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Social Support

Social support refers to the various types of support that people receive from others and is usually separated into two distinct categories: emotional and instrumental support. Emotional support is characterized by things that people do for each other that makes them feel cared for and supports feelings of esteem and worthiness. Instrumental support refers to the various types of tangible help that others may provide (i.e. financial support, child-care, etc). 

There does not, at this time, seem to be a “gold-standard” for social support scales as there are a variety of instruments currently used which have yielded scores successfully related to various health outcomes. Instruments range from single items used to assess whether or not major types of support are available to more extensive instruments including multiple items asking about various types of emotional support and various types of instrumental/informational support.

Choice of the appropriate measure(s) for use in research projects will likely be driven by such factors as: a) available time (some measures require considerably more time than others) and, b) whether assessments for different types of relationships are hypothesized to be important.

http://www.macses.ucsf.edu/research/psychosocial/socsupp.php, 

Summary prepared by Teresa Seeman in collaboration with the Psychosocial Working Group. Last revised April 2008.

 

Below: Multidimensional Scale of Perceived Social Support (Zimet, Dahlem, Zimet & Farley, 1988) 

Instructions:  We are interested in how you feel about the following statements.  Read each statement carefully.   Indicate how you feel about each statement. 

 

   Circle the “1” if you Very Strongly Disagree

   Circle the “2” if you Strongly Disagree

   Circle the “3” if you Mildly Disagree 

   Circle the “4” if you are Neutral

   Circle the “5” if you Mildly Agree

   Circle the “6” if you Strongly Agree

   Circle the “7” if you Very Strongly Agree

 

 1.  There is a special person who is around when I am in need. 

 2.  There is a special person with whom I can share my joys and sorrows.  

 3.  My family really tries to help me.  

 4.  I get the emotional help and support I need from my family. 

 5.   I have a special person who is a real source of comfort to me. 

 6.   My friends really try to help me. 

 7.  I can count on my friends when things go wrong

 8.  I can talk about my problems with my family. 

 9.  I have friends with whom I can share my joys and sorrows. 

10.  There is a special person in my life who cares about my feelings. 

11.  My family is willing to help me make decisions. 

12.  I can talk about my problems with my friends. 

 

In the classic Whitehall Study, an epidemiological study that followed middle-aged British civil servants over several years, researchers found that high job demands and effort-reward imbalance as well as low social support at work and low decision authority (e.g., job control) were associated with increased risk of psychiatric morbidity (including depression), even after controlling for psychiatric disorder at baseline, and adjusting for mood and “negative affectivity” [45]. 

While job demands and social support at the first stage of the study had a consistent impact on mental health at the next two time points (Phases 2 and 3), decision-making authority or control had less of an impact on psychiatric disorder at the last stage of the study than during the middle follow-up stage. The researchers suggest it might be because control at work has a more immediate effect on future mental health than other job characteristics [45, p. 306].  

Four cross-sectional studies have investigated the job demand and control model in relationship to burnout [44, 50]. Three of these four studies showed that demands and low control were associated with burnout. The non-supportive fourth study was of construction workers where burnout is not found to be as prevalent as in human service work. One study also investigated the role of social support among female social workers and found that those workers with high demands, low control, and low support were at greater risk of burnout [44].

Taken, in part, from: Schnall PL, Dobson M, Rosskam E, Editors Unhealthy Work: Causes, Consequences, Cures. Baywood Publishing, 2009.

  

 

 

Schnall PL, Dobson M, Rosskam E, Editors Unhealthy Work: Causes, Consequences, Cures. Baywood Publishing, 2009.

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Belkic, K., P. A. Landsbergis, P. Schnall, et al., Psychosocial Factors: Review of the Empirical Data among Men, in The Workplace and Cardiovascular Disease Occu- pational Medicine: State of the Art Reviews, Schnall, P., K. Belkic, P. A. Landsbergis, and D. Baker (eds.), Hanley and Belfus, Philadelphia, PA, pp. 24-46, 2000.

Belkic, K., P. Landsbergis, P. Schnall, and D. Baker, Is Job Strain a Major Source of Cardiovascular Disease Risk?, Scandinavian Journal of Work Environment and Health, 30:2, pp. 85-128, 2004.

Siegrist, J., R. Peter, A. Junge, P. Cremer, and D. Seidel, Low Status Control, High Effort at Work and Ischemic Heart Disease: Prospective Evidence from Blue Collar Men, Social Science and Medicine, 31, pp. 1127-1134, 1990.

Kivimaki, M., M. Virtanen, M. Elovainio, A. Kouvonen, A. Vaananen, and J. Vahtera, Work Stress in the Etiology of Coronary Heart Disease—A Meta-Analysis, Scandina- vian Journal of Work Environment and Health, 32:6(Special Issue), pp. 431-442, 2006.

Vahtera, J., M. Kivimaki, J. Pentti, et al., Organisational Downsizing, Sickness Absence, and Mortality: 10-Town Prospective Cohort Study, British Medical Journal, 328:7439, p. 555, 2004.

Kivimaki, M., J. Ferrie, E. Brunner, et al., Justice at Work and Reduced Risk of Coronary Heart Disease among Employees: The Whitehall II Study, Archives of Internal Medicine, 165, pp. 2245-2251, 2005.

Elovainio, M., P. Leino-Arjas, J. Vahtera, and M. Kivimaki, Justice at Work and Cardiovascular Mortality: A Prospective Cohort Study, Journal of Psychosomatic Research, 61 pp. 271-274, 2006.

Menotti, A. and F. Seccareccia, Physical Activity at Work and Job Responsibility as Risk Factors for Fatal Coronary Heart Disease and Other Causes of Death, Journal of Epidemiology and Community Health, 39, pp. 325-329, 1985.

Murphy, L. R., Job Dimensions Associated with Severe Disability Due to Cardio- vascular Disease, Journal of Clinical Epidemiology, 44:2, pp. 155-166, 1991.

Suurnakki, T., J. Ilmarinen, G. Wagar, E. Jarvinen, and K. Landau, Municipal Employees’ Cardiovascular Diseases and Occupational Stress Factors in Finland, Inter- national Archives of Occupational and Environmental Health, 59:2, pp. 107-114, 1987.

Belkic, K., R. Emdad, and T. Theorell, Occupational Profile and Cardiac Risk: Pos- sible Mechanisms and Implications for Professional Drivers, International Journal of Occupational Medicine and Environmental Health, 11, pp. 37-57, 1998.

Tuchsen, F., High-Risk Occupations for Cardiovascular Disease, in The Workplace and Cardiovascular Disease, Schnall, P., K. Belkic, P. Landsbergis, and D. Baker (eds.), Hanley & Belfus, Philadelphia, PA, pp. 57-60, 2000.

Greiner, B., N. Krause, D. Ragland, and J. Fisher, Occupational Stressors and Hyper- tension: A Multi-Method Study Using Observer-Based Job Analysis and Self-Reports in Urban Transit Operators, Social Science and Medicine, 59, pp. 1081-1094, 2004.

71. Kivimaki, M., J. Ferrie, E. Brunner, et al., Justice at Work and Reduced Risk of Coronary Heart Disease among Employees: The Whitehall II Study, Archives of Internal Medicine, 165, pp. 2245-2251, 2005.

72. Elovainio, M., P. Leino-Arjas, J. Vahtera, and M. Kivimaki, Justice at Work and Cardiovascular Mortality: A Prospective Cohort Study, Journal of Psychosomatic 61 pp. 271-274, 2006.

Mid-Mac Study Measures – Coefficient alphas of .83 – .91 for emotional support from spouse, family and friends indicate good internal reliability (data documentation from Mid-Mac).

MacArthur Successful Aging Study – Two-month test retest data indicate reasonable stability for measures of emotional support (.73) and for levels of demand/criticism (.80), and somewhat lower stability for instrumental support (.44 [.55 for rank correlation]) (Seeman et al, 1994).

 Interpersonal Support Evaluation List – Test-retest data reveal correlations between .77-.86 and internal alpha estimates of .88-.90.

 Canty-Mitchell, J. & Zimet, G.D. (2000). Psychometric properties of the Multidimensional Scale of Perceived Social Support in urban adolescents. American Journal of Community Psychology, 28, 391-400. 

 Zimet, G.D., Dahlem, N.W., Zimet, S.G. & Farley, G.K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52, 30-41. 

 Zimet, G.D., Powell, S.S., Farley, G.K., Werkman, S. & Berkoff, K.A. (1990). Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 55, 610-1

Low Social Support

Workplace social support has been added to the job strain model as a third major job characteristic in several studies of CVD (49, 50, Hall, Johnson and Tsou, 1993), all-cause mortality (8, 25), smoking and sedentary behavior (Johannson, Johnson and Hall, 1991), and ambulatory blood pressure (Landsbergis et al., 1994) as well as a number of studies of psychological strain outcomes (e.g., 60, 71).

The main effect of low social support on CVD was examined, with positive associations (25, 49), as well as the interaction between social support and job strain (8, 25, 49). Social support was as an effect modifier in the Swedish study of retired men (25) (increased job strain-mortality risk ratios for those with low social support), in the Swedish factory worker study (8) (reduced high latitude-mortality risk ratios for those with high workplace social support), and in a Swedish national study (49) (increased high demand-low latitude-CVD prevalence ratios with greater workplace social isolation).

One study of CVD risk factors (Johannson, Johnson and Hall, 1991) found an association between smoking and co-worker support, but only for women. While Landsbergis et al. (1994) found no association between social support and ambulatory blood pressure among 262 male employees in New York City, an earlier study found significant associations between a supportive foreman, supportive coworkers and lower casual diastolic blood pressure among 288 male factory workers (79).

The Evaluation of an Individual Burnout Intervention Program: The Role of Inequity and Social Support

D i r k v a n D i e r e n d o n c k 
Helen Dowling Institute

W i l m a r B . S c h a u f e l i 
Utrecht University

B r a m E B u u n k 
University o f Groningen

This study evaluated a 5-week, group-based burnout intervention program among direct-care professionals working with mentally disabled individuals. Equity theory was used as the theoretical framework. The main objective o f the program was to reduce perceptions of inequity in the relationship with the organization and with the recipients o f care by increasing the fit between the professional’s goals and expectations and the actual work situation. One experimental group and 2 control groups participated. All 3 groups filled out 3 questionnaires: be for e the program started, 6 months later, and 1 year later. Individual absenteeism rates were assessed for 1 year before and after the program. Results showed that in the experimental group burnout, absence, and deprived feelings diminished compared with the control groups. The most profound effects were among participants who could draw on social resources to benefit f rom the intervention.

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