Poor Social Support Networks Research Articles

Risk factors for depression in older adults in Bogotá, Colombia

PurposeThis paper aims to identify psychosocial, demographic and health risk factors associated with depression in older people.Design/methodology/approachA correlational study with 281 independent and autonomous persons of the community over 60 years old from Bogotá was conducted. The three instruments used to measure the variables included in the data analyses were Demographic and Health Data Questionnaire, Short version of 15 items of Geriatric Depression Scale (GDS) and Montreal Cognitive Assessment Test (MoCA).FindingsFifteen percent of the participants presented depression. Depression was associated with different demographic, low social support and health factors in this population group and was particularly high in women. Being a woman with poor social support networks and a previous history of depressive episodes should be considered as determining factors within a clinical risk profile for depression in older adulthood. It is essential to design prevention strategies focused on women and on the development of better social support in old age.Originality/valueDepression is a prevalent and highly disabling disease, when it is suffered by an older person it is associated with higher mortality, functional dependence, poor physical health, worse quality of life indicators and psychological well-being. In the elderly, the clinical diagnosis of depression is difficult, as it has a high comorbidity and is often confused with other health conditions prevalent during older adulthood.

Migrant Domestic Workers’ Experiences of Sexual Harassment: A Qualitative Study in Four EU Countries

Sexual harassment against female migrant domestic workers is a public health problem, which remains hidden and largely underreported. The current paper presents the results of a qualitative research study on sexually victimized migrant domestic workers in four European countries (Austria, Cyprus, Greece, and Sweden). The study aimed at exploring the profile and experiences of victimised individuals. Data were gathered via 66 semi-structured interviews with victimised female migrant domestic workers. Key findings of the current study indicate that the victims: (a) were usually undocumented and had low local language skills; (b) identified domestic work as the only way into the labour market; (c) suffered primarily psychological, economic, and social consequences; (d) had poor social support networks; (e) were poorly connected to governmental support services. This is the first study to explore this hidden problem via direct contact with victims. Addressing barriers of migrants’ social integration seems important. Better regulation and monitoring of this low-skilled occupation could minimise risks for vulnerable employees.

What do health workers think about a population exposed to health inequalities? The Bastogi case

Abstract Introduction Previous qualitative researches highlighted that people living in Bastogi - a peripheric area of Rome marked by social deprivation - have difficulties in accessing and relating health services. We explored the healthcare workers’ perception of the relationship with such population. Methods A 42 items questionnaire was addressed to the reference Local Health Unit employees, evaluating: context knowledge; perception of the relationship between users and health services and between users and operators; training needs. The association between answers and social characteristics of the respondents has been evaluated through Chi Square Test for categorical variables and T Student Test for continuous variables. Results Questionnaire respondents were 73 (50% of the total employees). 77% reported knowing Bastogi. Adverse social determinants mostly identified (>65%) were economic problems, housing conditions and unemployment, while less people pointed out the poor social support network (38%). 50% assumed that Bastogi inhabitants face health inequalities. 26% claimed to have difficulties in the relationship with users; 81% considered useful a training activity about the relationship with socioeconomic deprived users. 25% believed the responsibility for the main social problems in Bastogi lies in the inhabitants themselves. Such answer was statistically more frequent among: administrative professionals, professionals with longer length of service, those who deny the existence of health inequalities and those who don’t feel the need of training. Further results will be presented during the congress. Conclusions Preliminary results of the survey confirm that the relationship between users from a socially deprived area and the competent services is problematic, and underline the need for training of healthcare professionals on the subject. This need is also perceived by the majority of the respondent personnel. Key messages We explored the healthcare workers’ perception of the relationship they have with a population exposed to health inequalities. Interventions and trainings will be implemented to contain this problem.

Alcohol Dependence in Palliative Care: A Review of the Current Literature.

Alcohol misuse affects up to 28% of palliative care inpatients. This article aims to summarize the existing literature on the care of palliative patients with alcohol dependence. The author searched CINAHL, Scopus, MEDLINE, and PubMed from inception until July 2017 using search terms including "alcohol*," "dependence," and "palliative." The results were reported in a narrative manner. Identification of alcohol-dependent patients can be improved through the use of validated tools such as "Cut Down, Annoyed, Guilty, Eye Opener" (CAGE) and "Alcohol Use Disorders Identification Test" (AUDIT). These patients may have specific palliative care needs such as increased susceptibility to terminal agitation, high prevalence of comorbidities, and poor social support networks. Management may involve detoxification, controlled usage of alcohol, or treatment of alcohol withdrawal. Patients may derive clinical benefit when alcohol dependence is identified by health-care professionals. Routine screening should be considered. Further research is needed to directly compare treatments for alcohol dependence in palliative care.

OC21 - Psychosocial functioning of parents of infants diagnosed with complex congenital heart defect.

Theme: Parenting/parenthood. The diagnosis of complex CHD impacts the psychosocial status of parents and their functioning. A critical evaluation of the literature concerning the psychosocial parental response to their infant's diagnosis of complex CHD. Systematic review of 18 articles published after 2000 in PubMed and CINAHL. The impact of an infant's CHD on the family functioning is determined both by child's medical condition and family's psychosocial factors. The majority of parents experience intense loss and numerous stressors. Nurses and physicians need to be sensitive to the needs, thoughts and experiences of the parents when discussing treatment options. Families with poor social support networks may have the greatest need for professional interventions. Appropriate interventions assist the majority of parents to adapt to the diagnosis of complex CHD. However, there are a number of parents with an increased psychosocial risk associated with higher rates of emotional distress.

Factors associated with depressive symptoms in low‐income, older Korean women with hypertension

The purpose of this study was to identify the factors that are associated with depressive symptoms in community-dwelling, low-income, older Korean women with hypertension. A total of 107 low-income, older (aged 74 ± 6 years) Korean women with hypertension participated in the study. Information about depressive symptoms, functional status, and social support were collected by interviews that used the Geriatric Depression Scale, Katz's Activities of Daily Living, and the Lubben Social Support Network Scale, respectively. A logistic regression analysis was used to determine the factors that affected depressive symptoms. The results indicated that the depressed women had been diagnosed with hypertension for a longer period of time and took a larger number of medications than the women in the non-depressive group. They also had poorer functional status and an "isolated" social support network. The social support network, length of time since diagnosis, number of medications, and functional status were associated independently with depressive symptoms. It was concluded that clinicians should assess for the factors that are associated with depressive symptoms, including a poor social support network, poor daily activity, the number of medications, and the length of time since diagnosis in order to prevent the symptoms of comorbidities worsening in low-income, hypertensive, older women.

Social ties and risk for cancer – a prospective cohort study

Background. Poor social support and small social networks have been associated with increased risks for conditions such as coronary heart disease as well as with overall mortality. We investigated the association between social ties and risk for cancer. Material and methods. The study sample consisted of 8 548 Danes who had been examined in 1991–1994 within the Copenhagen City Heart Study. The median length of follow-up was 9.3 years (range, 0–11.2 years). Social ties were measured from answers to a questionnaire on social networks. Regression analyses for cancers at the most frequent sites (breast, lung, prostate and colon and rectum) were conducted with the Cox proportional hazards model, with adjustment for a number of well-known risk factors for cancer. Results. While we found no significant association between social ties and risk for cancer in men, women with high social network scores had an increased risk for lung cancer of borderline significance (HR, 2.16; 95% CI, 1.02–4.60). The risks for breast cancer and colorectal cancers were not significantly increased in the same group of women. Discussion. The results of this study do not support the hypothesis that social network size is associated with a decreased risk for cancer

Women with and without intellectual disability and psychiatric disorders

This article examines the literature on women with and without intellectual disability and psychiatric disorders, using a gender social model of health. Relevant empirical studies, international literature reviews and policies between 1980 and 2007 were identified from electronic databases, journals and secondary sources. Three areas were examined: psychiatric disorders, their contextual background, and their clinical presentation. There are minimal levels of research into women with intellectual disability and psychiatric disorders. However, this article hypothesizes that women with intellectual disability have higher rates of psychiatric disorders than women without. This may result from greater vulnerability related both to internal factors (;intra': cognitive deficits, poorer communication skills, limited social skills) and to the external world (;inter': lack of opportunities, stigma, poor social support networks). The article argues that such women require gender-sensitive mental health services. However, more empirical evidence is required to support this claim and to inform development and delivery of services.

Factors influencing attitudes of deinstitutionalized patients' neighbours

To investigate the psychosocial characteristics of homeless children and their parents.Homeless families were assessed within 2 weeks of admission to seven hostels and were compared with a group of housed families matched for socioeconomic status. Measures included a semistructured interview, the General Health Questionnaire (GHQ), the Interview Schedule for Social interaction, the Child Behavior Checklist (CBCL), the Communication domain of the Vineland Adaptive Behavior Scales, and height and weight percentiles. The sample consisted of 113 homeless families (249 children aged 2 through 16 years) and 29 comparison families (83 children).Homeless families primarily consisted of single mothers and an average of two children, who had become homeless because of domestic violence (56%) or violence from neighbors (29%). Homeless mothers reported high rates of previous abuse (45%) and current psychiatric morbidity (49% caseness on the GHQ) and poor social support networks compared with housed controls. Homeless children were more likely to have histories of abuse, living in care, and being on the at-risk child protection register and less likely to have attended school or a preschool/day-care center since admission to the hostel. They also had delayed communication and higher CBCL scores. Maternal GHQ scores best predicted CBCL caseness.Homeless mothers and children have high rates of psychosocial morbidity, which are related to multiple risk factors and chronic adversities. Their complex needs should be best met by specialized and coordinated health, social, and educational services. J. Am. Acad. Child Adolesc. Psychiatry, 1997, 36(7):881–889.

Self-reported skin morbidity and mental health. A population survey among adults in a Norwegian city

Several studies among dermatological patients have shown a link between various chronic dermatological diseases and mental morbidity. To explore the association between self-reported skin morbidity and psychosocial factors in the general population. This population-based cross-sectional study is part of the Oslo Health Study conducted during 2000-2001. All individuals in Oslo County, Norway, born in 1924/25, 1940/41, 1955, 1960 and 1970 received a postal questionnaire, which 18,770 men and women answered. The questionnaire provided information on sociodemographic factors and self-reported health and psychosocial factors. Dichotomous variables for 10 self-reported skin complaints were used. These were previously validated and refer to the most common chronic skin diseases. Mental distress was measured with a validated 10-item instrument, the Hopkins Symptom Check List-10; social support with the number of confidants; and negative life events with a 12-item validated instrument. The odds ratio (OR) for mental distress was 1.70 [95% confidence interval (CI) 1.21-2.38] for having itch, 1.64 (95% CI 1.15-2.34) for pimples and 1.72 (95% CI 1.06-2.80) for face rash in an adjusted model. In an adjusted model the OR for skin disease was 1.60 (95% CI 1.39-1.84) when the individual had experienced more than two negative life events; and 2.52 (95% CI 2.12-3.00) for mental distress. Skin morbidity increased for both genders, with poor social support network. There was a significant interaction between social support network and negative life events in the logistic regression model for skin disease when adjusted for sociodemographic factors. The study quantifies the association between dermatological problems and psychosocial factors at a population level. It underlines the need to focus on these issues in research and needs assessment in dermatology.

Prevalence and risk factors for depressive symptoms among community-dwelling elders in Taiwan

Depression in the elderly has become a serious health care issue worldwide. However, no studies have determined the prevalence and risk factors for depressive symptoms among a representative sample of community-dwelling elders in Taiwan. To determine the prevalence and risk factors for depressive symptoms among community-dwelling elders in Taiwan. Stratified random sampling was used to recruit a representative sample of 1200 elderly participants from northern, middle, southern, and eastern regions of Taiwan. The prevalence of depressive symptoms was 27.5%. Logistic regression analysis demonstrated that having a respiratory disease, poor cognitive function, poor social support network, dissatisfaction with living situation, perception of poor health status, and perceived income inadequacy were significant predictors of depressive symptoms in this sample. The risk factors for depression identified in this study need to be considered when assessing the health of elderly persons. In addition, interventions to reduce depressive symptoms in elders should include strategies to change some of these modifiable risk factors.

The Relative Contribution of Diagnostic and Psychosocial Factors in the Prediction of Adolescent Suicidal Ideation

Examined the relative importance of diagnostic and psychosocial factors in the prediction of adolescent suicidal ideation. Seventy-three high school students exhibitingemotional disturbance in the school setting completed a diagnostic interview and self-report measures assessing social support, family environment, negative life events, and problem solving. Using hierarchical regression analyses, only the presence ofapure internalizing disorder predicted suicidal ideation in addition to psychosocial variables. Interactions were found between psychiatric disorders and psychosocial variables. These results underscore the importance of including both diagnostic and psychosocial variables in research examining risk factors for adolescent suicidal behavior. Further, they suggest that adolescents presenting with psychiatric disorders, high levels of stress, and poor social support networks should be monitored for suicidality.

Why Gender Matters to the Euthanasia Debate: On Decisional Capacity and the Rejection of Women's Death Requests

On Decisional Capacity and Rejection of Women's Death Requests The debate has typically addressed tension between patient autonomy and physician obligations. Where physician-assisted suicide and active are concerned, ethicists balance a patient's request to die against both physician's role as healer and her duty of nonmaleficence. The physician is seen to be in a moral dilemma in which her commitments to healing and saving lives conflict with her commitment to serving her patients' needs, respecting their autonomy, and maintaining their trust. The focal question for ethical debate has thus been: how much should patient autonomy govern practices of physician-assisted suicide and active euthanasia? Such questions are too narrowly formulated because they fail to address background conditions that may affect a patient's death request. Besides individual agency, we must take into account ways gender roles and social circumstances affect patients' requests to die; and way those requests are received by our culture. Feminist approaches raise such contextual and cultural questions, yet there is little available feminist literature on physician-assisted suicide and euthanasia. Although feminists are concerned about cultural context within which women make medical decisions, they have primarily focused on women's reproductive decisions; only recently have feminist bioethicists turned to issues beyond reproduction. Susan Wolf offers one of few feminist treatments to date of euthanasia. She argues that women are more likely to request and physician-assisted suicide in an attempt to avoid burdening their families--a perversion of feminine ethic of care that takes women's caring for and about others to extreme--and that physicians are simultaneously more likely to fulfill women's death requests, based on the same historical valorization of women's self-sacrifice and same background sexism.[1] In a culture that valorizes their altruism and caring for others, women who suffer from severe pain or terminal illness may perceive themselves as failing in their appointed duties; unable to care for others, they may see themselves as actually burdening them. For Wolf, authenticity and rationality of a woman's request to die seems suspect at very least, given extent to which cultural expectations about burdening others have likely affected her. Indeed, Wolf chastens physicians not to accede to request for assisted suicide and euthanasia for this very reason (p. 308). Wolf also discusses unequal social conditions that may encourage women to seek death, such as poverty, higher incidences of depression, poor pain relief, lack of good medical care, and poor social support networks--essential topics in any ethical analysis of physician-assisted suicide and active euthanasia. While other feminists have shared these concerns for women's social conditions, Wolf is first to relate them to issue of euthanasia. Her analysis thus ushers in important theoretical and practical concerns regarding women's death requests and their implementation. I have isolated Wolf as an influential feminist voice because she brings depth to a debate that has, until recently, focused almost exclusively on issue of patient autonomy. I suggest, however, that Wolf's reasoning may actually lead to very different conclusions. While some women in particular can exhibit a preoccupation with and overemphasis on relationships, terminally ill women's death requests can also, like men's, stem from basic personal concerns for pain, psychic suffering, and determination that their lives have become meaningless or burdensome to them. In taking Wolf's feminist account seriously, I suggest that women's requests to die may be discounted, trivialized, and ignored for same reasons that Wolf claims they are too likely to be heeded. …

Psychosocial Functioning of Homeless Children

To investigate the psychosocial characteristics of homeless children and their parents. Homeless families were assessed within 2 weeks of admission to seven hostels and were compared with a group of housed families matched for socioeconomic status. Measures included a semistructured interview, the General Health Questionnaire (GHQ), the interview Schedule for Social Interaction, the Child Behavior Checklist (CBCL), the Communication domain of the Vineland Adaptive Behavior Scales, and height and weight percentiles. The sample consisted of 113 homeless families (249 children aged 2 through 16 years) and 29 comparison families (83 children). Homeless families primarily consisted of single mothers and an average of two children, who had become homeless because of domestic violence (56%) or violence from neighbors (29%). Homeless mothers reported high rates of previous abuse (45%) and current psychiatric morbidity (49% caseness on the GHQ) and poor social support networks compared with housed controls. Homeless children were more likely to have histories of abuse, living in care, and being on the at-risk child protection register and less likely to have attended school or a preschool/day-care center since admission to the hostel. They also had delayed communication and higher CBCL scores. Maternal GHQ scores best predicted CBCL caseness. Homeless mothers and children have high rates of psychosocial morbidity, which are related to multiple risk factors and chronic adversities. Their complex needs should be best met by specialized and coordinated health, social, and educational services.

Treatment approaches for older problem drinkers.

Recent research suggests that older adults with alcohol problems often drink in response to loneliness, depression, and poor social support networks. Although a variety of approaches such as psychodynamic, Twelve Step, social support, behavioral, and cognitive-behavioral, have been suggested, only those studies involving behavioral and cognitive-behavioral interventions have provided empirical support for treatment effectiveness. Some research also suggests that age-specific group treatment produces better outcomes than when older adults are placed in treatment with younger alcoholics.

A Population-Based Study of Functional Status and Social Support Networks of Elderly Patients Newly Diagnosed With Cancer

We assessed the functional status and social support networks of 799 men and women aged 65 years or older newly diagnosed with cancer and living in six New Mexico counties. Functional limitations included depending on others for transportation (33%) and mental incompetence or poor recent memory (42%). The percentage of patients with functional limitation increased sharply with increasing age. In a substantial number of patients there was also evidence for poor social support networks; 26.5% of subjects lived alone and 38.9% had no children living in the vicinity. In a multiple logistic regression analysis, the predictors of having a poor social support network included non-Hispanic white ethnicity, advanced age, low income, and being a recent migrant to the area. Subjects with functional limitations were more likely to have poor social support networks than subjects without such limitations. The deleterious combination of impaired functional status and a limited social support network may explain why elderly cancer patients are at increased risk for not receiving appropriate therapy. Given the potential complexities involving the evaluation and appropriate treatment of cancer, care must be taken to adequately assess functional status and support mechanisms of older patients, and to provide adequate support to ensure compliance with treatment.

A population-based study of functional status and social support networks of elderly patients newly diagnosed with cancer

We assessed the functional status and social support networks of 799 men and women aged 65 years or older newly diagnosed with cancer and living in six New Mexico counties. Functional limitations included depending on others for transportation (33%) and mental incompetence or poor recent memory (42%). The percentage of patients with functional limitation increased sharply with increasing age. In a substantial number of patients there was also evidence for poor social support networks; 26.5% of subjects lived alone and 38.9% had no children living in the vicinity. In a multiple logistic regression analysis, the predictors of having a poor social support network included non-Hispanic white ethnicity, advanced age, low income, and being a recent migrant to the area. Subjects with functional limitations were more likely to have poor social support networks than subjects without such limitations. The deleterious combination of impaired functional status and a limited social support network may explain why elderly cancer patients are at increased risk for not receiving appropriate therapy. Given the potential complexities involving the evaluation and appropriate treatment of cancer, care must be taken to adequately assess functional status and support mechanisms of older patients, and to provide adequate support to ensure compliance with treatment. (<i>Arch Intern Med</i>. 1991;151:366-370)