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PubMed2006

Social support and psychological and physical states among Japanese patients with breast cancer and their spouses prior to surgery.

PURPOSE/OBJECTIVES: To assess social support and psychological and physical states among Japanese patients with breast cancer and their spouses prior to surgery. DESIGN: Descriptive, comparative, and correlational. SETTING: A general hospital in northern Japan. SAMPLE: 38 Japanese patients with breast cancer and their spouses (N = 76). METHODS: The Japanese versions of three questionnaires were used to collect data before surgery: the Interpersonal Relationship Inventory, the General Health Questionnaire, and the Physical States Interview Form. MAIN RESEARCH VARIABLES: Social support (support, conflict, and reciprocity), social network, and psychological and physical states. FINDINGS: Significant differences were found in support and reciprocity between patients and their spouses. However, no significant differences were found in social network, conflict, or psychological states between patients and their spouses. Moreover, some significant correlations were found in the variables of conflict, social network, and psychological and physical states. CONCLUSIONS: Japanese patients with breast cancer perceived more support and reciprocity than their spouses before their breast surgery. Conflict was significantly correlated with psychological states among Japanese women with breast cancer and their spouses. IMPLICATIONS FOR NURSING: Healthcare professionals need to consider social support as an important factor to help Japanese patients with breast cancer and their spouses cope with the disease.

Adult↗
PubMed2006

Are factors associated with subjective quality of life in people with severe mental illness consistent over time?--A 6-year follow-up study.

OBJECTIVE: To investigate the cross-sectional relationship between subjective quality of life and sociodemographic clinical and social factors over three points of assessment during a 6-year follow-up, and to investigate longitudinal predictors of subjective quality of life. METHOD: We investigated a sample of people with severe mental illness (n = 92), mainly with a psychosis diagnosis, at baseline and at an 18-month and 6-year follow-up. Measures included the Lancashire quality of life profile, Manchester short assessment of quality of life, Symptom Check List 90, Camberwell Assessment of Needs and the Interview Schedule for Social Interaction. RESULTS: Cross-sectionally subjective quality of life was associated to self-reported symptoms, social network and unmet needs. However, these determinants varied in importance between points of assessment. Longitudinal predictors of subjective quality of life were changes in self-reported symptoms and social network. CONCLUSION: There was a rather consistent set of determinants of subjective quality of life over time. Social network seems to be an important factor with relevance for improvements in subjective quality of life, however largely overlooked in earlier studies within the field.

Adult↗
PubMed2005

Quality of life in people with severe mental illness. Reliability and validity of the Manchester Short Assessment of Quality of Life (MANSA).

The Manchester Short Assessment of Quality of Life (MANSA) is a short interview, which has received a recent interest in research investigating quality of life in people with mental illness. In the present study, the Swedish version of MANSA is examined with regard to reliability, in terms of internal consistency and construct validity. Ninety-two persons with severe mental illness were interviewed regarding quality of life, social network, psychosocial functioning, psychiatric symptoms, needs for care, empowerment and experiences of stigma. Internal consistency was adequate (alpha = 0.81). Positive correlations were found between MANSA and social network, empowerment and psychosocial functioning, and negative correlations with psychopathology, number of needs for care, perceived devaluation and discrimination, and rejection experiences. Social network, psychosocial functioning and beliefs of devaluation and discrimination altogether explained 67% of the variance in quality of life. The Swedish version of MANSA showed a satisfactory reliability in terms of internal consistency. The construct of validity of the scale was satisfactory insofar as associations with validation measures were of considerable magnitude and in expected directions.

Adult↗
PubMedDate not supplied

Developing coping styles and social support networks: an intervention outcome study with mothers of handicapped children.

This paper describes an intervention programme, evaluation procedures, and results from a study of skills training for reducing stress with parents of handicapped children. Four mothers of developmentally disabled children participated in an 8-week training programme designed to teach parents ways to enhance their coping skills, increase their social support networks, and collectively make changes in their environment. Post-test data indicate that the programme shows promise for teaching coping and social support enhancement skills to parents.

Adaptation, Psychological↗
PubMed2003

Influence of information sources on the adoption of uterine fibroid embolization by interventional radiologists.

OBJECTIVES: The purpose of the research was to (1) understand the influence of information sources on the awareness and adoption of uterine fibroid embolization (UFE) by interventional radiologists in Michigan and (2) to decipher communication relations in the social network of interventional radiologists that were most conducive to the flow of information about UFE. METHODS: Diffusion of innovations theory and constructs in social network analysis formed the basis for the development of an interview guide. Thirty-two interventional radiologists in Michigan were interviewed over the phone. Chi-square statistics were employed to analyze the awareness and adoption of UFE. Factor analysis was applied to decipher important communication relations in the social network of interventional radiologists. RESULTS: Conferences were found to be an initial source of information, creating awareness among early adopters (P < 0.05), but other individuals were found to be influential sources in the adoption of UFE by later adopters (P < 0.05). Radiologists rarely browsed Websites for information. Work relations in everyday clinical practice were the communication relations most conducive to the flow of information about UFE. Preliminary qualitative data indicated that opinion leaders in the diffusion of UFE in Michigan were located in hospitals primarily dedicated to practice rather than in hospitals affiliated with universities. CONCLUSIONS: Journals are important information sources for creating awareness and stimulating adoption of innovation among both early and late adopters of new procedures in interventional radiology. Conferences, however, are significantly more important for creating early awareness, while interactions with colleagues is the most important factor in stimulating use of the innovation among later adopters. Among colleagues, opinion leaders in nonacademic hospitals may be more influential than individuals in the academic community.

Adult↗
PubMed1997

"It's a 24-hour thing ... a living-for-each-other concept": identity, networks, and community in an urban village health worker project.

Social networks are webs of relationships between individuals, and they play an important role in the complex social processes through which individuals seek information, obtain social support, and mobilize for collective action to modify social, economic, and environmental conditions associated with health and illness. Studies have described and evaluated lay health advisor (LHA) programs that use social networks to improve individual and community health. The experience and perceptions of community members involved with LHA programs have been explored less often and offer essential information to health educators about the design, implementation, evaluation, and support of such programs. This article examines the perspective of LHAs in Detroit, Michigan. Their understanding and experience of their work, the relationships between their activities and a sense of self and community, and personal and programmatic rewards and challenges are examined. The authors discuss implications for health educators related to LHAs' roles, relationship to supporting organizations, recruitment, training, and ongoing support.

Adult↗
PubMed2003

Short-term alcohol and drug treatment outcomes predict long-term outcome.

INTRODUCTION: Although addiction is recognized as a chronic, relapsing condition, few treatment studies, and none in a commercially insured managed care population, have measured long-term outcomes. We examined the relationship of 6-month treatment outcomes to abstinence 5 years post-treatment, and whether the predictors of abstinence at 5 years were different for those who were, and were not, abstinent at 6 months. METHODS: The sample (N=784) is from an outpatient (day hospital and traditional outpatient) managed care chemical dependency program. Subjects were interviewed at baseline, 6 months, and 5 years. Logistic regression analysis was used to assess which individual, treatment and extra-treatment characteristics predicted alcohol and drug abstinence at 5 years. RESULTS: Abstinence at 6 months was an important predictor of abstinence at 5 years. Among those abstinent at 6 months, predictors of abstinence at 5 years were older age, being female, 12-step meeting attendance, and recovery-oriented social networks. Among those not abstinent at 6 months, being alcohol dependent rather than drug dependent, 12-step meeting attendance, treatment readmission, and recovery-oriented social networks predicted abstinence at 5 years. CONCLUSION: Our findings demonstrate a clear association between short-term and long-term treatment success. In addition, these results strongly support the importance of recovery-oriented social networks for those with good short-term outcomes, and the beneficial impact of readmission for those not initially successful in treatment.

Adolescent↗
PubMed1998

Social competence, social support, and attachment: demarcation of construct domains, measurement, and paths of influence for preschool children attending Head Start.

Two studies designed to (1) explore measurement issues for the construct domains of social competence and social support and (2) test a model relating social competence to social support and to child-parent attachment for low-income (primarily African American) preschool children attending Head Start are reported. In Study 1, the definition, measurement, and structure of the social competence construct are evaluated in 2 samples of children. For Study 1A, 167 4-year-old children were assessed with a battery of observation, interview, and Q-sort measures. Relations among the measures suggested a hierarchical structure that was tested using a structural equation model. Results from the analysis supported the conjecture that social competence should be viewed as a hierarchically organized construct. In Study 1B, the model was tested again for a group of 3- and 4-year-old children (n = 265), using a modified set of measures. The general structure of the model from Study 1A was reproduced in this independent sample, although paths from the second-order factor to lower-order factors were not perfectly coordinated across samples. In Study 2, data for a subset of the children in Study 1B (n = 182), gathered with respect to features of their social networks, were examined to assess the structure of their social support networks. Descriptive and structural equation analyses are reported. Sixty-nine of these children were observed at home with their mothers and described using the Waters Attachment Q-sort. A structural equation model testing relations consistent with causal pathways from attachment security to both social support networks and to social competence and from the social support network variable to social competence with peers fit these data with a high degree of confidence. Subsequent analyses locating social competence as antecedent to attachment security were not significant. We conclude that the construct domains of social competence and social support networks can be meaningfully measured for preschool children and that individual differences with respect to these construct domains are related to child-parent relationship qualities.

Child Development↗
PubMed2005

In spite of good intentions: patients' perspectives on problematic social support interactions.

BACKGROUND: In the setting of an acute coronary syndrome, the natural inclination of friends and family members is to provide social support. However, their efforts may be perceived as being problematic or unhelpful. The objective of this study was to identify the characteristics of problematic social support interactions from the perspectives of patients. METHODS: This was a qualitative study among a purposive sample of 59 patients who had been hospitalized for an acute coronary syndrome. Patients were asked: "Can you describe the types of things that your family members, close friends, and health care providers did during this period to try to be helpful or supportive but you felt was unhelpful or felt that it caused you more stress." Responses were analyzed using qualitative techniques and reviewed by two independent corroborators. RESULTS: The types of behaviors performed by social network members that were perceived as being unhelpful were grouped under 5 themes: (1) excessive telephone contact, (2) high expression of emotions, (3) unsolicited advice, (4) information without means for implementation, and (5) taking over. CONCLUSION: Patients in this study described actions of their social network members that were intended to be supportive but instead were perceived as problematic because they were in excess of what was needed, they were incongruous with what was desired, or they contributed to negative feelings. Helping social networks to understand the potential problematic aspects of social support can aid in tailoring effective social support interventions.

Acute Disease↗
PubMed2006

The dynamics of injection drug users' personal networks and HIV risk behaviors.

AIMS: While studies of the social networks of injection drug users (IDUs) have provided insight into how the structures of interpersonal relationships among IDUs affect HIV risk behaviors, the majority of these studies have been cross-sectional. The present study examined the dynamics of IDUs' social networks and HIV risk behaviors over time. DESIGN: Using data from a longitudinal HIV-intervention study conducted in Baltimore, MD, this study assessed changes in the composition of the personal networks of 409 IDUs. We used a multi-nomial logistic regression analysis to assess the association between changes in network composition and simultaneous changes in levels of injection HIV risk behaviors. Using the regression parameters generated by the multi-nomial model, we estimated the predicted probability of being in each of four HIV risk behavior change groups. FINDINGS: Compared to the base case, individuals who reported an entirely new set of drug-using network contacts at follow-up were more than three times as likely to be in the increasing risk group. In contrast, reporting all new non-drug-using contacts at follow-up increased the likelihood of being in the stable low-risk group by almost 50% and decreased the probability of being in the consistently high-risk group by more than 70%. CONCLUSIONS: The findings from this study show that, over and above IDUs' baseline characteristics, changes in their personal networks are associated with changes in individuals' risky injection behaviors. They also suggest that interventions aimed at reducing HIV risk among IDUs might benefit from increasing IDUs' social contacts with individuals who are not drug users.

Adolescent↗
PubMed1991

Factors influencing professional home care utilization among the elderly.

Most explanatory research into the utilization of home care for the elderly has been carried out in a cross-sectional design with multiple regression as the main method of analysis. For methodological reasons we chose another design in a project called 'Professional home care and informal help for the elderly', which has been conducted in the northern part of the Netherlands. Two types of causal variables were distinguished to detect influencing factors on professional home care utilization among the elderly, other than physical limitation: person-bound variables and social network variables. A Mokken Scale analysis for Polychotomous items (MSP) was used to measure the level of physical limitation and a matching procedure to compare 'users' and 'non-users' of professional home care. With regard to person-bound variables, sex, whether or not a person was living alone and the level of the elderly person's income appeared to play a role in the utilization of home care: the user group comprised significantly more women, more elderly living alone and more persons on a low income. Contrary to the findings in other Dutch research, depression and feelings of loneliness did not seem to discriminate between the two groups. With regard to social network variables, the size and structure of the social network was more or less identical in both groups. The non-users network lives slightly closer. In general, the small differences found between the groups were to the non-users' advantage. Moreover, the non-users received more informal and private care with ADL and IADL activities.

Aged↗
PubMed1995

[Sex differences in health behavior and self assessed health in 11-15 years old children. A comparison between life conditions and health].

A total of 1860 children aged 11, 13 and 15 years from a nationwide random sample of schools completed an anonymous questionnaire on their social backgrounds, social networks, perceived health, life satisfaction, and health behaviour. Boys perceived their health to be better and had fewer psychosomatic symptoms than girls. They also did more physical exercise than girls. Boys and girls showed differences in social networks. Self-reported health status, weekly psychosomatic symptoms and health behaviour (smoking, exercise, and diet) were associated with social networks for both sexes. In particular, a good relationship to adults was found to be associated with positive health behaviour and perceived health.

Adolescent↗
PubMed1998

Age and mental health services.

This paper examines how age is related to the use of formal and informal mental health services, adjustment to current life conditions, and expectations for improvement in future life conditions among a group of persons with serious mental illnesses. Interviews with 301 clients of 3 clinics at a public psychiatric facility serving West Brooklyn and Staten Island provide the data from the study. Outcome measures include nine sorts of help received from informal members of the social network and from mental health professionals; desires to improve current life conditions; and expectations for future improvements in life conditions. Through hierarchical regression procedures we examine the impact of age on these outcomes, with controls for self-reported symptoms and functioning, sex, and the presence of social network members. The results indicate that younger people receive more help from both informal social networks and from mental health professionals. In addition, younger people are more likely to want improvements in their current life conditions and to be optimistic about what the future holds for them. The decline in informal and formal support, optimism, and desire to improve their current life situations among older clients may be cause for concern among mental health professionals. Mental health service providers should give greater recognition to the impact of age on mental health service needs among persons with serious mental illnesses.

Adult↗
PubMed1991

Long-term support and personal adjustment of adolescent and older mothers.

Adolescent and older mothers reported the size and quality of social networks and perceptions of family support at 1, 6, and 12 months postpartum. Maternal behavior, general life satisfaction, and parental satisfaction were assessed at 12 months. No significant differences were found in the size of social networks and quality of interactions within those networks, though older mothers had significantly higher scores on perceived family support than did adolescent mothers. Perceived family support and quality of interactions within the social network generally were associated positively with maternal behavior, life satisfaction, and parental satisfaction. This was true in more cases for the adolescent than for older mothers.

Adaptation, Psychological↗
PubMed2000

A multilevel city health profile of Moscow.

This report describes a multilevel city-wide profile of physical health in Moscow, examining individual and urban level factors. Objectives of the paper were to: (1) identify macro and micro risk factors for poor physical health in Moscow;(2) assess the effect of two dimensions of micro determinants--personal health habits and social connectivity, such as social cohesion, social support, and social networks; (3) examine the hypothesis that relative social inequality is a significant structural condition at the community level which influences the physical health of individuals, as a main and as a joint effect with psychosocial behaviors. A random sample of Moscow adults, with household telephones (N = 2000), was collected 17-19 September, 1991, and had a completed interview rate of 81.8%. The questionnaire replicated items from the California Alameda Study and the US Health Interview Survey. Respondents' urban area of residence was linked to macro measures of inequality derived from the Moscow census. This report describes the baseline survey of a prospective study design. Results of this study demonstrate that the social context in a community affects the health of people living there independently from the effects of individual health lifestyle or social connectivity. The structural conditions in Moscow which significantly increased the vulnerability of specific social groups for poor physical health were identified in a hierarchical linear regression: relative social inequality in the form of income inequality; urban area poverty risks; and mean level of alcohol consumption in urban areas. The psychosocial conditions included poor diet, lack of social cohesion and social support, involvement in formal social networks in the form of professional groups. A multilevel theoretical perspective is important for defining the targets of preventive health policy by identifying the structural conditions which increase the health disadvantage of some social groups. Further research is needed in refining the concept of relative social inequality, as well as investigating whether psychosocial factors, such as social cohesion, are mediating links between sick societies and their sick citizens.

Adolescent↗
PubMed1991

Smoking, social support, and hassles in an urban African-American community.

BACKGROUND: Despite public health efforts, the prevalence of smoking among African Americans remains high. The determinants of smoking behavior in this population must be elucidated so that interventions can be better targeted and more effective. METHODS: As part of a prospective community intervention trial to reduce cancer mortality, we conducted a random household survey of 1137 African-American adults in San Francisco and Oakland between November 1985 and July 1986. The survey instrument included questions about social network characteristics, instrumental and emotional aspects of social support, smoking behavior, and stressors. RESULTS: The overall prevalence of smoking (41.9%) was higher than that reported in national surveys. Logistic models revealed that persons reporting high levels of stress, represented by an abbreviated hassles index, were more likely to smoke than those reporting less stress. Women with poor social networks were more likely to smoke (odds ratio = 3.1) than women with optimal networks; however, this relationship did not hold among men. Indeed, men lacking emotional support from friends or family were less likely to smoke (odds ratio = 0.5) than men receiving such support. No interaction between social support and hassles was observed. CONCLUSIONS: Stressful environments may contribute to high-risk smoking behavior among urban African Americans.

Black or African American↗
PubMedDate not supplied

Substance use and anger in mid-life women.

The purpose of this research was to examine individual and social network variables that relate to drinking alcohol and utilizing over-the-counter (OTC) medications. The present study sought to expand on the literature by adding modes of anger expression and social network variables as potential explanations of alcohol and OTC use in mid-life women. Secondary analyses were conducted on data from 87 mid-life women who were participating in a longitudinal study of health. Both alcohol and OTC users reported higher anger symptomatology than nonusers and had different profiles in terms of education and age. Social network variables were unrelated to substance use. Implications for intervention strategies and future research were discussed.

Adult↗
PubMed1997

Predicting the short-term outcome of first episodes and recurrences of clinical depression: a prospective study of life events, difficulties, and social support networks.

BACKGROUND: The study employed interview-based, investigator-rated measures of symptoms and psychosocial adversity in a panel survey to predict clinical course of depression. METHOD: 130 men and women attending psychiatric hospitals for episodes of depressive disorders were interviewed with the Present State Examination and Life Events and Difficulties Schedule. After a mean 4-month interval, 119 were successfully reassessed to test the hypothesis that recovery from clinical depression is related to rates of life event stress and difficulties (termed psychosocial adversity) in the 6 to 12 months preceding initial evaluation. RESULTS: The severity (p < .01) and the duration (p < .01) of the episode of depression up until the initial evaluation emerged as the only significant background predictors of episode severity at later follow-up. High levels of adversity were significantly (p < .05) related to a poor clinical course, due to failure to recover from first-onset and from second episodes. Recovery from all but first episodes was predicted by higher levels of social support rated at initial attendance. There was no evidence for the buffering of the harmful effects of adversity by larger, more connected social support networks. CONCLUSION: Both life event stress and support network characteristics are associated with the short-term outcome of depressive episodes. The findings for social support in particular confirm growing evidence of the importance of distinguishing between early and later relapsing episodes in causal investigations of depression. They reveal a progressive vulnerability to deficits in social circumstances with advancing course of disorder.

Adolescent↗