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PubMed2000

Social and personal resources and the prevalence of phobic disorder in a community population.

BACKGROUND: Phobic disorder is one of the most prevalent psychiatric disorders in community populations and much attention has focused on the association of sociodemographic factors and social resources with the disorder. There has been little investigation of the more personal resources such as self-confidence, religiosity, social support and self-perceived health that may increase vulnerability. METHODS: We used a sample of 2914 community residents aged 18 or older who participated in the Duke University Epidemiologic Catchment Area Study to explore the relationship between both social and personal resources and the prevalence of DIS/DSM-III phobic disorder. RESULTS: The 1-month prevalence of any phobic disorder was 7.6%. In bivariate analyses, we found both race/ethnicity and gender differences in prevalence, with a higher prevalence of phobic disorder in African-Americans and females. Lower socio-economic status, rural residence and unmarried status were also associated with current prevalence. No association was found for social network and social interaction. Impaired subjective social support, low self-confidence, perceived poorer physical health and co-morbid psychiatric disorder were significantly associated with current prevalence in uncontrolled analyses, while associations between lack of a confidant as well as religiosity and phobic disorder were not. Female gender (OR = 1.7), perceived low self-confidence (OR = 2.0), and two interaction terms, age x co-morbid psychiatric disorder and race/ethnicity x perceived physical health were associated with phobic disorder in controlled analyses using logistic regression. CONCLUSIONS: We conclude that both social and personal resources, particularly self-confidence, co-morbidity and perceived physical health are important correlates of phobic disorder.

Adolescent↗
PubMed2004

Social support and depressive symptoms among displaced older adults following the 1999 Taiwan earthquake.

This longitudinal study examines changes in depressive symptoms among displaced older Taiwanese adults (N = 54, M = 68 years), and the impact of various social supports for them at between 6 and 12 months after an earthquake. The average depression score between 6 and 12 months following the earthquake was unchanged and kept high score. Child and extended family support levels related to depressive symptoms after 6 months. In contrast, after 12 months, significant factors associated with a lessening of the depressive symptoms were social support from the extended family and neighbors, and social participation. Intervention to promote increased social networks and social participation, within their new environment in a temporary community, is highly recommended for older adults.

Aged↗
PubMed2002

What determines the use of home care services by elderly people?

The objective of the present study was to investigate the determinants of use of statutory and private home care services by older people living in the community. A questionnaire was distributed to a stratified random sample of 2,000 elderly people living in the community registered with 11 general practices in a British city (equal numbers of men and women, aged 65-74 years, and 75 years or over). The outcome measures were the use of statutory or private home care services in the previous 3 months. Logistic regression was used to explore potential determinants of the use of these services. The response rate was 79%. Increasing age, not owning a car and being a widow(er) were associated with greater use of both statutory and private home care services, as was worse self-reported overall health. Worse physical functioning, worse emotional health, problems with cognition, foot problems and a greater number of falls were determinants of use of statutory and private services. Older age on leaving full-time education was associated with increased use of private home care services. Problems with eyesight were determinants for both types of home care services for women, but only private services for men. For women, leakage of urine was associated with greater use of private services. Social networks and social support were not generally associated with use of these services after controlling for demographic factors. Understanding the determinants for the use of both statutory and private home care services is important because of the increasing numbers of elderly people in the population and the policy to maintain older people in their own homes. Purchasers and providers should be able to address at least some of the modifiable predictors.

Aged↗
PubMed2000

Employment, social inclusion and mental health.

Whereas unemployment is clearly linked to mental health problems, employment can improve quality of life, mental health, social networks and social inclusion. Yet in the UK only 15% of people with serious mental health problems are employed--despite an overwhelming consensus from surveys, case studies and personal accounts that users want to work. This paper aims to challenge common misconceptions surrounding employment, work and mental health problems. Drawing on a range of research evidence and legislative guidance it discusses significant barriers to work and proposes feasible solutions. The need for mental health staff and services to become involved in the provision of work opportunities is considered, as is the vital role they can play in changing communities. The potency of work as a vehicle for improving the social inclusion and community tenure of people with mental health problems is highlighted.

Attitude of Health Personnel↗
PubMed1981

Loneliness in the Swedish aged.

Feelings of loneliness in relation to disease, handicaps, social network and social background were studied in a representative sample of 1,007 70-year-old people living in Göteborg, Sweden. The results showed that loneliness was a problem to 24% of the women and 12% of the men. The study allowed a detailed analysis of the association between feelings of loneliness and health, disabilities due to other than medical reasons, consumption of social and medical service, social contacts, cognitive functioning and personality traits. The most important factors related to the feeling of loneliness were the loss of spouse, depression of mood and lack of friends. The lonely had a negative self-assessment of health and consumed more out-patient care, social welfare help and sedatives. The higher consumption of medical service and/or social care was, however, not associated with a higher prevalence of definable somatic disease or handicaps.

Aged↗
PubMed2001

Developing a strategy for community-based health promotion targeting homeless populations.

There is a need for targeted health promotion aimed at homeless populations. A survey of 100 Big Issue newspaper vendors was conducted, along with in-depth interviews and focus groups, in order to identify health promotion needs. Drug and alcohol problems, the effects of cold weather, nutritional deficiencies, and poor personal hygiene were reported as the main health concerns. However, health was not always an immediate priority for the homeless, with daily concerns predominating, such as shelter and getting money for food. A range of information needs were highlighted and a number of key health promotion topics identified. Social network and social activity data were collected from 14 Big Issue vendors to assess their penetration of groups of homeless people. Both generic and targeted health promotion activities are recommended, and the role of health advocacy and peer education should be further explored.

Adult↗
PubMed2001

Social support: a critical factor in women's health and health promotion.

Social networks and social support have been found to be beneficial to the health of individuals in a variety of ways--reducing mortality rates, improving recovery from serious illness, and increasing use of preventive health practices. Social relationships appear to be particularly important to women. Suggestions for health promotion and disease prevention activities include the use of buddy systems, feminist pedagogical techniques, group activities, and linkage to natural supports. Health promotion with women is an underdeveloped area of social work practice with great potential to increase the health of client populations.

Culture↗
PubMed1992

Influence of social support on cardiac event rate in men with ischaemic type ST segment depression during ambulatory 24-h long-term ECG recording. The prospective population study 'Men born in 1914', Malmö, Sweden.

Three-hundred and ninety-four 68-year-old men, representing 60.3% of a cohort of men born in 1914, were examined with ambulatory ECG during 24 h in 1982-83. Ninety-eight (24.8%) men had one or more episodes of ischaemic type ST segment depression (greater than or equal to 0.10 mV), 79 of whom had no history of previous ischaemic heart disease (IHD). During 63 months follow-up, 17 of the 98 suffered a cardiac event, i.e. fatal or non-fatal myocardial infarction (MI) or death due to chronic IHD. The objective of this study was to assess the influence of psychosocial factors, such as social network and social support, on cardiac event rate in men with ischaemic ST segment depression. A higher risk was found among men with little material and informational support (i.e. access to practical services and material resources and access to guidance, advice and information (crude relative risk 4.8; 95% CI; 1.6-14.8) and men with low availability of emotional support (i.e. opportunity for care, encouragement of personal value and feelings of confidence and trust) (crude relative risk 4.3; 95% CI: 1.4-13.3). This association was independent of history of IHD and other known risk factors for myocardial infarction (MI).

Aged↗
PubMed2000

Predictors of adolescent suicide attempts: a nationally representative longitudinal study of Norwegian adolescents.

OBJECTIVE: To investigate the risk and protective factors for previous and future suicide attempts among adolescents. METHOD: A representative sample of high school students (N = 9,679) in grades 7 through 12 (aged 12-20 years) were followed from 1992 to 1994. Response rate was 97% at initial testing and 80% at follow-up. Measures of psychiatric symptoms (depressed mood, eating problems, conduct problems), substance use, self-worth, pubertal timing, social network, and social integration were included. RESULTS: A total of 8.2% had ever attempted suicide and 2.7% reported an attempt during the 2-year study period. Logistic regression analysis showed that future attempts were predicted by previous attempt, female gender, young age, perceived early pubertal development (stronger among girls), suicidal ideation, alcohol intoxication, not living with both parents, and poor self-worth. CONCLUSIONS: The importance that the clinician ask about previous suicidal behaviors is underscored. Early pubertal timing (particularly among girls), loss of self-worth, and alcohol intoxication may serve as risk factors for future suicide attempts.

Adolescent↗
PubMed2003

Psychological distress associated with home parenteral nutrition in Swedish children, adolescents, and their parents: preliminary results.

OBJECTIVES: Home parenteral nutrition (HPN) is life saving in some patients with intestinal failure. Clinical experience suggests that there may be psychologic problems in HPN children, including food refusal on reintroduction of food, parent-child conflict, sibling rivalry, and disruption of family routine. The aim of this study was to investigate the psychologic distress in children with HPN and the social integration of their parents. METHODS: The parents were asked to fill in three questionnaires anonymously--one regarding the HPN procedures; the Child Behavior Checklist, which provides a standardized description of children's behavioral problems, as reported by their mothers; and the Interview Schedule for Social Interaction (ISSI), which in its short form comprises 30 questions about social network and social support. RESULTS: The Child Behavior Checklist questionnaires were returned from 20 families (80% response), and the ISSI questionnaires were returned from 21 families (84% response). Children and adolescents with HPN are quite distressed psychologically. The subscale within ISSI that measures social integration was significantly higher in the HPN group, whereas the subscale that measures adequacy of social integration did not differ between the groups. Both subscales measuring attachment were significantly lower in the HPN group. CONCLUSIONS: This study shows that children and adolescents with HPN are quite distressed psychologically, even though the exact reason for this may be somewhat unclear. The social integration of the parents is high, whereas attachment, which deals with deeper, emotional relations, is negatively affected.

Adaptation, Psychological↗
PubMed2006

Analysis of an evolving email network.

In this paper we study an evolving email network model first introduced by Wang and De Wilde, to the best of our knowledge. The model is analyzed by formulating the network topology as a random process and studying the dynamics of the process. Our analytical results show a number of steady state properties about the email traffic between different nodes and the aggregate networking behavior (i.e., degree distribution, clustering coefficient, average path length, and phase transition), and also confirm the empirical results obtained by Wang and De Wilde. We also conducted simulations confirming the analytical results. Extensive simulations were run to evaluate email traffic behavior at the link and network levels, phase transition phenomena, and also studying the behavior of email traffic in a hierarchical network. The methods established here are also applicable to many other practical networks including sensor networks and social networks.

Journal Article↗
PubMed2003

Sociability and susceptibility to the common cold.

There is considerable evidence that social relationships can influence health, but only limited evidence on the health effects of the personality characteristics that are thought to mold people's social lives. We asked whether sociability predicts resistance to infectious disease and whether this relationship is attributable to the quality and quantity of social interactions and relationships. Three hundred thirty-four volunteers completed questionnaires assessing their sociability, social networks, and social supports, and six evening interviews assessing daily interactions. They were subsequently exposed to a virus that causes a common cold and monitored to see who developed verifiable illness. Increased sociability was associated in a linear fashion with a decreased probability of developing a cold. Although sociability was associated with more and higher-quality social interactions, it predicted disease susceptibility independently of these variables. The association between sociability and disease was also independent of baseline immunity (virus-specific antibody), demographics, emotional styles, stress hormones, and health practices.

Adolescent↗
PubMedDate not supplied

Social support received by mothers of chronically ill children.

The main purpose of this study was to describe the characteristics of the social networks and social support of mothers of chronically ill children and adolescents. The data collected also allowed for the identification of the predisposing factors to receiving low social support among the mothers. Receipt of social support was assessed according to six dimensions: source of support, type of support, perceived need for support, satisfaction with the quality and the quantity of support, as well as most valued source of support. Results indicate that mothers wanted more support than they received, particularly in the areas of emotional, appraisal, and informative support. Furthermore, spouses, professionals, and immediate family members were identified by mothers as important sources of support. Discriminant analysis showed that the probability of receiving low support increased if the chronically ill child was an adolescent, the father had a higher level of education, and the family income was middle-low. Results are discussed in terms of the implications for intervention.

Activities of Daily Living↗
PubMed1995

Predictors of mortality in alcoholic men: a 20-year follow-up study.

This study investigates the predictors of mortality in 156 male alcoholics who were psychiatrically hospitalized between 1967 and 1968 and followed for > 20 years. The findings showed that an older age, liver cirrhosis, and separation or divorce at intake were all associated with a shorter time to death. These results corroborate those of other follow-up studies that have identified age, health, and social support as independent correlates of mortality in alcoholics. From a therapeutic standpoint, the most alterable predictor is social support. Thus, the establishment of a salutary social network and social support system should be an integral part of the alcoholic's treatment plan.

Alcoholism↗
PubMed2006

Use of computer technology to enhance immigrant families' adaptation.

PURPOSE: To summarize how computer technology influenced immigrant families' adaptation to life in the United States. DESIGN: Critical ethnography. METHODS: Data were collected from 1998 to 2000 from 13 parents and 16 children from nine Taiwanese immigrant families using semi-structured interviews and a questionnaire. Narrative analysis was used with interview data. FINDINGS: Participants faced the demands of language proficiency, economic survival, loss of social networks, and social disconnection during resettlement. Computer technology provided participants with new occupational opportunities and strategies to overcome the barriers and stress created by resettlement. Internet and E-mail access greatly facilitated these participant families' adaptation. CONCLUSIONS: Study findings warrant further exploration to assess bow new computer technology promotes immigrant families' adaptation and alleviates stress associated with resettlement, including information about their health and health care.

Acculturation↗
PubMed1993

The Utrecht comparative study on psychiatric day treatment and inpatient treatment.

A prospective randomized comparative study on the effectiveness of psychiatric day treatment and inpatient treatment is described. The target population consisted of patients who would normally have been admitted to an open inpatient unit. Outcome indicators were psychopathology, social functioning, interpersonal functioning, social network and social support. No differences in effectiveness were found between the two forms of treatment, although more patients accepted and completed day treatment, and day patients were more satisfied. Although a uniform treatment programme for both departments was established, distinct differences did arise in the actual treatment programme offered to the patients. The duration of treatment for the day patients was considerably longer, and the intensity of treatment was more low-key. No striking differences in the amount of medication prescribed and in the occurrence of crisis situations (including suicide) were found. Day treatment turns out to be a realistic alternative for 33% of all patients admitted for inpatient treatment. It was not possible to predict which type of patient in particular is suitable for day treatment.

Adult↗
PubMed2006

"It's important to be proud of the place you live in": housing problems and preferences of psychiatric survivors.

TOPIC: It is important to understand housing and mental health issues from the perspective of psychiatric survivors. This paper reports findings from a series of focus group meetings held with survivors of mental illness to address issues concerning housing preferences and housing needs. METHODS: The discussions were recorded, transcribed, and analyzed using an ethnographic method of analysis. The themes that emerged related to oppression, social networks and social supports, housing conditions, poverty and finances, and accessing services. Participants described the ongoing stigma, discrimination, and poverty that reduced their access to safe, adequate housing. FINDINGS: They preferred independent housing where supports would be available as needed. Participants described the dilemma of having to choose between the housing they wanted and the supports they needed, since supports were often contingent upon living in a less desirable housing situation. CONCLUSIONS: Nurses and other mental healthcare workers need to be aware of these issues for discharge planning, community support, and ongoing advocacy. The survivor voices need to be heard by decision-makers at various levels of government in order for housing policy to become more receptive to their realities.

Anthropology, Cultural↗
PubMed2004

Influence of sociodemographic and neighbourhood factors on self rated health and quality of life in rural communities: findings from the Agriproject in the Republic of Ireland.

OBJECTIVE: To examine the influence of sociodemographic and neighbourhood factors on self rated health, quality of life, and perceived opportunities for change (as one measure of empowerment) in rural Irish communities. DESIGN: Pooled data from cross sectional surveys two years apart. SETTING: Respondents in four randomly selected rural district electoral divisions with a population size of between 750 and 2000. PARTICIPANTS: 1738 rural dwellers aged 15-93, 40.5% men, interviewed at two time points. MAIN OUTCOME MEASURES: Determinants of self rated health (SRH), quality of life (QOL), and perceived opportunities for change, rated on a closed option Likert scale and assessed in multivariate logistic regression models. MAIN RESULTS: Overall 23.8% of the sample reported poor SRH, 22.2% poor QOL, and 50.1% low perceived opportunities for change. Low financial security and dissatisfaction with work were each significantly associated with poor SRH (OR = 1.96 (1.50 to 2.56) and 1.54 (1.11 to 2.14)), with poor QOL (OR = 2.04 (1.56 to 2.68) and 1.87 (1.34 to 2.61). Concern about access to public services was significantly predictive of SRH (OR = 1.47 (1.11 to 1.94)) rather than access to health care (that is, hospital and GP services). There were distinct sex specific patterns and a generational effect for educational status in men. Variables associated with social networks and social support were less strongly predictive of SRH and QOL when economic measures were accounted for. CONCLUSION: Inter-relations between indicators of health status, wellbeing, and deprivation are not well studied in rural communities. Material deprivation has a direct influence on both health status and quality of life, although immediate sources of support are relatively well preserved.

Adolescent↗