HIV感染者家属心身症状与社会支持关系

目的 了解人类免疫缺陷病毒(HIV)感染者家属的心身症状、应对方式、社会支持的现状,分析心身症状与应对方式、社会支持之间的关系.方法 使用症状自评评定量表(SCL-90)、应对方式、社会支持量表,对湖北省12个县市的44名HIV感染者家属进行问卷调查.结果 (1)HIV感染者家属心身症状的严重程度均高于正常人群;(2)心身健康状况可能存在一定的性别差异;(3)家属的积极应对方式与正常人群无异,但消极应对方式明显高于正常人群;(4)家人是家属最重要的支持来源,家属获得的朋友支持明显不足;(5)家属心身症状与其应对方式,社会支持的关系尚不清晰.结论 在为HIV感染者提供帮助的过程中,应加强对感染者家属的心理健康状况的重视与关注.     

Factors associated with social support for family members who care for stroke survivors

IntroductionVascular strokes are a primary cause of long-term disability for adults, with many social consequences for the patient, the family and healthcare systems worldwide.AimTo investigate the relation between patients'' and caregivers'' characteristics, as well as burden and depression, and the social support received by carers for stroke victims in Greece.MethodPatients and caregivers were recruited from community settings in the Attica region of Greece, using purposive sampling. They completed a set of questionnaires during face-to-face interviews. Correlational and multiple regression analyses were performed to identify factors associated with caregivers'' perceptions of social support.ResultsIn total, 109 dyads of patients and their respective caregivers were recruited. The patients'' mean age was 69.3 years, while caregivers'' mean age was 58.0 years; 51.4% of patients were males, whereas 67.9% of the caregivers were females. The majority of both patients and caregivers were married, with an annual family income less than €10,000. The level of perceived social support was significantly associated with patients'' or caregivers'' annual family income, caregivers'' working status and the daily caring hours (p < 0.01). Greater perceived support was significantly associated with a lower care burden BCOS (r = 0.29, p < 0.01) and female gender (p = 0.023), but not with the patient''s functional level nor with depression (p > 0.05).     

Promoting social capital to alleviate loneliness and improve health among older people in Spain

Loneliness is especially frequent among older people in Southern Europe. Furthermore, promoting social capital to tackle loneliness and its health effects is an understudied intervention strategy. Therefore, a complex intervention was piloted in Spain in a pre–post study with a 2‐year follow‐up. Its aims were to explore the feasibility of the intervention and its short‐ and long‐term effects. It was conducted in one mixed rural–urban and two urban areas of diverse socioeconomic levels from 2011 to 2012. The intervention framework was based on social capital theory applying a behaviour change model and care co‐ordination. The intervention comprised: (i) a co‐ordinated action aimed at building a network between primary healthcare centres and community assets in the neighbourhood and (ii) a group‐based programme, which promoted social capital among lonely older people, especially social support and participation. Older people active in senior centres volunteered as gatekeepers. The main outcome domain was loneliness. Secondary outcome domains were participation, social support, self‐perceived health, quality of life, depressive symptoms and use of health resources. Pre–post changes were assessed with t‐test, Wilcoxon signed‐rank test and McNemar's test. Differences between the three time points were assessed with a one‐way ANOVA with repeated measures. Social workers and nurses were successfully involved as group leaders, 10 volunteers took part and 38 participants were included. After the intervention, loneliness decreased while social participation and support significantly increased. Furthermore, the number of visits to nurses increased. Exactly 65.8% of the participants built social contacts within the group and 47.4% became engaged in new activities. Two years later, social effects were maintained and depressive symptoms had decreased. Exactly 44.7% of the participants continued to be in contact with at least one person from the group and 39.5% continued participating. The intervention contributes a novel and feasible social capital‐based approach for alleviating loneliness among older adults while prompting meaningful changes in their lives.     

Who's there and who cares: age as an indicator of social support networks for caregivers among people living with motor neurone disease

This paper explores the social support networks available to the informal carers of people living with motor neurone disease (MND). An ethnographic case study was undertaken using eco mapping, observation and conversational interviews to collect data from 18 primary carers of people living with MND. Interviews took place in participants' homes in metropolitan, regional and rural locations. Participants discussed the content of their support network and drew lines between individuals to indicate the type and strength of relationship. Changes to the network were depicted on eco maps during subsequent interviews. While health policy-makers assume that healthy social capital exists in Australian communities and that social cohesion will ensure active and available support networks in times of illness or disability, data from this exploratory study indicated that this was not consistently the case. Support networks varied in size and composition; however, age was identified as a discriminator of the availability and consistency of support. People in older age groups identified more diverse but consistent support systems while people in younger age groups reported more fluctuations in the strength of relationships and declines in support as caregiving became more demanding. Individual assessment of support networks at regular intervals in the caregiving trajectory is vital for all carers. However carers in younger age groups may need specific support to manage the psychological crises that occur and more access to paid care. Older carers may need consistent support to handle more of the instrumental aspects of care and assistance to mobilise their support networks. Community workers should be alert to the possible need for crisis intervention when tensions in relationships threaten carers' ability to provide effective care.     

Children's representations of pets in their social networks

OBJECTIVES: To develop a child-friendly methodology to study children's representations of social support available from their personal relationships; and to examine children's representations of support from their pets compared to support from human relationships. DESIGN: Participants were 22 year-3 primary school children aged 7-8 years. They were asked to list all the people and animals important to them and then to select a 'top 10' of most special relationships. Using a story-based methodology, children were asked who from their 'top 10' they would turn to if they were the child in the story. RESULTS: Consistency in the data indicated that the children could reliably discriminate between different relationships in terms of the support functions they serve. Pets were often ranked higher than certain kinds of human relationship, and they featured prominently as providers of comfort, esteem support and confidants for a secret. Confidence in these findings is gained through pets not being nominated for functions they could not realistically perform.     

流动儿童社会支持和社会融合对社会资本与生活满意感的链式中介作用

目的 分析流动儿童社会资本影响生活满意感的内在机制。方法 采用自陈问卷调查1 229名流动儿童,通过bootstrap法考察了社会支持和社会融合在社会资本与生活满意感关系中的中介作用。结果 1)社会支持(effect=0.19,60.55%)、社会融合(effect=0.05,16.51%)分别在社会资本与生活满意感之间起显著的中介作用;2)社会支持和社会融合在社会资本与生活满意感的影响中起链式中介作用。结论 流动儿童社会资本通过社会支持和社会融合的链式中介作用影响生活满意感,社会支持的中介效果比社会融合的中介效果强。     

The practitioners’ perspective on the upside and downside of applying social capital concept in therapeutic settings

Social capital, and more particularly the social networks that define its existence, is said to benefit health and well‐being. In individuals recovering from alcohol and drug addiction, social capital accruing from social networks support treatment, recovery and maintenance. Therefore, the concept of social capital is important for public health practitioners working in recovery interventions. This qualitative study seeks to explore what practitioners perceive as the importance of social capital and how they apply the concept in interventions to support individuals recovering from drug and alcohol addiction. Eight public health practitioners involved in drug and substance abuse interventions in West Yorkshire, England, were interviewed. The results of the interview were then deductively coded using two priori themes of perceived impact of social capital on health outcomes and application of social capital theory in recovery interventions. The findings reveal that practitioners understand the impact of social capital as the effects of social networks on recovery and apply the concept in their interventions. However, the nature of interventions created based on similarities in condition (alcohol and substance addiction) and intended outcome (recovery) create bonding social capital with mixed outcomes. This paper argues that the wider benefits to service users are unintentionally inhibited by the overwhelming downsides of bonding social capital. For instance, closed support groups comprised of individuals with high similarities further exclude the already socioeconomically deprived service users from integrating and accessing resources outside their groups.     

躯体形式障碍患者社会支持与家庭功能特征研究

目的 探讨躯体形式障碍患者社会支持及家庭功能特征。方法 2017—2018年,收集就诊于综合医院心理门诊的躯体形式障碍患者48例,以性别、年龄、学历匹配正常人群47例进行对照研究,用一般人口学调查表、社会支持评定量表(SSRS)、家庭功能评定量表(FAD)、家庭亲密度及适应性量表(FACES-II)进行评估,采用多元线性回归分析对躯体形式障碍的危险因素进行分析。结果 躯体形式障碍患者在社会支持总分[(34.58±7.47)vs(40.25±7.16)]、客观支持评分[(7.54±2.34)vs(8.85±2.89)]、主观支持评分[(20.02±4.44)vs(23.30±4.52)]、社会支持利用度评分[(6.00±2.02)vs(7.79±2.05)]、家庭亲密度评分[(54.35±10.87) vs (63.91±15.55)]、适应性评分[(35.75±10.27)vs (42.38±13.37)]均低于正常对照组(t值分别为-3.78、-2.43、-3.57、-4.28、-3.47、-2.71,P值分别为0.000、0.017、0.001、0.000、0.001、0.008);两组在问题解决、角色、情感反应、行为控制因子的评分差异无统计学意义(P值均＞0.05),躯体形式障碍患者在沟通评分[(2.69±0.57) vs (2.11±0.36),(t=5.95,P=0.004)]、情感介入评分[(2.60±0.36) vs (2.24±0.49),(t=4.13,P=0.032)]、家庭总的功能评分[(2.80±0.56)vs( 2.07±0.43),(t=7.14,P=0.004)]均高于正常对照组。多元线性回归分析结果显示问题解决、角色、情感反应是躯体形式障碍的危险因素(R=0.91,P＜0.01)。结论 躯体形式障碍患者在社会支持、家庭亲密度、适应性、沟通、情感介入方面表现较差,问题解决、角色、情感反应对躯体形式障碍的发病具有预测作用,其中影响最显著的为情感反应因子。     

Bonding versus bridging social capital and their associations with self rated health: a multilevel analysis of 40 US communities

STUDY OBJECTIVE: Few studies have distinguished between the effects of different forms of social capital on health. This study distinguished between the health effects of summary measures tapping into the constructs of community bonding and community bridging social capital. DESIGN: A multilevel logistic regression analysis of community bonding and community bridging social capital in relation to individual self rated fair/poor health. SETTING: 40 US communities. PARTICIPANTS: Within community samples of adults (n = 24 835), surveyed by telephone in 2000-2001. MAIN RESULTS: Adjusting for community sociodemographic and socioeconomic composition and community level income and age, the odds ratio of reporting fair or poor health was lower for each 1-standard deviation (SD) higher community bonding social capital (OR = 0.86; 95% = 0.80 to 0.92) and each 1-SD higher community bridging social capital (OR = 0.95; 95% CI = 0.88 to 1.02). The addition of indicators for individual level bonding and bridging social capital and social trust slightly attenuated the associations for community bonding social capital (OR = 0.90, 95% CI = 0.84 to 0.97) and community bridging social capital (OR = 0.96, 95% CI = 0.89 to 1.03). Individual level high formal bonding social capital, trust in members of one's race/ethnicity, and generalised social trust were each significantly and inversely related to fair/poor health. Furthermore, significant cross level interactions of community social capital with individual race/ethnicity were seen, including weaker inverse associations between community bonding social capital and fair/poor health among black persons compared with white persons. CONCLUSIONS: These results suggest modest protective effects of community bonding and community bridging social capital on health. Interventions and policies that leverage community bonding and bridging social capital might serve as means of population health improvement.     

A systematic review of interventions to promote social support and parenting skills in parents with an intellectual disability

The family support needs of parents with an intellectual disability (ID) are relatively unknown. This paper reviewed two types of intervention for parents with ID: those designed to strengthen social relationships and those teaching parenting skills. A literature search was conducted using electronic databases and a limited number of evaluative studies were found. The evidence for interventions aimed at strengthening social relationships was inconclusive; although positive changes were observed, there were limitations in study design which restricted the generalizability of the results. The evidence for parental skills teaching suggested that behavioural based interventions are more effective than less intensive forms such as lesson booklets and the provision of normal services, although these studies also had limitations. There is a need for further large scale controlled studies in this area to provide clearer evidence and to explore additional factors relating to child, parent and family which may impact on outcomes.     

The dynamics and processes of social support: families’ experiences coping with a serious paediatric illness

A large body of research has revealed that social support helps buffer the negative consequences of stressful life events. Yet research also suggests that social support exchanges involve complex interpersonal dynamics. Using in‐depth interview data from 76 parents of paediatric cancer patients in the US, the findings demonstrate that parents experienced difficulty sustaining support after the diagnosis crisis, uncertainty about how to ask for the support they needed and challenges managing support efforts. Given these complexities in negotiating social support, this article examines the mechanics of effective social support exchanges. The findings show the importance of the nature of the pre‐existing relationship between the support recipient and provider, as well as the interactions throughout the period of support. For example, parents found support efforts that involved frequent interactions and involvement in families’ daily lives (such as help with childcare) most effective when the support provider was a close network member. In contrast, support offered from members of extended networks was most effective when the effort required little marshalling from the parents, did not need to be asked for and did not intrude in the families’ private lives. These findings contribute to the medical sociology and social support literature by analysing the conditions under which effective support efforts are marshalled.     

Perceptions towards disability among social work students in Israel: Development and validation of a new scale

Over the last decades, the disability movement has been advocating for a paradigmatic shift in how disability is perceived and managed: from a medical or individual perspective focusing on the person's body and mind to a social perspective emphasizing the context and barriers of disability. However, we still know little about the perceptions of helping professionals, particularly social workers who work closely with disabled people. Thus, the aim of the current study is to develop and validate a scale—Perceptions Toward Disability Scale (PTDS)—to measure how social workers view disability: as an individual or social category. This paper describes the three phases of the scale's construction. First, scale items were formulated and its content validity was examined. Next, a pilot of 30 social workers completed a questionnaire and an initial exploratory factor analysis was conducted. In the third and main phase, the final draft was completed in 2016 by 565 Israeli social work students to assess its psychometric properties. Both exploratory and confirmatory factorial validity and discriminant validity analyses were conducted. The results of a confirmatory factor analysis revealed two distinct factors: an individual perspective of disability comprised of eight items (α = 0.77) and a social perspective of disability comprised of ten (α = 0.66). Subsequent analyses supported the scale's discriminant validity as indicated by the lack of an association between the Attitude Toward Disabled Persons Scale (ATDP) and the social model subscale (r = .13, p = .19) and by the weak negative relation with the individual model subscale (r = ?.25, p = .01). These findings show that the PTDS possesses promising construct validity and provide support for its utility. This easy‐to‐administer instrument offers several practical benefits and can serve as a framework for further empirical research regarding social work practice with disabled people.     

Social capital,collective efficacy and the provision of social support services and amenities by municipalities in the Netherlands

Differential provision of local services and amenities has been proposed as a mechanism behind the relationship between social capital and health. The aim of this study was to investigate whether social capital and collective efficacy are related to the provision of social support services and amenities in Dutch municipalities, against a background of decentralisation of long‐term care to municipalities. We used data on neighbourhood social capital, collective efficacy (the extent to which people are willing to work for the common good), and the provision of services and amenities in 2012. We included the services municipalities provide to support informal caregivers (e.g. respite care), individual services and support (e.g. domiciliary help), and general and collective services and amenities (e.g. lending point for wheelchairs). Data for social capital were collected between May 2011 and September 2012. Social capital was measured by focusing on contacts between neighbours. A social capital measure was estimated for 414 municipalities with ecometric measurements. A measure of collective efficacy was constructed based on information about the experienced responsibility for the liveability of the neighbourhood by residents in 2012, average charity collection returns in municipalities in 2012, voter turnout at the municipal elections in 2010 and the percentage of blood donors in 2012. We conducted Poisson regression and negative binomial regression to test our hypotheses. We found no relationship between social capital and the provision of services and amenities in municipalities. We found an interaction effect (coefficient = 3.11, 95% CI = 0.72–5.51, P = 0.011) of social capital and collective efficacy on the provision of support services for informal caregivers in rural municipalities. To gain more insight in the relationship between social capital and health, it will be important to study the relationship between social capital and differential provision of services and amenities more extensively and in different contexts.     

Disease-related social and family life: people coping with rheumatoid arthritis in Estonia

Objective: The aim of the article is to investigate the most severe problems aggravating the quality of life of people with rheumatism and to outline the role of support and assistance people with rheumatism receive from their family members/acquaintances in order to cope with their daily life. Methods: The article is based on the data and findings of the national sociological survey ‘Chronic Rheumatic Patients 2006’ carried out by the Rheumatic Association of Tallinn in the years 2005–2006 with the support from the Ministry of Social Affairs of Estonia. Data were collected via a questionnaire from 808 respondents. Results: The respondents indicated their state of health and shortage of money as their most severe problems, followed by dysfunctional family relations, poor living conditions, loneliness, etc. The problems are more severe for the respondents who live alone and have been coping with illness for over 10 years. The assistance received from relatives/acquaintances to cope with daily life is more varied and thorough than that received from children. Assistance is mostly received occasionally. On average, every tenth respondent does not have anyone to turn to for assistance. Conclusion: Severe problems and stress symptoms display a cumulative effect–the occurrence of one aspect often triggers others. To break this vicious circle, people with rheumatism need assistance and support from the state as well as from their immediate environment.     

Social networks of HIV-positive women and their association with social support and depression symptoms

Social support is important to the mental health and well-being of HIV-positive women. Limited information exists about the specific structure and composition of HIV-positive women’s support networks or associations of these network properties with mental health outcomes. In this pilot study, the authors examine whether support network characteristics were associated with depressive symptoms. Survey and network data were collected from HIV-positive women (N = 46) via a web-based survey and an iPad application in August 2012. Data were analyzed using multivariate linear regression models in SAS. Depressive symptoms were positively associated with a greater number of doctors in a woman’s network; having more HIV-positive network members was associated with less symptom reporting. Women who reported more individuals who could care for them had more family support. Those who reported feeling loved were less likely to report disclosure stigma. This work highlighted that detailed social network data can increase our understanding of social support so as to identify interventions to support the mental health of HIV-positive women. Most significant is the ongoing need for support from peers.