The effects of perceived social support on quality of life in patients awaiting coronary artery bypass grafting and their partners: testing dyadic dynamics using the Actor-Partner Interdependence Model

Patients awaiting coronary artery bypass grafting (CABG) need support from their partners or family caregivers to manage their self care successfully and to maximise quality of life. Partners need social support to help overcome the stressful tasks of an unexpected caregiving role. It is not known whether the individual's perceived social support contributes to their own, as well as their partner's quality of life. The aims of this study were to assess differences in social support and quality of life in patients and partners awaiting CABG, and to examine whether patients' and partners' perceived social support predicted their own, as well as their partner's quality of life before CABG. This cross-sectional study recruited 84 dyads (patients 84% males, aged 64.5 years and partners 94% females, aged 61.05 years). Perceived social support was assessed using the Medical Outcomes Study Social Support survey, with sub-scales for informational/emotional support, affectionate support, tangible support and positive social interaction. Quality of life was assessed using the Short-Form 12 Health Survey. Dyadic data were analysed using the Actor-Partner Interdependence Model, with distinguishable dyad regression. Results revealed the patients' informational/emotional support exhibited an actor effect on their own mental health (? = 0.19, p = 0.001); indicating those with low informational/emotional support had poorer mental health. There was a partner effect of the patients' informational/emotional support on their partner's mental health (? = 0.14, p = 0.024), indicating the patients' informational/emotional support was associated with the partner's mental health. None of the other types of social support exhibited an actor effect or a partner effect on the patient's or the partner's mental or physical health. More research into the relationship between social support and mental health is needed to help inform the design of interventions that target the dyad.     

Less pain and more to gain: why high-status group members blame their failure on discrimination.

Members of high-status groups are more likely than members of low-status groups to blame their failure on discrimination and are less likely to blame it on themselves. This tendency was demonstrated in 3 experiments comparing men and women, White and Black students, and members of experimentally created high- and low-status groups. Results also showed that when making an attribution to discrimination, high-status group members were less likely to experience a threat to their social state self-esteem, performance perceived control, and social perceived control and were more likely to protect their performance state self-esteem. These findings help to explain why high-status group members are more willing to blame their failure on discrimination by showing that it is less harmful for them than for low-status group members.     

Effective social support: Antecedents and consequences of partner support during pregnancy

This longitudinal study investigated a new conceptualization of the effectiveness of social support attempts called social support effectiveness (SSE) that takes into account the quantity and quality of support attempts and the extent to which they meet the needs of recipients. SSE was assessed in a sample of 176 pregnant women with regard to their partners’ social support behaviors. Potential antecedents of SSE were investigated, including individual and relationship variables. In addition, it was hypothesized that women who appraised their partner’s support as more effective would have lower prenatal anxiety, both concurrently (in mid‐pregnancy) and prospectively (in late pregnancy). Factor analyses confirmed that all hypothesized aspects of SSE contributed to a unitary factor of SSE. Structural equation modeling was used to test the proposed antecedents and consequences of SSE. Results revealed that women’s ratings of the effectiveness of partner support were predicted by their interpersonal orientation (adult attachment, network orientation, kin individualism–collectivism, and social skills) and by characteristics of their relationships with their partners (relationship quality, emotional closeness and intimacy, and equity). Furthermore, women who perceived themselves to have more effective partner support reported less anxiety in mid‐pregnancy and showed a reduction in anxiety from mid‐ to late pregnancy. Findings are discussed with regard to implications for advancing research on social support processes, especially within relationship contexts.     

Perceived partner support and psychosexual adjustment to breast cancer

Support from a partner can play a key role in a woman's emotional adjustment to breast cancer. However, little is known about the influence of partner behaviours on a woman's sexual adjustment. This study examined the prospective relationship between baseline levels of several types of perceived partner support (instrumental, informational, emotional and negative) and psychosexual adjustment (sexual functioning and relationship satisfaction) over the course of 12 months post-surgery in a sample of 130 women with breast cancer. Results indicated that perceptions of greater emotional and informational support from the partner at baseline were associated with less sexual difficulties among breast cancer patients concurrently and 6 months post-surgery. Baseline perceptions of greater emotional and instrumental support from a partner were associated with greater relationship satisfaction at all time points. Perceptions of informational support at baseline were related to greater concurrent relationship satisfaction. Baseline perceptions of negative partner support were related to less relationship satisfaction, but only concurrently. These findings suggest that the perception of a partner's provision of emotional, instrumental and informational support may each play a role in facilitating sexual adjustment and relationship satisfaction.     

Perceived partner support and psychosexual adjustment to breast cancer

Support from a partner can play a key role in a woman's emotional adjustment to breast cancer. However, little is known about the influence of partner behaviours on a woman's sexual adjustment. This study examined the prospective relationship between baseline levels of several types of perceived partner support (instrumental, informational, emotional and negative) and psychosexual adjustment (sexual functioning and relationship satisfaction) over the course of 12 months post-surgery in a sample of 130 women with breast cancer. Results indicated that perceptions of greater emotional and informational support from the partner at baseline were associated with less sexual difficulties among breast cancer patients concurrently and 6 months post-surgery. Baseline perceptions of greater emotional and instrumental support from a partner were associated with greater relationship satisfaction at all time points. Perceptions of informational support at baseline were related to greater concurrent relationship satisfaction. Baseline perceptions of negative partner support were related to less relationship satisfaction, but only concurrently. These findings suggest that the perception of a partner's provision of emotional, instrumental and informational support may each play a role in facilitating sexual adjustment and relationship satisfaction.     

Social support and happiness in immigrant women in Spain

The association between perceived social support and happiness was investigated in women who are members of various associations in Malaga (Spain) that work with immigrant women. Based on the Social Convoy model, the association between sources of support, frequency of support, satisfaction with support, and happiness reported by women were examined. The main social support predictor of happiness was satisfaction with the support received. Thus, the best predictors of happiness were emotional support from the family and instrumental support from the indigenous population and associations. The best predictor of frequency of support was the frequency of informational support received from social services. These results may prove useful for developing lines of action or interventions centred on the social network and the functions that social support can fulfil among immigrant women.     

Relationship of social support and social burden to repeated breast cancer screening in the women's health initiative.

Direct and interactive effects of social support, social burden (caregiving, negative life events, and social strain), education, and income on repeated use of breast cancer screening among a large (N=55,278), national sample of postmenopausal women participating in the Women's Health Initiative observational study were examined. Repeated screening decreased as emotional/informational support and positive social interactions decreased (ps<.01). Repeated mammography decreased with frequent caregiving (p<.01). Less social strain reduced the frequency of repeated breast self-examinations (BSEs; ps<.01), but frequent caregiving and more negative life events increased repeated use of BSE (ps<.01). Interactive effects suggested that emotional/informational but not tangible support is associated with repeated mammography and clinical breast examinations (ps<.01) and may be particularly important among low-income older women, especially those burdened by caregiving.     

Social support for women with chronic pelvic pain: what is helpful from whom?

Eight women with Chronic Pelvic Pain (CPP) were asked, by means of semi-structured interview, what had been helpful and unhelpful in terms of social support from their partners, families, friends, acquaintances, doctors, nurses and other women with CPP. Firstly, thematic analysis employing a pre-defined social support category system revealed that particular forms of tangible support were preferred from specific support providers but emotional and informational support was appreciated from the whole support network. Secondly, interpretative phenomenological analysis revealed three major additional themes: ‘Pain and Suffering’ described the trauma suffered by these patients and the anger and anxiety surrounding their experience; ‘Ideal Social Support’ revealed a picture of desired support consisting of enduring emotional and practical support which did not undermine individual autonomy; ‘Shortfalls in Social Support’ had subsidiary themes entitled ‘Lack of empathy’ and ‘Lack of engagement’. These themes were described and discussed in relation to each other, extant research and their clinical implications.     

Quality of relationships and structural properties of social support networks of female survivors of abuse

The purposes of this study were to examine the structural properties of the social support networks of female survivors of violence and abuse and to investigate the quality of the relationship, and specific level of satisfaction, survivors have with their social support networks. Participants averaged 5.8 persons in their social support networks. Their levels of satisfaction with the emotional, practical, financial, guidance, and socializing support they received from members of their social support networks were higher with respect to close friends and coworkers than with respect to family members and professionals (e.g., attorneys and social workers). The most common type of support provided by close friends who were themselves victims of abuse was emotional, guidance, and socializing support, and the most satisfying support was the financial and practical help that came from parents or family. An interesting finding was the significant presence of men in the survivors' social support networks. Overall satisfaction with the quality of support from the social support networks was high, and satisfaction with support from men was comparable, if not higher, than support from women. Multiple regression models revealed that satisfaction with support networks was a potent predictor of self-esteem, emotional health, and loneliness. Intimacy, especially in terms of exclusiveness and trust or loyalty, with at least a few members of the support network contributed significantly to the variance in self-esteem, emotional health, and loneliness among the abused women. The size of the support network also emerged as a limited contributor to well-being. Implications and applications are discussed for professionals working with female survivors of abuse.     

Determinants of Depression Severity and Duration in Canadian Adults: The Moderating Effects of Gender and Social Support

This study examined the effects of 4 subtypes of social support (tangible, affective, positive social interaction, and emotional/informational) and gender on the severity and duration of depressive symptoms within the general adult Canadian population. Data were collected from the Canadian Community Health Survey (CCHS; Statistics Canada, 2002 ). Upon meeting predetermined criteria, 6,316 participants were included in the study. The findings suggest that, overall, positive social interaction was significantly associated with decreases in depression severity; while emotional/informational support was significantly associated with increases in depression severity. Positive social interaction and emotional/informational support appeared to significantly decrease the duration of depression. Interesting gender differences also emerged among the 4 subtypes of social support. Implications of the findings are discussed.     

Social isolation and gender

This study investigated the relationship between gender and social support. It was found that men were more isolated than women although there were no gender differences in perceived adequacy (i.e., satisfaction with one's social support network) or network size. Given that both the adequacy and network size variables were associated with socially desirable responding but the isolation variable was not, the results suggest that the behaviorally oriented indicator of isolation was a better measure of the degree of social isolation than traditional subjective scales currently used by many researchers. This suggests that traditional measures of social support that incorporate the dimensions of network size and perceived adequacy of one's social support system need to control for socially desirable responding and that measures can and need to be developed that are not significantly influenced by this response set bias. Hence, the assessment of social support may need to be more multifaceted than is currently undertaken in many studies. Our finding that men reported being more isolated than women may be a function, in part, of the fact that the majority of the sample (76.7%) was single/did not live with a partner. Previous research has found that men generally get their emotional needs met by their spouses/partners while women often get their emotional needs met by their female friends. Consistent with the literature, and given that most of our respondents were single, this study supports the contention that men are generally more socially isolated than women because they do not create adequate emotional intimacy when they are not in partnership with a significant other.     

Exploring Perceived Social Support from Peer Facilitators in an HIV Treatment Adherence Intervention for African American Patients: A Content Analysis of Participant Perspectives

HIV treatment adherence interventions increasingly rely on peer facilitators to promote treatment adherence and improve patient retention, yet little is known about how participants perceive the role performed by peer facilitators. The present study examined participant perceptions in terms of the social support from peer facilitators in a hospital‐based intervention in Chicago. Content analysis was conducted with reference to four types of social support (instrumental, informational, emotional and affiliational) on exit interviews with 11 participants enrolled in the intervention that targeted African‐American patients living with HIV/AIDS. We examined how the type of social support perceived by participants was related to their self‐reported behaviours in three domains: adherence, sexual safety and general coping. Our analysis revealed that most participants perceived informational and emotional support from their peer facilitators, followed by instrumental support. Affiliational support was the least frequently perceived type of social support. We found that perceived informational support from peer facilitators with regard to adherence had greater impact and credibility amongst participants than the same type of support from medical providers. Informational support was cited most frequently with regard to influencing adherence and sexual safety behaviours, whereas perceived emotional support was cited primarily with helping participants cope with HIV. Copyright © 2015 John Wiley & Sons, Ltd.     

Social isolation and gender

This study investigated the relationship between gender and social support. It was found that men were more isolated than women although there were no gender differences in perceived adequacy (i.e., satisfaction with one's social support network) or network size. Given that both the adequacy and network size variables were associated with socially desirable responding but the isolation variable was not, the results suggest that the behaviorally oriented indicator of isolation was a better measure of the degree of social isolation than traditional subjective scales currently used by many researchers. This suggests that traditional measures of social support that incorporate the dimensions of network size and perceived adequacy of one's social support system need to control for socially desirable responding and that measures can and need to be developed that are not significantly influenced by this response set bias. Hence, the assessment of social support may need to be more multifaceted than is currently undertaken in many studies. Our finding that men reported being more isolated than women may be a function, in part, of the fact that the majority of the sample (76.7%) was single/did not live with a partner. Previous research has found that men generally get their emotional needs met by their spouses/partners while women often get their emotional needs met by their female friends. Consistent with the literature, and given that most of our respondents were single, this study supports the contention that men are generally more socially isolated than women because they do not create adequate emotional intimacy when they are not in partnership with a significant other.     

Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking

The purpose of the present study was to examine the role of emotional and instrumental social support seeking in the quality of life (QOL) and mental health of women with ovarian cancer. Participants were recruited through the Pennsylvania Cancer Registry, and one hundred women took part in a mail questionnaire that collected information on their demographics, medical status, social support seeking, QOL and mental health including anxiety, depression and stress. Hierarchical linear regression analyses were conducted to assess the influence of emotional and instrumental social support seeking on QOL and mental health. After controlling for remission status, greater emotional social support seeking was predictive of higher overall QOL, social/family QOL, functional QOL and lower depression scores. Instrumental social support seeking was not significant in the models. The results illustrate that social support seeking as a coping mechanism is an important consideration in the QOL and mental health of women with ovarian cancer. Future studies should examine the psychological and behavioral mediators of the relationship to further understand the QOL and mental health of women with ovarian cancer.     

Reciprocal Communication in Online Health Support Groups: Effects of Message Format and Social Support on Individual Responses to Health Issues

This study examines the extent to which message format and social support may affect individuals’ participatory responses in online health support groups and their subsequent affective and attitudinal responses. An experiment with a 2 (message format: narrative vs. nonnarrative) × 2 (social support: emotional support vs. informational support) between-subjects factorial design was conducted among 98 participants. Results indicated that narrative messages facilitated reciprocal communication. In turn, participants who provided such participatory responses reported less fear and sadness, more favorable health attitudes, and greater behavioral intentions.     

Lending a hand: social regulation of the neural response to threat

Social contact promotes enhanced health and well-being, likely as a function of the social regulation of emotional responding in the face of various life stressors. For this functional magnetic resonance imaging (fMRI) study, 16 married women were subjected to the threat of electric shock while holding their husband's hand, the hand of an anonymous male experimenter, or no hand at all. Results indicated a pervasive attenuation of activation in the neural systems supporting emotional and behavioral threat responses when the women held their husband's hand. A more limited attenuation of activation in these systems occurred when they held the hand of a stranger. Most strikingly, the effects of spousal hand-holding on neural threat responses varied as a function of marital quality, with higher marital quality predicting less threat-related neural activation in the right anterior insula, superior frontal gyrus, and hypothalamus during spousal, but not stranger, hand-holding.     

Adolescents who need help the most are the least likely to seek it: the relationship between low emotional competence and low intention to seek help

It has been found that university students who were the least skilled at managing their emotions also had the lowest intention of seeking help from a variety of nonprofessional sources (e.g. family and friends). The present study sought to extend these findings by focusing on adolescents, examining a larger number of emotional competencies, and exploring the possibility that social support explains the relationship between emotional competence and help-seeking. A total of 137 adolescents (aged 16-18) completed an anonymous survey that assessed social support, emotional competencies, and intention to seek help from a variety of professional and nonprofessional sources. As expected, adolescents who were low in emotional awareness, and who were poor at identifying, describing, and managing their emotions, were the least likely to seek help from nonprofessional sources and had the highest intention of refusing help from everyone. However, low emotional competence was not related to intention to seek help from professional sources (e.g. mental health professionals). The significant results involving nonprofessional sources were only partially explained by social support, suggesting that even adolescents who had high quality support were less likely to make use of that support if they were low in emotional competence.