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PubMed2005

Social support among homeless and housed mothers: an integrative review.

Homelessness has been associated with levels of stress beyond the normal strain of living in poverty. For mothers who are homeless, support from their social networks may provide a buffer from some of the stresses associated with being homeless. To better understand the relationship between social support and female-headed homeless families, an integrative review was conducted of 12 research articles that compare social support among low-income housed mothers and homeless mothers, using guidelines set forth by Ganong. The included studies revealed four significant attributes of social support among housed and homeless mothers: size of the social support network; composition of the social support network; contacts with members of the social support network; and perceived support from members of the social support network. Nurses who work with homeless families are in a position to help develop ways for these families to cultivate and maintain their social support networks while homeless. Nurses can be available to offer support, including the necessary mental health services or referrals.

Ill-Housed Persons↗
PubMed2001

Psychosocial determinants of perceived vulnerability to harm among adult drinkers.

OBJECTIVE: Perceived vulnerability to harm is widely acknowledged as a determinant of behavior change, but little is known about why some drinkers believe that they are personally "at risk" for problems while others do not. This study examined perceived vulnerability to alcohol-related harm in relation to epidemiological risk status on a standardized problem-drinking measure and two psychosocial measures of drinking context: (1) typical reasons for drinking and cutting down and (2) social network influences related to alcohol use. We evaluated the general hypothesis that these psychosocial variables would independently affect perceived vulnerability to alcohol-related harm, over and above epidemiological risk status. METHOD: Adults between the ages of 18 and 79 (N = 430; 249 women, 173 men, 8 gender unknown) completed a questionnaire about drinking behavior and drinking-related social and motivational context. RESULTS: There was a positive relationship between problem-drinking status and perceived risk of experiencing harm, and no support for the idea that objectively "at-risk" drinkers believe that they are less likely to personally experience harm than comparable peers. Drinking motives and social network variables each significantly improved the prediction of perceived vulnerability when epidemiological risk status was controlled. CONCLUSIONS: Interventions designed to alter drinkers' risk perceptions should take into account the reasons that people have for drinking and the social network context of alcohol use, in addition to whether or not individuals are "problem drinkers."

Adolescent↗
PubMed2005

Predictors of quality of life among spouses of stroke patients during the first year after the stroke event.

BACKGROUND: Stroke, a disease with severe consequences for patients and their families, often lead to psychosocial stress, and a decline in the quality of life (QoL) among carers. Predicting the QoL is essential in the development of effective nursing support interventions. AIM: The aim of the present study was to identify predicting factors for the general QoL among spouses of stroke patients, and to determine whether these predictors change during the first year after the patient's stroke event. DESIGN: One hundred spouses were followed three times during 1 year regarding QoL, own illness, economic situation, well being, life situation, sense of coherence, social network and the patients' ability in activities of daily living (ADL). Stepwise multiple linear regression analyses were conducted for the baseline, 6- and 12-month assessments respectively, with the present QoL as the dependent variable. RESULTS: Over time during the first year after the patients' stroke event, there were significant differences in the spouses perceived general QoL. Life situation and economic situation were the only predictors of the spouses' QoL, which emerged during the entire year after the patient's stroke event, while well being, education, own illness, social network and ADL ability (patient) emerged at one or two occasions. CONCLUSION: The psychosocial factors -- life situation, well being, social network, education and economy -- are important in predicting QoL among spouses of stroke patients, and these predicting factors change over time. Determining the predictors at an early stage, and continuously over time, will help to focus clinical nursing interventions on the spouses' changing needs.

Aged↗
PubMed1985

Patient attitudes in short-term psychiatric care. Relations to social and psychiatric background, clinical symptoms, and treatment model.

The attitudes of patients were measured after 4 days and at discharge during two 4-month periods. The attitudes were related to ratings of symptoms, patient background, and type of treatment contract used (cooperation or staff-directed). The patients were generally satisfied with their treatment. A mere 7% disapproved of the general ward structure. The attitude data were subjected to a factor analysis and a 7-factor solution explaining 70% of the variance was found to be suitable. The factors were labelled Ward Structure, Key Worker, Nursing Care, Group Treatment, Psychopharmacological Treatment, Social Network, and Other Patients. A high level of satisfaction in the Ward Structure, Nursing Care, Psychopharmacological Treatment, and Other Patients factors was found to be related to a lower incidence of symptoms at discharge. The staff-contract group showed more favourable attitudes in the Nursing Care factor (both initially and at discharge) and the Psychopharmacological Treatment factor (only initially), while the cooperation-contract group did so in the Social Network factor. It is suggested that the two contract procedures resulted in the development of different kinds of interpersonal relationships during treatment, the cooperation group relying more on the social network, whereas the staff-contract group was more apt to rely on psychopharmacological treatment and on the nursing staff.

Consumer Behavior↗
PubMed2003

Socio-economic and demographic factors associated with injecting drug use among drug users in Karachi, Pakistan.

OBJECTIVE: To identify the socio-economic and demographic factors associated with injecting drug users (IDUs) in Karachi. METHODS: We recruited 242 IDUs (taking drugs through sub-dermal routes) and 231 non-IDUs (taking drugs other than sub-dermal routes) from February through June 1996. IDUs were interviewed regarding sociodemographic factors, economic condition, and social network (marital status, living with spouse). In addition, information regarding location of drug users within the city (districts of Karachi) and current history of sexually transmitted diseases (STDs) were gathered. Moreover, blood samples were also obtained for HIV testing. RESULTS: Multivariate analysis showed that the income generation via illegal modes [AOR 1.6, 95% CI 1.0-2.6], non-sharing of income with family [AOR 1.7, 95% CI 1.1-2.7] and presence of suicidal thoughts [AOR 2.0, 95% CI 1.1-3.8] were associated with the use of drugs through injections. Further, drug users from districts West, East and Central were more likely to use drug through injection as compared to drug users from district South. The history of genital herpes was also found to be associated with injecting drug use. One IDU was found seropositive for HIV. CONCLUSION: The high-risk behaviors, such as illegal modes of earning and presence of suicidal thoughts, among IDUs suggest that the group needs rehabilitation programme. Moreover, non-sharing of income suggest that IDUs are isolated from social network, therefore primary prevention activities with focus on improving socio-economic conditions and social networking can reduce drug use through injections. Focused interventions on target districts would be helpful in reducing IDU.

Adult↗
PubMed2006

Socio-economic and demographic factors associated with injecting drug use among drug users in Karachi, Pakistan.

OBJECTIVE: To identify the socio-economic and demographic factors associated with injecting drug users (IDUs) in Karachi. METHODS: We recruited 242 IDUs (taking drugs through sub-dermal routes) and 231 non-IDUs (taking drugs other than sub-dermal routes) from February through June 1996. IDUs were interviewed regarding sociodemographic factors, economic condition, and social network (marital status, living with spouse). In addition, information regarding location of drug users within the city (districts of Karachi) and current history of sexually transmitted diseases (STDs) were gathered. Moreover, blood samples were also obtained for HIV testing. RESULTS: Multivariate analysis showed that the income generation via illegal modes [AOR 1.6, 95% CI 1.0-2.6], non-sharing of income with family (AOR 1.7, 95% CI 1.1-2.7) and presence of suicidal thoughts (AOR 2.0, 95% CI 1.1-3.8) were associated with the use of drugs through injections. Further, drug users from districts West, East and Central were more likely to use drug through injection as compared to drug users from district South. The history of genital herpes was also found to be associated with injecting drug use. One IDU was found seropositive for HIV. CONCLUSION: The high-risk behaviors, such as illegal modes of earning and presence of suicidal thoughts, among IDUs suggest that the group needs rehabilitation programme. Moreover, non-sharing of income suggest that IDUs are isolated from social network, therefore primary prevention activities with focus on improving socio-economic conditions and social networking can reduce drug use through injections. Focused interventions on target districts would be helpful in reducing IDU (JPMA 53:511; 2003).

Journal Article↗
PubMedDate not supplied

A model for linking networks in social work practice with the institutionalized elderly.

The authors describe a demonstration project that used network theory as a framework for a broad-range ecological approach to social work practice in long-term care facilities for the elderly. The importance of developing and maintaining social supports and the reciprocal benefits in linking kinship, friendship, formal caregiving, and mutual-aid networks are examined. Examples of the practical applications of network theory are presented also.

Aged↗
PubMed2006

Social pressure, coercion, and client engagement at treatment entry: a self-determination theory perspective.

Research on coercion in addiction treatment typically investigates objective sources of social pressure among legally mandated clients. Little research has examined the impact of clients' perceptions of social pressures in generalist addiction services. Clients seeking substance abuse treatment (N=300; 221 males and 79 females; M age=36.6 years) rated the extent to which treatment was being sought because of coercive social pressures (external motivation; alpha=.89), guilt about continued substance abuse (introjected motivation; alpha=.84), or a personal choice and commitment to the goals of the program (identified motivation; alpha=.85). External treatment motivation was positively correlated with legal referral, social network pressures to enter treatment, and was inversely related to problem severity. In contrast, identified treatment motivation was positively correlated with self-referral and problem severity, and was inversely related to perceived coercion (ps<.05). Hierarchical multiple regression analyses showed that referral source (i.e., mandated treatment status), legal history, and social network pressures did not predict any of 6 measures of client engagement at the time treatment was sought. However, treatment motivation variables accounted for unique variance in these outcomes when added to each model (DeltaR(2)s=.06-.23, ps<.05). Specifically, identified treatment motivation predicted perceived benefits of reducing substance use, attempts to reduce drinking and drug use, as well as self (and therapist) ratings of interest in the upcoming treatment episode (betas=.18-.31, ps<.05). Results suggest that the presence of legal referral and/or social network pressures to quit, cut down, and/or enter treatment does not affect client engagement at treatment entry.

Age Factors↗
PubMed2003

[A follow-up study on mental and physical function function among stroke patients: comparisons between admission and discharge status in a rehabilitation-specialized hospital].

PURPOSE: To assess results of a 5 year-follow-up, in terms of disability, depression, quality of life, and social network in cases of stroke patients. This report deal with results at admission and discharge (in average, from 2.5 to 6 months of the onset) in a rehabilitation-specialzed hospital. OBJECT AND METHOD: The subjects were 87 stroke patients hospitalized in the Ibaraki Prefectural University Hospital. They were 64 men and 23 women, and their age were between 42 and 79 with an average of 59 years. Systematic evaluation for mental and physical functions was conducted at admission and discharge, and it is intended that the evaluation will be repeated 1, 2, 3 and 5 years from the stroke onset. RESULTS: There were substantial improvements in motor functions, general intelligence, and the status of dementia during the hospitalization. Activities of daily living and degrees of job execution and satisfactory were also improved. The prevalence of depression remained 40%, and the acceptance of limb paralysis or reduced quality of life did not change. Social network scores declined. DISCUSSION: Lack of improvement of depressive status and quality of life, and deterioration social network may increase the rist of major difficulties after discharge of stoke patients. Prevention programs at hospital may be necessary to cope with these potential problems.

Activities of Daily Living↗
PubMedDate not supplied

Trust and collaboration in the prevention of sexually transmitted diseases.

High rates of sexually transmitted diseases (STDs) are sustained in communities by a relatively small group of people, referred to as the core of transmission. Definitions of the core vary but inevitably include people who are socially marginalized and who distrust people in authority, such as public health practitioners and university researchers. Having an effect on a marginalized group usually depends on effective collaboration with people they trust. Researchers from the University of North Carolina School of Public Health developed a trust-based collaboration with community members of a rural county in North Carolina to implement an STD prevention program that, in turn, relied on trust in local social networks. As part of the STD prevention demonstration project, the research team established a community resource group made up of local African Americans who helped design, implement, and evaluate the intervention. The group identified 21 women to whom others in the community turned for advice on sex and STDs. These women were trained as lay health advisors to disseminate information and skills for preventing STDs among their social networks. Through face-to-face structured interviews before and after the intervention, the authors measured improvements in STD treatment and prevention behaviors. The proportion of people practicing each of the targeted behaviors improved during the evaluation period. In addition to disseminating information through their own social networks, the lay health advisors demonstrated new skills and a desire to interact with local care providers to influence the provision of care for STDs for low-income African Americans in this county. Each participant in the collaboration played a role in establishing or building upon trust with others. These trusting relationships were critical for empowering a marginalized group at high risk for STDs.

Adolescent↗
PubMed2005

Dynamics of social balance on networks.

We study the evolution of social networks that contain both friendly and unfriendly pairwise links between individual nodes. The network is endowed with dynamics in which the sense of a link in an imbalanced triad--a triangular loop with one or three unfriendly links--is reversed to make the triad balanced. With this dynamics, an infinite network undergoes a dynamic phase transition from a steady state to "paradise"--all links are friendly--as the propensity p for friendly links in an update event passes through 1/2 . A finite network always falls into a socially balanced absorbing state where no imbalanced triads remain. If the additional constraint that the number of imbalanced triads in the network not increase in an update is imposed, then the network quickly reaches a balanced final state.

Adaptation, Physiological↗
PubMed2003

Life satisfaction several years after severe multiple trauma--a retrospective investigation.

OBJECTIVES: To describe the prevalence of self-reported changes in life satisfaction after multiple trauma, to analyse associations between satisfaction with life as a whole and with domains in life, and to identify important contributors for satisfaction with life. DESIGN: Retrospective follow-up study. SETTING: Rehabilitation hospital three years after multiple trauma. SUBJECTS: Sixty-nine subjects with severe multiple trauma (ISS > or = 16). MAIN OUTCOME MEASURES: Clinical examinations to reveal prevalences of impairments and disabilities. Questionnaires about satisfaction with life as a whole and eight domains of life, both for the time before trauma, and for the actual situation; sense of coherence (SOC-13); social network. RESULTS: A total of 87% experienced a decrease in at least one of the nine life satisfaction items from before to after trauma (six-graded scale). After trauma significantly fewer subjects reported to be satisfied with life as a whole, as well as the domains sexual life, ADL, contact with friends, leisure, vocational and financial situation. Satisfaction with family life and partner relationship did not decrease significantly. The most important domains after trauma were satisfaction with leisure, family life and vocation. Vocational and leisure disability after trauma were important determinants for satisfaction with life as a whole. A strong sense of coherence and sufficient social network quality had significant impact on satisfaction with life as a whole and some of the domain-specific satisfactions. CONCLUSIONS: Both personal resources (a strong sense of coherence) and the presence of a qualitatively sufficient social network can buffer the negative influence of disabilities on life satisfaction after trauma.

Activities of Daily Living↗
PubMed1994

Therapeutic use of humor to improve social support in an institutionalized schizophrenic inpatient community.

We attempted to use passive communal laughter to improve social support within a chronic schizophrenic inpatient population. Two identical wards were compared on classical measures of social support (emotional and functional), social network (size and dispersion), satisfaction, and the nature of the social relationships (source). The experimental group was exposed to video projection of humorous movies four times daily for 3 months, and the control group to video projections of other, assorted movies at the same rate. In the experimental ward a significant improvement was manifest in the category of "distinct individuals supporting each patient." The difference may have been due to an improvement in the relationship with the staff. No improvement was found on any of the other measures. We concluded that the positive atmosphere that humor creates affects the therapeutic alliance between staff and patients but does not affect other social networks because of the regressed nature of the schizophrenics' social relationships.

Adult↗
PubMed2005

Network based models of infectious disease spread.

It has recently become possible to simulate directly dynamics on very large networks. This paper describes a model of epidemiology on a social network, the Epidemiological Simulation System (EpiSims), and offers general speculation on analyzing disease dynamics on networks. We describe the process of building a realistic social network, describe several different definitions of the network, each useful for certain purposes. Finally, we raise some important questions about structural properties of networks and how they influence dynamics.

Communicable Diseases↗
PubMed2001

[Are there predictors for sexual risk behavior in HIV-infected patients?].

The influence of four coping strategies ("rumination," "search for affiliation," "threat minimization," and "search for information"), four social network dimensions ("affectively positive," "affectively negative," "accepting confidants," and "liking confidants") and sociodemographics on the sexual risk behavior of HIV-infected persons were analyzed in sexual encounters with steady and casual partners. The analysis examines bi- and multivariately the predictors for sexual risk behavior. The study population consisted of 103 asymptomatic HIV-infected persons (80 men, 23 women, mean age 34 years, range 21-69 years) who participated in our prospective study and reported their sexual contacts during the previous 6 months. In sexual encounters with steady partners, the risk of unprotected behavior increased with the frequency of sexual contact. In these encounters, coping strategies and social network had no influence on sexual risk behavior. In sexual contacts with casual partners, the number of contacts with these partners was also of importance. The coping strategy "rumination" correlates significantly with enhanced risk behavior. In sexual contacts with casual partners, there was no correlation between sexual risk behavior and the three other coping strategies or social network. In multivariate analysis, the number of sexual contacts was the only significant predictor for sexual risk behavior with steady partners as well as casual ones. As sexual activity with HIV-infected persons is not absolutely safe, further prevention campaigns have to focus more on the motivation for safe sex, its situational aspects, and partners' responsibility.

Adaptation, Psychological↗
PubMed1993

Effect of parental factors on social skills of preschool children with craniofacial anomalies.

This study investigated the parenting stress and style and the social networks of parents with preschool children with and without craniofacial anomalies (CFA), and the effect of these factors on the child's level of social skill. Fifty-two families participated in the study. No differences were found between the CFA and control groups on level of parenting stress, parenting style, or social network characteristics. However, parents with children with visible defects found their social support networks more helpful, and advocated a more nurturing parenting style. For the CFA group, parenting stress predicted child level of social skill. These results underscore the importance of investigating the interaction between parent and child factors.

Child Rearing↗
PubMed2006

On analytical approaches to epidemics on networks.

One way to describe the spread of an infection on a network is by approximating the network by a random graph. However, the usual way of constructing a random graph does not give any control over the number of triangles in the graph, while these triangles will naturally arise in many networks (e.g. in social networks). In this paper, random graphs with a given degree distribution and a given expected number of triangles are constructed. By using these random graphs we analyze the spread of two types of infection on a network: infections with a fixed infectious period and infections for which an infective individual will infect all of its susceptible neighbors or none. These two types of infection can be used to give upper and lower bounds for R(0), the probability of extinction and other measures of dynamics of infections with more general infectious periods.

Communicable Diseases↗