Social Support

Social Support

Conceptually, social support refers to the protection and assistance provided to those in need. The support can either be tangible or intangible but the nurses should shield patients from stressful situations. Inherently, scholars build the social support concept on reciprocity, whereby at least two parties have to exchange resources. Langford et al. (2012) identified critical attributes, antecedents, and social support consequences using Walker and Avant’s methodology.

Search Strategy

The researcher used CINAHL and Medline databases to search terms social support as the main keyword combined with healthcare and nursing. Other secondary keywords include motivation, nurse managers, and work environment. There are five main requirements for the articles used. First, the journal must be published in an English language and should be a primary research paper. Second, the authors must back their outcome with credible sources and experiments. Third, the main themes should revolve around the social environment for instance nursing or a work setting. Fourth, the reviewed documents should be less than five years old to capture the latest research in this field. However, the research participants in empirical studies are not restricted to nurses or people working in intensive care institutions. Besides, the researcher does not place a limitation on the main discipline represented in any journal. Notably, most of the articles used relate to medicine, psychology, social science, and health fields (Robinson & Dickerson, 2012). Moreover, ten relevant articles are considered for literature review, although the researcher coded and abstracted a limited number of empirical information using the authors’ coding sheets.

Significance of Social Support

Dean et al. (2014) associate social support with improved psychological wellbeing in a healthcare setting because it influences fundamental life events like movements from one country to the other. When people are stressed up, they can reduce the depression or anxiety through this healthcare concept. Simultaneously, it can function as an emotional and problem-focused strategy (for instance when patients receive tangible details to solve a rising matter). Not only does it relieve acute pains but also social support in stressful circumstances promotes psychological adjustment for immigrants suffering from chronic illnesses like stroke, cancer, HIV, and arthritis.

Individuals with little or no social support exhibit more sign of unease and depression as compared to those that have higher social support. Additionally, patients with relatively lower support show acute mental disorders as compared to people with high social support. Some of these disorders are schizophrenia, PTSD, major depressive ailment, and sociophobia. Even worse, low support leads to suicidal ideation, excessive consumption of alcohol and a potential of drug abuse. The results are the same for children, though a positive psychological adjustment to stressors correlates remarkably with religious coping.

Akey et al. (2013) conducted a qualitative study of 35 subjects with eating disorders. The researchers then used HBM (Health Belief Model) to explain why they did not seek social support. Since most people with eating disorders deny their illness, they have a low apparent susceptibility. In particular, comparing their illness with how it affects others influences the severity perception, hence cannot seek medical assistance. In addition, there is a low perception to seek social support, given the misleading speculation and poor past experiences. Some of the barriers that prevent people from visiting medical professionals include financial resources, social stigma, and unavailability. If healthcare facilities create a strong social support system, it will be easier for people affected by chronic illnesses to improve their mental and physical health.

There are several studies examining the long-term effects of social support on distress. In the early 2000s, US publishers produced a series of articles that reviewed the association between social disintegration and psychiatric disorders. All of them discovered that social network disruption and absence of social support were common themes. 

Physical Health

Moreover, a link exists between individual physical health and social support, especially with regards to mortality. Studies indicate that people with low social support are susceptible to lethal diseases such as terminal cancer. On the other hand, Cohen et al. (2013) argue that people that enjoy better social support are highly likely to live longer. They recover faster from coronary artery surgery and are less susceptible to herpes attacks. Further, the elderly are less likely to show signs of age-related cognitive decline. In case a patient is diabetic, high social support enables better control of sugar fluctuations in the body. Due to less atherosclerosis, the progression of an already diagnosed cardiovascular condition diminishes significantly. Social support also encourages better immune system among senior citizens.

Literature

The latest research extends people’s understanding of how social support influences healthcare and nursing. For example, some epidemiological studies such as that of Unchino (2011) concentrate on establishing a link between social support measures and physical health outcomes. However, other studies focus on new areas such as health links to provision and receipt. In essence, the researchers outline relevant pathways that include behavioural and biological mechanisms affecting health. Although the long-term impact of physical health interventions is yet to be determined, they promise an improved quality of life for populations affected by chronic diseases.

According to Zimet et al. (2014), social support focuses in the vitality of interpersonal relationship because it encapsulates instrumental aid, emotional support, and personal appraisal. However, there can be a lack of clarity given its construct nature. Social support sources emanate from social networks. They are important because they act as a buffer against stressful situations, hence allowing for adoption. Chronic family illness is one of the main sources of social support, particularly among women and caregivers. Today America’s department of health recognize the negative relationship between healthcare and social support as a major issue.

Arguably, the wellbeing and health of an immigrant depend on his integration into the society. The Western governments have organized their societies around individual differences rather than similarities. Therefore, the people pursue self-interests instead of social solidarity. In the United States, citizens recognize their private interests by becoming less dependent on others. Consequently, they lack social support to cope with modern life stress due to less social group integration. Of keen to note is that the latest sociological research on illnesses and mental health support this hypothesis.

Different authors give distinct definitions of social support in nursing and healthcare. Others expound social concept to check research utility and to cover its complexity. Social support is time-related in that its significance and meaning is variable along the life’s course. It demands the establishment of social relations as per the strength and structure of cognitive resources. Due to social bonds, people can solve their emotional problems, given the internal occurrence of interactions. Vaux (2012) says that the influence can either be negative or positive depending on the perception of support and the acknowledgement of personal needs. In brief, social support is spoken or unspoken information provided by healthcare professionals for a positive emotional behaviour. It is a reciprocal process that benefits the recipient and the provider for a greater life control.

Numerous researchers utilize social support classifications (for instance instrumental, informational, and emotional support) for expression of empathy and affection. However, they can analyze it in terms of complexity with qualifications in antecedents, attributes, and types that solidify the nursing and healthcare study. Antecedents, on the other hand, refer to preconditions of social support. They include the acknowledgement of patients that the need the caregiver’s help and other events that favour initiation of support. Most studies focus on quantitative social support measures such as scale assessment, reliability, scores, and data validity.

In healthcare, it is imperative to distinguish between social network and social support. Broadhead  et al. (2013) insist that the two are mutually different concepts despite being interwoven. A social network is an institutional or structural dimension linked to a person, for religious organizations, neighbourhood, and healthcare system. Contrastingly, social support is composed of networked members and is observable at an individual dimension. Some of its components include geographical dispersion, connection strengths, and membership composition.

It is true that the researchers have widely studied social support as one of the nursing and healthcare concepts, but there is no consensus among them. The main reason for this is that there are numerous difficulties and facets to measure and define the concept. A person will be ill-informed to think that all concepts are diversifiable for practicality in all circumstances. Additionally, the model of social support forms part of practice models and theoretical frameworks.

Measuring Social Support

Social support is measurable using a perception that a patient has a readily available assistance and can receive it at any time. In addition, the researcher should consider the degree of personal integration to a social network. The sources include friends, family pets, organizations, and government. There two proposed models to discuss the link between healthcare and social support are direct effect hypothesis and buffering hypothesis. Cultural and gender differences can also measure the level of support (Krause & Markides, 2012).

Differences in Social Support Measurement

Scholars can categorize and measure social support in four different ways. First, the emotional support is the offering of trust, empathy, and encouragement. People can show emotions through love, acceptance, caring, and intimacy. Essentially, it is the nurturance and warmth as provided by social support sources. In this way, the recipient understands how people value him. Secondly, Tangible support refers to the provision of material goods or financial assistance to a person in need. It is an instrumental assistance encompassing direct and tangible ways of serving others. Thirdly, informational support is the provision of useful suggestions and guidance to other parties to solve their problems. Lastly, people that lack a sense of belonging need companionship support to participate in shared social engagements. Furthermore, there is a distinction between received and perceived support. The former is a specified supportive action such reassurance or advice.

Social Support and Technology

In the modern times, social media defines a day-to-day life of the global online community. Tye availability of online social support is increasing with the advancement of communication technology. Therefore, nurses and medical experts can use social media websites like Facebook, blogs, and health care forums to assist others in need.  even better, the online support through video conferencing is similar face-to-face interaction in real life. At the same time, there are additional unique aspects of non-judgemental interactions, anonymity, and convenience. Moreover, the internet users get emotional comfort and support through social media as others learn about particular health care matters. Patients suffering from terminal diseases such as cancer can form support groups online which will be effective in minimizing the members’ perceived stress, depression, and other illness-related trauma. In this way, they will remarkably increase their capability to cope with stressful situations. The advantage of online social support is that people across the globe can form relationships to encourage each other on issues they face. Since internet users can retain their anonymity, their freedom to air out feelings and thoughts allows healthcare professionals to learn about confidential views and experiences of their clients. The users also will access unlimited useful data that improve their health and social lives.

Costs

Undeniably, social support has numerous benefits and links to healthcare. At the same time, it has to match the desires of an ailing person. If it surpasses the recipient’s wishes, chances are that there will be a spike in psychological stress. In the end, the patient’s health outcome will be severely impaired. Contrastingly, scientists are yet to discover a consistent link between healthcare and received support. If anything, it can worsen the victims’ mental health condition. Therefore, whenever there is a discussion on social support, it is advisable that the researcher considers its possibility as an antagonistic influence.

Dominant Models

The two main models that address healthcare with respect to social support are direct effects hypothesis and buffering hypothesis (Cohen & Willis, 2011). The main difference is that the former projects the benefits of social support at all times while the latter considers its significance during stressful times. Evidence exist for both scenarios. For example, in the buffering hypothesis, social support shields victims of job loss or those whose spouses have died from bad stress effects. A researcher observes the confirmation of stress buffering if the correlation between poor health and stressful situations for individuals with low and high social support. Indeed, social support protects people from stress if there is a weak correlation between health and depression. Moreover, the doctor is more likely to observe stress buffering for perceived support rather social integration.

Theories that Explain the Social Support Concept in Healthcare

According to Rosenstock et al. (2012), stress and coping theory is one of the most dominant in social support research. Scholars designed it to highlight the buffering hypothesis in detail. According to this theory, social support influences how people cope with day-to-day events to protect themselves from negative health effects of stress. Normal events will be stressful if people think negatively and cope with them ineffectively. Coping involves conscious and deliberate actions like relaxation or solving problems. Studies observing effects of stress buffering for social support contain adequate evidence on this theory. However, its main problem is that the support accorded is not linkable with better health results since stress buffering is unobservable in the case of social integration.

The second theory is RRT (relational regulation theory. It explains the direct effects of hypothesis between mental health and perceived support. It explains the main effects of perceived support on mental health otherwise not highlighted in stress and coping theory. It hypothesizes that the correlation between mental health and perceived support emanates from regulation of emotions through shared activities and ordinary communication between different parties. In addition, this theory is relational given that conversational topics and support providers regulating emotions depend on personal taste and preferences.

Thirdly, the lifespan theory focuses on the distinction between received and perceived support. It states that while social support is an ongoing process throughout a person’s lifespan, it is particularly stronger between a child and his mother. In this case, it develops alongside personality traits like high optimism and low hostility. Support and other personality aspects promote weight management and exercise to minimize health-related stressors.

Biological Pathways

Numerous studies have pointed at biopsychological pathway as an important link between healthcare and social support.  Biologists have discovered a positive impact of social support on cardiovascular, neuroendocrine, and immune systems. In the case of an immune system, Power& Hertzman, 2013) argues that lower level of inflammation (through c-protein measurement) is correlated with social integration. Therefore, a lower susceptibility to common cold is a reality for individuals with more support. Regarding neuroendocrine system, lower cortisol levels (also referred to as stress hormone) can be linked with social support in response to stress. Neuroimaging reveals that social support deactivates brain regions associated with social stress. Lastly, social support diminishes the reactivity of cardiovascular system to stressors, thus lowering the heart rates and blood pressure.

Support groups provide emotional and educational support by encouraging people that experience similar circumstances. When a person supports another, there will be both benefits and costs. Therefore, a prolonged care or support to another party is a source of chronic stress such as alteration in the immune system, depression, high mortality rate, and anxiety. Still, support provision is beneficial in terms of health. Ironically, studies show that the provision of a constructive support to neighbours, friends, and relatives or emotional support to family members significantly minimizes mortality risks. In addition, the move activates the brain’s reward areas.

Gender

Statistics show that females engage more in social support than males. Additionally, women are more likely to seek counselling services and healthcare support to deal with stressful family situations. Despite this, researchers are at a consensus that both men and women equally seek instrumental ad informational types of assistance but there are divergent views in seeking emotional support.  Furthermore, non-married men are more susceptible to depression than married men because the latter consult their female partners when overwhelmed with emotions. Nevertheless, women are influenced by and react more to social contexts than their male counterparts. In contrast, men are more antisocial because they hardly consider how other will react to their coping mechanisms. Females focus mainly on how their partners, friends, and family react to their actions.

Culture

While social support is a universal resource, there are cultural differences existing in it. For example, in most Asian nations, people see each other as a more collective societal unit. In the West, however, people are conservative and individualistic (Kim et al., 2013). Therefore, they conceptualize social support as a transaction whereby one party seeks assistance from the other. It is a similar situation in a healthcare setting because medical practitioners expect remuneration for their services. In interdependent Eastern cultures such as Japan, the citizens are less liable to solicit the assistance of others.

Gaps from Literature

Social support in healthcare is one of the most research topics but there are areas yet to be addressed in future studies. For instance, there is limited information on the indirect impact that social support has on individual outcomes. In this case, I reasonably hypothesize that the managers of caregivers that empower and support their juniors will hire skilled workers to deliver better support to patients’ satisfaction. In addition, there is scant information on the potential social support impact on a healthcare team whose members are from different disciplines. Therefore, it is recommendable that future studies should focus on measures like collegiality and collaboration with regards to the patient outcomes. Indeed, the literature explored social support that supervisors and co-workers (males and females) experience. However, the study of social support from allied medical professionals and support services is limited. Notably, the researchers used homogenous subjects (for instance white females or white male doctors). Therefore, it is hard to validate the outcome since other cultures and ethnicities are unrepresented. Generation of findings from a heterogeneous population is important in the enhancement of workforce diversity and the design of targeted intervention strategies.

Clearly, the literature gaps imply that future researchers need to develop experimental designs for testing interventions of social support. Not only should they incorporate qualitative designs but also, they should utilize heterogeneous respondents from medical fields like nursing and mental health care. From a healthcare standpoint, the literature explains the fundamental role of social support its long-term impact on the workforce and patients. Most importantly, the leadership ought to recognize the power and value of social support for the empowerment of nursing and healthcare professional practice.

References

Akey, J. E., Rintamaki, L. S., & Kane, T. L. (2013). Health Belief Model Deterrents of Social Support Seeking among People Coping with Eating Disorders. Journal of Affective Disorders, 145(2), 246-252.

Broadhead, W. E., Kaplan, B. H., James, S. A., Wagner, E. H., Schoenbach, V. J., Grimson, R., ... & Gehlbach, S. H. (2013). The Epidemiologic Evidence for a Relationship between Social Support and Health. American Journal of Epidemiology, 117(5), 521-537.

Cohen, S., & Wills, T. A. (2011). Stress, Social Support, and the Buffering Hypothesis. Psychological Bulletin, 98(2), 310.

Cohen, S., Underwood, L. G., & Gottlieb, B. H. (Eds.). (2013). Social Support Measurement and Intervention: A Guide for Health and Social Scientists. London: Oxford University Press.

Dean, A., Lin, N., & Ensel, W. M. (2014). The Epidemiological Significance of Social Support Systems in Depression. Research in Community & Mental Health.

Kim, H. S., Sherman, D. K., & Taylor, S. E. (2012). Culture and Social Support. American Psychologist, 63(6), 518.

Krause, N., & Markides, K. (2012). Measuring Social Support among Older Adults. The International Journal of Aging and Human Development, 30(1), 37-53.

Langford, C. P. H., Bowsher, J., Maloney, J. P., & Lillis, P. P. (2012). Social Support: A Conceptual Analysis. Journal of Advanced Nursing, 25(1), 95-100.

Power, C., & Hertzman, C. (2013). Social and Biological Pathways Linking Early Life and Adult Disease. British Medical Bulletin, 53(1), 210-221.

Robinson, K. A., & Dickersin, K. (2012). Development of a Highly Sensitive Search Strategy for the Retrieval of Reports of Controlled Trials using PubMed. International Journal of Epidemiology, 31(1), 150-153.

Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (2013). Social Learning Theory and the Health Belief Model. Health Education & Behavior, 15(2), 175-183.

Vaux, A. (2011). Social Support: Theory, Research, and Intervention. New York: Praeger publishers.

Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (2014). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52(1), 30-41.