Port Said Scientific Journal of Nursing
Vol.4, No. 1, June 2017
Relationship between Social Support and the Quality of Life
Among Psychiatric Patients
1
Amal Sobhy Mahmoud; 2Abeer Elsayed Berma; 3Samar Atiya Abo Saleh Gabal
1
Assistant Professor of Psychiatric Nursing and Mental Health, 2Lecturer of
Psychiatric Nursing and Mental Health, 3Clinical Instructor of Psychiatric Nursing
and Mental Health, Faculty of Nursing, Port Said University
ABSTRACT
Background: Mental health disorders are medical conditions that influence
individuals‘ daily functioning, ability to maintain social relationships, and decrease
their quality of life (QOL). Social support is meaningful because it is essential for
mental health as well as enhancing psychiatric patients‘ QOL. Aim This study was to
assess the relationship between social support and QOL among psychiatric patients.
Subjects and Method A descriptive correlational research design is utilized for the
current study. The study subjects are a convenience sample of 115 patients from five
psychiatric inpatient units and one outpatient clinic of Port-Said Mental Health
Hospital. Three structured interview schedules were utilized to collect the necessary
data: Tool I: WHO Quality of Life Scale Bref version, Tool II: The Multidimensional
Scale of Perceived Social Support, in addition to a socio demographic and clinical data
questionnaire. Results The study revealed that more than half of the psychiatric
patients reported low QOL and two thirds of them reported low social support. In
addition, there was a statistically significant positive correlation between social
support and QOL. It was observed that disease onset, onset of treatment, and previous
hospitalization significantly affect the social support level. But, the age, income,
employment status, diagnosis, and disease onset significantly affects the QOL.
Conclusion and Recommendation It can be concluded that most of psychiatric
patients have low social support and QOL. In addition, there is a relation between
social support and QOL. Therefore, social support should be an essential part of
psychiatric treatment because of its important role in enhancing patients‘ QOL. The
study recommended increasing the awareness of the mental health team about the
importance of dealing holistically with psychiatric patients as considering his/her
physical, psychological, social, and environmental aspects.
Keywords: psychiatric illness, Quality of Life and Social support.
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INTRODUCTION
Mental illness can have devastating effects on the individual and his/her family.
Mentally ill patients can experience loss of support from family, friends or partners,
resulting in small or restricted social support resources predominately consist of
family members or mental health professionals. Small social support networks have
been associated with isolation and depression. It also threats psychological and
emotional well-being, quality of life (QOL), and increases the likelihood of psychiatric
re-hospitalization. Individuals living with mental illness experience functional
impairments in daily living skills and social skills. These impairments can negatively
affect social opportunities (Pernice-Duca, 2005).
Human beings are social by nature and rely on each other not only for survival but also
for intimacy, support, knowledge, understanding and guidance. The longing for
interpersonal intimacy stays with every human being from infancy throughout life.
Most human life in a matrix of relationships that define their identity (I am a daughter,
wife, mother, student, etc.) and their personality (I am extroverted, friendly, and kind)
(Osman, 2014).
Social support is a term that does not have a widely agreed-upon definition in the
development literature because it is a multidimensionality construct (Hernandez,
2012). Social support is generally defined as a range of interpersonal relationships or
connections that have an impact on the individual‘s functioning (Barker, 2007).
Another definition of social support is ―individuals‘ perceptions of general support or
specific supportive behaviors (available or enacted) from people in their social
network, which enhances their functioning and buffer them from adverse outcomes of
stress‖ (Malecki and Demaray, 2002).
Positive social relationships may be associated with happiness and well-being.
Inclusion in a social network may provide a source of generalized positive affect and
this positive psychological state may contribute to overall health and leads to better
QOL (Pasmeny, 2009). Quality Of Life is defined as ―a measure of individuals‘ ability
to function physically, emotionally and socially within their environment at a level
consistent with their own expectations‖ (Barcaccia, Esposito, Matarese, Bertolaso,
Elvira, and De Marinis, 2013).
Patients with severe mental illness experience a lower QOL than general population.
They have high unemployment rates, live in substandard housing or are homeless, and
have few social supports (Evans, Banerjee, Leese, and Huxley, 2007). QOL is a
person‘s sense of well-being, health status and satisfaction with life circumstances,
including access to resources and opportunities (Medici, Vestergaard, Hjorth,
Hansen, Shanmuganathan, Viuff, and Jørgensen, 2016).
Significance of this study:
Mentally ill patients found difficulty in social support and QOL. So, one of the
psychiatric nursing objectives is to improve psychiatric patients‘ QOL through
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enhancing social support provided to the patient. In order to do this the nurse should
first assess patients‘ QOL and social support, identify the problems within social
support and spheres of physical, psychological, social and environmental aspects to
assist the patient in achieving their maximum possible functions as well as expanding
their social relationships.
AIM OF STUDY:
The aim of this study is to assess the relationship between social support and quality of
life among psychiatric patients.
Objectives of the present study to:
1. Assess social support of psychiatric patients in Port Said Psychiatric Health
Hospital.
2. Assess quality of life of psychiatric patients in Port Said Psychiatric Health
Hospital.
3. Identify factors affecting QOL for these patients.
4. Find the relationship between social support and quality of life.
SUBJECTS AND METHOD:
Research design
A descriptive correlational research design was followed in this study.
Study setting
The present study was carried out at Port Said Psychiatric Health Hospital that
affiliated to the Ministry of Health. The hospital is composed of eight departments:
five inpatient psychiatric units ( three units for male patients and two units for female
patients). One ward for drug dependents, one outpatient clinic, and one child unit.
Study subjects
The total sample size amounted to 118 patients. While 115 psychotic patients
attending the psychiatric outpatient clinic and five inpatient units in the previously
mentioned hospital were collected by, a convenience sample and three patients
dropped out during data collection.
Sample size
To achieve the study objective, the sample size is determined by using the following
equation. The sample size is determined by using the following equation (Naing,
2003):
Sample size (n) = (z /∆) ² p (1 –p).
Where:
P: The prevalence of conventional of (The impact of social support on the quality of
life among psychiatric patients) = 8 % (Yasien, Alvi, Moghal, 2013).
Zα/2: a percentile of standard normal distribution determined by confidence level =
1.96
∆: The width of confidence interval = 5%
(Sample Size (n) = 113 patients)
The sample size is 113 patients, due to the expected drop out rate (5%); the final
sample size is =118 patients.
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Tools of data collection:
Tool I: WHO Quality of Life Scale (Bref version) (WHOQOL – Bref)
The WHOQOL – Bref developed by World Health Organization (1998) and
translated into Arabic by Ahmed (2008). The scale has 26-items that measure the
following broad domains: physical domain (7 items), psychological domain (6 items),
social relationships domain (3 items), and environmental domain (8 items), general
health and overall QOL (2 items). The 26 items have only three negative questions and
the remaining 23 questions are positive questions. The score ranges of 1(Not at all), 2
(Not much), 3 (Moderately), 4 (Mostly), and 5 (Completely). A critical value (i.e.
60%) is indicated as the optimal cut-off point for assessing QOL. The patient‘s QOL
was considered high if the percentage was 60% or more and low if less than 60%
(Silva, Soares, Santos, and Silva, 2014).
Tool II: The Multidimensional Scale of Perceived Social Support (MSPSS)
This questionnaire was developed by Zimet, Dahlem, Zimet, and Farley (1988), and
translated by Abou Hashem (2010). It is a 12-item instrument designed to assess
perceptions of social support from three specific sources: family, friends and
significant other. The scale is rated on a 5 – likert scale with a range from strongly
disagree = 1, to strongly agree = 5. A critical value 60% is indicated as the optimal
cut-off point for assessing perceived social support. The patient‘s social support was
considered high if the percentage was 60% or more and low if less than 60%.
In addition, socio-demographic and clinical characteristic questionnaire, this was
developed by the researcher after review of literature. It included socio demographic
data such as patient‘s age, gender, marital status, educational level, current
employment status, family income, number of family members. As regarding clinical
characteristics, these included outpatient clinic or inpatient units, clinical diagnosis,
onset of disease, duration of illness.
Pilot study:
Before entering the actual study, a pilot study was carried out on 10 % of the total
sample of the hospitalized mentally ill patients and was conducted from 1/1/2015 to
4/2/2015. They were excluded from the entire sample of research work. The pilot
study was done to ascertain clarity, feasibility, and applicability of the study tools, to
estimate the proper time required for answering the questionnaire, and to identify
obstacles that may be faced during data collection.
Method of data collection:
- The 115 patients were selected from the previous setting according to the previous
criteria. (115 patients complete the interview and three of them refuse to complete
after completing the half of the sheets).
- The tools were filled by the researcher using the interview method on an individual
basis.
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- Each interview lasted about 60 to 90 minutes according to the patient‘s attention,
concentration, and willing to cooperate or talk.
- A number of 2-5 patients were interviewed per day.
- Patients‘ clinical data were checked from their medical charts to be implemented in
the tools.
- Data were collected over a period of six months starting from first of June and
ending December 2015 (Two days per week (Saturday and Tuesday) from 9 a.m. to
2 p.m.).
Administrative design:
Before the study carried out, an official letter was addressed from the Dean of the
Faculty of Nursing to the Director of the identified study setting, requesting his
cooperation and permission to conduct the study after explaining the aim of the
study.
Ethical Considerations:
A written consent was taken from patients and delivered to the hospital, after
explaining the purpose and the importance of the research study. Patients assured
about the confidentiality of the information gathered and that it will be used only for
the purpose of the study.
Statistical Design:
Data were collected, organized, tabulated and statistically analyzed with SPSS 18.0
software computer statistical. Data were presented using descriptive statistics in the
form of frequencies and percentages for qualitative variables, means and standard
deviations for quantitative variables. Qualitative categorical variables were compared
using chi-square test. In larger than 2x2 cross-tables, no test could be applied
whenever the expected value in 10% or more of the cells was less than 5. Person
correlation analysis was used for assessment of the inter-relationships among
quantities variables. Statistical significance was considered at P-value <0.05.
RESULTS:
Table (1): reveals that patients‘ age ranges between 20 and 65 years old with a mean
age ± SD of 34.1±12.0 years; the age of more than half of them (i.e.53.9%) ranges
between 20 and 35 years old; 61.7% were males; and 59.1% of them were single;
and40% of them have secondary education, whereas, only 14.0% of patients are
illiterate. More than three quarters (87.8%) of the studied patients were unemployed.
Whereas, 80% of them were employed as a manual worker, compared to 20.0% were
employees, 55.7% have enough income, and only 4.3% of them living alone.
Table (2): presents that about two thirds of studied patients (65.2%) admitted to
inpatient ward, 62.7% of them admitted to free departments, more than half of them are
schizophrenic (56.5%), while 25.2% have bipolar disorders. The studied patients have a
mean disease onset 6.2 + 5.3 years and about 53.0% have been ill for one year. Only 20%
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of the studied patients had no previous history of hospitalization, while the majority of
them (80.0%) were previously hospitalized.
Table (3): illustrates that the majority of the studied patients (80.9%) have a low score
in social domain, almost two thirds of them (67.8%) have also a low score of
environmental domain, and 67.0 % of them had also a low score of psychological
domain. But, 40.9% of them had high score toward physical domain. Three quarters of
the studied patients (75.7%) had a low QOL, with a mean of 47.3±18.5. The studied
patients perceive highly social support from significant others, followed by from
family (60% and 51.3% respectively), while, most of studied patients perceived a low
social support from friends (73%). More than half of patients (60%) have a low social
support, with a mean of 52.1±23.8.
Table (4): shows statistically significant positive correlations between total of QOL in
relation to social support from significant others, from family and from friends (r=0.741,
0.643, and 0.568). In addition, there is positive correlation between total score of QOL and
total score of social support (r=0.743).
Table (5): illustrates that high social support level is statistically significant among
patients in inpatient department as P<0.0001,while, low social support level was
statistically significant among patients who had disease from one year to less than five
years P=0.018. Furthermore, high social support level was statistically significant
among patients who started treatment from one year to less than five years and have
previous hospitalization as MCP<0.0001.
Table (6): illustrates that 59.5% of schizophrenic patients have the lowest level of quality
of life compared to other patients. Moreover low level of QOL was statistically significant
among schizophrenic patients as MCP=0004.
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Table (1): Socio-demographic characteristics of the studied patients.
Socio-demographic Characteristics
Gender
Male
Female
Age (years)
20-<35
35-<50
50-65
Min-Max,
Mean ±SD
Marital Status
Single
Married
Divorced/ Widow
Educational Level
Illiterate/ Read and write
Basic education
Secondary education
University education or higher
Current Employment Status
Employed
Unemployed
Type of Current Work (n=14)
Manual worker*
Employee*
Family Income/Month
Enough
Not enough
Number of Family Members
1-3
4-6
7 or more
Min-Max,
Mean ±SD
* Employee (Teacher, social worker, administrative)
* Manual worker (Electrician, driver, machinist)
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Studied patients (n=115)
No.
%
71
44
61.7
38.3
62
35
18
20-60
53.9
30.4
15.7
34.1±12.0
68
25
22
59.1
21.8
19.1
16
39
46
14
14.0
33.9
40.0
12.1
14
101
12.2
87.8
10
4
80
20
64
51
55.7
44.3
53
54
8
1-10
46
47.0
7.0
3.7±1.7
Port Said Scientific Journal of Nursing
Vol.4, No. 1, June 2017
Table (2): Clinical characteristics of the studied psychiatric patients.
Clinical Characteristics
Department
Outpatient clinic
Inpatient
Diagnosis
Schizophrenia
Bipolar disorder
Depression
Drug induced psychosis
Schizoaffective disorder
Disease Onset (years)
1-<5
5-<10
10-<15
15-20
Min-Max,
Mean ±SD
Onset of Treatment (years)
Not started treatment yet
1-<5
5-<10
10-<15
15-20
Min-Max,
Mean ±SD
Pervious Hospitalization
Yes
No
189
Studied patients
(n=115)
No.
%
40
75
34.8
65.2
65
29
8
9
4
56.5
25.2
7.0
7.8
3.5
61
23
18
13
1-20
53.0
20.0
15.7
11.3
6.2±5.3
18
54
15
16
12
0-20
15.7
47.0
13.0
13.9
10.4
5.4±5.5
92
23
80
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Vol.4, No. 1, June 2017
Table (3): Total quality of life and social support among the studied patients.
Item
Quality of life
Physical domain
Psychological domain
Social
relationship
domain
Environmental domain
Total quality of life
Perceived
Social
Support
Social support from
significant others
Social support from
family
Social support from
friends
Total Social Support
Score (%)
Low (<60%)
High (60%≤)
No.
%
No.
%
Min-Max
Mean ± SD
10.7-96.4
4.2-100.0
0.0-100.0
53.3±16.6
48.9±20.1
36.2±25.2
68
77
93
59.1
67.0
80.9
47
38
22
40.9
33.0
19.1
0.0-93.8
3.7-87.1
50.7±19.1
47.3±18.5
78
87
67.8
75.7
37
28
32.2
24.3
20.0-100.0
61.0±28.3
46
40.0
69
60.0
20.0-100.0
55.7±26.5
56
48.7
59
51.3
20.0-100.0
39.6±26.5
84
73.0
31
27.0
20.0-100.0
52.1±23.8
69
60.0
46
40.0
Table (4): Correlation between total quality of life and social support level among the
studied patients.
Total quality of life
Social Support Subcomponents
r
P
Social support from significant other
0.741
<0.0001*
Social support from family
0.643
<0.0001*
Social support from friends
0.568
<0.0001*
Total Score
0.743
<0.0001*
r: Pearson correlation coefficient
*significant at P≤0.05
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Table (5): Relation between social support level and clinical characteristics of the studied
patients (n =115).
Social Support Level
Low (<60%)
High (60%≤)
[n=69]
[n=46]
No.
%
No.
%
Clinical Characteristics
Department
Outpatient clinic
Inpatient department
Diagnosis
Schizophrenia
Bipolar disorder
Depression
Drug induced psychosis
Schizoaffective disorder
Disease Onset (years)
1-<5
5-<10
10-<15
15-20
Onset of Treatment (years)
Not started treatment yet
1-<5
5-<10
10-<15
15-20
Pervious Hospitalization
No
Yes
X2: Chi-Square test
MC
33
36
47.8
52.1
7
39
15.2
84.8
38
15
8
6
2
55.1
21.7
11.6
8.7
2.9
27
14
0
3
2
58.7
30.5
0.0
6.5
4.3
39
18
8
4
56.5
26.1
11.6
5.8
22
5
10
9
47.8
10.9
21.7
19.6
18
29
11
8
3
26.1
42.0
15.9
11.6
4.3
0
25
4
8
9
0.0
54.3
8.7
17.4
19.6
22
47
31.9
68.1
1
45
2.2
97.8
Significance
X2=17.619
P<0.0001*
X2=6.558
MC
P=0.162
X2=10.032
P=0.018*
X2=20.795
MC
P<0.0001*
X2=15.226
MC
P<0.0001*
P: Monte Carlo corrected P-value *significant at P≤0.05
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Table (6): Relation between total quality of life and clinical characteristics of the
studied patients (n =115).
Total quality of life
Low (<60%)
High (60%≤)
[n=87]
[n=28]
No.
%
No.
%
Clinical Characteristics
Department
Outpatient clinic
Inpatients units
Diagnosis
Schizophrenia
Bipolar disorder
Depression
Drug induced psychosis
Schizoaffective disorder
33
54
37.9
62.1
7
21
25.0
75.0
52
15
8
9
3
59.8
17.2
9.2
10.4
3.4
13
14
0
0
1
46.4
50.0
0.0
0.0
3.6
Disease Onset (years)
1-<5
5-<10
10-<15
15-20
44
21
14
8
50.6
24.1
16.1
9.2
17
2
4
5
60.7
7.1
14.3
17.9
Onset of Treatment (years)
Not started treatment yet
1-<5
5-<10
10-<15
15-20
16
38
13
13
7
18.4
43.7
14.9
14.9
8.0
2
16
2
3
5
7.1
57.1
7.1
10.7
17.9
Previous Hospitalization
No
Yes
20
67
23.0
77.0
3
25
10.7
89.3
X2: Chi-Square test
MC
Significance
X2=3.005
P=0.223
X2=15.154
MC
P=0004*
X2=4.92
MC
P=0.184
X2=5.744
MC
P=0.215
P: Monte Carlo corrected P-value *significant at P≤0.05
X2=1.995
P=0.158
DISCUSSION:
Psychotic disorders are often chronic, lifelong illnesses that have a major impact on the
individual, family, and community resources (Capleton, 2000). People with mental
illness struggle with poor QOL and social support; they often cannot develop or
sustain supportive relationships within their lives (Mordoch, 2005).
Social support is widely recognized as a crucial factor for mental health and wellbeing
(Ng, Nurasikin, Loh, Anne Yee, and Zainal, 2012). It is one of the most effective
means by which people can cope with and adjust to difficult and stressful events
(Kim, Sherman, and Taylor, 2008) and has a positive effect on the process and
outcome of psychotherapy and psychiatric treatment (Brüggemann, Garlipp,
Haltenhof, and Seidler, 2007). Therefore, the present study aimed to explore the
impact of social support on the quality of life in psychiatric patients.
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The finding of the present study denoted that most of the study subjects had a low
QOL almost on all dimensions as well as on the total score. This may be because of
the impact of psychiatric disorder is understandable considering the many dimensions
of QOL that these disorders influence. This result was supported by Langeland,
Wahl, Kristoffersen, Nortvedt and Hanestad (2007), who studied QOL among
Norwegians with chronic mental health problems versus the general population and
found that they scored substantially lower than the general population in QOL total
score and its sub- dimensions.
The present study revealed that most of patients had a low score in many areas
especially the social domain and environmental domain as well as psychological
domain. This might be interpreted by that, mentally ill patients have fewer social and
cognitive skills, and fewer environmental assets, especially money. Similar findings
were reported from China, as Young (2012), studied QOL of people with severe
mental illness and found that respondents were least satisfied with their social,
environmental, and psychological domains.
The results of the present study also indicated that the physical domain was the
highest domain that psychiatric patients had; this may be due to that, mental illness
affects cognitive, affective, and behavioral status of patients rather than their physical
status. This result was supported by a study conducted in England, as Blenkirson and
Hammille (2003) studied patients‘ satisfaction with their mental health care and QOL
and stated that the highest domain that psychiatric patients had was the physical
domain. In contrast to that, Nyboe and Lund (2012), who examined physical activity
in people with mental health conditions in Denmark and demonstrated that, patients
with severe mental illness had very low physical activity level.
The results of this study revealed that the highest social support perceived by studied
patients was from significant others. This may be due to the fact that, significant
others may include any special person in the patient‘s life such as a boyfriend
/girlfriend, a doctor, a nurse or a clerk and support psychiatric patients more than their
family members. A Boland study by Bronowski and Załuska (2008) supported this
result as they studied social support of chronically mentally ill patients and reported
that therapists were the most numerous group who provided support and close
relatives come second.
The present study found that the studied patients secondly perceived social support
from their families. This is probably may be due to that family ties are strong in the
Middle East and this can play a positive role to the extent that they are used as social
support rather than social pressure. Many people with serious mental illness either
live with their families including parents, spouses, siblings, and children or have
regular ongoing contact with their families. This result was supported by Goldberg,
Rollins and Lehman (2003) in United States. They studied social network among
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people with psychiatric disabilities and found that the subjects mentioned their closest
relatives as the most frequently used supporters. In addition, Brunt and Hansson
(2002), who studied social networks of persons with severe mental illness in inpatient settings and supported community settings in Sweden, found that patients had
a higher proportion of family members in their social networks.
The present study showed that most of the studied patients perceived a low social
support from friends. This may be attributed to that most of friends may cut their
relationships with psychiatric patients because of the negative view of psychiatric
illness in the community. Egyptian society still fears insanity and crazies, despite
being all around. It is a disgrace being a mentally ill patient, or associated to someone
who is. This result contradicted with Sharir (2005) in United States. Sharir studied
social support and QOL among psychiatric patients in residential homes and found
that social support from friends had a higher mean than the other two sub-components
of social support from family and social support from a significant other.
In relation to total social support level, the present study revealed that more than half
of patients had a low social support level. This is probably may be due to stigma and
discrimination, which have a direct effect on the social opportunities of people with
mental illness. Also, the public does not understand the impact of mental illness and
frequently fears persons with these disorders. This result was consistent with Brunt
and Hansson (2002), who studied social networks of persons with severe mental
illness in in-patient settings and supported community settings in Sweden. They found
that a greater proportion of them in comparison to the general population, have
smaller social networks and a low network density.
The current results revealed that there were statistical significant positive correlations
between QOL in relation to social support from significant others, from family, and from
friends. Besides, there was a positive correlation between total score of QOL and total
score of social support. Many explanations for these findings are possible; as life
revolves around close relationships including family, friends, significant others and
their existence and support have positive impact on physical and psychological wellbeing as well as QOL. Social support can reduce the negative effects of stressful life
events via the supportive actions of others that enhance coping performance, or
through the belief that support is available, which leads to the appraisal of potentially
threatening situations as less stressful.
This result was in line with a Pakistani study by Yasien, Alvi, and Moghal (2013),
who studied perceived social support and QOL of psychiatric patients. This study
revealed that social support from family, friends and significant others was related
with QOL and its subcomponents in patients with mental illness. Similar results were
identified by Yanos, Rosenfiel , and Horwitz (2001) in United States. They studied
social interactions and QOL among persons diagnosed with severe mental illness and
reported that supportive social interactions and frequency of social contact were
correlated to higher QOL of persons diagnosed with severe mental illness.
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As for the present study, it was noticed that high social support was statistically
significant among patients in inpatient departments than outpatient clinics. This may
be related to the fact that patients who were in in-patients departments are more
stable and can make social contact with doctors, nurses, and other patients as well as
their families, relatives, and friends during visiting hours. This is in agreement with
McCall, Reboussin, and Rapp (2001), in United States, who revealed that social
support increased in the year after inpatient treatment of psychiatric patients. In
addition, Browne and Courtney (2004), in Australia found that people with severe
mental illness living in apartments or community housing had less social support
because of social stigma.
The current results illustrated that low social support system was statistically
significant among patients who had disease from one year to less than five years. This
might be due to the fact that people around psychiatric patients with new diagnosis are
unable to understand nature of this disorder and unable to deal with them. In addition,
they avoid these patients and reject them because of social stigma that caused by
mental illness to patients and their social relationships. This interpretation was
supported by Ostman and Kjellin (2002), who studied stigma association and
psychological factors in relatives of people with mental illness, and reported that
stigma often carried over to friends and relatives of a person who is mentally ill,
which is known as ―courtesy‖ or ―associative‖ stigma leading to disturbance in the
patient‘s relationships.
The results of this study revealed that high social support system was statistically
significant among patients who started treatment from one year to less than five years.
This might be explained by that patients‘ social support network may be increased in
the first years of treatment as symptoms may be controlled by the treatment. This
explanation is supported by Brugha, Morgan, Bebbington, Jenkins, Lewis, Farrell,
and Meltzer (2003), in Britain. They studied social support networks and type of
neurotic symptoms, and reported that these symptoms were highly statistically
significantly associated with deficient social support.
The result of the present study illustrated that high social support system was
statistically significant among patients who had previous hospitalization. This may be
because patients who had previous hospitalization had additional social support from
doctors, nurses, and other patients. In the same line, Holmes-Eber and Stephanie
(1990) in United States, who studied hospitalization and composition of mental
patients‘ social networks found that previous hospitalizations are related to a larger
number and percentage of mental health and other professionals in patients' social
networks.
The present study showed that schizophrenic patients had lowest QOL compared to
other patients. This may be due to that schizophrenia is a severe mental illness
associated with a wide range of symptoms including positive symptoms such as
hallucinations, delusions, and a disorganized symptoms and this may have a
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significant negative effect on QOL. This result supported by, Bechdolf, Klosterkötter,
Hambrecht, Knost, Kuntermann, Schiller, and Pukrop (2003) in Germany, who
studied determinants of subjective QOL in post acute patients with schizophrenia and
found that patients with schizophrenia had the lowest QOL than other patients. In
contrary, a study in Finland by Saarni, Härkänen, Sintonen, Suvisaari, Koskinen,
Aromaa, and Lönnqvist (2006) examined the impact of chronic conditions on healthrelated QOL and revealed that depressive and anxiety disorders have a major impact on
QOL than psychosis.
CONCLUSION &RECOMMENDATIONS:
Based on the findings of the current study, it can be concluded that most of
psychiatric patients have low social support and QOL. In addition, there is a relation
between social support and QOL. Therefore, social support should be an essential part
of psychiatric treatment because of its important role in enhancing patients‘ QOL.
Also, it was observed that the age, educational level, employment status, disease
onset, onset of treatment, and previous hospitalization significantly affect the social
support level. However, the age, income, employment status, diagnosis, and disease
onset significantly affects the QOL.
In the light of the results of the present study, the following recommendations are
suggested:
- Increase awareness of the mental health team about the importance of dealing
holistically with psychiatric patients (i.e. considering their physical, psychological,
social, and environmental aspects).
- There is a great need to establish programs for families of psychiatric patients to
increase their understanding of the nature of psychiatric illness to increase their support
for their patients.
- A training program for nurses about the importance of social support to patients and
their families during difficult times.
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انعاللّ ت ٍٛانًساَذج اإلخرًاعٛح ٔ خٕدج انحٛاج نذ٘ انًشظ ٙانُفسٍٛٛ
د .أيم صثح ٙيحًٕد ;1د .عثٛش انسٛذ تشيّ ; 2سًش عط ّٛأتٕصانح خثم
3
اعزبر ِغبػذ اٌزّش٠غ إٌفغٚ ٟاٌظؾٗ اٌؼمٍِ,1 ٗ١ذسط اٌزّش٠غ إٌفغٚ ٟاٌظؾٗ اٌؼمٍِ ,2 ٗ١ؼ١ذ اٌزّش٠غ
إٌفغٚ ٟاٌظؾٗ اٌؼمٍ 3ٗ١وٍ١خ اٌزّش٠غ عبِؼخ ثٛسعؼ١ذ
انخالصح
إْ ا ػطشاثبد اٌظؾخ اٌؼمٍ١خ رؤصش ػٍ ٝاألداء اٌٌ ِٟٛ١ألفشادٚ ,اٌمذسح ػٍ ٝاٌؾفبظ ػٍ ٝػاللبر ُٙاإلعزّبػ١خ
ٚأخفبع عٛدح ؽ١بر .ُٙإْ ًٌ ِغبٔذح اإلعزّبػ١خ فبئذح وج١شح ٌٍظؾخ اٌؼمٍ١خ ,فؼال ػٓ رؼض٠ض عٛدح اٌؾ١بح
ٌٍّش٠غ إٌفغْ .ٟذف انثحث :رم ُ١١اٌؼاللخ ث ٓ١اٌّغبٔذح اإلعزّبػ١خ ٚعٛدح اٌؾ١بح ٌذ ٞاٌّشػ ٝإٌفغ .ٓ١١غشق
ٔادٔاخ انثحث :أعش٠ذ اٌذساعخ اٌٛطف١خ راد اٌؼاللبد اٌّشزشوخ ػٍِ 115 ٟش٠غ ِٓ اٌّزشدد ٓ٠ػٍ ٟخّغخ
ِٓ األلغبَ اٌذاخٍ١خ ٚاٌؼ١بدح اٌخبسع١خ ٌّغزشف ٟاٌظؾخ إٌفغ١خ ثجٛسعؼ١ذ .رُ رغّ١غ اٌج١بٔبد ػٓ ؽش٠ك اٌّمبثٍخ
اٌشخظ١خ ٌىً ِش٠غ ثبعزخذاَ صالصخ أدٚاد ٟ٘ٚاعزّبسح رم ُ١١عٛدح اٌؾ١بح ,اعزّبسح رم ُ١١اٌّغبٔذح اإلعزّبػ١خ
ٚاعزّبسح ث١بٔبد شخظ١خ ٚاوٍ١ٕ١ى١خ .انُرائحِ :ؼظُ اٌّشػ ٝإٌفغ٠ ٓ١١ؼبٔ ِٓ ْٛإٔخفبع اٌّغبٔذح اإلعزّبػ١خ
ٚعٛدح اٌؾ١بحٚ .لذ وبْ أوضش عٛأت اٌؾ١بٖ رأصشا ٘ ٛاٌغبٔت اإلعزّبػٚ .ٟثبإلػبفخ إٌ ٝرٌه ,وبٔذ ٕ٘بن ػاللخ
راد دالٌخ إؽظبئ١خ ث ٓ١اٌّغبٔذح اإلعزّبػ١خ ٚعٛدح اٌؾ١بحٚ .لذ ٌٛؽع أْ اٌغٓ ,اٌّغز ٜٛاٌزؼٍ ,ّٟ١اٌٛػغ
اٌٛظ١ف ,ٟثذا٠خ ظٛٙس أػشاع اٌّشع ٚ ,ثذا٠خ اٌؼالط ِٓ اٌؼٛاًِ اٌز ٟرؤصش ػٍِ ٝغز ٜٛاٌّغبٔذح اإلعزّبػ١خ.
ف ٟؽ ٓ١أْ اٌؼّش ,اٌذخً ,اٌٛػغ اٌٛظ١ف ,ٟاٌزشخ١ض ٚ ,ثذا٠خ اٌّشع ِٓ اٌؼٛاًِ اٌز ٟرؤصش ػٍ ٝعٛدح
اٌؾ١بح .االسرُراخاخ ٔانرٕصٛاخ ّ٠ :ىٓ االعزٕزبط أْ أوضش ِٓ ٔظف اٌّشػ ٝإٌفغٌ ٓ١١ذ ُٙ٠أخفبع ف ٟعٛدح
اٌؾ١بح ٚصٍض ٟاٌّشػٌ ٟذ ُٙ٠أخفبع ف ٟاٌّغبٔذح اإلعزّبػ١خٚ .ثبإلػبفخ إٌ ٝرٌهٕ٘ ,بن ػاللخ ث ٓ١اٌّغبٔذح
اإلعزّبػ١خ ٚعٛدح اٌؾ١بحٌ .زٌه٠ ,غت أْ رى ْٛاٌّغبٔذح اإلعزّبػ١خ عضءا أعبع١ب ِٓ اٌؼالط إٌفغ ٟثغجت
دٚس٘ب اٌٙبَ ف ٟرؼض٠ض عٛدح اٌؾ١بح ٌٍّشػٚ.ٝلذ أٚطذ اٌذساعخ ثض٠بدح ٚػ ٟفش٠ك اٌظؾخ إٌفغ١خ ؽٛي أّ٘١خ
اٌزؼبًِ ثشىً وٍِ ٟغ اٌّشػ ٝإٌفغ ٓ١١أ ٞإٌظش إٌ ٟاٌغٛأت اٌّبد٠خ ,إٌفغ١خ ,اإلعزّبػ١خ ٚ ,اٌج١ئ١خ ٌٍّش٠غ
انكهًاخ انًششذج :اٌّشع إٌفغ, ٟاٌّغبٔذح اإلعزّبػ١خ ,عٛدح اٌؾ١بح.
201