variables (β = −0.02-0.04, all p < .01) but pain intensity. Main effects for SS were found for cognition (β = 0.31, p = .00) and sleep disturbance (β = −0.21, p = .00). A significant SS × time interaction was found for anxiety (β = 0.01, p = .02) and sleep disturbance (β = 0.02, p = .00). Plots for these associations can be found in Figs 1 and 2. Marginal means were plotted and 25%, 50% and 75% quantiles were used to separate the different levels of SE and SS. There were no significant interactions between treatment modality (HDF vs. HD) and SE/SS. Conclusion Our results indicate that higher SE and better SS are independently associated with higher HRQL of dialysis patients over time, showing no significant interactions with HDF. SE had the largest effects on HRQL. This bears the chance to develop targeted psychosocial interventions to improve health outcomes when introducing new therapy options for patients. However, patients achieving higher HRQL over the course of the treatment may also experience higher SE and SS over time. Future research should include longitudinal assessments on these psychosocial determinants to evaluate their effect further.

Heterosexism and Suicidal Ideation.

Background: Heterosexism has been identified as being a contributing factor of suicidality in sexual minority adults (SMA), and social support is believed to be important for mitigating these effects. Research evaluating racial/ethnic differences in suicidality among SMA is limited despite racial/ethnic minorities being at greater risk. Aims: We aimed to examine the associations between heterosexism, suicidal ideation, and social support in a sample of racially/ethnically diverse SMA. Method: SMA (N = 239) were recruited as part of an online survey on sexuality and health based in the United States. Results: There were significant positive main effects of heterosexism and significant negative main effects for non-White racial/ethnic identity on suicidal ideation. There were significant negative main effects for social support from family and a significant other but not from friends. A significant interaction of social support from a significant other and racial ethnic identity was qualified by a significant three-way interaction with heterosexism. Social support from a significant other buffered the effect of heterosexism on suicidal ideation among non-White but not among White SMA. All other interactions were not significant. Limitations: Within-group differences of racial/ethnic groups and other domains of social support were not examined, and the cross-sectional nature of the data precludes causal inference. Conclusion: Support from a significant other may be important for suicidality, particularly for racial/ethnic minority SMA.

Perceived Functional Social Support and Self-Rated Health: The Health Promoting Effects of Instrumental Support for the Irish Community in London.

Despite an increasing volume of research on Irish migrants to the UK, limited scientific data exists on the main effects of social support on the health of this community. A sample of Irish migrants in London was purposefully recruited (n = 790). Linear regression was used to predict social support. Logistic regression examined the independent association between functional social support and self-rated health (SRH) controlling for low risk covariates. Older age, economic factors and better SRH precited stronger social support. Irish migrants who reported being able to rely on at least three people in times of crisis and those who perceived strongeremotional support were more likely to report good SRH when adjusted for demography and socio-economic factors. As risks increased only perceived support in times of crisis predicted SRH. Interventions which build reliable and trusted social networks may have a direct effect on migrant health.

The relationship between social support and anxiety among caregivers of children in HIV-endemic South Africa

Caring for children can be a source of joy and fulfilment, but also a source of stress, especially for caregivers living with illness and/or coping with difficult socio-economic conditions. Risks for poor caregiver mental health are especially salient in many parts of southern Africa affected by a generalised HIV-epidemic, high rates of physical illness, difficult livelihood conditions and an increasing number of orphaned and vulnerable children in need of care. Given limited availability and low uptake of formal mental health services in South Africa, the potential protective role of informal community or “social” resources for caregiver populations requires greater attention. To our knowledge, this is the first study to quantitatively assess the relationship between social support and symptomatic anxiety among caregivers of children living in HIV-endemic southern African communities. The data are from household survey interviews with 2477 adult primary caregivers of children aged 10–17 years living in two (urban and rural) resource-deprived HIV-endemic South African communities. Hierarchical logistic regression analysis with interaction terms was conducted to assess whether HIV and other illness were significant stressors for caregiver anxiety, whether social support had main or stress-buffering protective effects on anxiety and whether gender moderated the association between social support and anxiety. Our findings showed significant main effects of social support on caregiver anxiety, but no evidence of stress-buffering effects of support or of gender moderating the support-anxiety relationship. This suggests that social support is a general mental health resource for both male and female caregivers of children in these HIV-endemic communities, regardless of whether they are facing specific stressors related to HIV or other illness. Our results highlight the importance of paying greater attention to the social environment when designing and implementing caregiver health interventions, and indicate that social support could be a valuable component of such interventions.

Everyday Physical Activity in Ambulatory Heart Transplant Candidates: the Role of Expected Health Benefits, Social Support, and Potential Barriers

Physical activity (PA) is recommended for stable patients with advanced heart failure (HF). We evaluated expected health benefits of PA and social support as facilitators of PA, and physical symptom distress and psychological distress (depression, anxiety) as barriers to PA. Additionally, we investigated if facilitators of PA are of particular importance for patients who report barriers. We analyzed data assessed at time of waitlisting in 231 ambulatory patients (53.4 ± 10.3years, 18% women) who were enrolled in the multisite Waiting for a New Heart Study in 1 Austrian and 16 German hospitals. Self-reported everyday PA scores (number of activities, duration of activities) was regressed on demographic characteristics and indicators of disease severity (ejection fraction, peak oxygen consumption), facilitators (expected health benefits of PA, perceived emotional support, perceived support for PA), and barriers to PA (physical symptom distress, psychological distress). Interaction terms of facilitators with barriers were also examined. PA was positively associated with higher peak oxygen consumption, validating self-reported PA. Regarding facilitators, expected health benefits of PA were independently associated with higher PA (p values < 0.001). There were no main effects for social support on PA. Regarding barriers, depression tended to be associated with fewer activities (p = 0.068). However, in the presence of barriers (depression, physical symptoms), feeling supported for being physically active was positively associated with PA (p values < 0.05). Interventions to improve PA may benefit from strengthening positive expectations of health outcomes associated with everyday PA and fostering PA-specific social support for those distressed by HF symptoms or depression.

Stressors, social support and psychological responses to sport injury in high- and low-performance standard participants

Objective The purpose of the present study was to examine the main and buffering effect relationships between social support and psychological responses to sport injury with samples of high- and low-performance standard injured participants. Method High- ( N = 147) and low-performance ( N = 114) standard injured participants completed measures of perceived social support, injury-related stressors and psychological responses during physiotherapy clinic visits. Results Moderated hierarchical regression analyses revealed the following key findings: a) in the high-performance sample, there were significant ( p < .05) main effects for social support in relation to psychological responses; b) in the low-performance sample, there were significant buffering effects for social support in relation to psychological responses. That is, in the low-performance sample, the detrimental relationships between stressors and psychological responses were reduced for those with high social support compared to those with low social support, but level of social support was relatively unimportant at low levels of stressors. Conclusion These results highlight that the relationships between social support, stressors, and psychological responses to sport injury may differ, depending upon the performance standard of the athlete. The impact of social support in the injury process may therefore be more complicated than first thought, and this has implications for interventions aimed at increasing social support for injured athletes.

Does social support differentially affect sleep in older adults with versus without insomnia?

Objective Insomnia is a significant public health problem, particularly among older adults. We examined social support as a potential protective factor for sleep among older adults (60 years and older) with insomnia ( n=79) and age- and sex-matched controls without insomnia ( n=40). Methods Perceived social support, sleep quality, daytime sleepiness, and napping behavior were assessed via questionnaires or daily diaries. In addition, wrist actigraphy provided a behavioral measure of sleep continuity parameters, including sleep latency (SL), wakefulness after sleep onset (WASO), and total sleep time (TST). Analysis of covariance for continuous outcomes or ordinal logistic regression for categorical outcomes were used to examine the relationship between social support and sleep-wake characteristics and the degree to which observed relationships differed among older adults with insomnia versus non-insomnia controls. Covariates included demographic characteristics, depressive symptoms, and the number of medical comorbidities. Results The insomnia group had poorer subjective sleep quality, longer diary-assessed SL and shorter TST as compared to the control group. Higher social support was associated with lesser actigraphy-assessed WASO in both individuals with insomnia and controls. There was a significant patient group by social support interaction for diary-assessed SL, such that higher levels of social support were most associated with shorter sleep latencies in those with insomnia. There were no significant main effects of social support or social support by patient group interactions for subjective sleep quality, daytime sleepiness, napping behavior, or TST (diary or actigraphy assessed). Conclusion These findings extend the literature documenting the health benefits of social support, and suggest that social support may similarly influence sleep in individuals with insomnia as well as non-insomnia controls.

Independent Association Between Lower Level of Social Support and Higher Coagulation Activity Before and After Acute Psychosocial Stress

To investigate the relationship between social support and coagulation parameter reactivity to mental stress in men and to determine if norepinephrine is involved. Lower social support is associated with higher basal coagulation activity and greater norepinephrine stress reactivity, which in turn, is linked with hypercoagulability. However, it is not known if low social support interacts with stress to further increase coagulation reactivity or if norepinephrine affects this association. These findings may be important for determining if low social support influences thrombosis and possible acute coronary events in response to acute stress. We investigated the relationship between social support and coagulation parameter reactivity to mental stress in men and determined if norepinephrine is involved. We measured perceived social support in 63 medication-free nonsmoking men (age (mean +/- standard error of the mean) = 36.7 +/- 1.7 years) who underwent an acute standardized psychosocial stress task combining public speaking and mental arithmetic in front of an audience. We measured plasma D-dimer, fibrinogen, clotting Factor VII activity (FVII:C), and plasma norepinephrine at rest as well as immediately after stress and 20 minutes after stress. Independent of body mass index, mean arterial pressure, and age, lower social support was associated with higher D-dimer and fibrinogen levels at baseline (p < .012) and with greater increases in fibrinogen (beta = -0.36, p = .001; DeltaR(2) = .12), and D-dimer (beta = -0.21, p = .017; DeltaR(2) = .04), but not in FVII:C (p = .83) from baseline to 20 minutes after stress. General linear models revealed significant main effects of social support and stress on fibrinogen, D-dimer, and norepinephrine (p < .035). Controlling for norepinephrine did not change the significance of the reported associations between social support and the coagulation measures D-dimer and fibrinogen. Our results suggest that lower social support is associated with greater coagulation activity before and after acute stress, which was unrelated to norepinephrine reactivity.

Social support in unaccompanied asylum‐seeking boys: a case study

The situation of unaccompanied asylum-seeking children (UASC) is characterized by a substantial disruption of the social network and loss of parental support, seriously jeopardizing their psychological well-being. However, little is known about the role of social support in the lives of UASC. Twelve UASC completed a social support instrument and interview exploring perceived social support and what this implies for both buffering and main effects of social support. Asylum centre staff and the ethnic community were the most important resources of support. High importance was ascribed to social companionship as a way of coping. Despite pro-social efforts towards Belgian peers, this group provided hardly any social support. The provision of social support could enhance UASC's well-being through buffering effects (e.g. social companionship as avoidant/distractive coping) and main effects (acceptance by Belgian peers enhancing self-esteem). The asylum centre shows a great potential to stimulate UASC's psychological well-being by expanding the psychosocial function of staff members and community treatment.

Stressors, social support, and effects upon performance in golf

In this study, we extended the work of Rees and Hardy (2004) by examining the main and stress-buffering effects of social support upon sports performance in a different context, using a different outcome measure, and a specific time-frame. A high-level performance sample of 117 male golfers (mean age 24.8, s = 8.3) completed measures of social support and stressors before competitions. Performance outcome was recorded. Moderated hierarchical regression analyses revealed significant (P < 0.05) main effects for stressors upon performance in 8 of the 11 models tested (R 2 = 0.08 – 0.21). Over and above the variance accounted for by stressors, there were significant (P < 0.05) main effects for social support upon performance in all models tested (ΔR 2 = 0.10 – 0.24). In all models, stressors were associated with worse performance, whereas social support was associated with better performance. There were no significant interactions (stress-buffering effects). Main effects for social support upon performance suggest that social support may have aided performance directly, regardless of the level of stress.

Social support during pregnancy: effects on maternal depressive symptoms, smoking and pregnancy outcome

The goal was to study the effects of social support during pregnancy on maternal depressive symptoms, quality of life and pregnancy outcomes. Eight hundred ninety-six women were prospectively studied in the first trimester of pregnancy and following completion of the pregnancy. The sample was divided into quartiles yielding groups of low, medium and high social support based on perceived social support. Pregnant women with low support reported increased depressive symptoms and reduced quality of life. The effects of social support on pregnancy outcomes were particularly pronounced in women who had smoked during pregnancy, with significant main effects of social support in a two-way analysis of variance (smoking status and social support) for child body length (F = 4.26, P = 0.04; 50.43 +/- 2.81 cm with low support versus 51.76 +/- 2.31 cm with high support) and birthweight (F = 11.35, P = 0.001; 3175 +/- 453 g with low support versus 3571 +/- 409 g with high support). In smokers, pregnancy complications occurred more frequently when given low support {34 versus 10.3% with high support, chi(2) = 5.49, P = 0.019; relative risk (RR) = 3.3 [95% confidence interval (95% CI) = 1.1-10.2]}, and the proportion of preterm deliveries was greater given low support (10.0 versus 0% with high support, chi(2) = 3.84, P = 0.05, odds ratio = 8.1). Lack of social support constitutes an important risk factor for maternal well-being during pregnancy and has adverse effects on pregnancy outcomes.

Social support, life events and physical symptoms: A prospective study of chronic and recent life stress in men and women

The objective of this study was to examine whether functional social support buffers the effects of chronic and recent life stress on physical symptom reporting in men and women and assess whether perceptions of support remain stable over time. A longitudinal design was used. Self-ratings of stressful experiences were completed every 3 months over a period of 1 year. Physical symptoms were assessed at 6 and 12 months, and perceptions of social support were measured at baseline and at 12 months. Three groups were formed on the basis of average stress values for the first and second 6 months of the year: chronic low stress, chronic high stress and a recent high-stressed group consisting of individuals who reported low stress for the first 6 months, but high stress for the second 6 months of the year. As expected, high life stress was associated with greater symptom reporting. Perceptions of support remained stable and did not decline over the 12 months. After controlling for negative affectivity and physical symptoms at 6 months, no main effects of social support were found on reported physical health. However, perceived social support did moderate physical symptom reporting in those reporting recent high stress. For chronically high-stressed individuals there was no significant difference in physical symptoms between those with high or low social support. It was concluded that social support moderates the impact of recent but not chronic life stress on physical symptom reporting.

Variation in the impact of social network characteristics on physical functioning in elderly persons: MacArthur Studies of Successful Aging.

Social support and social networks have been shown to exert significant effects on health and functioning among elderly persons. Although theorists have speculated that the strength of these effects may differ as a function of sociodemographic characteristics and prior health status, few studies have directly tested the moderating effects of these variables. Longitudinal data from the MacArthur Study of Successful Aging were used to examine the effects of structural and functional social support on changes in physical functioning over a 7-year period, measured by the Nagi scale, in a sample of initially high-functioning men and women aged 70 to 79 years. Multiple regression analyses were used to test the main effects of social support and social network variables, as well as their interactions with gender, income, and baseline physical performance. After controlling for potential confounding effects, respondents with more social ties showed less functional decline. The beneficial effects of social ties were stronger for respondents who were male or had lower levels of baseline physical performance. The effects of social support and social networks may vary according to the individual's gender and baseline physical capabilities. Studies of functional decline among elderly persons should not ignore this population variation in the effects of social networks.

Moderating effects of affective disposition and social support on the relationship between person-environment fit and strain.

The moderating effects of affective disposition and social support on the relationship between fit and strains were examined. Person-environment fit was measured in terms of occupational needs and reinforcers. Both positive and negative affectivity were investigated. Data were collected by means of a self-report questionnaire from 241 nurses in a Canadian hospital. Consistent with previous findings, fit was related to work satisfaction and all but one measure of psychological strain. Some support was found for the moderating effects of positive affectivity on work satisfaction and burnout, and scores on both positive and negative affectivity showed significant main effects on strain measures. Although there was no evidence of a buffering effect for social support, main effects of social support were significant for work satisfaction and one component of burnout, i.e., emotional exhaustion. Implications are discussed and recommendations for future research proposed.

MODERATING EFFECTS OF AFFECTIVE DISPOSITION AND SOCIAL SUPPORT ON THE RELATIONSHIP BETWEEN PERSON-ENVIRONMENT FIT AND STRAIN

The moderating effects of affective disposition and social support on the relationship between fit and strains were examined. Person-environment fit was measured in terms of occupational needs and reinforcers. Both positive and negative affectivity were investigated. Data were collected by means of a self-report questionnaire from 241 nurses in a Canadian hospital. Consistent with previous findings, fit was related to work satisfaction and all but one measure of psychological strain. Some support was found for the moderating effects of positive affectivity on work satisfaction and burnout, and scores on both positive and negative affectivity showed significant main effects on strain measures. Although there was no evidence of a buffering effect for social support, main effects of social support were significant for work satisfaction and one component of burnout, i.e., emotional exhaustion. Implications are discussed and recommendations for future research proposed.

Effects of occupational stress on the physical and psychological health of women in a microelectronics plant

Physical and psychological effects of occupational stress were examined in a sample of 552 female blue collar employees of a microelectronics facility. After controlling for demographic and biological risk factors, non-work life events, and solvent exposure, job-related conflict was associated with depressive symptomatology, severe headaches, lightheadedness weakness/fatigue, rashes, and presence of multiple symptoms. Job demands were only associated with multiple symptoms. Solvent exposure did not interact with either of the job stress measures synergistically to increase symptom reports. Although the main effects of social support, when present, were in the direction of reducing symptomatology, the interactive effects of social support and stress on health were inconsistent and dependent on the source of support.

Hardiness and social support as predictors of psychological discomfort in mothers of children with autism

Mothers of 60 children with autism participated in this study to measure the effects of social support and hardiness on the women's responses to the stressful demands of raising a child with a disability. MANOVA analysis indicated a significant main effect for hardiness, Wilks' lambda = .859, approx. F(2, 55) = 4.494, p less than .02. There were no main effects for social support, or for the interaction of social support and hardiness. In regression analyses, the best combination of predictors of depressive symptoms were the Commitment dimension on the Hardiness Questionnaire and the total score on the Interpersonal Support Evaluation List social support inventory, mult. R = .783, p less than .001. The best predictor of somatic complaints was total Hardiness score, mult. R = .698, p less than .01. There was a significant correlation between hardiness and perceived social support, r(57) = -.67, p less than .001. Results are discussed in terms of the relationship between perceived social support and hardiness and the potential buffering effect of these dimensions.

The effects of social support on nuclear worker responses to the Three Mile Island accident

AbstractThis study examines the effects of social support on the reactions of nuclear workers at the Three Mile Island plant and a comparison site to stress during the 1979 crisis. Results show broad main effects of social support on stress, strain, and health outcome variables. Moderating effects of support are highly selective and become less extensive as the hypothesized stress process moves from stress to strain to health outcomes. Findings are compared between the two nuclear plants and with other studies conducted under non‐crisis conditions.

The Role of Social Support During an Organizational Crisis: Stress Reactions of Nuclear Workers to the Three Mile Island Accident.

Results of a study of the nuclear worker reactions to the TMI accident show broad main effects of social support on stress, strain, and health outcome variables. Moderating effects of support are highly selective and become less extensive as the hypothesized stress process moves from stress to strain to health outcomes.

Social Support, Occupational Stress, and Health

The present paper is concerned with the buffering hypothesis that social support ameliorate. the impact of occupational stress on job-related strain and health. Previous studies of this hypothesis have yielded conflicting results. Our purpose, therefore, is twofold. First, we summarize the literature in this area and review several studies in detail, all of which found main effects of social support on perceived occupational stress and on some health outcome measures. Three of the studies were specifically designed to examine the buffering effects of support. Of the three, two found little or no evidence for buffering (LaRocco and Jones, 1978a; Pinneau, 1975), whereas the third reported buffering effects (House and Wells, 1978). Second, we attempt to reconcile these different conclusions by reanalyzing one data set-first analyzed by Caplan et al. (1975) and then by Pinneau (1975)-using a moderated regression technique identical to that used in the LaRocco and Jones (1978a) and House and Wells (1978) studies. The data usedfor this analysis consist of a randomly stratified sample of men from 23 occupations (N 636). Our review andfindings support the buffering hypothesis for mental and physical health variables (anxiety, depression, irritation, and somatic symptoms), but, as in the previous three studies, fail to support the buffering hypothesis in regard to job-related strains (job dissatisfaction, boredom, dissatisfaction with work load).