The
International Journal of Psychosocial Rehabilitation
Social Support
and Life Satisfaction
Kim Wan Young, PhD
Young, K.W. (2006).
Social Support and Life Satisfaction.
International Journal
of Psychosocial
Rehabilitation. 10 (2), 155-164 .
Abstract
This study aims at exploring the
relationship between social support and life satisfaction for people
with
long-term mental illness. Research sample included 146 subjects, coming
from
two large residential homes in
Key words: Life
Satisfaction, Social Support, Mental Illness
Introduction
Although many researchers concern with the significant effect of social support on individual’s mental heath (e.g. Brown et al. [1]), few research studies have been done in exploring the relationships between social support and life satisfaction for people with long-term mental illness. Baker et al.’s study [2] is one the few studies giving a detailed analysis in this area. In his study of 844 people with chronic psychiatric illness receiving community support services, case management service, as one type of social support, was shown to improve respondents’ subjective overall life satisfaction over the nine months period. Moreover, the increase of social support was related to the increase of subjective overall life satisfaction.
While acknowledging the existing relationship between social support and life satisfaction for people with long-term mental illness, little is known on how social support system affects life satisfaction. There are several important issues in the investigation of this area which are discussed below.
Firstly, in social support research, there is a distinction between received support and perceived support. Received support is a measurement of the actual support received from supportive members, while perceived support is typically measured by asking people to what extent they believe in their network are available to help them. For example, Earls et al. [3] found that frequency of social support (actual received support) was related to individual’s life satisfaction for people with psychiatric illness. On the other hand, Turner et al. [4] reported that perceived social support was correlated with psychological well-being for people with psychotic mental illness. Research evidences tend to suggest that perceived social support, but not received support, is more strongly related to life satisfaction [5].
Secondly, some researchers further examine the different modes and functions of perceived social support on individual’s life satisfaction. Although there are different categories regard to the functions of social support, social support could simply be categorized in two aspects: emotional or instrumental support [6]. Different modes of social support seem to meet the needs of people with different types of psychiatric illness. For example, while people with depression need emotional support [7], people with schizophrenia need a combination of problem solving and low level emotional support [8]. Thus it seems that different modes and functions of social support, i.e. emotional or instrumental support, may have different effects on individual’s life satisfaction.
Thirdly, research studies consistently found that the sources of supportive network of people with mental illness are different from that of the general population [8, 9]. While, their supportive networks are smaller in size [10], they are more likely to emphasize non-family support, such as: social service providers [11, 12]. For example, when facing with stressful life events, people with psychotic mental illness were found to seek support from mental health professionals, rather than from family [8]. It seems that different sources of support (i.e., family and non-family) may have different effects on individual’s life satisfaction.
Finally, some researchers have tried to
investigate about the complex process how social support interacts with
psychological well-being. Several theoretical models have been
developed in
this area. The first model is called stress buffering model. This model
assumes
that social supports have an effect upon the individual’s psychological
well-being only in the presence of certain social conditions, such as
stressful
life events [13]. The second
model is the direct or main effect model. The model suggests that
social
support has independent effects on individual’s psychological
well-being [14]. The third model
is the indirect model. It
assumes that social support exerts an indirect effect on individual’s
psychological well being by directly reducing perceived stress, which
in turn,
promote individual’s well-being [15]. Although many empirical research
studies
have been carried out to test these models, research evidences for
these models
was inconsistency [13, 14, 15, 16]. More research needs to be done
before
reaching any firm conclusion in this issue.
Research Objective
The aim of this research study is to explore the effects of different sources of social support (i.e. family, friends and staff) and functions (i.e. emotional support and instrumental support) on individual’s life satisfaction for people with long-term mental illness.
Research Design and Sample
This
study has adopted a cross-sectional
research strategy. The studied group of
people with long-term mental illness came from two large residential
homes in
Measuring Scales and Data Collection
1)
Quality of Life Interview scale
In
this study, Lehman’s Quality of Life
Interview [17] is adopted to measure the subjective life satisfaction
of the
studied group. The reliability and validity of the scale are well
established
[17, 18] and the scale has been widely used [19, 20]. In this study, there is no modification in
this scale, and the reliabilities of sub-scales of` overall life
satisfaction
as well as subjective satisfaction in various life domains have been
tested to
be satisfactory (Cronbach’s a=
.73 for overall life
satisfaction sub-scale; and Cronbach’s a range from .75 to .91 for
subjective satisfaction indicators in various life domains).
2)
Multi-Dimensional Scale of Perceived Social
Support
With regard to
the measurement of different sources and functional aspects of social
support,
the Multidimensional Scale of Perceived Social Support (MSPSS)
[21] is modified and
adopted in this study. The validity and reliability of the scale has
been
reported to be satisfactory [5, 21]. However, this
scale is originally designed for people without mental illness. So this scale is modified so as to be more
relevant and applicable for people with long-term mental illness living
in
residential home. Two modifications have
been made. Firstly the scale has been
shortened, and respondent is asked whether supportive persons would
provide
assistance in seven occasions instead of twelve. These seven occasions
included: financial support; using public transport and community
facilities;
giving advice; going out for tea; sharing pleasant and unpleasant
feelings;
comforting; and giving concern.
Assistances to the first four occasions refer to instrumental
support,
while assistances to last three occasions refer to emotional support. Secondly, “significant others” of the
original scale is replaced by staff of residential home.
So, in this scale, respondents would rate and
compare their perceived social support from family members, friends and
staff.
A typical question is: “Would your family member / friend / staff
provide
financial support to you?” Each item is
rated in a 4-point scale: “1” Not at all; “2” Sometimes; “3” Often; “4”
Certainly.
In this study, the reliabilities of MSPSS and its subscales have been tested to be satisfactory (Cronbach’s a was .90 for whole scale, and ranked from .98, .86 and .85 for the subscales of perceived support from family, friends and staff respectively). In addition, factor analysis has been carried out for this scale by using principal component analysis through Window SPSS program. Results shows that each items of this scale are satisfactory explained by three factors (please refer to Table 1 & 2). So this scale can be grouped into three factors as if the original scale [5, 21] and these three factors are: family support (item S1 to S7), friend’s support (item S8-S14) and staff support (item S15-S21).
Table 1 Total
Variance Explained
for each item of MSPSS
|
|
Initial Eigenvalues |
|
|
Extraction
Sums of Squared Loadings |
|
|
Rotation Sums
of Squared Loadings |
|
|
|
Component |
|
|
|
|
|
|
|
|
|
|
Total |
% of Variance |
Cumulative % |
Total |
% of Variance |
Cumulative % |
Total |
% of Variance |
Cumulative % |
|
|
S1 |
|
|
|
|
|
|
|
|
|
|
7.267 |
34.603 |
34.603 |
7.267 |
34.603 |
34.603 |
6.588 |
31.373 |
31.373 |
|
|
S2 |
|
|
|
|
|
|
|
|
|
|
5.768 |
27.465 |
62.068 |
5.768 |
27.465 |
62.068 |
4.953 |
23.587 |
54.960 |
|
|
S3 |
|
|
|
|
|
|
|
|
|
|
1.225 |
5.833 |
67.901 |
1.225 |
5.833 |
67.901 |
2.717 |
12.940 |
67.901 |
|
|
S4 |
|
|
|
|
|
|
|
|
|
|
1.118 |
5.324 |
73.225 |
|
|
|
|
|
|
|
|
S5 |
|
|
|
|
|
|
|
|
|
|
.905 |
4.311 |
77.536 |
|
|
|
|
|
|
|
|
S6 |
|
|
|
|
|
|
|
|
|
|
.770 |
3.669 |
81.204 |
|
|
|
|
|
|
|
|
S7 |
|
|
|
|
|
|
|
|
|
|
.573 |
2.728 |
83.932 |
|
|
|
|
|
|
|
|
S8 |
|
|
|
|
|
|
|
|
|
|
.556 |
2.649 |
86.582 |
|
|
|
|
|
|
|
|
S9 |
|
|
|
|
|
|
|
|
|
|
.482 |
2.297 |
88.878 |
|
|
|
|
|
|
|
|
S10 |
|
|
|
|
|
|
|
|
|
|
.433 |
2.060 |
90.939 |
|
|
|
|
|
|
|
|
S11 |
|
|
|
|
|
|
|
|
|
|
.396 |
1.888 |
92.826 |
|
|
|
|
|
|
|
|
S12 |
|
|
|
|
|
|
|
|
|
|
.343 |
1.632 |
94.458 |
|
|
|
|
|
|
|
|
S13 |
|
|
|
|
|
|
|
|
|
|
.291 |
1.384 |
95.842 |
|
|
|
|
|
|
|
|
S14 |
|
|
|
|
|
|
|
|
|
|
.285 |
1.358 |
97.200 |
|
|
|
|
|
|
|
|
S15 |
|
|
|
|
|
|
|
|
|
|
.221 |
1.054 |
98.253 |
|
|
|
|
|
|
|
|
S16 |
|
|
|
|
|
|
|
|
|
|
.116 |
.553 |
98.807 |
|
|
|
|
|
|
|
|
S17 |
|
|
|
|
|
|
|
|
|
|
6.951E-02 |
.331 |
99.138 |
|
|
|
|
|
|
|
|
S18 |
|
|
|
|
|
|
|
|
|
|
6.494E-02 |
.309 |
99.447 |
|
|
|
|
|
|
|
|
S19 |
|
|
|
|
|
|
|
|
|
|
5.125E-02 |
.244 |
99.691 |
|
|
|
|
|
|
|
|
S20 |
|
|
|
|
|
|
|
|
|
|
3.625E-02 |
.173 |
99.864 |
|
|
|
|
|
|
|
|
S21 |
|
|
|
|
|
|
|
|
|
|
2.860E-02 |
.136 |
100.000 |
|
|
|
|
|
|
|
Extraction
Method: Principal Component Analysis.
S1
to S21 refer to the questionnaires items of MSPSS
Table
2 Structural Matrix of MSPSS
|
Items |
Component |
||
|
1 |
2 |
3 |
|
|
S1 |
|
|
|
|
-.952 |
|
|
|
|
S2 |
|
|
|
|
-.970 |
|
|
|
|
S3 |
|
|
|
|
-.972 |
|
|
|
|
S4 |
|
|
|
|
-.977 |
|
|
|
|
S5 |
|
|
|
|
-.969 |
|
|
|
|
S6 |
|
|
|
|
-.975 |
|
|
|
|
S7 |
|
|
|
|
-.961 |
|
|
|
|
S8 |
|
|
|
|
|
.809 |
|
|
|
S9 |
|
|
|
|
|
.772 |
|
|
|
S10 |
|
|
|
|
|
.742 |
|
|
|
S11 |
|
|
|
|
|
.339 |
|
|
|
S12 |
|
|
|
|
|
.480 |
|
|
|
S13 |
|
|
|
|
|
.605 |
|
|
|
S14 |
|
|
|
|
|
.481 |
|
|
|
S15 |
|
|
|
|
|
|
.472 |
|
|
S16 |
|
|
|
|
|
|
.651 |
|
|
S17 |
|
|
|
|
|
|
.668 |
|
|
S18 |
|
|
|
|
|
|
.733 |
|
|
S19 |
|
|
|
|
|
|
.624 |
|
|
S20 |
|
|
|
|
|
|
.688 |
|
|
S21 |
|
|
|
|
|
|
.799 |
|
Extraction
Method: Principal Component Analysis.
Rotation
Method: Oblimin with Kaiser Normalization.
S1
to S21 refer to the questionnaires items of MSPSS
Characteristics
of the research sample
Below describes the characteristics of the studied sample which came from two large residential homes, i.e. home A group (n=77) and home B group (n=69). Results showed that these two studied groups did not differ in almost all demographic factors, except in age and financial situation. Taking together, the whole studied group had slightly more male than female. Most of them were aged under 60 (mean 53 years), schizophrenic, single and had reached primary school level. They had a mean continuous hospital stay of 7.5 years just before admitting into residential home. Most were single or divorced, and had few contacts with their families. They did not have any friends outside the hospitals and residential home. Almost all of them had to rely on governmental social security schemes to support their lives.
Research Results
A.
Subjective Life Satisfaction
Table
3 Subjective
Satisfaction of Studied Sample in various life domains
|
Subjective Life Satisfaction (Score between 1-7 with 7 means most satisfactory) |
Mean score |
Standard Deviation |
|
Living Situation |
5.3 |
0.889 |
|
Daily Activities & Functioning |
5.3 |
1.133 |
|
Family |
4.7 |
1.840 |
|
Social Relationship |
5.0 |
1.180 |
|
Financial Situation |
4.9 |
1.450 |
|
Legal and Safety Issue |
5.4 |
1.081 |
|
Health |
4.8 |
1.330 |
|
Overall Life Satisfaction |
5.5 |
1.1473 |
Most residential home residents (82%) were satisfied with their overall life. So the studied group viewed their overall lives as positive at their current places after their discharge from mental hospitals. The reported level of life satisfaction of the studied group is found to be similar to that reported in other studies [20, 22].
B. Social
Support
The social supports of the studied group are found to be weak. About 80% of respondents were single, divorced or widowed. The majority of the studied group had few or nor contacts with their family members, and less than one fifth of respondents had weekly contacts with their families. Comparatively, the studied group had more contacts with other residents living at the same residential home. Over one third of respondents talked with other residents at least weekly. Most of the respondents (80%) rated their perceived total social support as fair and weak, while more than seventy percentage (76%, 88% and 72% respectively) rated their perceived support from family, friends and staff as fair and weak (score <3).
C.
Subjective Life Satisfaction and Social Support
1. Effects of different sources of
support on
individual’s Overall QoL
Overall life satisfaction is
significantly
related to and predicted by individual’s perceived support from friends
(Pearson correlation coefficient (r) =.260, p=.002) and staff ( r=.280, p=.001), but not from family. (Data of
regression
analysis please refer to Table 4 for reference).
2. Effects of emotional and
instrumental support on
individual’s Overall QoL
Overall life satisfaction is
significantly
related to and predicted by individual’s instrumental support from
friends
(r=.215, p=.009) and emotional support from friends (r=.266, p=.001),
instrumental support from staff (r=.262, p=.001) and emotional support
from
staff (r=.291, p=.000).
In
particular, individual’s overall life
satisfaction is found to be significantly correlates with support from
friends in
their company for going for tea (r=.239, p=.004) and
comforting (r=.224,
p=.007) concern (r=.332, p=.000). In
addition, it is found correlated with almost all items of support from
staff
including: financial support (r=.206, p=.013), assistance in
using community facilities (r=.216,
p=.009), advice (r=.207,
p=.012), sharing of feeling (r=.196
p=.018), comforting (r=.242,
p=.003) and concern (r=.296,
p=.000).
For support from friends, emotional
support
from friends could explain 6.4% variance of individual’ life
satisfaction,
while instrumental support could explain 4%. (Please refer to Table 4
for
reference). So for support from friends, emotional support seems to
have higher
predictive power than perceived instrumental support for individual’s
life
satisfaction. For support from staff, emotional support from friends
could
explain 7.8% variance of individual’ life satisfaction, while
instrumental
support could explain 6.2%. (Please refer to Table 4 for reference). So
for
support from staff, instrumental
support and emotional support seems to have similar predictive power
for
individual’s life satisfaction.
Table 4 Independent
Predictive Power of Social Support variables and Life Satisfaction
|
|
Dependent Variable |
Independent Variable |
R |
|
Adjusted |
Std. Error of the Estimate |
|
1 |
Overall Life Satisfaction |
Total Support from friends |
.260 |
.068 |
.061 |
1.1117 |
|
2 |
Overall Life Satisfaction |
Instrumental
support from friend |
.215 |
.046 |
.040 |
1.1244 |
|
3 |
Overall Life Satisfaction |
Emotional support
from friend |
.266 |
.071 |
.064 |
1.1097 |
|
4 |
Overall Life Satisfaction |
Total Support from staff |
.280 |
.078 |
.072 |
1.1053 |
|
5 |
Overall Life Satisfaction |
Instrumental
support from staff |
.262 |
.069 |
.062 |
1.1111 |
|
6 |
Overall Life Satisfaction |
Emotional support
from staff |
.291 |
.085 |
.078 |
1.1048 |
3. Mediating Effects
of Satisfaction with
Friend
As discussed
above, overall life satisfaction is significantly related to
individual’s
support from friend. Interestingly, after controlling subjective
satisfaction
with friend, this correlation becomes non-significant (Please refer to
Table 5
for reference). This result shows that subjective satisfaction in
friend has
mediating effects on the
relationships between overall life satisfaction and support from friend.
Table 5 Correlation of Overall QoL
with Perceived social supports
|
Item |
Test |
Without controlling any variables |
Controlling Subjective
Satisfaction in friends and staff |
||
|
Value |
Significance |
Value |
Significance |
||
|
Perceived Support from friends |
Pearson correlation coefficient |
.260 |
.002* |
.022 |
.796 |
Remark : significance <=.001
Discussion
In this study, several interesting findings
are found. Firstly, it is found that different sources of social
support have
different effects on individual’s subjective life satisfaction. Perceived support from friend and staff are
found to predict individual’s overall life satisfaction.
However, perceived family support is found
not related to individual’s overall life satisfaction. These findings
are
supported by Lehman’s study [17] which has found that intimate social
relationships, rather than family relationships, predict
individual’s overall life satisfaction.
People with long-term mental illness are so impaired and
disabled that
they emphasize and
rely more on non-family support rather than family support in
their daily lives [11, 12]. Moreover, the majority of them
have few or
even no contacts with their family members, and so non-family support play a
more significant role in their daily lives. Thus it is not surprising
to find
that perceived support from friends and staff, rather than family
support, play
a more important role in enhancing individual’s overall life
satisfaction for
people with long-term mental illness.
Secondly, both emotional support and
instrumental support are found to predict individual’s overall life
satisfaction. Thus although emotional
support is repeatedly cited in literature as an important correlate of
psychological well being,
people with long-term mental illness may need a
combination of
both instrumental and emotional support in enhancing their life
satisfaction.
Furthermore, support from staff and friends
are found to affect individual’s life satisfaction through different
ways. For
support from friends, emotional support seems to have higher predictive
power
than instrumental support for individual’s life satisfaction. So,
emotional
support from friends is more important in enhancing individual’s life
satisfaction. For support from staff, both instrumental support and emotional support
seems to have similar predictive power as well as importance in
enhancing
individual’s life satisfaction.
Finally, it is found that subjective
satisfaction with friends has mediating effect on the relationship
between
overall life satisfaction and perceived support from friend. This interesting and preliminary finding
indicate that perceived support from friends lead to a better overall
life
satisfaction indirectly, i.e. by
improving the subjective satisfaction in friend. That
is to say: perceived support from friend
leads to a better subjective satisfaction in the domain of friend which
in turn
leads to a better overall life satisfaction.
This preliminary finding suggests that social support interact
with life
satisfaction in an indirect way and so it is in favor of the indirect
model.
However, as the underlying interaction between perceived staff support
and life
satisfaction needs further exploration, more research is needed in this
area.
The
above findings have important service
implications. According to the above findings, in order to enhance
individual’s
overall life satisfaction, it is important for mental health
professionals to
strengthen the social support system of our service users.
It could be done in several ways. Firstly, it
is important to strengthen the support of staff in all aspects of the
daily
life of our service users, including both instrumental as well as
emotional
support. As staff becomes the main source of social support and has
daily
contact with individual service user, so it is important to strengthen
staff
support first. According to the above research results, in order to
enhance
individual’s life satisfaction, staff support could be strengthen in
the
following ways: financial support; use of public transport; use of
community
facilities; giving advice; sharing pleasant and unpleasant feelings;
comforting; and giving concern, etc. On the other hand, in order to
strengthen
support from friends, it is important to encourage service users to
have more
social gathering with other residents, especially in going out for tea;
and to
encourage service users to have emotional sharing and support towards
each
others.
Conclusion
This
study aims at exploring the
relationship between individual’s social support and life satisfaction
for
people with long-term illness. In
this study, several interesting findings have been found. Different
sources of social support have different effects on individual’s life
satisfaction. Supports from staff and friends, but not family support,
are
found to lead to a better overall life satisfaction. For friends’
support,
emotional support seems to have a higher predictive power than
instrumental
support for individual’s life satisfaction. For staff support, instrumental and
emotional supports
have similar predictive power for individual’s overall life
satisfaction. Finally, perceived support
in friend leads to
a better subjective satisfaction in friend which in turn leads to a
better
overall life satisfaction. The above findings suggest that
strengthening
individual’s social support, especially staff and friends’ support,
could
improve life satisfaction for people with
long-term
mental illness. In addition, based on the research results, effective
ways of
strengthening social support have also been discussed.
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