Social Anchorage Research Articles

Abstention, alcohol use and risk of myocardial infarction in men and women taking account of social support and working conditions: the SHEEP case-control study.

Very few studies indicating that low-moderate alcohol consumption protects from myocardial infarction (MI) controlled for social support and working conditions, which could confound the findings. Therefore, a first aim was to study the risk of non-fatal and total MI in relation to volume of alcohol consumption and measures of social support and working conditions. A second aim was to analyse the impact of the volume of earlier alcohol use in abstainers. Data came from a case-control study, the Stockholm Heart Epidemiology Program (SHEEP), including first MI among Swedish citizens 45-70 years old. Stockholm County 1992-94. There were 1095 cases of MI in men and 471 in women (928 and 372 were non-fatal), and 2339 living controls from the general population. Information about alcohol use at different periods in life and job strain, social anchorage and life control besides pre-existing health problems, smoking, physical activity, socio-economic status and marital status was obtained by a questionnaire from the cases and the controls. In multivariate logistic regression analyses, the relative risk for MI (especially non-fatal) was reduced among alcohol consumers. RR for non-fatal MI was 0.52 (95% confidence intervals 0.32, 0.85) in men with a consumption of 50-69.9 g 100% ethanol/day and 0.21 (95% confidence interval 0.06, 0.77) in women with a consumption of 30 g or more per day (reference category 0.1-5 g 100% ethanol/day). Men who were abstainers during the previous 1-10 years and with an earlier average consumption of 5-30 g 100% ethanol/day had a significantly lower relative risk compared to such abstainers with an earlier higher consumption. Earlier consumption among abstainers may also have an impact on gender differences in MI. Analyses showed positive interaction between abstention and low life-control in women, but only 4% of the female cases were due to this interaction. There were no other interactions between measures of alcohol use and social anchorage, life control and working situations. Alcohol use had a protective impact on MI, with little impact of job strain, social anchorage and life control, giving increased support for a protective impact of low-moderate alcohol use. The level of previous alcohol consumption among male 1-10-year-long abstainers influenced the risk of MI.

Musculoskeletal pain and its socioeconomic implications.

Pain is the most common reason for patients seeking advice from their physician. One adult in five suffers from chronic pain. In general, musculoskeletal pain, often in the form of arthritis, non-articular rheumatism, peripheral neuropathies and low back disorders, represents the most common cause of chronic non-malignant pain (CNMP). Exposure to low social support, low social anchorage or low social participation significantly increases the odds of a high level of pain. Most patients do not attribute chronic musculoskeletal pain to injury, but those who do report significantly higher levels of emotional distress. Pain is the third leading reason for absence from work in the United States, where the problem of chronic pain translates into an annual expenditure of at least $50 billion. The effectiveness of opioids for chronic pain goes unchallenged, but issues of potential dependence, abuse, and social and legal concerns have rendered their use in CNMP controversial. Numerous consensus statements, guidelines and policies have been issued by a variety of advocate organisations for the treatment of CNMP with opioids. Undertreatment of chronic pain persists despite the availability of drugs and other therapies for effective pain management.

Um estudo sobre as formas de preconceito contra homossexuais na perspectiva das representações sociais

Este artigo analisa, na perspectiva das representacoes sociais, as formas como estudantes universitarios expressam o preconceito contra homossexuais e a relacao desse preconceito com as explicacoes da homossexualidade. Para tanto, aplicaram-se questionarios a 220 alunos de uma universidade publica da cidade de Joao Pessoa. Os resultados permitiram classificar os estudantes em uma tipologia composta por tres grupos de individuos: preconceituosos flagrantes, preconceituosos sutis e nao preconceituosos. A analise da ancoragem social do tipo de preconceito apresentado pelos estudantes mostrou que os preconceituosos flagrantes se opuseram as explicacoes psicossociais (proprias das mulheres e dos estudantes de psicologia) e aderiram mais fortemente as explicacoes etico-morais e religiosas (proprias dos estudantes de engenharia). Os nao preconceituosos estudam psicologia e aderem as explicacoes psicossociologicas. Ja os preconceituosos sutis explicaram a homossexualidade a partir de causas biologicas e psicologicas, proprias dos estudantes de medicina e das mulheres.

Common symptoms in middle aged women: their relation to employment status, psychosocial work conditions and social support in a Swedish setting

STUDY OBJECTIVEOver the past few decades there has been a growing interest among researchers, in women's overall life circumstances and their relation to women's health status. For example, paid employment...

Gender specific associations between social network and health behavior in old age

Social networks may affect old people's health behaviors, such as their subjective health evaluations, health care utilization and symptom reporting. In this study, the relationships between social network characteristics and health behaviors were investigated for each gender separately. It was assumed that the relationships differ between the genders and that female health behavior would be more strongly related to the social network. Social network characteristics, reported symptoms, subjective health and health care utilization were assessed for 107 men and 77 women that were 71 years of age.The results showed that, for women, a general satisfaction with the social network was associated with good subjective health. In addition, satisfaction with social participation and social anchorage were associated with a high frequency of health care utilization. For men, none of these health-related behaviors were bivariately associated with the social network. Furthermore, for women, the frequency of reported symptoms were more often associated with social network characteristics. Multivariate analyses showed that for women, dissatisfaction with social participation and support from the neighborhood predicted stomach symptoms. For men, dissatisfaction with instrumental support and contact with children predicted tension symptoms. This study suggests that health behaviour relates both to social network and gender.

Social relations: network, support and relational strain

We introduce a conceptual framework with social relations as the main concept and the structure and the function of social relations as subconcepts. The structure of social relations covers aspects of formal relations and social network. The function of social relations covers social support, social anchorage and relational strain. We use this conceptual framework to describe social relations in the Danish population, with questionnaire data from the Danish Longitudinal Health Behaviour Study including a random sample of each of the age groups 25-, 50-, 60- and 70-year olds, N=2,011. The postal questionnaires were answered by a random sample in each of the age groups. The results show marked age and gender differences in both the structure and the function of social relations. The social network, measured as weekly contacts, weakens with age and so does instrumental support. Emotional support is unrelated to this decline in contact frequency and appears to be at the same level for younger and older individuals. Relational strain, measured as conflicts, declines with age for all kinds of social relations. The weakening of the social network with age does not seem to affect the level of emotional support and in turn seems to be partly compensated for by a simultaneous decline in relational strain.

Stages of acculturation as reflected by depression reduction in immigrant nursing students.

Depression amongst immigrant students from the former Soviet Union was assessed as an index of the stage of their acculturation into the new host society, Israel. At the beginning of the first year of nursing school, three groups completed the Beck Depression Inventory. The two groups of immigrants: immigrant nurses preparing for licensing (N = 26) and immigrant students (N = 16), reported mild levels of depression, while Israeli students (N = 33) were significantly less depressed, within the normal range. Six months later, both immigrant groups were within the normal range, the immigrant nurses group showing the greatest decrease in depression. This change may be explained by adaptation to the educational setting, mastering the host society's language and social anchorage. The importance of background variables for predicting depression reduction is examined. The findings are discussed within the framework of multistage models of acculturation and the implications for counseling immigrant students are presented.

Social network patterns among the elderly in relation to their perceived life history in an Eriksonian perspective

Past research has shown that social network patterns, the remembered past, and sense of coherence (SOC) are all important factors for well-being in old age. In this study, these interrelationships were examined, with special attention given to the gender differences, concerning structures and functions of the social network. Fifty-eight elderly individuals reported life-history evaluations according to the psychosocial conflicts, proposed by Erik H. Erikson. They also reported social network patterns and SOC according to standardized questionnaires. Factor analyses revealed that there are gender differences concerning the patterns of social network. For women, social anchorage was an important factor, while for men, social influence was more important. Structures and functions of the social network correlated with both positive and negative life history evaluations, but the correlations differed between the sexes. When SOC was controlled the correlations changed, but to a small degree. Stepwise discriminant analyses showed that the male social network patterns were predicted from negative evaluations of the identity period, low scores on the sense of manageability, positive evaluations of the trust/autonomy period and high scores on the sense of comprehensibility. The female social network patterns were predicted from negative evaluations of the trust/autonomy and from the late generativity periods and positive evaluations of the early generativity period. It was hypothesized that structures and functions of the social network are sometimes used as compensation for shortcomings in the internal-based self-concept.

Does organization matter? A multilevel analysis of the demand-control model applied to human services

The demand-control model (DC model) in occupational epidemiology suggests that health, an individual attribute, is partly determined by work organization, via the interplay of demand and control, job strain. The objective of this study was empirical assessment of the model's tenet of an organizational determination of individual health. An emerging analytic method, multi-level modelling, permits such an assessment The study encompasses two large Swedish human service organizations. It was based on a nationally representative sample of 291 local organizational units (level 2) with 8296 employees (level 1), a median of 18 employees per unit. 5730 persons (69.1%) completed the questionnaire. Listwise deletion of missing data left a net study base of 4756 individuals in 284 units. Missing data were largely random. Demand and control were measured by standard questions and combined into a job strain index. Two such indices were calculated, one for quantitative demands and one for emotional demands. Individual attributes included age, gender, marital status, having children, social anchorage, and education. There were two dependent variables, self-assessed psychovegetative symptoms (worry, anxiousness, sadness, sleep difficulties, restlessness, and tension) and exhaustion (fatigue, feelings of being used up and overworked), both measured as summative indices. For psychovegetative health, a null model yielded 2.2% level 2 variance, unchanging when individual attributes were included in a random intercepts model. Inclusion of the strain variables rendered level 2 variance non-significant, decreasing level 1 variance by 23% and level 2 variance by 62%. For exhaustion, level 2 variation was 8.3% in the null model and 1.6% in the final model, with strain variables. The strain variables utilized in the DC-model thus draw a substantial part of their variation from the organizational level. It is concluded that the claim of the DC model to rely on organizational factors receives support.

Carotid atherosclerosis in middle-aged men. Relation to conjugal circumstances and social support

The purpose of this study was to examine the association of conjugal circumstances and social support with carotid atherosclerosis. The subjects were 212 men randomly selected from those (N = 4,853) aged 50-60 years, living in Kuopio and a nearby residental area in eastern Finland. Social network and support levels were assessed with a structured 34-item questionnaire. Conjugal circumstances were constituted by cohabition or otherwise. Intima media thickness of the carotid artery (IMT) was chosen to designate atherosclerosis, and determined by quantitative B-mode ultrasonography. The analyses showed that the men living alone had greater common carotid (p = 0.008) and carotid bifurcation (p = 0.011) IMT values than their cohabiting counterparts. The differences remained significant even when the confounding factors (age, health status and education level) and potential intervening factors (saturated fat consumption and smoking) were allowed for. Of the social support subindices, strong adequacy of emotional support (p < 0.001) and of the social network subindices, strong social anchorage (p = 0.031) were correlated to increased common carotid IMT. The present data suggest that conjugal circumstances are an independent social factor predicting carotid atherosclerosis.

Social network, social support and the prevalence of neck and low back pain after retirement. A population study of men born in 1914 in Malmö, Sweden.

In this study we investigated the importance of social network and social support systems outside the workplace and workload and psychological job strain in former work for the prevalence of daily neck and low back pain. The study population (n = 621) comprised a random half of all male residents in Malmö, Sweden, born in 1914, of whom 500 (80.5%) participated. Two of the social network and social support indices (social anchorage and availability of material and informational support) were independent of life-style factors (leisure time physical activity, smoking and alcohol consumption) related to daily neck and back pain after retirement (OR = 2.0, 95% CI 1.2-3.4 and OR = 1.7, 95% CI 1.0-2.7, respectively), while the psycho-social and physical factors in former work were not. As no conclusion about the direction of the association can be drawn, prospective studies are needed to further explore these findings.

Social network, social support and heavy drinking in elderly men--a population study of men born in 1914, Malmö, Sweden.

We analysed whether there were associations among different aspects of social network and social support, on one hand, and heavy drinking and alcohol problems on the other. The study sample (n = 621) comprised a random half of all male residents born in 1914 in Malmö, Sweden. Five hundred (80.5%) participated. Heavy drinking was defined as an alcohol consumption above 250 g alcohol per week and alcohol problems were assessed by a modified Michigan Alcoholism Screening test. Eight conceptually differential aspects of social networks and social support were measured. Four of five social network indices (social anchorage, social participation, contact frequency, spousal support) were associated with heavy drinking (OR 1.9-2.5) and two social network indices (social anchorage, spousal support) were associated with alcohol problems (OR 2.1-2.3). The results in this study are independent of social class, but based on a cross-sectional study, so we do not know if heavy drinking has caused social isolation or the contrary. If these results can be verified in a prospective study, a strengthening of the social network of the individual could perhaps lead to more moderate alcohol habits and better health, a finding of potential importance in the field of health promotion.

Social network and social support predict improvement of physical working capacity in rehabilitation of patients with first myocardial infarction

A cohort of 50 patients under 70 years of age who had suffered their first myocardial infarction (MI) entered an exercise-based rehabilitation programme. An extensive personal interview concerning psychosocial factors, including social network and social support, as well as an assessment of an array of clinical and laboratory variables was made before the patients were discharged from the hospital. A follow-up 6 months later of the 40 patients that completed the programme showed that material social support and social anchorage at baseline predicted improvement in physical working capacity, independently from age, gender and important clinical variables. The authors conclude that psychosocial factors could be predictors of equal importance as many of the standard risk factors and clinical assessments in the rehabilitation of a majority of post-MI patients. It is suggested that training programmes should provide opportunities for involvement of the patients' social network, in order to benefit from optimal social support during the rehabilitation process.

Social network, social support and acute chest complaints among young and middle-aged patients in an emergency department—A case-control study

The risk of developing non-specific chest complaints was higher among young and middle-aged persons with a weak social network and low social support, when comparing cases with controls at a hospital emergency department (ED). The study was comprised of 62 cases; two different control groups were recruited from other patients at the medical ED ( n = 67) and from patients at the surgical ED with urolithiasis or cholecystitis ( n = 31). Relative risks for non-specific chest complaints were 2.3-3.4 for patients with a low score on two of the social network factors (an overall index and social anchorage) and two social support factors (emotional esteem support and support by a confidant). These results could be used for developing guidelines for a more adequate clinical management of these patients, as well as for the prevention of stress-related conditions in general. An analysis was made of the conceptual validity of the instrument used for assessing social network and social support. It was concluded that structural elements, such as social network factors, represented a more valid measurement that was less affected by subjectivity. Future research is of importance for finding overbridging concepts, rather than to further continue the dissection of presently used indices into even more ‘specific’ variables.

Social anchorage and blood pressure in elderly men--a population study.

The present study was designed to test the hypothesis that there is an independent association between the three concepts of psychosocial factors, social network, social support, social influence and blood pressure (see Materials and methods for definition). The study sample chosen (n = 621) comprised a randomly selected group of half the male residents of Malmö born in 1914, 500 (80.5%) of whom participated. A study based on a model with clearly defined criteria was used to measure the different aspects of social network, social support and social influence. In multiple regression analysis, social anchorage (a subconcept of social network) was shown to have an association with both systolic (P = 0.03) and diastolic blood pressure (P less than 0.001), when adjustments for social class, marital status, medication for hypertension, alcohol consumption, smoking habits, body mass index (BMI) and physical activity were made. Social anchorage is a concept on a structural level, that describes to what degree the individual belongs to and is anchored within formal and informal groups in society. As such, it may contribute to a deeper understanding of mechanisms behind high blood pressure and could thus be significant in the field of health promotion.

Different social network and social support characteristics, nervous problems and insomnia: Theoretical and methodological aspects on some results from the population study ‘men born in 1914’, Malmö, Sweden

A representative sample of 68-year-old men in the Swedish city of Malmö, were interviewed in detail regarding their social network, social support and social influence as a part of an extensive examination of their health status. Emphasis in this paper is put on the definition and operationalization of different social network, social support and social influence characteristics included in a tentative model. The reliability and validity of the different social network, social support and social influence indices are analyzed and discussed. The relation between the different indices and marital status and social class are analyzed implying that men living alone and men in the lowest social class have the most insufficient social network, social support and social influence. The indices were then used in an analysis of nervous problems and insomnia. Social anchorage, social participation and contact frequency, all subconcepts of social network, had independent associations with mental health in this cross-sectional study. The addition of the social network, social support and social influence indices to social class and marital status gives a more differentiated and thereby a more valid picture of the association between the psychosocial environment and this type of mental health problems.

Impact of Bereavement on the Self‐Conceptions of Older Surviving Spouses

The purpose of this longitudinal study was to assess the extent to which the social anchorage dimension of the self‐concept is impacted by the death of a spouse among a sample of older surviving spouses. Social anchorage was measured by the Twenty Statements Test (TST) in mailed questionnaires and consisted of self‐statements that signify important social relationships and group memberships. As hypothesized, the 42 bereaved persons had lower social anchorage scores than the 72 nonbereaved controls. This significant effect was evident as early as three to four weeks following the death, and it persisted through five more measurement periods that covered the first two years of bereavement.

THE TRUE SELF METHOD FOR STUDYING THE SELF‐CONCEPTION*

An open‐ended questionnaire technique for identifying the self‐conception which can be used in lieu of or in combination with the TST is described. Respondents are asked to relate experiences in which they felt that their true selves were expressed, and in which their true selves were misrepresented. It is assumed that investigators can make more refined inferences about the social anchorage of the self‐conception from accounts of experience than from single words and short phrases, and that understanding the circumstances which evoke vital feelings of true‐self and not‐self is more fundamental than knowing the self designations that people make on the basis of these experiences. Possible uses of the method are discussed. Preliminary findings from using the method to distinguish between self‐anchorage in impulse and in institution are briefly presented.