Social Support Group for People with Diabetes - Research Paper Example

?Introduction In nursing, middle range theories are bodies of knowledge used to support the nursing practice, which are testable and as such, containa limited number of variables and are thus also limited in terms of their scope (Peterson & Bredow, 2008). However, its mere nature of generality makes it useful enough to be used in a number of different clinical research questions that involve the nursing practice. Because of its nature, middle range theories are often found in a number of researches and studies aimed at providing additional information regarding the nursing profession. One such theory is the Theory of Social Support, which looks into the individual’s “needs for intimacy, social integration, nurturing of others, reassurance of personal worth, steady source of alliance, and guidance” (Weiss, 1974 in Sieloff, Frey, & King, 2007). The role of social support in the health care profession is well accepted and has been shown to provide a certain degree of assistance in terms of alleviation of a number of illnesses and diseases (Sieloff, Frey, & King, 2007). However, there are also still a number of pathological fields that have yet to explore the efficacy of social support in terms of alleviations of symptoms and general recovery. Along these lines, this paper explores the hypothesis, “A social support group for people with diabetes will increase their medication compliance,” within the boundaries of relevant concepts, particularly social support. A total of eight articles are reviewed in this paper, offering insights on the population and sample, background literature, and significance of earlier studies made in support of the mid-range theory of social support. Some of these articles cover the theory of social support and its perceived effects on people with diabetes, while others focus on a more general application of the theory on other diseases and medical conditions. The conceptual definitions of social support in nursing researches are largely the same, varying only in terms of the degree of intimacy that researchers agree upon. Operational definitions of social support, however, differ depending on the focus and the extent of the study. Different populations were used in the studies investigating the effects of the existence of a social support group. Since the particular hypothesis herein focuses on people with diabetes, the population utilized for a majority of the researches included in this review involves diabetic patients Social support: Review of Related Literature In a study by Patterson and Brewer (2009), social support was defined as “the informational, instrumental / practical, emotional, and affirmational resources that people can receive from others” (p. 178). Operationally, social support was measured in terms of the amount of “information, aid, strategy, or resource that helps the parent to cope with the stressors and challenges associated with parenting an adolescent with diabetes” (p. 179). In this study, the population considered were parents of children with diabetes and the sample consisted of nine parents (six mothers and 3 fathers) of children with Type 1 diabetes. The study explicitly mentions reference to theories of support (p. 179) and it supports the existing theory by showing that parents are necessary social support for adolescents with diabetes. In the second study reviewed, Goz, et al (2005) defined social support as “the assistance and protection given to others, especially to individuals.” Presence of social support was measured in terms of the presence of family, including parents, spouse, offspring, siblings and grandparents; friends; and, a significant other, in the form of boy/girlfriend, relative, neighbor, and doctor using a pre-piloted survey questionnaire delivered to the participants (Goz, et al, 2005). The population for the study consisted of patients with Type 2 diabetes while sample group consisted of “66 type 2 diabetes patients being followed up in the Diabetes Polyclinic of Kocaeli State Hospital in the Marmara region of Turkey who visited the polyclinic in May and June 2003” (Goz, et al, 2005, p. 1354). Although there is not explicit mention of a theoretical framework in the study, it does promote the theory of social support because analysis of its results indicated that a social support group, particularly the presence of health care providers including nurses, improves the quality of life of participants (Goz, et al, 2005). For the study by Rees, Karter, and Young (2010), social support was the available presence of other people in one’s life and was measured by the presence of “someone to to talk over problems or help make a difficult decision,” “anyone to help pay bills, housing costs, hospital visits, or provide food or clothes,” and “marital status, number of close friends, and number of times church was attended in the last year” (p.437). The population of the study included individuals with physician diagnosed diabetes. The research sample consisted of those who answered the social support questionnaire presented by the researchers, belonging to the White, Black, and Latino races. The study does not explicitly mention the social support theory, but nonetheless supports the theory, further specifying the effect of race in the influence that social support extends on diabetic patients. The fourth study, which is by Barrera, et al (2002) takes social support to a new dimension and focuses on an internet-based social support group system. In their study, social support was measured using selected items from Cohen and Hoberman’s (1983) ISEL measure of general social support, but modified the items to fit the internet-based environment (Barrera, et al, 2002). Their research population consisted of 40 to 75 year old members of the local area with Type 2 (noninsulin dependent) diabetes for one year. Out of this population, they gathered a sample of 75 men and 85 women (Barrera, et al, 2002). There was a brief reference to the theory in the study (Barrera, et al, 2002, p. 639) but no elaboration was made. As with other researches earlier mentioned in this paper, the study demonstrated that even an internet-based social support system greatly improved their perceptions regarding social support (Barrera, et al, 2002). The fifth study again focuses on the social support group provided for an adolescent diabetes patient and his or her caregiver. Social support was defined by Idalski, et al (2011) as the assistance provided by the people from one’s immediate environment. They measured social support through a questionnaire that contained items exploring the available “support for the adolescent (coming) from family… and friends, and support for the caregiver from another adult, and support to the family from the health care provider” (Idalski, et al, 2011, p. 582). The population of the study’s concern consisted of with insulin-managed diabetes and their primary caregivers (the group included nurses and other health care providers), and the study’s sample consisted of 141 participants from this group. The study failed to refer to the middle range theory of social support but emphasized that primary caregivers are an important source of social support for adolescent diabetic patients (Idalski, et al, 2011). Significance of the Study Because of the extent of researches concerned with the positive effects of a social support group to diabetic patients, a research study examining the given hypothesis would be able to shed light on a number of other factors that involve a social support group, especially the types and media by which this support is offered. Moreover, such a study would greatly aid social health workers and other medical professionals in determining a suitable social environment for people with diabetes. Furthermore, such a study would allow diabetic patients to know how appropriately they should manage their lifestyle and accommodate the presence of a social support group in order to provide themselves a better quality of life. Perhaps owing to the abundance of studies establishing the benefits of social support to medical compliance, a look on studies that qualify these alleged benefits is in order. This is the aim of the longitudinal study by Skinner, John, and Hampson (2000), which focused on how well social support predicted self-care and well being. Again, the definition of social support was assumed in this study as it was not exactly conceptualized in the study. However, it was mentioned that social support was measured using four questionnaires, each focusing on a different type of social support (Perceived Social Support from Family, Perceived Social Support from Friends, Diabetes Family Behavior Checklist, and the Diabetes Inventory of Peer Support). The members of the population of this study were outpatient from four regional hospitals in the south of England. Members of the sample group were made up of patients who were 12-18 years old, had a diagnosis of IDDM of at least 9 months, and were able to complete the questionnaire without any external help (Skinner, John, & Hampson, 2000). The study strictly considered testing the repercussions of social support theory as it aimed to investigate the established concept of peer support and illness representation as being mediators in linking between family support, self-management and well-being. Ultimately, the study confirmed earlier hypothesis which established the importance of friends and family in supporting adolescents living with and managing their diabetes. In considering the effects of a social support group in helping people with diabetes, it is also of the literature’s interest to find out whether one form of social support is more beneficial than another. Such was the thrust of Helsler, et al (2010) as they compared effects of two social support groups in the form of peers and nurse care management. There was no reference to existing middle range theories in the study but there was a mention of investigating different peer support group models. The population members of the study were made up of old-aged males as the sample came from 244 men from two US Department of Veterans Affairs health care facilities. These men exhibited hemoglobin A1c (HbA1c) levels greater than 7.5% during the previous 6 months (Heisler, et al, 2010). Conclusions from the study indicate that reciprocal peer support provides promising effects as a method for diabetes care management if it supplements periodic nurse-facilitated, patient-driven group sessions (Heisler, et al, 2010). As a final piece of literature for review, this paper looks into a meta-analysis research. It is supposed that in conducting a review of the literature for a given research study focus, a review of a review of earlier studies provide an encapsulated insight on the status of previous research. An appropriate research that may accomplish this is the one conducted by Di Matteo (2004) on the social support and patient adherence to medical treatment. No definition for social support was provided although the paper mentions that it focused on the following elements of structural or functional social support: “practical support, emotional support, unidimensional social support (combining all types into a single measure), family cohesiveness, family conflict/dysfunction, marital status, and living arrangement (alone or with others)” (Di Matteo, 2004, p. 208). The meta-analysis considered 122 researches found in medical and psychological literature that are peer-reviewed and in the English language, which correlated adherence with social support. As indicated by this meta-analysis, while few researches were grounded in social support theory, each of the 122 researches identifies an existing correlation of improvement in the patient’s quality of life through adherence to medical prescriptions as a result of social support. Thus, this meta-analysis serves as the “icing to the cake” of the abundant benefits offered by social support to patients, particularly those with diabetes. Conclusion The review of the researches above show strong support for the hypothesis that: A social support group for people with diabetes will increase their medication compliance. The above-mentioned researches strongly suggest that a social support group is vital in the continuing wellness of the quality of life of people with diabetes because it allows them to manage their condition and adjust to the many challenges that their condition’s symptoms provide. Thus, people with diabetes must be provided with a social support group for the benefit of their good health. References Barrera, M., Glasgow, R., McKay, G., Boles, S., & Feil, E. (2002). Do internet-based support interventions change perceptions of social support?: An experimental trial of approaches for supporting diabetes self-management. American Journal of Community Psychology , 30, 637-656. Di Matteo, M. R. (2004). Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology , 23, 207-218. Goz, E., Karaoz, S., Goz, M., Ekiz, S., & Cetin, I. (2005). Effects of the diabetic patients' perceived social support on their quality of life. Journal of Clinical Nursing , 16, 1353 - 1360. Heisler, M., Vijan, S., Makki, F., & Piette, J. (2010). Diabetes control with reciprocal peer support versus nurse care management: A randomized trial. Annals of Internal Medicine , 153, 507-515. Idalski, C., Ellis, D., Weisz, A., & Naar-King, S. (2011). Social support for diabetes illness management: Supporting adolescents and caregivers. Journal of Developmental Behavior in Pediatrics , 32, 581-590. Patterson, B., & Brewer, J. (2009). Needs for social support among parents of adolescents with diabetes. Journal of Nursing and Healthcare of Chronic Illness , 1, 177-185. Peterson, S., & Bredow, T. (2008). Middle range theories: Application to nursing research. Lippincott Williams & Wilkins. Sieloff, C., Frey, M., & King, I. (2007). Middle range theory development using King's conceptual system. Springer Publishing Company. Skinner, T. C., John, M., & Hampson, S. (2000). Social support and personal models of diabetes as predictors of self-care and well-Being: A longitudinal study of adolescents with diabetes. Journal of Pediatric Psyhology , 25, 257-267. Read More