The International Journal of Psychosocial Rehabilitation
Social Support and Life Satisfaction


 


 

Kim Wan Young, PhD
 
University of Bristol, U.K.

                           



 Citation:
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 Hong Kong. Results show that different sources of social support have different effects on individualís life satisfaction. Supports from staff and friends, but not from family, predict individualís life satisfaction well. Emotional and instrumental supports from staff and friend have different predictive power and importance on individualís life satisfaction. These findings suggest that strengthening staff and friendsí support could improve life satisfaction for people with long-term mental illness.

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Key words: Life Satisfaction, Social Support, Mental Illness


Introduction

Although many researchers concern with the significant effect of social support on individualís 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.ís 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 respondentsí 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 individualís 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 individualís 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 individualís 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 individualís 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 individualís 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 individualís psychological well-being [14]. The third model is the indirect model. It assumes that social support exerts an indirect effect on individualís psychological well being by directly reducing perceived stress, which in turn, promote individualís 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 individualís 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 Hong Kong. In each residential home, four to five residents lived in the same bedroom. Various kinds of professional and non-professional staff had been employed to provide 24-hour personal care services for its residents. Staff to resident ratio is about 1:4.  Those residents, who were being assessed by registered psychiatric nurse as mentally stable, had suitable comprehensive and communicative skills, and discharged from mental hospitals and then lived at the residential home for one year or more, were eligible for being selected into the studied sample.  Finally 146 residents had given their written consent and were interviewed by the author successfully. The data of subjective life satisfaction and social support of the studied group were collected and completed in 1998.

 

 

Measuring Scales and Data Collection

1) Quality of Life Interview scale

In this study, Lehmanís 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 (Cronbachís a= .73 for overall life satisfaction sub-scale; and Cronbachís 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, ďsignificant othersĒ 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: ďWould your family member / friend / staff provide financial support to you?Ē  Each item is rated in a 4-point scale: ď1Ē Not at all; ď2Ē Sometimes; ď3Ē Often; ď4Ē Certainly.

 

In this study, the reliabilities of MSPSS and its subscales have been tested to be satisfactory (Cronbachís 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), friendís 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 individualís Overall QoL

Overall life satisfaction is significantly related to and predicted by individualís 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 individualís Overall QoL

Overall life satisfaction is significantly related to and predicted by individualís 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, individualís 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 individualí 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 individualís life satisfaction. For support from staff, emotional support from friends could explain 7.8% variance of individualí 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 individualís life satisfaction. 

 

Table 4  Independent Predictive Power of Social Support variables and Life Satisfaction

 

Dependent Variable

Independent Variable

R

R Square

Adjusted

R Square

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 individualís 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 individualís subjective life satisfaction.  Perceived support from friend and staff are found to predict individualís overall life satisfaction.  However, perceived family support is found not related to individualís overall life satisfaction. These findings are supported by Lehmanís study [17] which has found that intimate social relationships, rather than family relationships, predict individualís 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 individualís overall life satisfaction for people with long-term mental illness.

 

Secondly, both emotional support and instrumental support are found to predict individualís 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 individualís life satisfaction through different ways. For support from friends, emotional support seems to have higher predictive power than instrumental support for individualís life satisfaction. So, emotional support from friends is more important in enhancing individualís life satisfaction. For support from staff, both instrumental support and emotional support seems to have similar predictive power as well as importance in enhancing individualís 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 individualís 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 individualís 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 individualís 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 individualís life satisfaction. Supports from staff and friends, but not family support, are found to lead to a better overall life satisfaction. For friendsí support, emotional support seems to have a higher predictive power than instrumental support for individualís life satisfaction. For staff support,  instrumental and emotional supports have similar predictive power for individualís 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 individualís social support, especially staff and friendsí 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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