Booth B M, Russell D W, Soucek S, Laughlin P R
Iowa Health Services Research & Development Field Program VA Medical Center, Iowa City 52246.
Am J Drug Alcohol Abuse. 1992;18(1):87-101. doi: 10.3109/00952999209001614.
Social support is becoming recognized as a positive influence on health and health maintenance. Forms of support which bolster the patient's sense of personal efficacy should enhance the alcoholic's ability to cope with a specific stressor (i.e., overcoming his or her addiction). Patients reporting higher levels of social support during alcoholism treatment, especially support that enhances his or her self-esteem, should therefore demonstrate improved outcome compared to patients with lower levels. Sixty-one consecutive admissions to an inpatient alcoholism treatment program at a rural midwestern medical center completed an assessment of six forms of social support (Guidance, Reliable Alliance, Reassurance of Worth, Opportunity for Nurturance, Attachment, and Social Integration) in terms of support obtained from family and friends and from the treatment environment. For each patient, additional information concerning age, marital status, financial support, and previous alcohol-related hospitalizations was also obtained. Outcome of treatment was measured by readmission for an alcohol-related diagnosis within 1 year of discharge. Survival analysis found that reassurance of worth from family and friends and number of previous hospitalizations were independent and significant predictors of time to readmission. Higher levels of reassurance of worth or esteem support significantly lengthened time to readmission, with the reverse relationship found for number of previous hospitalizations. These results suggest that specific sources (family and friends) and forms (reassurance of worth) of social support are important to the recovering alcoholic and that the effect of social support on treatment outcome is independent of the alcoholic's history of prior treatment failure. Interventions or program modifications should be designed specifically to bolster these facets of social support rather than addressing more general forms of support.
社会支持正被视作对健康及健康维持具有积极影响。增强患者个人效能感的支持形式应能提高酗酒者应对特定压力源（即克服其成瘾问题）的能力。因此，与社会支持水平较低的患者相比，在酒精成瘾治疗期间报告社会支持水平较高的患者，尤其是能增强其自尊的支持，治疗效果应会更好。一家中西部乡村医疗中心的住院酒精成瘾治疗项目连续接收的61名患者完成了一项评估，内容涉及从家人和朋友以及治疗环境中获得的六种社会支持形式（指导、可靠联盟、价值肯定、养育机会、依恋和社会融合）。针对每位患者，还获取了有关其年龄、婚姻状况、经济支持以及既往与酒精相关的住院情况的额外信息。治疗效果通过出院后1年内因酒精相关诊断再次入院来衡量。生存分析发现，来自家人和朋友的价值肯定以及既往住院次数是再次入院时间的独立且显著的预测因素。更高水平的价值肯定或自尊支持显著延长了再次入院时间，而既往住院次数则呈现相反的关系。这些结果表明，社会支持的特定来源（家人和朋友）及形式（价值肯定）对康复中的酗酒者很重要，且社会支持对治疗效果的影响独立于酗酒者既往治疗失败的病史。干预措施或项目调整应专门设计以强化社会支持的这些方面，而非处理更一般的支持形式。
