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PubMed1996

Gender differences in the support networks of caregivers.

Nurses in home care and long-term care settings play an important role in assisting family caregivers of elders who are cognitively impaired to sustain personal support while caregiving. Research has shown that such support is associated with positive health status. The characteristics of the caregiver's social network provide information about the potential for support. The purpose of this study was to describe and compare the social networks of men and women caregivers in terms of the composition of the social network and the size of the available, utilized and conflicted social networks. The possible relationship between the demographic characteristics of caregivers and the size and composition of their social networks was also examined. In comparison to men, the conflicted social networks of women were larger and comprised of more family members. For women, age, years of caregiving and socioeconomic status were not significantly related to the size of their social network. However, younger men and men of higher socioeconomic status reported significantly larger available social networks than other men. Knowledge of the gender differences in network size and composition that were identified in this study contributes to nurses' ability to identify caregivers who may be at risk for inadequate social support. In conjunction with the findings from related studies these results have implications for nursing assessment and intervention in home care and long-term care settings.

Adult↗
PubMed2002

The impact of pain and symptoms of depression in scleroderma.

Systemic sclerosis (scleroderma) is a rare connective tissue disease that can affect multiple organ systems. Case reports and small treatment studies suggest that pain is significant in scleroderma, but few data speak of the frequency or impact of pain. This study sought to determine the frequency and impact of pain, symptoms of depression, and social network characteristics on physical functioning and social adjustment in patients with scleroderma. One hundred and forty-two scleroderma patients completed measures of pain, depressive symptoms, social network characteristics, physical functioning, and social adjustment. Sixty-three percent reported at least mild pain and 50% reported at least mild levels of depressive symptomatology. Hierarchical regression analyses revealed that pain, depressive symptoms, and employment status (disabled/unemployed vs. not) were significant, independent predictors of physical functioning, together accounting for 37% of the total variance. Pain was the single strongest predictor of physical function, accounting for 20% of the variance. Depressive symptoms, physical functioning, diversity of social network, and employment status were significant independent predictors of social adjustment, together accounting for 63% of the variance. Depressive symptoms were the single strongest predictor of social adjustment, accounting for 26% of the variance. The effects of pain and physical function on social adjustment became non-significant when depressive symptoms were entered into the model, suggesting that symptoms of depression mediate the effect of pain and physical function on social adjustment. These findings indicate that pain is common in scleroderma and that pain and depressive symptoms are significant determinants of physical functioning and social adjustment, two important components of health-related quality of life. Increased attention to effective management of pain and symptoms of depression in scleroderma will likely lead to improved functioning and quality of life.

Adult↗
PubMed1993

Psychosocial predictors of stroke outcomes in an elderly population.

The influence of premorbid psychosocial factors on physical function and institutionalization 6 weeks after hospital discharge was studied in elderly stroke patients. The predictor variables of interest were social networks, availability of social support, pre-stroke depression (CES-D), and religiousness. The data were obtained from a prospective longitudinal study based on 2,812 noninstitutionalized individuals aged 65 years and older living in New Haven, Connecticut. Incident stroke cases from this study were followed for post-stroke outcomes. Results from 87 survivors indicated that larger social networks were associated with fewer limitations in physical function, controlling for relevant health and sociodemographic conditions. Larger networks were also associated with a lower risk of institutionalization (p < .05). None of the other psychosocial factors assessed appeared to be related to these outcomes.

Aged↗
PubMed2005

Social support modifies perceived stigmatization in the first years of mental illness: a longitudinal approach.

Perceived stigmatization of mentally ill people impairs their social relations and well-being. While perceived stigmatization theoretically and empirically has been accounted for as an independent and unalterable factor, this longitudinal study focuses on reciprocal effects between stigmatization and social ties. The duration of mental illness is included as a grouping variable to extend the longitudinal perspective. A sample of severely mentally ill persons (n=165) in two psychiatric hospitals in Zurich took part in a structured interview during their admission and 1 year later. Cross-lagged path models were designed to test the interrelations of (1) perceived stigmatization, (2) a defensive stigma coping orientation, (3) concrete stigmatizing experiences, and either (4) social network, or (5) perceived social support as dependent variables. Contrary to previous findings, neither of the three components of stigmatization tested has any influence on social network or support. Social support, though, strongly predicts perceived stigmatization 1 year later, but only in the group with a more recent onset of illness. This finding suggests that the perception of stigma is subject to modification in the course of new life circumstances and underlines the importance of activating social resources in the first years of mental illness. Duration of illness should be included as a central variable in future research, as it influences the nature of the relation between stigmatization and social ties.

Adult↗
PubMed1995

Social and sexual networks: their role in the spread of HIV/AIDS among young gay men.

This article examines how networks of social and sexual relations affect risky sexual behavior and HIV seroprevalence among young gay men. Social networks can transmit information and cultural norms regarding safer sex, while networks of sexual partners channel the risk of exposure to HIV infection. These two network effects may help to explain some of the behavior and seroconversion differentials in the gay community. A number of recent studies have shown higher rates of unsafe sex among younger gay men. In the Longitudinal AIDS Impact Project, for example, younger gay men (18-24) report unsafe receptive anal sex at rates double that for any other age group (30% vs. 14-16%). One possible explanation is that younger men have watched fewer friends and colleagues contract HIV or AIDS, and are correspondingly less cautious. We test this hypothesis by comparing the personal networks of younger and older gay men to see whether those who practice safer sex have more exposure to persons with HIV or AIDS. The results give only weak support for the hypothesis that personal exposure to the effects of HIV and AIDS increases adherence to safer sex practices. Seroprevalence patterns among young men may be the result of their sexual networks, with those choosing older partners more likely to be exposed to HIV infection. We examine this hypothesis by comparing the age composition of the unsafe sexual partner network for seropositive and seronegative young men. The results strongly support the hypothesis that younger gay men with older partners are the leading edge of the epidemic in their cohort.

Acquired Immunodeficiency Syndrome↗
PubMed2004

[Role of the social support network which influences age of death and physical function of elderly people: study of trends in and outside of Japan and future problems].

Concerning associations between the social support network and physical health of the elderly, longitudinal studies have been conducted using various measurement indexes. The studies indicated that the support network influences on physical function and life expectancy. In this study we compared research papers from Japan and elsewhere that appeared after 1980, from the viewpoint of 1) social support effects, and 2) social network effects, to examine potential problems in the future. The main knowledge obtained was that the receipt of emotional support, wide network size, and participation in social activities reduced the risk of early death and decrease in physical function of elderly people. Sex differences were indicated, and in many cases, the effects were more remarkable in men than women. In addition the positive influence of receiving help from a support network, a major subject of conventional research, the effects of offering help to others and negative findings were also examined. It has been indicated that participation in volunteer groups and offer of support to other people can prevent decrease in physical function or early death. As negative effects, improper instrumental support rather disturbs the mental and physical independence of elderly people. As future issues, it is necessary to focus on both positive/negative and receipt/offer effects of support network, and to clarify how to provide example which best match the life of elderly people by comparing sexes and regions. It is also important to actually apply the knowledge gained from observational studies to prevent the elderly from becoming a condition requiring care, and to develop intervention studies which can increase the social contacts of elderly people at the same time as conducting health education and medical treatment.

Aged↗
PubMed1992

Social support networks of adults with mental retardation who live at home.

The social support networks of 418 adults with mental retardation who live at home were found to be large, durable, active, and diverse in their composition. Family members predominated as members of these support networks. Differences were found in many network characteristics based on the gender and level of mental retardation of the adults. Males and those with the most severe mental retardation were found to be at risk for social isolation. Contrasts with the social support networks of adults in nonfamily settings were discussed.

Adolescent↗
PubMed1996

Social support networks of confidants to people with AIDS.

AIDS has a devastating impact on the social support networks of those most closely involved with the person with AIDS (PWA). This qualitative study of the social support networks of confidants to PWAs reports the findings of intensive, semistructured interviews with 11 confidants. Numerous changes were observed in the confidants' supportive resources, network structure, and functioning. Implications for social work practice are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1994

A prospective community-based pilot study of risk factors for the investigation of elder mistreatment.

PURPOSE: To identify risk factors for the investigation of elder abuse, neglect, self-neglect, exploitation, and abandonment in a population-based observational cohort of community living elders. STUDY POPULATION: Population-based sample of 2,812 community-living men and women in New Haven, Connecticut who were over age 65 in 1982. METHODS: Matching process whereby cohort members who were investigated by Connecticut's State Ombudsman on Aging in 1985 or 1986 were identified. ANALYSIS: Relative risks for ombudsman investigation in 1985 or 1986 were calculated based on risk factors status at baseline interview in 1982. RESULTS: Sixty-eight (2.4%) members of the cohort received investigation. Features at cohort entry significantly associated with investigation in multiple logistic regression included: requiring assistance with feeding (Adjusted OR 3.5, 95% CI 1.2, 11.7), being a minority elder (Adj. OR 2.3, 95% CI 1.4, 2.8), over age 75 at cohort inception (Adj. OR 1.9, 95% CI 1.1, 3.1), and having a poor social network as defined by a social network index (Adj. OR 1.7, 95% CI 1.0, 2.7). When stratified by race, requiring assistance with feeding was associated with ombudsman investigation in minority elders (Adj. OR 10.8, 95% CI 2.8, 40.5) but not non-minority elders (Adj. OR 1.1, 95% CI 0.5, 7.5). CONCLUSION: Functional disability, minority status, older age, and poor social networks were associated with investigation for elder mistreatment in this prospective, community-based population of men and women over the age of 65.

Activities of Daily Living↗
PubMed1983

Predictors of help-seeking in an urban setting: the search for child care.

The aim of this exploratory study was to identify variables which predict how parents search for child care. Structured interviews were conducted with 50 parents of young children who had searched for full-time nonrelative child care. The respondents represented a 1% sample of Detroit parents. Search behaviors were found to be related to perceived neighborhood age, personal social network ties, and income and family structure. Personal social network ties related to contrasting sets of search behaviors, described as cosmopolitan versus parochial help-seeking patterns. However, perceived neighborhood age modified the relationship between social network ties and search behaviors in that the contrast between cosmopolitan and parochial help-seeking patterns was found only in neighborhoods where most residents had lived more than 10 years (established areas). The findings point to the need for multivariate investigations of the relationship between neighborhood context and patterns of help-seeking, especially in regards to the role of personal social networks. Implications of the findings for the design of a local child care information and referral service are discussed.

Adolescent↗
PubMed2003

Nurse managers' professional networks, psychosocial resources and self-rated health.

BACKGROUND: Nurse managers act under constant pressure to develop strategies in response to professional challenges within a changing and restructured health care system. When such environmental stress is present, they need access to sufficient psychosocial recourse. AIM: The study aimed to investigate whether nurse managers' professional networks, psychosocial work conditions, job support, social network and support were associated with self-rated health, sick-leave and salary. METHODS: From a total of 268 Swedish nurse managers, active in management positions, 205 (77%) agreed to participate in the study by answering a self-report questionnaire. Cronbach's alpha was used to calculate internal consistency. Odds ratios were used to estimate the bivariate association between self-rated health and psychosocial resources. RESULTS: Nurse managers exposed to high job demands had significantly increased odds for low self-rated health. It was also found that low level of support from professional network, job support, social network and social support outside work displayed increased odds for low self-rated health, independently of age, gender and education. There were additive (but no synergistic) effects found for job demand in combination with professional networks, job support and emotional support and in relation to self-rated health. CONCLUSION: The study showed that nurse managers exposed to high job demands had elevated odds for low self-rated health, regardless of level of psychosocial resources within or outside work. Two-thirds of the nurse managers who were affiliated to professional networks did not consider this a supporting factor in their management work. Those with low job support had increased odds for sick-leave compared with those with high support. No significant associations were found between psychosocial characteristics and salary.

Adult↗
PubMedDate not supplied

The role of informal and formal social support networks for patients with cancer.

PURPOSE: In this study, the authors examined the role of informal and formal social support networks in mitigating barriers to cancer treatment among whites, blacks, and Hispanics, based on a representative sample of cancer patients in Texas. DESCRIPTION OF STUDY: The sample frame for this study was obtained from the University of Texas M. D. Anderson Cancer Center's Texas Community Oncology Network, a consortium of cancer treatment facilities in Texas. Of the 910 patients who were contacted, 593 (65%) responded to the survey. RESULTS: The results show the value of social support networks in assisting cancer patients with continuing treatment. An important finding indicated that health professionals do not provide information regarding social support groups to patients with cancer at the time of diagnosis. Fewer than half of the respondents were asked whether they would be interested in joining a formal social support group. Individuals of all racial/ethnic groups reported that the formal support groups provided emotional assistance. Minorities were more apt to report that the formal support groups helped with continuing treatment. In addition, informal social support networks, such as extended families and civic clubs, were seen as more helpful for blacks and Hispanics as compared with whites. CLINICAL IMPLICATIONS: The need for formal and informal networks is indicated by the results of this study, which show that networks, such as relationships with family, friends, and relatives, play an important role in assisting patients in coping with their cancer. These networks are part of the patient's total treatment experience and must be acknowledged by healthcare professionals. A large number of patients are not asked to join social support groups, suggesting a need for training healthcare professionals to provide information regarding the potential benefits of support groups for cancer patients.

Adolescent↗
PubMed2000

Hospital networking. Comparing the work of nurses with flexible and traditional schedules.

OBJECTIVE: This research study was conducted to contrast workplace socialization of nurses working flexible (flex) and traditional schedules in an acute care setting. The study illustrates the types of social networks used by both types of nurses in a reengineered healthcare environment. SUMMARY BACKGROUND DATA: Reengineering strategies, such as flex nurse staffing, add a new dimension to workplace change and adaptation. Few studies have examined the similarities and differences between nurses working flex and traditional schedules. The research literature shows that workplace socialization significantly affects job satisfaction, organizational commitment, and retention. No studies have examined how the process of socialization--forming social networks--differs for nurses working traditional or flex schedules. METHODS AND SUBJECTS: A convenience sample of 120 nurses working traditional schedules and 46 nurses working flex schedules from a pediatric, tertiary care setting completed the Social Network Questionnaire (SNQ), a standardized instrument that records individuals' social network composition and function. RESULTS: No significant differences were found in the nurses' social network composition. Both types of nurses constructed peer-based networks and nurse managers were also present in their networks. Nurses working traditional schedules used significantly more peer members for different types of emotional support, such as reassurance and handling emotional upsets. CONCLUSIONS: Workplace networks are important to both types of nurses. Nurses on flex schedules may form less social attachments in order to manage the increased demands of moving among multiple units. This group of nurses can provide clues for adaptive change in reengineered environments.

Female↗
PubMed1981

Aspects of social support networks among institutionalized adolescents.

This study describes the social support networks on two adolescent units in two mental health centers. The purpose is to explore the possible existence and functions of informal peer support groups. A semi-structured interview schedule consisting of six questions was used. Participant observation was also used as a secondary method to substantiate the interview responses of 16 patients and 4 staff members (10 patients and 2 staff members on one ward and the remainder on the other ward). The results indicate that some form of peer support network exists on the wards as well as outside the institutions. Two emergent types of network, with some overlapping, are the action-oriented and the dialogue-oriented, with age and gender as the factors discriminating between them. Conclusions from the results are suggestive rather than conclusive. A much more extensive study would need to be undertaken to decisively refute or support the significance of peer groups among instiutionalized adolescents.

Adolescent↗
PubMed1991

Relationship of perceived maternal acceptance-rejection in childhood and social support networks of pregnant adolescents.

In a sample of 53 at-risk pregnant adolescents, the relationship between their perceptions of maternal acceptance-rejection in childhood and the nature of their social supports was examined. Perception of acceptance-rejection was significantly correlated with both frequency of interaction with social network members and expectations of their future support. Implications for public health strategies are discussed.

Adaptation, Psychological↗
PubMed2005

The vertebrate social behavior network: evolutionary themes and variations.

Based on a wide variety of data, it is now clear that birds and teleost (bony) fish possess a core "social behavior network" within the basal forebrain and midbrain that is homologous to the social behavior network of mammals. The nodes of this network are reciprocally connected, contain receptors for sex steroid hormones, and are involved in multiple forms of social behavior. Other hodological features and neuropeptide distributions are likewise very similar across taxa. This evolutionary conservation represents a boon for experiments on phenotypic behavioral variation, as the extraordinary social diversity of teleost fish and songbirds can now be used to generate broadly relevant insights into issues of brain function that are not particularly tractable in other vertebrate groups. Two such lines of research are presented here, each of which addresses functional variation within the network as it relates to divergent patterns of social behavior. In the first set of experiments, we have used a sexually polymorphic fish to demonstrate that natural selection can operate independently on hypothalamic neuroendocrine functions that are relevant for (1) gonadal regulation and (2) sex-typical behavioral modulation. In the second set of experiments, we have exploited the diversity of avian social organizations and ecologies to isolate species-typical group size as a quasi-independent variable. These experiments have shown that specific areas and peptidergic components of the social behavior network possess functional properties that evolve in parallel with divergence and convergence in sociality.

Animals↗
PubMed2006

Cognitive mediators linking social support networks to colorectal cancer screening adherence.

This paper argues that normative considerations are more important than attitudinal factors in engaging colorectal cancer screening, and tests a model explaining how unique cultural expressions of social networks influence screening adherence. Structural equation modeling was used to understand colorectal cancer screening in a population-based sample of 341 Japanese Americans aged 50 and over. The model accounted for 25% of the variance in screening adherence. Adherence was most strongly associated with family/friend subjective norms about colorectal cancer screening use. Emotional family support, but not the size of the networks, was indirectly related to adherence via increased family/friend subjective norms, while emotional friend support was directly related to adherence. While usual source of care was directly associated with adherence, better provider-patient communication was directly and indirectly associated with adherence via increased perceived benefits. The findings of this study support strengthening informal support networks to enhance adherence among Japanese Americans at risk.

Aged↗
PubMed1988

The taxonomy of social support: an ethnographic analysis among adolescent mothers.

Current approaches to assessing the health-related functions of social support are based on a theoretical frame of reference regarding the taxonomic structure of social networks. Nearly all previous work addresses the issue of social network taxonomies from an etic (i.e. objective, outside) rather than emic (i.e. subjective) perspective. Because of this, we intensively studied 5 unmarried adolescent mothers over the year following the delivery of their firstborn infants, utilizing ethnographic methods to elicit detailed portrayals of their personal, subjective taxonomies of social network support. Ranked in order of successful adaptation to parenthood, the young women with the best outcomes displayed a richer, more differentiated view of their social networks' taxonomic structure and regarded individual network members as more diverse in their capacity to provide broad, multi-faceted support. A common element among all subjects was the tendency to discriminate among categories of network members according to the stability and continuity perceived in individual relationships.

Adolescent↗