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Social network, social support and dental status in elderly Swedish men.

The objective of this study was to investigate whether there were associations between different aspects of social network and social support and dental status. The study sample (n = 621) comprised a random half of all male residents in Malmö, Sweden, born in 1914. Five hundred (80.5%) participated. Eight conceptually different aspects of social networks and social support were measured, and all men were clinically examined regarding number of teeth, prevalence of removable dentures, fixed bridges and anterior open tooth spaces. We found that some aspects of dental status were associated with social class, while others were associated with different aspects of social network and social support. Prevalence of complete dentures and fixed bridges was strongly associated with social class, a low number of functioning teeth was associated with both low social class belonging and an insufficient social network and social support, while anterior open tooth spaces were associated mostly with an insufficient social network and social support. This study shows that there are significant associations between some aspects of dental status and the social network and social support of the individual, while other aspects of dental status are associated with social class, which from a psychosocial perspective contribute to a deeper understanding of the backgrounds of dental status.

Aged↗

Social network, social support and heavy drinking in elderly men--a population study of men born in 1914, Malmö, Sweden.

We analysed whether there were associations among different aspects of social network and social support, on one hand, and heavy drinking and alcohol problems on the other. The study sample (n = 621) comprised a random half of all male residents born in 1914 in Malmö, Sweden. Five hundred (80.5%) participated. Heavy drinking was defined as an alcohol consumption above 250 g alcohol per week and alcohol problems were assessed by a modified Michigan Alcoholism Screening test. Eight conceptually differential aspects of social networks and social support were measured. Four of five social network indices (social anchorage, social participation, contact frequency, spousal support) were associated with heavy drinking (OR 1.9-2.5) and two social network indices (social anchorage, spousal support) were associated with alcohol problems (OR 2.1-2.3). The results in this study are independent of social class, but based on a cross-sectional study, so we do not know if heavy drinking has caused social isolation or the contrary. If these results can be verified in a prospective study, a strengthening of the social network of the individual could perhaps lead to more moderate alcohol habits and better health, a finding of potential importance in the field of health promotion.

Aged↗

Social network, social support and the concept of control--a qualitative study concerning the validity of certain stressor measures used in quantitative social epidemiology.

Twenty-five in-depth interviews were made with middleaged persons of both sexes, who had suffered a first myocardial infarction (MI) two months previously. The purpose was to assess the layman's understanding of concepts such as social network, social support and control which are exposures commonly used or suggested for use in quantitative research in the area of social epidemiology. The validity of the instruments and the underlying concepts in assessing such exposures has important implications for the interpretation of the association between psychosocial factors and health or health behavior. The layman's understanding of social network and social support concepts seemed unproblematic, but the concept of control was understood in rather disparate ways among those interviewed. The experience of control/decision latitude in the work environment, seemed to form a model for the overall understanding of control among several of those interviewed and there also seemed to be important differences based on gender. Another impression, was that the individual's level of aspiration might be an important confounder in the assessment of control in population studies. It is therefore suggested that epidemiologcal data should be stratifyed by basic demographic variables like age, sex and social class in analyses including the control variable, to improve the valid use of this type of measure.

Aged↗

Social networks, social integration, and social engagement determine cognitive decline in community-dwelling Spanish older adults.

OBJECTIVES: To examine the influence of social networks and social engagement on cognitive decline in a population-based cohort of elderly people, and to assess gender differences in the effect of social relations on cognition. METHODS: A longitudinal study of community-dwelling people over 65 was carried out. Cognitive function (orientation and memory) in 1997 and cognitive decline (absent, mild, and severe) over 4 years (1993-1997) were assessed using an instrument previously validated for populations with a low level of education. The effect of social networks, social integration, and social engagement with friends, children, and relatives on cognitive function and cognitive decline was estimated by multiple linear and logistic regressions after adjusting for age, sex, education, depressive symptoms, systolic and diastolic blood pressure, and functional status. RESULTS: Poor social connections, infrequent participation in social activities, and social disengagement predict the risk of cognitive decline in elderly individuals. The probability of cognitive decline was lower for both men and women with a high frequency of visual contact with relatives and community social integration. Engagement with friends seemed to be protective for cognitive decline in women but not in men. DISCUSSION: This longitudinal study indicates that few social ties, poor integration, and social disengagement are risk factors for cognitive decline among community-dwelling elderly persons. The nature of the ties that influence cognition may vary in men and women.

Aged↗

Social network, social support and acute chest complaints among young and middle-aged patients in an emergency department--a case-control study.

The risk of developing non-specific chest complaints was higher among young and middle-aged persons with a weak social network and low social support, when comparing cases with controls at a hospital emergency department (ED). The study was comprised of 62 cases; two different control groups were recruited from other patients at the medical ED (n = 67) and from patients at the surgical ED with urolithiasis or cholecystitis (n = 31). Relative risks for non-specific chest complaints were 2.3-3.4 for patients with a low score on two of the social network factors (an overall index and social anchorage) and two social support factors (emotional esteem support and support by a confidant). These results could be used for developing guidelines for a more adequate clinical management of these patients, as well as for the prevention of stress-related conditions in general. An analysis was made of the conceptual validity of the instrument used for assessing social network and social support. It was concluded that structural elements, such as social network factors, represented a more valid measurement that was less affected by subjectivity. Future research is of importance for finding overbridging concepts, rather than to further continue the dissection of presently used indices into even more 'specific' variables.

Adaptation, Psychological↗

HIV infection: social network, social support, and CD4 lymphocyte values in infected homosexual men in Malmö, Sweden.

STUDY OBJECTIVE: The aim was to determine if there is an association between social network and social support and the CD4 cell count in HIV infected homosexual men. DESIGN: The study was cross sectional. A structured questionnaire assessing psychosocial factors such as social network and social support was administered at interview. Information on CD4 cell counts and HIV symptoms were obtained from participants' medical records. SETTING: The study population consisted of all HIV seropositive homosexual and bisexual men who had not been diagnosed as having AIDS seen at the Department of Infectious Diseases, the only hospital clinic in the city of Malmö (230,000 inhabitants), Sweden that provides care for HIV infected patients. PARTICIPANTS: Altogether 47 (68%) of 69 men in the population agreed to be interviewed. MAIN RESULTS: A low CD4 cell count was found more frequently in men with low social participation scores (OR 3.3; 95% CI 1.0, 11), in those with a low adequacy of social participation (OR 3.8; 95% CI 1.1, 13), and in men with low material support scores (OR 3.9; 95% CI 1.1, 13). After adjustment for age and time of awareness of the HIV infection, the two former associations remained statistically significant. CONCLUSIONS: These results, if reproduced in a longitudinal study, might suggest that psychosocial factors can affect an individual's immune system.

Adult↗

Social network, social support and the prevalence of neck and low back pain after retirement. A population study of men born in 1914 in Malmö, Sweden.

In this study we investigated the importance of social network and social support systems outside the workplace and workload and psychological job strain in former work for the prevalence of daily neck and low back pain. The study population (n = 621) comprised a random half of all male residents in Malmö, Sweden, born in 1914, of whom 500 (80.5%) participated. Two of the social network and social support indices (social anchorage and availability of material and informational support) were independent of life-style factors (leisure time physical activity, smoking and alcohol consumption) related to daily neck and back pain after retirement (OR = 2.0, 95% CI 1.2-3.4 and OR = 1.7, 95% CI 1.0-2.7, respectively), while the psycho-social and physical factors in former work were not. As no conclusion about the direction of the association can be drawn, prospective studies are needed to further explore these findings.

Aged↗

Social network, social support, and loneliness in older persons with different chronic diseases.

OBJECTIVES: This study examines whether patterns of social network size, functional social support, and loneliness are different for older persons with different types of chronic diseases. METHODS: In a community-based sample of 2,788 men and women age 55 to 85 years participating in the Longitudinal Aging Study Amsterdam, chronic diseases status, social network size, support exchanges, and loneliness were assessed. RESULTS: Social network size and emotional support exchanges were not associated with disease status. The only differences between healthy and chronically ill people were found for receipt of instrumental support and loneliness. Disease characteristics played a differential role: greater feelings of loneliness were mainly found for persons with lung disease or arthritis, and receiving more instrumental support was mainly found for persons with arthritis or stroke. DISCUSSION: The specifics of a disease appear to play a (small) role in the receipt of instrumental support and feelings of loneliness of chronically ill older persons.

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Reliability and validity assessments of measures of social networks, social support and control--results from the Malmö Shoulder and Neck Study.

The reliability and validity of methods to assess social networks, social support and control were investigated in a population of 12,009 females and males born between 1926 and 1945 (the "Malmö Shoulder and Neck Study"). This study demonstrated an overall reliability with kappa coefficients between 0.70 and 0.47, but the reliability was more varying among females and lower in the youngest age group. The analysis of the construct validity indicated that the different indices measure different aspects of the psychosocial environment, but both theoretical and methodological problems were identified, when the validity of multidimensional concepts are to be determined. The validity of such indices can best be judged by combining quantitative and qualitative methods. Potential validity problems must be kept in mind when these indices are used in epidemiological research. The results from the reliability analysis call for repeated assessments and the sample size must be adjusted vis-a-vis the reliability.

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Social network, social support and the rate of decline of CD4 lymphocytes in asymptomatic HIV-positive homosexual men.

AIMS: To test a stress-disease hypothesis by investigating the influence of social network and social support factors on the course over time of the CD4 lymphocytes in an HIV-positive population of gay men. METHODS: The study is a prospective cohort study of a representative population of HIV-positive gay men, undertaken at the Department of Infectious Diseases, Malmö University Hospital. This is the only clinic providing care for HIV-positive individuals in the city of Malmö in southern Sweden (population 248,000). A total of 115 HIV-positive homosexual men, who had not received an AIDS diagnosis, were invited to take part in the study. Seventy-five men (65%) accepted to be interviewed and 64 men (56%) fulfilled the inclusion criteria for the statistical analysis. RESULTS: In a multivariate analysis adjustments were made for age, level of the first CD4 count and time since first contact with the clinic. Men with high family contact frequency had a longer half-life (20.3 years) of the CD4 lymphocyte count than men with a low family contact frequency (7.4 years) (p = 0.03). Men with high social participation also had a longer half-life of CD4 lymphocyte count (14.7 years), compared with men with low social participation (6.3 years, p = 0.10). CONCLUSIONS: The findings of this study imply the importance of social support and social network factors as modifiers of the rate of decline of the CD4 lymphocyte level, which is an important prognostic marker of survival in HIV-positive homosexual men.

Adult↗

Social networks, social support, and elderly institutionalized people.

This article shows how social network studies contribute to development of knowledge about social support and describes research on the social networks of elderly institutionalized people. Network patterns emerged from data obtained through an anthropological fieldwork approach to network analysis. They are discussed in connection with a conceptualization of support as esteem enhancement and coping assistance. Residents' points of view are reported in their own words as much as possible to preserve active images that confront stereotypes of elderly people as passive and dependent. Their responses illustrate important aspects of social support in institutional settings that have implications for scientific nursing practice.

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Social networks, social support, and mortality among older people in Japan.

This study examined the effects of social networks and social support on the mortality of a national probability sample of 2,200 elderly Japanese persons during a three-year period. The direct and indirect effects of social relationships were assessed by using hazard rate models in conjunction with ordinary least squares regressions. Among the five measures of social relationships, social participation is shown to have a strong impact on mortality, and this effect remains statistically significant when other factors are considered. Social participation, social support, and feelings of loneliness are found to have indirect effects on the mortality of the Japanese elders through their linkages with chronic diseases, functional status, and self-rated health. On the other hand, marital status and social contacts are not shown to have statistically significant effects on the risk of dying, either directly or indirectly.

Aged↗

Associations with social networks, social support, health status and psychiatric morbidity in three samples of elderly people.

The effects of social network structure, support and physical health status on psychiatric morbidity were investigated among 1415 people over retirement age who took part in three independent but comparable surveys in London (urban area) and Essex (semi rural area). Multivariate analysis showed that the model explained between 14.3% and 28.6% of the variation in psychiatric morbidity in the three samples. Poor health status was a more powerful predictor of psychiatric morbidity than the social network variables. Age and sex contributed little to the model. The model was strongest among the two samples of Hackney respondents.

Activities of Daily Living↗

Social networks, social support, personal empowerment, and the adaptation of psychiatric consumers/survivors: path analytic models.

In this paper, we examine the relationships between social network characteristics, personal empowerment, social support, and adaptation of psychiatric consumer/survivors. Using path model analyses, we found that: (1) personal empowerment had statistically significant direct effects on positive affect, meaningful activity, and negative affect; (2) positive social support mediated the relationship between the proportion of women in consumer/survivors' networks and positive affect and meaningful activity; and (3) negative social interaction mediated the relationship between consumer/survivors' gender and negative affect. The results point out the importance of gender effects in social support processes, the differential association between type of social interaction (positive vs negative) and adaptation indices (positive vs negative), and the importance of personal empowerment for consumer/survivors' adaptation. We discuss the findings in terms of their implications for further research and community-based housing programmes for psychiatric consumer/survivors.

Adaptation, Psychological↗

Social networks, social support, health and HIV-positive gay men.

The present pilot study explored the experiences of social support on the part of a number of HIV-positive gay men. It drew upon the growing body of literature that highlights links between social support, and the health and well-being of people with chronic illnesses. In particular, it drew upon the way in which social network analysis can be used to illustrate patterns of both emotional support and instrumental support. The study informants were 30 HIV-positive gay men who were recruited through community support organisations which they accessed at the time of the study. The findings highlighted patterns of support among members of this marginalised community. At a time when access to treatment is extending the life expectancy of people infected with HIV and when, in the UK at least, there are major changes in the funding of HIV services, this paper raises pertinent questions about the impact of social support on people suffering from this illness and about the development of appropriate services.

Adult↗

Absence of social networks, social support and health services utilization.

BACKGROUND: This study examines the effects of distress and three types of social relationships (family, friends, and confidantes) on the use of out-patient health services in an adult sample from a community survey of 3481 persons in Baltimore, Maryland. METHODS: Independent effects of predisposing (age, education, marital status, race and sex), enabling (employment, income and insurance) and need (physical health) factors are adjusted for in estimating the odds of using health care services. RESULTS: Illness, being female, and having insurance were positively related to use of services, while being aged was inversely related. After adjustment for the above factors, social support interacted with psychological distress to effect the use of medical care: the combination of high distress and low social support by a confidante results in a fourfold increase of medical utilization. CONCLUSIONS: Our findings support the inclusion of psychological distress and social network variables in addition to physical health status in models attempting to explain the use of health services. Despite an inability to analyse change over time, our data suggest an understanding of the interrelationship between psychosocial factors, distress and health care use would benefit health providers and their patients.

Adolescent↗

Social networks, social support and coping with serious illness: the family connection.

Selected social support and family research is reviewed to highlight potential problems in social support exchange as patients and families collectively cope with illness and disability. Results indicate that family support is a primary source of patient support and that the impact of illness on families is substantial, underscoring their need for support. Results also indicate that there are numerous opportunities for problematic supportive exchange within families. The case is made that future studies of social support are needed to answer a series of questions about social support process within families coping with serious illness.

Adaptation, Psychological↗