Mediating effect of social support on the association between life events and depression: A cross-sectional study of adolescents in Chongqing China

Depression is one of the most common mental health problems in adolescents. The link between negative life events and depression has been well established. However, our understanding about the role of social support in the link, which is likely culture-dependent, is quite limited. This study aimed to determine the mediating effect of social support on the association between life events and depression in adolescents in Chongqing China.A total of 1512 adolescents aged 12 to 17 years old in Chongqing of China were selected using a stratified cluster sampling strategy. Depression symptoms, negative life events, and perceived social support of the participants were measured using the Children''s Depression Inventory, Adolescent Life Event Scale, and Child and Adolescent Social Support Scale, respectively. Pearson correlation analyses were performed to detect their associations. A multivariate linear regression model was established to determine the association between life events and depression after adjustment for variations in socio-demographic variables. The mediating effect of social support on the association between negative life events and depression was tested using the structural equation model.About 16.8% of the participants were detected with depression. Depression was associated with negative life events and low levels of social support (P < .05). Both frequency and perceived importance of social support showed a mediating effect on the association between life events and depression.Social support has a mediating effect on the association between life events and depression. Strengthening social support may be considered as an effective interventional strategy on depression in adolescents.     

性途径感染的PLWHA生存质量和社会支持分析

目的了解经性途径感染的艾滋病病毒感染者和艾滋病病人（PLWHA）的生存质量和社会支持现状,并分析其相关因素。方法应用世界卫生组织生存质量量表（WHOQOL-BREF）中文版,评价常住广州市海珠区、能随访到的经性途径感染的所有PLWHA的生存质量。用社会支持评定量表（SSRS）评价其社会支持。结果经性途径感染的PLWHA生存质量4个领域的平均得分为生理领域（14.26±2.27）分,心理领域（12.82±2.55）分,社会关系领域（13.00±2.28）分,环境领域（12.03±2.27）分。生理、心理和社会关系领域的得分低于全国常模,差异有统计学意义（P〈0.05）,但环境领域与全国常模的差异则无统计学意义（P〉0.05）。多元线性回归分析显示,性别、文化程度、居住方式、主观支持和对支持利用度是生存质量的相关因素,PLWHA社会支持3个维度的平均得分为客观支持（4.51±2.11）分,主观支持（17.55±5.03）分,对支持利用度（5.92±1.82）分,社会支持总分为（27.99±7.12）分。多元线性回归分析显示,年龄、婚姻、文化程度、居住方式、感染途径和社会关系领域是社会支持的相关因素。结论性途径感染的PLWHA生存质量和社会支持受多方面因素的影响,可根据不同的影响因素给予针对性的干预,以提高其生存质量和社会支持。     

The relationship between social support and health-related quality of life in patients with antiphospholipid (hughes) syndrome

Objective: Antiphospholipid (Hughes) syndrome (APS) is recognised as a systemic autoimmune disease defined by recurrent thromboembolic events and/or pregnancy morbidity. Little is known about the psychological burden of this long-term condition. This study aims to explore the relationship between social support and health-related quality of life (HRQoL) in patients with APS.

Methods: A total of 270 patients with a clinical diagnosis of APS participated in a cross-sectional online questionnaire survey. Data included demographics, disease-related information, social support and HRQoL.

Results: Both perceived and ideal social support were associated with HRQoL in APS. Patients reported receiving insufficient social support. Perceived emotional support was related to physical functioning (B?=?7.77, p?=?.006, 95% CI: 2.25, 13.29); perceived instrumental support was associated with bodily pain (B?=?17.52, p? .001, 95% CI: 11.15, 23.90) and perceived informational support with physical and social functioning (B?=??6.30, p?=?.05, 95% CI: ?12.52, ?0.08; B?=?8.06, p?=?.02, 95% CI: 1.17, 14.94). Ideal emotional support was related to physical and social functioning (B?=?5.80, p?=?.04, 95% CI: 0.26, 11.34; B?=?7.53, p?=?.04, 95% CI: 0.55, 14.51); ideal instrumental support was associated with mental health (B?=?4.73, p?=?.03, 95% CI: 0.38, 9.07) and ideal informational support with vitality (B?=?5.85, p?=?.01, 95% CI: 1.23, 10.46).

Conclusion: Social support was linked to HRQoL in patients with APS. Insufficient social support was associated with limitations in various HRQoL domains. Increasing social support especially through provision of disease-specific education might contribute to improving HRQoL in patients with APS. Patient-tailored interventions addressing psychosocial aspects of living with APS are needed to improve patients’ psychological and physical status.     

Meaning in life and risk of cognitive impairment: A 9-Year prospective study in 14 countries

BackgroundA meaningful and purpose-driven life is associated with better health outcomes. We test whether meaning in life is associated with risk of cognitive impairment using data from a large, multi-national study.MethodsParticipants (N = 22,514) were from the Survey of Health, Ageing and Retirement in Europe (SHARE). Participants from 14 countries reported on their meaning in life. Cognitive impairment was derived from performance on cognitive tasks administered at baseline and at up to three follow-up waves (waves 2–6 assessed between 2010–2015).ResultsLack of meaning in life was associated with a more than 20 % increased risk of incident cognitive impairment over the up to 9-year follow-up (Hazard Ratio = 1.24; 95 % Confidence Interval = 1.17–1.31). Further, compared to participants who reported often feeling meaning in life, participants who reported never feeling meaning in life were at an approximately 75 % increased risk of impairment (Hazard Ratio = 1.75, 95 % Confidence Interval = 1.19–2.57). The association between meaning in life and risk of cognitive impairment was apparent across four regions of Europe (Northern, Southern, Eastern, Western) and in Israel and was not moderated by sociodemographic characteristics.ConclusionsReporting lower meaning in one’s life is associated with risk of incident cognitive impairment. Meaning may be a potential target of intervention for healthier cognitive aging.     

艾滋病病毒感染者/艾滋病病人生存质量与社会支持的典型相关分析

目的了解艾滋病病毒感染者/艾滋病病人(HIV/AIDS病人)生存质量和社会支持现状。方法采用世界卫生组织生存质量量表简表(WHOQOL-BREF)中文版和社会支持评定量表,对98名HIV/AIDS病人进行面对面询问式匿名调查。结果 2010年7月至2011年3月共发出调查问卷100份,完成有效调查98份。典型相关分析结果显示:社会支持中影响较大的是主观支持和对支持的利用度2个因素,生存质量中影响较大的是社会关系领域和环境领域。主观支持、对支持的利用度与社会关系领域和环境领域成正相关。第一对典型变量(U1、V1)的典型相关系数分别为0.569(P=0.0001)。结论 HIV/AIDS病人获得的主观支持越多、对支持的利用度越高,其社会关系领域和环境领域得分越高。     

Perceived social support,coping, and stigma on the quality of life of people living with HIV in Nepal: a moderated mediation analysis

Perceived social support, coping strategy, and internalized stigma have been linked with the quality of life (QOL) among people living with HIV (PLHIV). However, little is known about how these psychosocial factors interact with each other and affect QOL. This study incorporated a moderated mediation model to investigate whether coping strategy mediates the relationship between perceived social support and QOL, and to examine whether this mediating effect varies with the level of internalized stigma among PLHIV. A cross-sectional study was conducted among 599 PLHIV in Nepal. The multidimensional scale of perceived social support, World Health Organization Quality of Life-BREF, Brief COPE, and AIDS-related stigma scales were used to measure perceived social support, QOL, coping strategy, and internalized stigma, respectively. Data were analyzed using structural equation modeling, and moderated mediation analysis was conducted with multi-group approach. The relationship between perceived social support and QOL was significantly and partially mediated by problem-focused coping strategy. Internalized stigma significantly moderated the mediating effect of coping strategies on the association between perceived social support and QOL. For high internalized stigma group (total stigma score?>?2), the effects of perceived social support on QOL were indirect (β?=?1.48; 61.0% of total effects) through the mediating effect of coping strategy, especially problem-focused coping one. For low internalized stigma group (total stigma score?≤?2), problem-focused coping strategy did not significantly affect the QOL, and most of the effects of perceived social support were direct (β?=?1.24; 99.2% of total effects). Internalized stigma was found to moderate the mediating effect of problem-focused coping on the relationship between perceived social support and QOL. Enhancing the problem-focused coping and social support may be helpful to improve QOL among PLHIV reporting high stigma.     

The social support system of the Japanese elderly

The social support system of the Japanese elderly was observed in a national representative sample of elderly community residents. Perceived availability of emotional and instrumental support from family members, children living apart, siblings and relatives, neighbors, and friends was respectively estimated. For both emotional and instrumental support, the perceived most dependable source of support was family members living together, followed by children living apart, while neighbors and friends were less dependable sources of support. The results clearly indicated family-centrality in the social support system of the Japanese elderly. However, the results also indicated differential roles of family members, children living apart, and non-kin others in the social support system of the elderly, and suggested the need to observe dyadic social relationships of Japanese elderly individuals.Department of Public Health Practice Institute of Public Health     

Stigma,marginalization and psychosocial well-being of orphans in Rwanda: exploring the mediation role of social support

Stigma and marginalization are one of the major challenges orphans face in their daily lives, particularly in developing countries, but little is known about their impacts on mental health. This study examines how orphan-related characteristics, stigma and marginalization are associated with psychosocial well-being. It further analyses the role of social support in mediating between stigma and marginalization and mental health, indicated by emotional well-being and mental distress. The participants in this study were 430 Rwandan orphans who were 10–25 years of age, and of whom 179 were females and 251 were males. Results showed that high levels of stigma and marginalization were associated with a lower level of emotional well-being and higher levels of mental distress. A mediation analysis indicated that low level of social support due to stigma and marginalization contributed significantly to low level of emotional well-being. Once stigma, marginalization and social support were fully accounted for, AIDS orphans exhibited higher levels of mental distress than those who were orphaned by genocide or other causes. Future interventions designed to reduce stigma and marginalization for orphans and actions that facilitate social support can significantly improve emotional well-being and reduce mental distress among orphans.     

The mediating effects of functions of social support on HIV-related trauma and health-related quality of life for PLHIV in China

ABSTRACT

The purpose of this study was to examine the effect of social support as a buffer between traumatic life events and HRQOL. We hypothesized that social support would mediate the effect of traumatic life events on HRQOL. A total of 2987 PLHIV participated in this study. The sample included 1876 (62.8%) males, and 1111 (37.2%) females. Data were collected using survey instruments measuring exposure to traumatic life events, functions of social support and HRQOL. The Structural Equation Model (SEM) produced a chi-square (χ²?=?486.63, df?=?32, p?<?.001) along with other goodness of fit indices such as CFI/TLI?=?.958/.941 and RMSEA?=?.069 (90%CI: .064, .074). Structural coefficients for traumatic life events, functions of social support, and HRQOL were statistically significant (≤.05). Crisis was the strongest predictor of traumatic life events, emotional support was the strongest predictor of functions of social support, and health distress was the strongest indicator of HRQOL. Traumatic life events had a significant direct effect on HRQOL. For PLHIV, experiencing a financial crisis associated with loss and/ or difficulty finding employment and enacted stigma were experienced as traumatic life events. Emotional support, described as having supportive interpersonal relationships, was identified as essential for HRQOL. Implications for interventions were discussed.     

Influence of social support on health-related quality of life in patients with systemic lupus erythematosus

The objective of this study was to examine health-related quality of life (HRQOL) and social support in patients with systemic lupus erythematosus (SLE) and compare it with healthy people, to identify the relationship between social support and HRQOL in SLE patients, and to assess the influence of age, SLE Disease Activity Index (SLEDAI) and disease duration on HRQOL. We administered The Medical Outcomes Study Short Form-36 (MOS SF-36) questionnaire and the Social Support Rate Scale (SSRS) to a group of 202 patients with SLE and a healthy control group of 207 individuals. Spearman correlation was performed to identify the relationship between social support and HRQOL in SLE patients. The ordinal regression analyses were used to identify independent variables that were associated with the PCS and MCS. Results show that the physical (PCS) and mental (MCS) component summary scores of MOS SF-36 were lower in patients compared with healthy controls. Patients with SLE have a poorer social support as compared with healthy controls in subjective support, objective support, and availability of support. There was a positive correlation between social support and PCS and MCS. MCS and PCS were negatively associated with age and SLEDAI. MCS were negatively associated with disease duration. Taken together, this data suggested that patients with SLE have significant impairment of their HRQOL and less social support. HRQOL may be affected by social support, age, and SLEDAI.     

乙型肝炎肝硬化患者生活质量与社会支持的调查研究

目的调查乙型肝炎肝硬化患者的生活质量和社会支持状况,分析社会支持与生活质量的相关性,为临床有效提高乙型肝炎肝硬化患者的生活质量提供科学依据。方法采用生活质量量表和社会支持评定量表对104例乙型肝炎肝硬化患者的生活质量和社会支持状况进行调查分析。结果乙型肝炎肝硬化患者的生活质量总分及各维度得分均低于常模人群;肝硬化患者客观支持、主观支持和对支持的利用度三方面与常模人群比较,差异有显著性意义（t=-9．875,P〈0．01）;肝硬化患者生活质量与社会支持总分呈显著的正相关（r=-0．597,P〈0．001）,客观支持、主观支持及对支持的利用度三个维度也与生活质量呈正相关（P〈0．05或P〈0．001）。结论帮助乙型肝炎肝硬化患者建立有效的社会支持系统,对提高其生活质量有重要的意义。     

The relationships among social support and quality of life in persons living with HIV/AIDS in Jiangxi and Zhejiang provinces,China

Several empirical studies, particularly those conducted in developed countries, have linked social support to quality of life among persons living with HIV/AIDS (PLWA). However, few studies have been conducted in developing countries, such as China; therefore, the question of any association being present between social support and quality of life in PLWA in China remains unanswered. This retrospective cross-sectional study was conducted to examine the relationships between social support and quality of life among PLWA in the Jiangxi and Zhejiang provinces of China. A total of 377 PLWA participated in this study, and questionnaires used included demographics, the Chinese Medical Outcomes Study Short Form-36, and a Social Support Rating Scale, all of which were collected through face-to-face interviews between 1 March and 15 April 2013 in six different County Centers of Disease Control and Prevention in Jiangxi and Zhejiang provinces, and one hospital in the Jiangxi. The health-related quality of life score was 64.7 ± 13.5 (out of a total score of 100), which was significantly lower than the national norm level of 78.2 ± 15.9. The total score of social support was 29.4 ± 7.8 (full score 66). The canonical correlation between social support and quality of participants' lives was shown to be statistically significant (p < 0.0001). The relationship between subjective support and quality of life among PLWA was also significant (p = 0.004). Subjective support and the use of social support showed a positive correlation with vitality, role-physical, and role-emotional, and a negative correlation with body pain. The current study suggests that PLWA with lower social support have diminished quality of life.     

Depression and anxiety mediate perceived social support to predict health-related quality of life in pregnant women living with HIV

Pregnant women living with HIV represent one of the most high-priority groups for HIV treatment and health assessment. Although social support has been shown to be a protective factor for improved health-related quality of life (HRQoL), and depression and anxiety have been identified as two major causes of psychological distress among people living with HIV, it is still unclear how social support, anxiety, and depression interact to influence HRQoL. The objective of our study was to demonstrate the nature of predictors, direct effects and mediator effects among social support, anxiety, depression symptoms and HRQoL in pregnant women living with HIV. We investigated a total of 101 pregnant women living with HIV in Yunnan province in China from April 2016 to June 2016. All participants completed the Social Support Rating Scale (SSRS), the Chinese version of the Hospital Anxiety and Depression Scales (HADS) and Quality of Life instruments (EuroQoL Five Dimensions Questionnaire, EQ-5D). The relationships between the variables were examined by Pearson's or Spearman's correlation analysis. Predictor effects were tested using separate multiple regressions, controlling for demographic variables and HIV diagnosis variables. Direct and mediation effects of social support on HRQoL were tested using a structural equation model (SEM). Anxiety and depression symptoms were negatively correlated with subjective social support, support utilization, social support and HRQoL. Social support significantly predicted better HRQoL, and anxiety and depression symptoms significantly predicted poorer HRQoL. Anxiety and depression symptoms partially mediated the associations between social support and HRQoL. Anxiety and depression symptoms completely mediated the associations of objective support and support utilization with HRQoL. Interventions to improve HRQoL in pregnant women living with HIV must consider the mediation effect of anxiety and depression symptoms on the association between social support and HRQoL. Social support interventions are valid only when anxiety and depression symptoms are managed effectively.     

Depression,social support,and stigma as predictors of quality of life over time: results from an Asha-based HIV/AIDS intervention in India

Quality of life (QOL) is associated with better outcomes in HIV/AIDS populations. We explored predictors of improved QOL over time in 600 Women Living with HIV/AIDS (WLH/A) in India [mean age = 34.31, SD = 6.97], enrolled in a nurse-led-Asha (Accredited Social Health Activist) intervention. Trained local interviewers ascertained self-report data at baseline and six-month follow-up (post-intervention). Latent Class Analysis (LCA) identified constellations of responses on psychosocial indicators (depression, social support, internalized stigma and stigma fears); their relationship with QOL over time was examined. We identified three classes: Class 1) Highest Social Resources/Lowest Depression; Class 2) Some Social Resources/Highest Depression; and Class 3) Lowest Social Resources/Higher Depression. At baseline, Class 3 reported the lowest QOL (M = 0.25, SD = 0.26); Class 1 reported the highest (M = 0.37, SD = 0.33). Class 2’s QOL did not differ from Class 3’s QOL, likely due to the potent effects of high depression. At six-month follow-up, all groups reported improved QOL; class membership no longer predicted variability (contrast between Class 2 and 1 = ?0.05, 95% CI = ?0.14, 0.04; contrast between Class 3 and 1 = 0.01, 95% CI = ?0.03, 0.05; contrast between Class 3 and 2 = 0.07, 95% CI = ?0.02, 0.16). Psychosocial indicators are important predictors of QOL; an Asha-supported approach may have broad applicability to improve QOL in WLH/A in India.     

农村居家失能老年人社会支持满意度影响因素分析

目的:了解农村居家失能老年人对社会支持满意度影响因素,为进一步提高社会支持水平和失能老年人的养老质量提供决策依据。方法:于2020年6月—10月采用随机抽样法在陕西陕南、陕北、关中三个地区共6个乡镇对211名失能老年人开展问卷调查并进行访谈,并用有序Logistic回归模型分析失能老年人社会支持满意度的影响因素。结果:...     

Age differences in the understanding of wealth and power: the mediating role of future time perspective

Individuals’ understanding of wealth and power largely determines their use of resources. Moreover, the age range of wealth and power holders is increasing in modern societies. Thus, the current study examines how people of different ages understand wealth and power. As varying future time perspective is related to changes in prioritised life goals, it was tested as a potential mediator of the age differences. A total of 133 participants aged 18–78 years were asked 8 open-ended questions regarding their understanding of the possible use and desired use of wealth and power, after which they reported their future time perspective. Compared with possible use, the participants mentioned relatively more prosocial elements when they talked about their desired use of the resources, especially power. The older adults expressed more prosocial understanding in regard to the desired use of wealth and the possible use of power compared to their younger counterparts. The age differences were fully mediated by future time perspective. The results suggest that age is a critical factor that influences individuals’ conceptualisation of wealth and power. Life-span developmental stage and future time perspective are important factors to consider for explaining individual differences in the exercise of wealth and power and for promoting their prosocial usage.     

Quality of life,social support,and knowledge of disease in women with rheumatoid arthritis

Objective

To examine the relationships between the quality of life (QOL) of women with rheumatoid arthritis (RA) and 1) their perceived levels of social support and 2) their primary caregivers' knowledge of RA and its treatment.

Methods

Women aged 40–60 years with established RA completed validated questionnaires on health status (Arthritis Impact Measurement Scales 2) and satisfaction with the levels of social support from their primary caregiver (Significant Others Scale A). In addition, both the caregivers and patients independently completed questionnaires that were designed to elicit knowledge of RA and its treatment.

Results

Fifty‐eight patients and their primary caregivers completed the questionnaires. Analysis of the patients' health status demonstrated widespread biopsychosocial impairments. Arthritis pain, identified as the poorest health status dimension, was associated with the lowest levels of satisfaction, and received the highest priority for health status improvement. In contrast, the patients reported highest levels of satisfaction with social support from family and friends. Positive associations between social support variables and a number of QOL measures were observed. Both the caregivers and the patients displayed limited knowledge of RA and its treatment. Associations between the levels of knowledge and the patients' QOL measures were not observed.

Conclusion

In this study of women with RA and their caregivers, a limited knowledge of disease did not appear to impact QOL measures. However, failure to detect an association between knowledge of disease and QOL may have been influenced by a combination of the relatively small study numbers and insufficient variation in caregivers' knowledge, such that a floor effect existed.

     

社会支持度与老年人听力障碍预后的关系研究

目的 探讨社会支持度与老年人听力障碍预后的关系。方法 入选2008年1月～2014年12月在中山大学附属第三医院耳鼻咽喉头颈外科因听力障碍就诊的门诊及住院患者中资料齐全并可持续随访的130例＞60岁的老年患者,调查其就诊主诉、发病到就诊时间、对诊疗的顺从性、预后以及其所获得的社会支持度。结果 （1）就诊主诉。老年人因听力障碍而就诊时,除了中青年人中常见的听力下降、耳鸣、听不清等主诉之外,还有“把电视机声音调大、没听见婴儿哭声、错过电话、错过敲门声”等导致干扰家人生活以及误事等原因。听力障碍发生后,仅22%的患者能在1周内就诊。（2）社会支持度。130例听力障碍老年人的社会支持度明显低于健康中青年人常模及中青年听力障碍患者对照组,主要在主观支持、支持利用度两个维度,差异显著。（3）顺从性。因为医疗保障不足、交通不便等诸多原因,听力障碍老年人对诊疗的顺从性差,仅49%的患者能选择并执行医生推荐的诊疗方案,30%的患者中断治疗,21%的患者放弃干预。（4）预后。诊疗结束时,较好耳的听力仅5例达正常水平,轻度、中度、重度及极重度聋分别为49例、40例、22例和14例。结论 听力障碍老年人因为对听力保健常识以及干预措施的知晓率低,在医疗费用、就诊时间等方面的保障缺乏,以致于听力障碍发生后不能及时就诊、难以选择最佳诊疗方案甚至于中断治疗或放弃干预,最终严重影响预后。     

Types of social support and their relationships to physical and depressive symptoms and health-related quality of life in patients with heart failure

Objectives

To examine the various types of social support associated with physical and depressive symptoms and health-related quality of life (HRQOL) in patients with heart failure (HF) and the mediating effects of symptoms on the relationship between social support and HRQOL.

Background

Patients with HF have a high burden of physical and depressive symptoms, along with poor HRQOL. Social support may improve symptoms and HRQOL.

Methods

Data on social support (marital status, family relationships, relationships with health care providers, social networks, emotional support, and instrumental support), symptoms, and HRQOL were collected from 71 patients. Hierarchical regression was used to analyze the data.

Results

Emotional support was related to all physical and depressive symptoms and HRQOL. Physical and depressive symptoms mediated the relationship between emotional support and HRQOL.

Conclusions

Further studies are needed to identify ways to improve emotional support and determine whether the improvement leads to improvements in symptoms and HRQOL.