Psychological support needs of patients with head and neck cancer and their caregivers: A qualitative study

Objective: The aim of this study was to explore the psychological support needs of patients with head and neck cancer (HNC) and their caregivers. The appropriate timing, length, format and content of sessions were also investigated.

Design: Eighty-three patients with HNC and 73 of their caregivers completed questionnaires at diagnosis. Follow-up questionnaires were mailed to patients six months later.

Main outcome measures: Free text-comments to open-ended questions in the questionnaires were analysed using an inductive thematic approach with coding and theme development directed by the content of responses. This was used to determine psychological support needs both at diagnosis and at six month follow-up.

Results: Patients described ‘just being there’, empathy, maintaining normality and practical support as helpful from family/friends. They desired information, honesty, positivity and empathy from clinical staff. Formal psychological support was desired by approximately 40% of patients and caregivers, particularly early after diagnosis and during treatment. Most participants desired face to face sessions, providing individualised information and coping strategies.

Conclusion: The results of this study suggest that psychological interventions for patients with HNC and their caregivers should be delivered early after diagnosis in face to face sessions, presenting honest and factual information about the disease and coping strategies.     

The impact of social support on the acceptance process among RA patients: A qualitative study

Acceptance is an important component of pain management, being associated with improved quality of life and lower levels of pain and depression. In enabling patients with chronic diseases to accept unpleasant consequences and to establish a new way of living, the support they receive from their social environment may play a decisive role. In this article, we identify the key sources and types of social support that are relevant for rheumatoid arthritis (RA) patients, and explore when and how those sources are important across the different stages of the acceptance process. We conducted a qualitative study involving 20 semi-structured interviews with RA patients in Switzerland. Analysis of the data followed the precepts of grounded theory. We found that, amid the complexity and variety of patients’ struggles for acceptance, there were some common experiences or ‘key moments’ in which social support played an important role. While three sources of support – family, physicians and the external social context – are fundamental for RA patients, all three may inhibit as well as encourage acceptance, due to the invisible and unpredictable character of the disease. There is a pervasive risk either of underestimating patients’ suffering or of over-supporting, both of which prevent patients accepting the disease and developing a new ‘normal’ life. We conclude that sources of social support need to find a middle way between scepticism and solicitousness.     

Manifestations of anxiety and coping strategies in patients with metastatic lung cancer and their family caregivers: a qualitative study

Objective: Advanced non-small cell lung cancer (NSCLC) is common, deadly, and associated with impairing anxiety for patients and caregivers who often co-experience similar symptoms that can vary together over time. We aimed to discover themes as to how NSCLC patients and caregivers express and cope with anxiety.

Design: Semi-structured interviews of patient-caregiver dyads (N?=?21), coded using NVivo Software.

Main Outcome Measures: Open-ended questions on anxiety mutuality, giving or receiving care, communication, and the most difficult aspects of having or caring for someone with Stage IV NSCLC.

Results: Analyses revealed that patients and caregivers were linked psychologically, co-experiencing symptoms of distress or coping, rising and falling together. Shared patient and caregiver themes emerged of cognitive, behavioural and physiological manifestations of anxiety and coping mechanisms.

Conclusions: Patient and caregiver expressions of anxiety and coping methods mapped onto the cognitive-behavioural model, implying potential use of cognitive behavioural therapy (CBT) to address these issues. This expands understanding of symptoms and coping strategies in NSCLC, explores patient-caregiver interaction, and confirms the need for future clinical intervention. Future research should focus on development and dissemination of CBT-based dyadic interventions addressing anxiety in NSCLC patients and caregivers.     

Resource replacement and psychological well-being during unemployment: The role of family support

There is an established inverse relationship between unemployment and psychological wellbeing. However, little is known about the processes that underlie this relationship. Using latent deprivation, conservation of resources, and social capital to form a theoretical framework, this study explored the relationship between the latent benefits associated with employment, family support, and financial strain. In a sample of 174 unemployed individuals, latent benefits were shown to partially mediate the relationship between family support and psychological well-being. Additionally, this mediation was moderated by financial strain, with latent benefits being more related to psychological well-being in those with greater financial strain. These findings provide guidance in understanding how to better address the needs that contribute to psychological well-being in those who are unemployed.     

Effects of perceived social support and family demands on college students' mental well‐being: A cross‐cultural investigation

The effects of perceived social support and family demands on college students' mental well‐being (perceived stress and depression) were assessed in 2 samples of Jordanian and Turkish college students. Statistically significant negative correlations were found between perceived support and mental well‐being. Multiple regression analyses showed that perceived family support was a better predictor of mental well‐being for Jordanian students, while perceived support from friends was a better predictor of mental well‐being for Turkish students. Perceived family demands were stronger predictors of mental well‐being for participants from both ethnic groups. Jordanian and Turkish participants who perceived their families to be too demanding were more likely to report higher depression and stress levels. None of the interactions between social support or family demands and either of the 2 demographic variables were statistically significant. These findings provide a more nuanced view of the relationship between social support and mental health among college students, and point to the relevance of some cultural and situational factors. They also draw further attention to the detrimental effects of unrealistic family demands and pressures on the mental health of college youths.     

Clarifying relationships among work and family social support, stressors, and work-family conflict

Although work and family social support predict role stressors and work-family conflict, there has been much ambiguity regarding the conceptual relationships among these constructs. Using path analysis on meta-analytically derived validity coefficients (528 effect sizes from 156 samples), we compare three models to address these concerns and clarify relationships. Results revealed that social support, controlling for role involvement, is best viewed as an antecedent of role stressors and subsequent work-family conflict. Controlling for work and family involvement, work and family social support were most related to same domain role conflict (β = −.46, p < .05; β = −.43, p < .05) and role ambiguity (β = −.28, p < .05; β = −.33, p < .05). Subsequently, work role conflict and time demands were most related to work-to-family conflict (β = .39, p < .05; β = .21, p < .05), while family role conflict and role ambiguity were most related to family-to-work conflict (β = .22, p < .05; β = .24, p < .05). Implications for research and practice, along with suggestions for theoretical advances, are discussed.     

The social dynamics involved in recovery and return to sport following a sport-related concussion: A study of three athlete-teammate-coach triads

An athlete's connection to their team and team members is an important part of their sport experience. However, researchers currently know little about the nature of these social dynamics with respect to concussed athletes. Our study explored athletes' recovery and reintegration into the team environment following a sport-related concussion. We conducted semi-structured interviews with each member of three athlete-teammate-coach triads (N = 9). We analysed the data using thematic narrative analysis and present the results as three stories that focused on each athlete's experience. For Cassie, we found two major plot points in her story: the transition in her role (and shift in identity) from athlete to student assistant coach/team manager and, once recovered, back to an athlete on the team. For Jess, we found that the main plot in her story was “pressure”. Specifically, the interplay between internal (placed on herself) and external (perceived from teammates and coaches) pressures to return to sport. In the third and final story, the main plot point was the tensions that arose from Jaden's preferences for social support and the type of support that his teammates and coaches believed he needed during his recovery. Our results highlight the interplay between athlete's personal and social identities, feelings of pressure to return and readiness, and the challenges of providing the right amount and type of social support. This research contributes to our limited understanding of the social dynamics involved in athletes' return to sport following a concussion.     

The relationship between self-reported received and perceived social support: A meta-analytic review

Social support is broad term encompassing a variety of constructs, including support perceptions (perceived support) and receipt of supportive behaviors (received support). Of these constructs, only perceived support has been regarded as consistently linked to health, and researchers have offered differing assessments of the strength of the received-perceived support relationship. An overall estimate of the received-perceived support relationship would clearly further the dialogue on the relationship between received and perceived support and thus assist in the theoretical development of the field. This study evaluated all available studies using the Inventory of Socially Supportive Behaviors (ISSB; Barrera, Sandler, & Ramsey, 1981, American Journal of Community Psychology, 9, 435–447) and any measure of perceived social support. Using effect sizes from 23 studies, we found an average correlation of r = .35, p < .001. Implications of this estimate for further development of models of social support as well as interventions to enhance social support are discussed.     

Social influence and perceived organizational support: A social networks analysis

We suggest that employees’ perceptions of organizational support (POS) are not solely a product of independent evaluations of treatment offered by the organization, but are also shaped by the social context. We argue that coworkers will directly (through inquiry via cohesive friendship and advice ties) and indirectly (through monitoring of employees structurally equivalent in advice and friendship networks) affect employees’ perceived organizational support. Network studies in the admissions department of a large public university and a private company specializing in food and animal safety products indicate that employees’ POS are similar to those of coworkers with whom they maintain advice relationships as well as to those who hold structurally equivalent positions in organizational friendship and advice networks. Our work contributes to organizational support theory by developing and testing a theoretical explanation for the relationship between the social context and perceptions of support among employees. Implications for research and practice are offered.     

Life events,social support and depression in haemodialysis patients

This study examined the effects of life events and social support on depression in 200 dialysis patients. The instruments used included the Beck Depression Inventory, a modified version of Sarason's Life Experiences Survey and a Social Support Inventory (SSI) constructed by the authors. The SSI consisted of five quantitative measures and three measures of perceived social support. These measures were found to be internally consistent and stable over time. Results showed that clinically depressed dialysis patients reported fewer positive life events and appraised life events more negatively than non‐depressed patients. The total number of life events and the number of negative life events were not found to differentiate between depressed and non‐depressed patients. With regard to social support variables, results showed that depressed patients reported less frequent actual contact and telephone contact with others and perceived a smaller amount and less availability of social support and less satisfaction with perceived social support along the functional dimensions of emotional, informational, appraisal and instrumental support and social companionship. The results were found to provide support for a main effect model of social support and not for a buffering model. Copyright © 1999 John Wiley & Sons, Ltd.     

Reciprocal relations among job demands, job control, and social support are moderated by neuroticism: A cross-lagged analysis

This study investigated whether neuroticism moderates the relations among social support (from coworkers and supervisors) and work strain characteristics (i.e. job demands and job control). A full cross-lagged panel analysis was used to test whether social support predicts job demands and control or whether job demands and job control predict support among individuals with high and low neuroticism. Workers (N =  247; 42.1% men) of five occupations filled out questionnaires twice, with a time gap of 1 month. Work characteristics (job demands, job control, and social support) together with age and gender were included in a two-group path model with neuroticism as a moderator. Neuroticism moderated relations between social support and work strain characteristics: among individuals with high neuroticism, high job demands predicted low support from supervisors and low job control predicted low support from supervisors. Among individuals with low neuroticism, high support from supervisors predicted high job control.     

Friends and family: A cross-cultural investigation of social support and subjective well-being among college students

Despite the growing number of cross-cultural studies focusing on well-being, little is known about social support outside of western civilization, particularly among people in Middle Eastern cultures. The current study examined the relationships between perceived social support and components of subjective well-being (i.e. positive and negative affect, satisfaction with life) among college students in Iran, Jordan, and the United States. Perceived support from family significantly predicted each aspect of well-being within each country. However, perceived support from friends did not predict any component of well-being in Iran; yet, in Jordan and the US, friend support predicted higher levels of positive mood. These results will be examined in terms of roles and relationship norms in these countries.     

Social relationships and social support among post‐war youth in Northern Uganda

Although social relationships and social support are salient factors for post‐war adolescents' psychosocial coping and adjustment, there is only limited information regarding war‐affected adolescents' views on social support and the relationships within which social support is provided. This study therefore explored both elements among a clinical sample of 20 adolescents living in post‐war Northern Uganda. Following Braun and Clarke's thematic analysis, we found a prominent role of the biological mother and other primary biological family members in the upbringing of our participants. Spiritual and material support were perceived to be the most important type of support, respectively, while the adolescents were growing up and in their current lives. These findings provide support for the perception that caregiving systems are adaptable to particular sociocultural contexts. Further, the importance of particular functions of social support could signify a potentially selective buffering effect of these functions in adverse contexts. Because of the importance of the primary biological family and the salient role of parent–child relationships in the face of adversity, future research needs to focus on this particular kind of social relationship in contexts of prolonged collective violence.     

Role of personality and affect on the social support and work family conflict relationship

The relationship between support and work family conflict has been studied extensively, but previous studies have not examined if personality moderates this relationship. In this research, we examine the moderating influence of personality on the relationship between contextual support and work-family conflict across two studies. In Study 1, we examine if core self-evaluations (CSE) moderate the relationship between four different types of workplace support, 1. family friendly work policies (FFOP), 2. family supportive organizational climate (FSOC), 3. perceived organizational support (POS), and 4. perceived supervisor support (PSS), and work interfering with family conflict (WIF) using a sample of working adults (N=435). In Study 2, we examine if Big Five personality traits and negative affect moderate the relationship between co-worker support and (WIF) using a large national sample (N=1130) of working respondents from the “midlife in the US” (MIDUS) study of health and well-being. Taken together, the current research examines the moderating effect of several key personality variables on the relationship between important forms of social support and work family conflict. Results based on these two samples indicate CSE moderates the relationship between POS and WIF, and PSS and WIF, but does not moderate the relationship between FFOP and WIF, or FSOC and WIF. Further, conscientiousness and agreeableness moderate the relationship between co-worker support and WIF. Co-worker support and WIF is stronger for individuals with higher levels of negative affect. We discuss the implications for research and practice relating to work family conflict.     

Olympic athletes back to retirement: A qualitative longitudinal study

ObjectiveIn this qualitative longitudinal study we assess the retirement process of Olympic athletes. We aim to evaluate the influence that following a dual career or being exclusively focused on sport can have in this process. We compare athletes' prospective views before retirement (Torregrosa, Boixadós, Valiente, & Cruz, 2004) with their retrospective accounts ten years later. This allows us to assess athletes' accuracy in predicting the process and its outcomes in relation to the trajectory followed.DesignWe designed a qualitative longitudinal study (Epstein, 2002) conducting semi-structured interviews.MethodFifteen Olympic athletes were interviewed twice. Thematic analysis was performed on the qualitative data comparing prospective views and retrospective accounts of: (a) retirement planning, (b) voluntary termination, (c), multiple personal identities, (d) availability of social support, and (e) active coping strategies.ResultsTen athletes reported positive transitions related to their favorable approach to the five categories above. Most athletes reporting positive transitions followed dual careers (i.e., parallel or convergent trajectories). Five out of fifteen athletes reported unexpected difficulties in the transition. Four of these followed a linear trajectory during their sporting career. A clear view of retirement in the prospective interviews also facilitated retirement for an athlete following a linear trajectory. While a diffuse view of retirement in the prospective interview signaled future difficulties.ConclusionResults from this qualitative longitudinal study suggest that promoting dual careers in elite sport and working on the prospective view of retirement can facilitate retirement from elite sport and the transition to an alternative professional career.     

Religiousness,social support and subjective well‐being: An exploratory study among adolescents in an Asian atheist country

Few studies have focused on the relationships among religiousness, social support and subjective well‐being in Chinese adolescent populations. This study tries to fill this gap. Using cluster sampling, we selected two groups: Group A, which included 738 Tibetan adolescents with a formal religious affiliation and represented adolescents from a religious culture, and Group B, which included 720 Han adolescents without a religious affiliation and represented adolescents from an irreligious culture. Structural equation modelling showed that only in Group A did social support mediate (partially) the relationship between religious experience and subjective well‐being; furthermore, the results of a hierarchical regression analysis showed that only in Group A did social support moderate the relationship between religious ideology and subjective well‐being. Possible explanations for the discrepancies between the findings obtained in this study and those obtained in previous studies are discussed.     

Social support,coping, and psychological adjustment among caregivers of head-injured patients

Abstract

The purpose of this study was to test a mediational model of risk and protective factors associated with the psychological adjustment of caregivers of head-injured patients. Forty-three caregivers of patients who had suffered a head injury participated in the study. Findings strongly supported hypotheses. Caregiver burden was associated with poorer psychological adjustment. Social support and a higher percentage of approach coping strategies relative to overall coping strategies were associated with better psychological adjustment. As predicted, caregiver burden showed a direct relationship to psychological adjustment, while social support showed an indirect relationship to adjustment mediated by percentage approach coping.     

With a little help from my friends: A computational model for the role of social support in mood regulation

The growing interest in the role of social support in mental and physical health has led to the development of several intelligent systems that aim to use social mechanisms to simulate healthy behaviour. In this paper a computational model of a human agent is presented which describes the effect of social support on mood. According to the literature, social support can either refer to the social resources that individuals perceive to be available or to the support that is actually provided in problematic situations. The proposed model distinguishes between both roles of social support. The role of social network characteristics has been taken into account, as an individual can perceive or receive social support through his/her social network. In addition, the number of connections (friends), strength of ties (relationships), social isolation and social integration have been studied. Simulation experiments have been done to analyze the effect of the different types of support in different scenarios and also to analyze the role of various social network characteristics on the mood level. It is shown that support can help to reduce the induced stress and thus can contribute to healthy mood regulation and prevention of depression. The presented model provides a basis for an intelligent support system for people with mood regulation problems that take the social network of people into account.