جستجوی مقالات مرتبط با کلیدواژه « social support » در نشریات گروه « پزشکی »
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Background
Numerous epidemiological studies have explored the relationship between social support and suicidal behaviors; however, the overall impact remains unclear. Therefore, a systematic assessment of the association between social support and suicide is necessary.
Study Design:
This is a systematic review study.
MethodsWe conducted a comprehensive search of PubMed, Web of Science, and Scopus databases until March 2023 and screened reference lists for relevant studies. Epidemiological studies that investigated the associations between social support and suicidal behaviors were included. Furthermore, between-study heterogeneity was investigated using I2 statistics. In addition, the likelihood of publication bias was evaluated using the Begg and Egger tests, and a trim-and-fill analysis was conducted. The overall effect size was calculated as an odds ratio (OR) with 95% confidence intervals (CIs) using a random-effects model.
ResultsOut of the 21004 identified studies, 118 studies (involving 692266 participants) met the eligibility criteria. The analysis of data revealed a significant inverse association between social support and suicidal ideation (OR: 0.79, 95% CI: 0.76-0.82), suicide plans (OR: 0.86, 95% CI: 0.79-0.95), suicide attempts (OR: 0.96, 95% CI: 0.94-0.98), and suicide death (OR: 0.85, 95% CI: 0.75-0.96). Moreover, significant heterogeneity was observed across studies, but there was little concern regarding the presence of publication bias.
ConclusionOur meta-analysis provides clear evidence for a significant inverse association between social support and suicidal behaviors. However, the observational nature of the included studies and the significant heterogeneity observed across studies highlight the need for further research, including prospective studies and intervention trials, to explore the complex relationship between social support and suicidal behaviors.
Keywords: Social Support, Suicidal Ideation, Suicide Plan, Attempted Suicide, Completed Suicide, Meta-Analysis} -
زمینه و هدف
درد مزمن، حاصل تعامل پیچیده عوامل جسمی، روانی و اجتماعی است که باعث تجربه درد می شود. هدف از پژوهش حاضر تعیین الگوی ساختاری درد مزمن بر اساس ذهن آگاهی، حمایت اجتماعی و رویدادهای زندگی با میانجی گری پریشانی روانشناختی و فاجعه سازی درد بود.
روش کاراین پژوهش، یک مطالعه توصیفی همبستگی از نوع الگویابی معادلات ساختاری بود. جامعه آماری شامل کلیه افرادی بودند که در سال 1401 با شکایت از درد عضلانی- اسکلتی و آرتریت روماتوئید به کلینیک های درد، متخصصان درد، متخصصان مغز و اعصاب، فیزیوتراپیست ها، مراکز بهداشتی- درمانی (مراجعین بخش ارتوپدی، فیزیوتراپی و مغز و اعصاب بیمارستان های مختلف و مراجعان ارتوپدی) و درمانگاه های مناطق 22 گانه شهر تهران مراجعه کرده بودند. از بین آنها تعداد 496 نفر با استفاده از روش نمونه گیری در دسترس انتخاب و پرسشنامه های درد مک گیل، ذهن آگاهی بائر، حمایت اجتماعی ادراک شده زیمت و همکاران، رویدادهای استرس زای زندگی پیکل، افسردگی، اضطراب و استرس لویباند و مقیاس فاجعه سازی درد سالیوان و همکاران را تکمیل کردند. داده ها با کمک نرم افزارهای آماری SPSS-26 و AMOS-23 و با استفاده از ضریب همبستگی پیرسون و روش مدل یابی معادلات ساختاری، مورد تجزیه و تحلیل قرار گرفت.
یافته هانتایج الگویابی معادلات ساختاری، حاکی از برازش مطلوب مدل با داده های تجربی بود. اثر ضریب مسیر استاندارد مستقیم ذهن آگاهی و میزان عوامل استرس زا بر درد مزمن، معنادار (0/01<p) و اثر مستقیم حمایت اجتماعی و تعداد عوامل استرس زا بر درد مزمن، غیرمعنادار بود. همچنین اثر ضریب مسیر استاندارد غیرمستقیم ذهن آگاهی، حمایت اجتماعی، تعداد عوامل استرس زا و میزان عوامل استرس زا با نقش میانجی پریشانی روانشناختی و فاجعه سازی درد بر درد مزمن معنادار بود (0/01<p).
نتیجه گیرینتایج نشان داد که ذهن آگاهی، حمایت اجتماعی و رویدادهای زندگی با میانجی گری پریشانی روانشناختی و فاجعه سازی درد، نقش مهمی در تبیین درد مزمن ایفا می کنند. این یافته می تواند در برنامه ریزی دقیق تر مداخلات روان درمانی به بیماران دارای درد مزمن مورد استفاده قرار گیرد.
کلید واژگان: درد مزمن, ذهن آگاهی, حمایت اجتماعی, پریشانی روانشناختی, فاجعه سازی درد}BackgroundChronic pain results from a complex interaction of biological, psychological and social factors that causes the experience of pain. The purpose of this research was to identify the structural model of chronic pain based on mindfulness, social support and life events with the mediating role of psychological distress and pain catastrophizing.
MethodsThis was a descriptive-correlational study with structural equation modeling. The study population included all patients suffering from chronic pain with musculoskeletal and rheumatoid arthritis related pain, which had referred to Tehran medical centers for follow-up in 2023. A total of 496 people were selected using the convenience sampling method. They completed the McGill Pain Questionnaire (1957), the Bauer Five Factor Mindfulness Questionnaire (2006), the Perceived Social Support of Zimmet et al. (1988), the Pickel's Stressful Life Events (1971), the Leviband's Depression, Anxiety and Stress Questionnaire (1995) and the Pain Catastrophizing Scale of Sullivan et al. (1995). Research data were analyzed using SPSS-26 and AMOS-23 softwares using Pearson correlation coefficient and structural equation modeling.
ResultsThe results of the structural equation model indicated that this model fits the experimental data well. The direct effects of the standard pathway mindfulness coefficient and the amount of stressors on chronic pain were significant (p<0.01) and the direct effects of social support and the number of stressors for chronic pain was insignificant. Additionally, the effects of standard indirect path coefficients for mindfulness, social support and the number and the amount of stressors with the mediating role of psychological distress and pain catastrophizing on chronic pain was significant (p<0.01).
ConclusionMindfulness, social support and life events play an important role in explaining chronic pain through the mediation of psychological distress and pain catastrophizing. Therefore, the findings of this study can be used in more detailed planning of psychotherpeutic interventions for patients with chronic pain.
Keywords: Chronic Pain, Mindfulness, Social Support, Psychological Distress, Pain Catastrophizing} -
زمینه و هدف
کروناویروس علاوه بر علائم جسمانی، موجب بروز علائم روانی شده و بهزیستی روان شناختی را کاهش می دهد. هدف از پژوهش حاضر، پیش بینی بهزیستی روان شناختی بر اساس حمایت اجتماعی و کارکرد خانواده در بهبودیافتگان بیماری کووید- 19 بود.
روش کاراین پژوهش از نوع مطالعات توصیفی- همبستگی بود که در سال 1402 روی 350 نفر از بهبودیافتگان بیماری کووید- 19 بستری در بیمارستان امام رضا (ع) شهر بندرعباس انجام شد. نمونه ها به شیوه نمونه گیری در دسترس انتخاب و پرسشنامه های بهزیستی روان شناختی ریف، حمایت اجتماعی واکس و کارکرد خانواده اپشتاین را تکمیل کردند. به منظور تجزیه و تحلیل داده ها از ضریب همبستگی پیرسون و رگرسیون گام به گام در نرم افزار SPSS-24 استفاده شد.
یافته هانتایج نشان داد که حمایت اجتماعی و کارکرد خانواده قادر به پیش بینی بهزیستی روان شناختی در بهبودیافتگان بیماری کووید- 19 بودند (0/001>p). براساس نتایج آزمون رگرسیون، حمایت اجتماعی به میزان 0/381 و کارکرد خانواده به میزان 0/478 توانستند به طور مستقیم بهزیستی روان شناختی را در بهبودیافتگان کووید- 19 پیش بینی کنند (0/05>p).
نتیجه گیریبا توجه به یافته های مطالعه، روانشناسان و مشاوران لازم است هنگام مشاوره به بهبودیافتگان کووید- 19، عوامل موثر بر بهزیستی روانشناختی مانند حمایت اجتماعی و کارکرد خانواده را شناسایی نموده و از این طریق مشکلات روانی آن ها را کاهش دهند.
کلید واژگان: بهزیستی روان شناختی, حمایت اجتماعی, کارکرد خانواده, کووید- 19}BackgroundIn addition to physical symptoms, the coronavirus also causes psychological symptoms and reduces psychological well-being. The purpose of this study was to predict psychological well-being based on social support and family functioning in people who have recovered from COVID-19.
MethodsThis study was a descriptive correlation study that was conducted in 2023 on 350 people who had recovered from the COVID-19 disease and were hospitalized at Imam Reza Hospital in Bandar Abbas city. Samples were selected using convenience sampling and completed RIF psychological well-being, Vax social support and Epstein family functioning questionnaires. To analyze the data, Pearson correlation coefficient and stepwise regression were used in SPSS-24 software.
ResultsThe results showed that social support and family functioning were able to predict psychological well-being of people who recovered from COVID-19 (p<0.001). Based on the regression test, social support (0.381) and family function (0.478) were able to directly predict the psychological well-being of those who recovered from COVID-19 (p<0.05).
ConclusionAccording to the findings, psychologists and counselors need to identify factors that influence psychological well-being, such as social support and family functioning, and reduce their issues when counseling people who have recovered from COVID-19
Keywords: Psychological Well-Being, Social Support, Family Functioning, Covid-19} -
مقدمه
شیوع بیماری کووید 19 و ترس از ابتلای به آن، باعث ایجاد اضطراب در بسیاری از افراد از جمله ورزشکاران شده است. اضطراب ناشی از این بیماری، می تواند بر کیفیت خواب تاثیر منفی بگذارد. حمایت اجتماعی ادراک شده، یکی از عوامل بالقوه موثر بر پیشگیری و مدیریت اضطراب است. پژوهش حاضر با هدف بررسی تاثیر حمایت اجتماعی ادراک شده بر کیفیت خواب با نقش میانجی گری اضطراب کرونا در ورزشکاران مبتلا به کووید 19 انجام گردید.
روش هااین مطالعه از نوع توصیفی- تحلیلی و نمونه آماری شامل 230 نفر از ورزشکاران مبتلا به کووید 19 بود که به صورت نمونه گیری در دسترس و از طریق شبکه های مجازی تلگرام و واتساپ با توزیع لینک پرسش نامه آنلاین در تحقیق شرکت نمودند. اطلاعات مورد نیاز از طریق پرسش نامه های استاندارد اضطراب کرونا علیپور و همکاران، مقیاس چند بعدی حمایت اجتماعی ادراک شده (Multidimensional Scale of Perceived Social Support یا MSPSS) و شاخص کیفیت خواب Pittsburgh (Pittsburgh Sleep Quality Index یا PSQI) جمع آوری گردید. در نهایت، داده ها با استفاده از روش های آمار توصیفی و تحلیل مسیر در نرم افزارهای SPSS و SmartPLS مورد تجزیه و تحلیل قرار گرفت.
یافته هااضطراب کرونا تاثیر معکوس و معنی داری را بر کیفیت خواب ورزشکاران نشان داد. حمایت اجتماعی ادراک شده، تاثیر معکوس و معنی داری بر اضطراب کرونا و تاثیر مثبت و معنی داری بر کیفیت خواب ورزشکاران داشت. همچنین، حمایت اجتماعی ادراک شده از طریق کاهش اضطراب کرونا، باعث بهبود معنی دار کیفیت خواب ورزشکاران شد (05/0 > P).
نتیجه گیریحمایت اجتماعی و اضطراب کرونا نقش مهمی در کیفیت خواب ورزشکاران ایفا می کند و هدف قرار دادن این دو متغیر به وسیله درمان های روان شناختی و رفتاری، می تواند منجر به بهبود کیفیت خواب آن ها در دوران اپیدمی کووید 19 شود.
کلید واژگان: حمایت اجتماعی, کیفیت خواب, کووید 19, اضطراب}BackgroundThe coronavirus disease 2019 (COVID-19) and the fear of being affected by it have caused anxiety among many individuals, including athletes. Anxiety about COVID-19 can negatively affect sleep quality (SQ). Perceived social support (SS) is a factor with potentially positive effects on preventing and managing anxiety. This study aimed to assess the effects of perceived SS on SQ among athletes with a history of COVID-19 with anxiety about the disease playing a mediating role.
MethodsThis descriptive-analytical study was conducted in 2020. Participants were 230 athletes with a history of COVID-19 conveniently recruited through Telegram and WhatsApp. Data collection instruments included Alipour et al.’s Corona Disease Anxiety Scale (CDAS), the Multidimensional Scale for Perceived Social Support (MSPSS), and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed descriptive statistics and path analysis using the SmartPLS and SPSS software.
FindingsAnxiety related to COVID-19 had a significant negative impact on SQ, while perceived SS had a significant negative impact on anxiety related to COVID-19 and a significant positive impact on SQ. Moreover, perceived SS significantly improved SQ through reducing anxiety about COVID-19 (P < 0.05).
ConclusionPerceived SS and anxiety related to COVID-19 have significant effects on SQ among athletes. Manipulating these factors through cognitive behavioral therapies (CBT) can improve SQ among athletes during the COVID-19 pandemic.
Keywords: Social Support, Sleep Quality, COVID-19, Anxiety} -
Introduction
Social support is a crucial factor in how well older adults adjust to the aging process and related challenges, such as anxiety about death. Body image in older adults is a complex and important concept, yet it has been under-researched. This study examined the correlations between social support, death anxiety, and body image in older adults residing in Yazd City, Iran.
MethodsThis cross-sectional study involved older adults from Yazd City, Iran, who visited comprehensive urban health centers in 2022. A convenience sample of 200 participants was selected. They completed questionnaires on demographics, social support perception, body image concerns, and death anxiety.
ResultsThe total social support score (p < 0.01) as well as the score of family support (p < 0.05) and others' support (p < 0.01) showed a significant negative correlation with death anxiety. However, no significant association was found between death anxiety and body image, nor between social support and body image. Regression analysis revealed that only "support from others" was a significant predictor of death anxiety (p < 0.01). Men reported receiving more friends' social support than women (p < 0.05). Participants with higher socioeconomic status were more likely to receive greater family’s social support (p < 0.01) and experience less death anxiety (p < 0.05).
ConclusionSocial support positively impacts the mental well-being and morale of older adults. It can, therefore, be considered a readily available resource and a form of social capital to reduce death anxiety, enhance their sense of purpose, and improve their quality of life.
Keywords: Social Support, Body Image, Death Anxiety, Aging} -
Aims
Psychological well-being is an important factor affecting career women’s job satisfaction and performance. Resilience predicts psychological well-being, acting as a catalyst for boosting psychological well-being. This systematic literature review explored the relationship between resilience and psychological well-being among career women.
Information & MethodsRelevant papers were retrieved using Scopus, ScienceDirect, and PubMed. The inclusion criteria included research published between the years 2012 and 2021 to examine whether there is a relationship between resilience and psychological well-being, as well as the predictors of resilience and psychological well-being.
FindingsThere was a favorable relationship between resilience and psychological well-being, with those having higher levels of resilience reporting greater psychological well-being. Resilience is believed to be one of the most essential variables in maintaining positive psychological well-being. Additionally, social and family support, work experience, marital status, education level, and self-esteem were found to predict resilience and psychological well-being.
ConclusionAge, life experience, work experience, marital status, level of education, and self-efficacy are key predictors of resilience.
Keywords: Career Counseling, Job Satisfaction, Psychological Resilience, Social Support, Stress, Physiological} -
Background
Post-traumatic stress disorder (PTSD) is a well-known psychiatric disorder that can occur after a major traumatic event and adversely impact the individual’s mental health. PTSD is a multifaceted mental health problem that requires long periods of treatment and expensive treatment protocols. Despite significant advances in treatment, there is little evidence of the economic burden and social support associated with PTSD. Hence, this study examines empirical research on the economic burden and social support associated with patients with PTSD.
MethodsIn this study, we used the preferred reporting items for systematic reviews and meta-analyses guided scoping review protocol to assess the research on the economic burdens and social support associated with PTSD patients. Accordingly, we selected 14 primary research studies examining the economic burden and 17 primary studies examining social support for PTSD patients.
ResultsPTSD patients incur a high economic burden worldwide with huge direct cost variability. Meanwhile, social support is an impactful approach to curbing the impacts of PTSD on patients. This study demonstrated the substantial role of social support in reducing PTSD symptoms and as a significant moderator in the treatment of PTSD patients.
ConclusionPTSD is a mental health problem associated with a highly variable economic burden on patients and healthcare systems across the globe. In addition, social support facilitates the speedy recovery of PTSD patients. Because of the high economic burden associated with PTSD, the World Health Organization (WHO) should formulate a policy that improves resource allocation specifically for vulnerable individuals with PTSD.
Keywords: Economic Burden, Social Support, Post-Traumatic Stress Disorder (PTSD), Scoping Review, Individuals With PTSD} -
فصلنامه علوم پزشکی دانشگاه آزاد اسلامی، سال سی و چهارم شماره 2 (پیاپی 116، تابستان 1403)، صص 170 -184سابقه و هدف
یکی از پیامدهای مهم شیوع جهانی ویروس کووید-19 در 2019 تاثیر روانشناختی بر مردم به ویژه مبتلایان بازمانده از این ویروس و پیامدهای آسیب شناسی روانی بود. پیش بینی ادراک استرس براساس انعطاف پذیری شناختی، حمایت اجتماعی ادراک شده و باورهای فراشناختی با میانجیگری تنظیم شناختی هیجانی در بازماندگان کرونا هدف اساسی این مطالعه بود.
روش بررسیبراساس مفروضه تحقیقات توصیفی از نوع همبستگی و اجرای پرسشنامه های ادراک استرس، انعطاف پذیری شناختی، حمایت اجتماعی ادراک شده، باورهای فراشناختی و تنظیم شناختی هیجانی بر روی 200 نفر از جامعه بازماندگان از کرونا که با روش نمونه گیری در دسترس انتخاب شده بودند، داده های لازم جمع آوری شد.
یافته هانتایج نشان داد که انعطاف پذیری شناختی، باورهای فراشناختی، تنظیم شناختی هیجانی بر ادراک استرس تاثیر مثبت دارند، در حالی که حمایت اجتماعی ادراک شده و ادراک استرس رابطه منفی با هم دارند. همچنین، انعطاف پذیری شناختی، حمایت اجتماعی ادراک شده و باورهای فراشناختی با میانجیگری تنظیم شناختی هیجانی بر ادراک استرس تاثیر مثبت داشته و در طول همه گیری کووید-19 ادراک استرس را پیش بینی می کنند.
نتیجه گیرینتایج حاضر از یک سو ارتباط مثبت انعطاف پذیری شناختی، باورهای فراشناختی، تنظیم شناختی هیجانی با ادراک استرس را برجسته کرد و از سوی دیگر، رابطه منفی حمایت اجتماعی ادراک شده با ادراک استرس را نشان داد. علاوه براین، متغیرهای مورد پژوهش با عامل واسطه تنظیم شناختی هیجانی پیش بینی کننده ادراک استرس در بازماندگان کووید-19 بودند.
کلید واژگان: استرس, حمایت اجتماعی, شناخت, فراشناخت, هیجان}Medical Science Journal of Islamic Azad Univesity Tehran Medical Branch, Volume:34 Issue: 2, 2024, PP 170 -184BackgroundThe one of consequences of global epidemic of the Covid-19 virus in 2019 was the psychological impact on people, especially the surviving victims of this virus and its psychopathologic outcomes. The Aim of this study was the prediction of stress perception based on cognitive flexibility, perceived social support and metacognitive beliefs with the mediation of emotional cognitive regulation in Corona survivors.
Materials and methodsThis study was done based on the assumption of descriptive correlational research and the implementation of stress perception questionnaires, cognitive flexibility, perceived social support, metacognitive beliefs and emotional cognitive regulation on 200 people from the Corona survivor community who were selected by available sampling method.
ResultsThe results showed that cognitive flexibility, metacognitive beliefs, emotional cognitive regulation had a positive effect on stress perception, while perceived social support and stress perception had a negative association. Also, cognitive flexibility, perceived social support and metacognitive beliefs had a positive effect on stress perception through the mediation of cognitive emotional regulation and predict stress perception during the covid-19 pandemic.
ConclusionThe present results highlighted the positive effect of cognitive flexibility, metacognitive beliefs, emotional cognitive regulation with stress perception, and on the other hand, it showed the negative effect of perceived social support with stress perception. Also, the research variables with the mediating factor of cognitive emotional regulation were predictors of stress perception in the survivors of Covid-19.
Keywords: Stress, Social Support, Cognition, Metacognition, Emotion} -
زمینه و هدف
خود زنی غیر خودکشی به عنوان یکی از اختلال های مزمن و ناتوان کننده مطرح شده است. حمایت اجتماعی از سوی خانواده، دوستان و دیگران نیز نقش مهمی در پیشگیری، ایجاد و تداوم این اختلال دارد. ازاین رو هدف پژوهش حاضر بررسی نقش تعدیل کننده حمایت اجتماعی در رابطه بین پریشانی روان شناختی و خودزنی غیر خودکشی بود.
روش هااین پژوهش به روش توصیفی-همبستگی و به صورت مقطعی در سال 1402 بر روی 271 دانشجوی کارشناسی در حال تحصیل در دانشگاه آزاد اسلامی واحد نیشابور انجام شد. واحدهای پژوهش به روش نمونه گیری خوشه ای انتخاب شدند. گردآوری داده ها با استفاده از مقیاس پریشانی روان شناختی کسلر، مقیاس چندبعدی حمایت اجتماعی ادراک شده و سیاهه خود آسیب رسانی آگاهانه و تعمدی انجام شد. داده ها با استفاده از افزونه PROCESS در نرم افزار SPSS نسخه 26 و روش های آماری ضریب همبستگی پیرسون و تحلیل رگرسیون تحلیل شدند.
نتایجمیانگین و انحراف استاندارد سن دانشجویان5/94± 24/03 سال بود. 80/8 درصد از شرکت کنندگان دانشجویان دختر و 80/4 درصد دانشجویان در حال تحصیل در دانشکده علوم انسانی بودند. نتایج پژوهش نشان داد که بین پریشانی روان شناختی و خودزنی غیر خودکشی (0/01>p، 0/505 =r)، حمایت اجتماعی و خودزنی غیر خودکشی (0/01>p، 0/316- =r) و همچنین بین پریشانی روان شناختی و حمایت اجتماعی (0/01>p، 0/378- =r) رابطه معنی دار وجود دارد. همچنین حمایت اجتماعی تعدیل کننده رابطه بین پریشانی روان شناختی و خودزنی غیر خودکشی بود.
نتیجه گیریحمایت اجتماعی به عنوان یک عامل محافظت کننده نقش مهمی در کاهش خودزنی غیر خودکشی دارد. پژوهشگران و متخصصان حوزه بهداشت روان می توانند به نقش حمایت اجتماعی در پیشگیری و درمان خودزنی غیر خودکشی توجه نمایند.
کلید واژگان: پریشانی روان شناختی, حمایت اجتماعی, خودزنی غیر خودکشی}Background & AimNon-suicidal self-injury has been proposed as one of the chronic and debilitating disorders. Social support from family, friends and others plays an important role in prevention, development and maintenance of this disorder. Therefore, the aim of this study was to investigate the moderating role of social support in relationship between psychological distress and non-suicidal self-injury.
MethodsThis descriptive-correlational research was conducted cross-sectionally on 271 undergraduate students studying at the Islamic Azad University of Neyshabur branch in 2023. The research units were selected by cluster sampling method. Data collection was done using Kessler's Psychological Distress Scale, Perceived Social Support Multidimensional Scale, and Deliberate and Intentional Self-Injury Inventory.
The data were analyzed using the PROCESS plugin in SPSS version 26 and the statistical methods of Pearson's correlation coefficient and regression analysis.ResultsThe mean and standard deviation of the students' age was 24.03 years. In the study, 80.8% of the participants were female and 80.4% were students studying in the faculty of humanities. The research results showed that there is a significant relationship between psychological distress and non-suicidal self-injury (r= 0.505, p<0.01), social support and non-suicidal self-injury (r= 0.316, p<0.01) and also between psychological distress and social support (r = -0.378, p< 0.01). Also, social support moderated the relationship between psychological distress and non-suicidal self-injury.
ConclusionSocial support as a protective factor plays an important role in reducing non-suicidal self-injury. Researchers and specialists in the field of mental health can pay attention to the role of social support in the prevention and treatment of non-suicidal self-injury.
Keywords: Non-Suicidal Self-Injury, Psychological Distress, Social Support} -
Introduction
During the COVID-19 epidemic, the mental status of nurses and other healthcare workers was strongly influenced by environmental conditions.
ObjectiveThis study aimed to determine the association between social support and resilience with the mediating role of self-efficacy in nurses working in public hospitals.
Materials and MethodsIn this cross-sectional study, 220 nurses working in the educational and medical centers of Rasht City, Iran, in 2021 were recruited by simple random sampling. The general self-efficacy scale, multidimensional scale of perceived social support questionnaire, and Connor and Davidson resilience scale were used to collect data. The Pearson correlation coefficient test was used to investigate the linear relationship of the variables. To evaluate the fit of the proposed model, the chi-square test, degrees of freedom, goodness of fit index, Tucker-Lewis index, comparative fit index, and root mean square error of approximation were calculated. Bootstrap test was used to investigate the role of self-efficacy in the middle of social support and resilience and to assess the direct effects of variables.
ResultsThe results showed that 201 women (91.4%) and 19 men (8.6%), with a mean age of 36±8.43 years, participated in this study. Moreover, 25.5% and 74.5% of participants worked in COVID-19 or non-COVID-19 wards, respectively. Data analysis using the Bootstrap test showed that self-efficacy mediated between social support and resilience (P=0.001). Also, the study findings have shown that the direct effects of social support on resilience are significant, with a path coefficient of 0.203 (P=0.004), so when social support increases, resilience increases, too. Also, in this research, the direct path of self-efficacy on resilience was significant with a path coefficient of 0.595 (P=0.001), so when self-efficacy increases, resilience increases, too.
ConclusionsFindings of this study have shown that nurses’ self-efficacy serves as a mediator in the relationship between social support and productivity. Empirical evidence suggests that individuals who receive greater social support exhibit heightened levels of self-efficacy.
Keywords: Social Support, Psychological Resilience, Self-Efficacy, COVID-19, Nurse} -
نقش اضطراب مرگ، ترس از ابتلا به کرونا، حمایت اجتماعی ادراک شده و تاب آوری در پیش بینی اختلال سازگاریزمینه و هدفاختلال سازگاری، یکی از شایع ترین اختلالات روان پزشکی است که تعیین عوامل دخیل در آن حائز اهمیت است. این مطالعه با هدف بررسی نقش پیش بین تعیین کننده های فردی، اجتماعی و روان شناختی در اختلال سازگاری انجام گرفت.مواد و روش هاطرح پژوهش حاضر، توصیفی و از نوع همبستگی است. جامعه آماری پژوهش شامل 402 شرکت کننده از افراد ساکن شهر تهران بودند که به صورت نمونه گیری در دسترس انتخاب شدند. داده ها با استفاده از پرسش نامه اختلال سازگاری بین المللی (IADQ)، مقیاس اضطراب مرگ (DAS)، مقیاس ترس از ابتلا به کووید - 19 (FCV-19S)، مقیاس چندبعدی حمایت اجتماعی ادراک شده (MSPSS) و مقیاس تاب آوری کانر - دیویدسون (CD-RISC) جمع آوری شد و با استفاده از نرم افزار SPSS-26 با تحلیل رگرسیون خطی چندگانه به روش گام به گام تحلیل شد.یافته هانتایج آزمون همبستگی بیانگر ارتباط معنادار متغیرهای پیش بین ترس از ابتلا به کرونا، حمایت اجتماعی ادراک شده، تاب آوری و وضعیت تاهل با اختلال سازگاری بود و نتایج رگرسیون خطی چندگانه بیانگر تبیین اختلال سازگاری به ترتیب بیشترین سهم برای متغیرهای تاب آوری (0/220-=β، 0/001=P)، حمایت اجتماعی ادراک شده (0/153-=β، 0/003=P)، ترس از ابتلا به کرونا (0/150=β، 0/002=P) و وضعیت تاهل (0/109-=β، 0/031=P) بود.نتیجه گیریتاب آوری، حمایت اجتماعی ادراک شده، ترس از ابتلا به کرونا و وضعیت تاهل در اختلال سازگاری نقش دارند و توان تبیین تغییرپذیری اختلال سازگاری را دارند، در نتیجه درنظرگرفتن این متغیرها در افرادی با اختلال سازگاری بااهمیت به نظر می رسد.کلید واژگان: اختلال سازگاری, کووید19, تاب آوری ختلال سازگاری, اضطراب, کووید 19, حمایت اجتماعی, تاب آوری}IntroductionAdjustment disorder is one of the most common psychiatric disorders, and it is important to determine the factors involved in it. This study investigated the predictive role of individual, social, and psychological determinants in adjustment disorder.Materials and MethodsThe current research design is descriptive and correlational. The statistical population of the research includes 402 people living in Tehran, who were selected through the convenience sampling method. Data were collected using the International Adjustment Disorder Questionnaire (IADQ), Death Anxiety Scale (DAS), Fear of Covid-19 Scale (FCV-19S), Multidimensional Perceived Social Support Scale (MSPSS), and the Connor-Davidson Resilience scale (CD-RISC) was collected and analyzed using SPSS-26 software with multiple linear regression analysis in a stepwise method.ResultsThe results of the correlation test showed a significant relationship between predicting variables of fear of being infected by Covid-19, perceived social support, resilience, and marital status with adjustment disorder, and the results of multiple linear regression showed that adjustment disorder was explained by the highest contribution of resilience variables (0.220). β=-, P=0.000), perceived social support (β=-0.153, P=0.003), fear of infected by Corona (β=0.150, P=0.002) and status Marriage was (β=0.109, P=0.031).ConclusionResilience, perceived social support, fear of being infected by COVID-19, and marital status play a role in adjustment disorder and can explain the variability of adjustment disorder. As a result, it seems important to consider these variables in people with adjustment disorder.Keywords: Adjustment Disorder, Anxiety, COVID-19, Social Support, Resilience}
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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد، سال شصت و هفتم شماره 1 (پیاپی 193، فروردین و اردیبهشت 1403)، صص 223 -236مقدمه
توجه به فرایندهای هیجانی، روانی و اجتماعی دانشجویان امروی ضروری است. بر این اساس پژوهش حاضر با هدف ارائه مدل پیش بینی امید بر اساس حمایت اجتماعی و معنای زندگی با میانجیگری عزت نفس در دانشجویان صورت پذیرفت.
روش هاروش پژوهش، توصیفی- همبستگی و تحلیل مسیر بود. جامعه آماری این پژوهش مشتمل بر کلیه دانشجویان دوره کارشناسی دانشگاه های غیردولتی شهر تهران بود که در سال تحصیلی 1399-1398 به تحصیل اشتغال داشتند. نمونه آماری شامل 480 دانشجو بود که با استفاده از روش نمونه گیری تصادفی خوشه ای انتخاب شدند. ابزارهای مورد استفاده شامل پرسشنامه حمایت اجتماعی (SSQ) (زیمت و همکاران، 1988)؛ پرسشنامه معنای زندگی (MLQ) (استگر و فرازیر، 2006)؛ پرسشنامه عزت نفس (SEQ) (روزنبرگ، 1979) و پرسشنامه امید (HQ) (سیمپسون، 1999) بود. تحلیل داده ها با استفاده از تحلیل مسیر با استفاده از نرم افزار SPSS و AMOS ویرایش 23 صورت گرفت.
یافته هانتایج نشان داد حمایت اجتماعی، معنای زندگی و عزت نفس با امید در دانشجویان همبستگی معنادار دارند (01/0>p). همچنین حمایت اجتماعی، معنای زندگی و عزت نفس بر امید دانشجویان دارای اثر مستقیم معنادار است (01/0>p). علاوه بر این نتایج بوت استراپ نشان داد که عزت نفس در رابطه حمایت اجتماعی و معنای زندگی با امید دانشجویان دارای نقش میانجی گری معنادار است (01/0>p). در نهایت مدل از برازش مناسب برخوردار بود.
نتیجه گیریبا توجه به نقش میانجی معنادار عزت نفس لازم است که درمانگران و مشاوران با بکارگیری آموزش های مناسب عزت نفس دانشجویان را بهبود بخشیده تا از این طریق امید را در نزد آنان نیز افزایش یابد.
کلید واژگان: امید, حمایت اجتماعی, معنای زندگی, عزت نفس}IntroductionIt is essential to pay attention to the emotional, psychological and social processes of students. according to this the present study was conducted to offer a model of predicting hope according to the social support and meaning in life with the mediation role of Self-esteem in the university students.
MethodsThe research method was descriptive-correlational and pathway analysis. The statistical population of the study included all undergraduate students at non-state universities in the city of Tehran in academic year 2019-20. The statistical sample included 480 students who were selected through clustered random sampling method. The applied questionnaires included Social Support Questionnaire (SSQ) (Zimet, et.al. 1988), Meaning in Life Questionnaire (MLQ) (Steger, Frazier, 2006); Self-esteem Questionnaire (SEQ) (Rosenberg, 1979) and Hope Questionnaire (HQ) (Sympson, 1999). The data analysis was conducted through pathway analysis via SPSS and AMOS version 23.
ResultsThe results showed that social support, meaning in life and Self-esteem have significant relationship with hope in the students (p<0.01). Moreover, social support, meaning in life and Self-esteem have significant direct effect on the students’ hope (p<0.01). Furthermore, Bootstrap results showed that the Self-esteem has significant medication role in the relationship between social support and meaning in life (p<0.01). Finally the model enjoyed a suitable fitness.
ConclusionConsidering the meaningful mediating role of self-esteem, it is necessary for therapists and counselors to improve the self-esteem of students by using appropriate training, so as to increase their hope.
Keywords: Hope, Social Support, Meaning In Life, Self-Esteem} -
مقدمه و هدف
عزت نفس به عنوان عامل پیش بینی کننده ی سلامت جسمی و روانی، تحت تاثیر عوامل اجتماعی است. افراد در دوران سالمندی روابط خود را به اعضای خانواده و دوستان محدود می کنند. بااین حال مشخص نیست که عزت نفس افراد در دوران سالمندی متاثر از کدام یک از اعضای شبکه ی اجتماعی است؛ لذا این مطالعه با هدف بررسی ارتباط حمایت اجتماعی درک شده با عزت نفس سالمندان ساکن منزل شهر خرم آباد در سال 1401 انجام شد.
روش کاردر این مطالعه ی توصیفی تحلیلی، تعداد 340 سالمند 60 سال و بالاتر شهر خرم آباد با روش نمونه گیری خوشه ای تصادفی بررسی شدند. داده های پژوهش با استفاده از فرم اطلاعات جمعیت شناختی، پرسش نامه ی وضعیت شناختی (ATM)، پرسش نامه ی حمایت اجتماعی درک شده ی زیمت (Zimet) و پرسش نامه ی عزت نفس روزنبرگ جمع آوری شد. برای تحلیل داده ها از آزمون های t مستقل، ANOVA، ضریب هم بستگی پیرسون و رگرسیون خطی و نرم افزار SPSS22 استفاده شد.
یافته هامیانگین و انحراف معیار سنی سالمندان برابر با 55/7± 51/69 بود. از نظر جنسیت، 175 نفر از آن ها (5/51 درصد) زن بودند. 235 نفر (1/69 درصد) متاهل بودند. نتایج مطالعه نشان داد که متغیر حمایت اجتماعی کل، حمایت اجتماعی خانواده و دوستان با عزت نفس رابطه ی مستقیم و معناداری دارد (001/0>P). همچنین، ارتباط معنی داری بین تحصیلات و عزت نفس وجود داشت (001/0>P).
نتیجه گیریحمایت اجتماعی درک شده، به خصوص از سوی خانواده و دوستان، نقش مهمی در احساس عزت نفس سالمندان و به خصوص سالمندان تنها دارد. توصیه می شود سالمندان و خانواده ها از روابط خانوادگی و دوستی های خود محافظت کنند و آن را توسعه دهند.
کلید واژگان: حمایت اجتماعی, حمایت خانواده, حمایت دوستان, عزتنفس, سالمندان}Introduction and purposeSelf-esteem as a predictor of physical and mental health is affected by social factors. People in old age limit their relationships with family members and friends; nonetheless, it is not clear which members of the social network affect the self-esteem of people in old age. Therefore, the present study aimed to assess the relationship between perceived social support and self-esteem of the elderly residents of Khorramabad in 2023.
MethodsIn this descriptive-analytical study, 340 older adults aged 60 years and older in Khorramabad were selected via random cluster sampling method. Research data were collected using demographic information form, abbreviated mental test score, Zimet perceived social support questionnaire, and Rosenberg self-esteem questionnaire. The data were analyzed in SPSS software (version 22) using independent t-tests, ANOVA, Pearson's correlation coefficient, and linear regression.
ResultsThe mean age score of participants was 69.51±7.55 years; 175 (51.5%) cases were female; and 235 (69.1%) subjects were married. The results of the study demonstrated that the variable of total social support, social support of family and friends, had a direct and significant relationship with self-esteem (P<0.001). In addition, there was a significant relationship between education and self-esteem (P<0.001).
ConclusionPerceived social support from family and friends plays a key role in older adults' self-esteem, especially the lonely ones. It is recommended that older adults and families protect and develop their family relationships and friendships to have better mental health.
Keywords: Elderly, Family Support, Friend Support, Self-Esteem, Social Support} -
Background and purpose
Students with learning disabilities face difficulties in social, emotional, and academic aspects. The main objective of this study is to examine how social support plays a role in the connection between psychological capital and mental well-being in these students.
Materials and methodsThe research used both correlational and cross-sectional methods in addition to structural equation modeling (SEM). The statistical population for the study comprised all students with learning disabilities residing in Tehran from July to November 2023. A sample of 250 adolescent students with a history of learning disabilities was selected using a multi-stage cluster and targeted sampling method. The research utilized measurement tools such as the Multidimensional Scale of Perceived Social Support (MSPSS), Subjective Well-being Scales (SWS), and Luthans Psychological Capital Questionnaires (PCQ). Descriptive statistics were conducted using SPSS version 27 software, while path coefficients between variables were analyzed using SmartPLS version 4 software. The significance of the mediator variable was assessed using Sobel's test.
ResultsThe present study found that Self-Efficacy positively influenced Mental well-being through the Social Support variable, with a significant effect (β=0.241, P=0.000). Hope had a beneficial effect on mental wellness through social support, with a substantial positive impact (β=0.091, P=0.017). "Nonetheless, there was no notable impact of Optimism on mental health when considering the Social support factor (β=-0.014, P=0.750)."
ConclusionThe results of this study show that hope and self-efficacy, two psychological assets, improve both mental well-being and social support. However, optimism only boosts well-being, while resilience only improves social support.
Keywords: Social Support, Psychological Capital, Mental Well-Being, Learning Disabilities} -
زمینه و هدف
بنظر می رسد مراقبت های پرستاری از دست رفته توسط عواملی مانند حمایت اجتماعی کنترل می شوند. مطالعه حاضر با هدف تعیین ارتباط حمایت اجتماعی درک شده و مراقبت های پرستاری از دست رفته در پرستاران انجام شده است.
روش کاردر این پژوهش توصیفی همبستگی، تعداد 156 پرستار شاغل در مراکز آموزشی- درمانی شهر همدان به روش نمونه گیری تصادفی طبقاتی انتخاب شدند. ابزار گردآوری داده ها شامل چک لیست مشخصات دموگرافیک، مقیاس حمایت اجتماعی ادراک شده زیمت و همکاران و پرسشنامه مراقبت های پرستاری از دست رفته کالیش و ویلیامز بود. تجزیه و تحلیل داده ها در نرم افزار SPSS-24 و با آمار توصیفی و آزمونهای ضریب همبستگی اسپیرمن، من- ویتنی و کروسکال- والیس انجام شد.
یافته هانتایج مطالعه نشان داد که بیشتر پرستاران شرکت کننده در مطالعه زن (53/8%) و دارای مدرک کارشناسی (82/7%)، بودند. میانگین نمرات حمایت اجتماعی درک شده و مراقبت های پرستاری از دست رفته، به ترتیب برابر با 5/74 ±45/35 و 6/92 ±32/46 بود. بین حمایت اجتماعی درک شده و مراقبت پرستاری از دست رفته، ارتباط منفی و معنی دار آماری وجود داشت (0/001 >p، 0/329- =r).
نتیجه گیریبا توجه به وجود ارتباط منفی بین حمایت اجتماعی درک شده و مراقبت های پرستاری از دست رفته، پیشنهاد میشود مدیران ذیربط، در جهت افزایش میزان حمایت های اجتماعی از پرستاران بکوشند تا بدین ترتیب به کاهش میزان مراقبت های پرستاری از دست رفته و نهایتا بهبود کیفیت خدمات پرستاری ارائه شده به مددجویان، کمک نمایند.
کلید واژگان: حمایت اجتماعی درک شده, مراقبت های پرستاری از دست رفته, پرستاران}BackgroundMissed nursing care seems to be controlled by factors such as social support. The present study was conducted with the aim of determining the relationship between perceived social supports and missed nursing care in working nurses.
MethodsIn this descriptive correlational study, 156 nurses working in teaching hospitals of Hamedan city were selected by randomized stratified sampling method. The data collection tools included: Checklist of demographic characteristics, Perceived Social Support Scale by Zimmet et al., and Missed Nursing Care Questionnaire by Kalish and Williams. Data analysis was done in SPSS 24 software with descriptive statistics and Pearson, Mann-Whitney and Kruskal-wallis correlation coefficients. Also, the significance level of the tests was less than 0.05.
ResultsThe results of study showed that 53.8% of the nurses were female and 82.7% have bachelor's degree, and the scores of perceived social support and missed nursing care were 45.35±5.74 and 6.92±46.32, respectively. Also, there is a negative and statistically significant relationship between these two variables (p<0.001, r= -0.329).
ConclusionConsidering the negative relationship between social support and missed nursing care, it is therefore suggested that managers increase the social support of nurses to reduce missed nursing care and improve the quality of nursing services.
Keywords: Social Support, Missed Nursing Care, Nurses} -
Background
Social support has been considered one of the factors that facilitate health behaviors, and there is some evidence related to the subordination of the treatment of hemophilia patients according to various factors. Therefore, the present study was conducted with the aim of determining the measure of social support and its relevance to the clinical and demographic characteristics of patients going to the hemophilia center.
MethodsThis cross-sectional study was conducted at Sanandaj Hemophilia Center in Sanandaj, Kurdistan, Iran, in 1402. A total of 120 patients were voluntarily selected as samples based on inclusion criteria. The data collection tool included the registration form of demographic and clinical characteristics and the Social Support Questionnaire of Vaux et al. To analyze the data of the study, independent t-student statistical tests and unilateral analysis of variance in STATA software version 12 were used.
ResultsIn this study, the dimensions of social support were examined: Family support, support from others, and support from friends. Family support, with an average of 4.36 out of 5, was considered the highest value, compared to other dimensions.
ConclusionsBased on the results of this study, the average social support of hemophilia patients was appropriate. In the case of increasing the social support of hemophilia patients through creating job opportunities, increasing income, access to urban treatment facilities and services, material and moral coverage of organizations, and social support, the improvement of the health level of hemophilia patients can be expected.
Keywords: Hemophilia, Social Support, Clinical Characteristics, Demographic Characteristics} -
Introduction
Elderly people usually feel lonely that can have adverse health effects. The purpose of current paper is to determine the loneliness score in the elderly population of the Ardakan Cohort and the factors affecting it.
MethodsThis is a cross sectional study using data from the Ardakan Cohort Study on Ageing (ACSA). Loneliness was measured using a 6-item De Jong Gierveld short scales. The 11-item Duke Social Support Index (DSSI) was used to measures social support of aging. living arrangement, demographic factors and self-rated health was also collected using a checklist. Linear regression was used to examine the relationship between loneliness and predictor factors. The data was analyzed with Stata software version 17 and a p-value of 0.05 was considered as a significant level.
ResultsAmong the 5,188 participants, 48.13% were male and most of the participants were over 60 years old. Total score of loneliness was 3.27±1.45(95% CI: 3.24 to 3.31). Among covariates, age (p value=0.000), sex (p value=0.000), marital status (p value=0.046), education (p value=0.001) and economic status (p value=0.001) have significant association with loneliness score. People with good self-rated health had a lower loneliness score (p value<0.001). The score of social support has an inverse association with the score of loneliness (p value<0.001). Adults who lived with others had a higher loneliness score (p value<0.001).
ConclusionAccording to the results, elderly people who have more social support and have better self-rated health feel less lonely.
Keywords: Loneliness, Older Adults, Social Support, Self-Rated Health, Ardakan Cohort Study Onaging (ACSA), Living Arrangement} -
Background & aim
With the growing elderly population, addressing the personal and social aspects of menopausal women is vital. Paying attention to their quality of life and solving their physical, mental and social problems can be effective in improving the health of the family and ultimately the society. This study aimed to determine the relationship between social support and quality of life in postmenopausal women.
MethodsThe present study was a cross-sectional study that was conducted on 158 women. Sampling was stratified with proportional allocation method between February 2019 and August 2019 in Mahshahr health centers. The data collection tools were the demographic profile questionnaire, the Menopause Quality of Life (MENQOL) and the Phillips Social Support Questionnaire. The data were analyzed using SPSS statistical software (version 24). Pearson's, ANOVA, linear regression tests were used to analyse data.
ResultsThe average score of social support and quality of life was 84.13±10.99 (range 34-112) and 58.30±30.69 (range 110-49), respectively. There was a significant correlation between the quality of life and social support (P=0.0001). In terms of quality of life dimensions, a significant relationship was observed between social support with psychosocial (P=0.001) and physical dimension (P=0.003).
ConclusionAccording to the significant relationship between social support and quality of life, it seems that providing social support by the family and surrounding people can be effective in improving the quality of life of postmenopausal women.
Keywords: Quality of life, Social Support, health, Menopause} -
Background
Well-being is related to various social, psychological, and physical factors. This study investigated these factors and their relationship with the well-being of the elderly.
MethodsThis cross-sectional study was conducted based on the data of Ardakan Cohort Study on Aging (ACSA) in 2020, including 5190 people aged 50 and above. The World Health Organization (WHO)-5 questionnaire was used to measure wellbeing. Using a logistic regression model and adjusting the variables, the relationship between well-being and related factors was measured.
ResultsAmong the participants, 2586 people (49.8%) were women. Well-being was good in 3014 people (58.2%). According to the findings, the poor well-being of the elderly has an inverse and significant relationship with medium to high economic status (OR = 0.63, P ˂ 0.001), physical activity (OR = 0.99, P ˂ 0.001), and social support (OR = 0.90, P ˂ 0.001). The elderly with high school education (OR = 1.43, P = 0.005) and extremely bad health status (OR = 1.32, P = 0.008) had poor well-being. Furthermore, the odds of depression (OR = 1.21, P = 0.035) and anxiety (OR = 1.05, P ˂ 0.001) were higher in the elderly who had poor well-being. The mental and physical quality of life were also higher in the group with good well-being (P < 0.05).
ConclusionTo promote the elderly’s well-being, they should be involved in regular physical activity, which should be planned to increase their quality of life (physical and mental) and improve their economic status as well as social support.
Keywords: Wellbeing, Elderly, Depression, Social support, Economics} -
Background
Patients with Multiple Sclerosis (MS) often experience varying levels of social stigma, which can impact their health.
ObjectivesThis study aimed to explore the relationship between perceived stigma and coping strategies among MS patients.
MethodsConducted from December 2019 to June 2020, this cross-sectional and correlational study involved 100 MS patients. Participants were recruited from a neurologic clinic in Qazvin, Iran, using convenience sampling. Data collection employed the Lazarus Coping Strategies Questionnaire and the Korean version of the Stigma Scale for Chronic Illness 8-item (SSCI-8). Patients completed these questionnaires at the clinic. Data analysis utilized Pearson’s and Spearman’s correlation coefficients.
ResultsThe average age of participants was 35.93 ± 7.20 years. Mean scores for internal and external stigmas were 6.47 ± 2.03 and 8.73 ± 3.48, respectively. Problem-focused strategies were most commonly used by MS patients. Pearson correlations revealed a significant positive relationship between internal stigma and escape-avoidance (r = 0.391, P < 0.000), seeking social support (r = 0.215, P = 0.031), confronting (r = 0.240, P = 0.016), and self-controlling strategies (r = 0.222, P = 0.026). Significant associations were also noted between external stigma and escape avoidance (r = 0.322, P = 0.001) and confronting strategies (r = 0.240, P = 0.016). Inverse correlations were found between educational level and internal stigma (r = -0.273, P = 0.006) and between MS duration and external stigma (r = -0.296, P = 0.003).
ConclusionsMultiple sclerosis (MS) patients experiencing higher levels of stigma tended to use more negative coping strategies. Implementing programs to reduce stigma and promote effective coping strategies may enhance the physical and psychological well-being of these patients.
Keywords: Social Stigma, Coping Strategies, Multiple Sclerosis, Social Support}
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