Tough Hannah, Siegrist Johannes, Fekete Christine
Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207 Nottwil, Lucerne, Switzerland.
Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, P.O. Box 4466, 6002, Lucerne, Switzerland.
BMC Public Health. 2017 May 8;17(1):414. doi: 10.1186/s12889-017-4308-6.
Research has consistently found that favourable exchange with one's proximal social environment has positive effects on both mental health and wellbeing. Adults with physical disabilities may have fewer opportunities of favourable exchange, and therefore the effects on mental health and wellbeing may be less advantageous. The aim of this study is to systematically review quantitative studies exploring associations of social relationships with mental health and wellbeing in persons with physical disabilities.
The databases PubMed, PsycINFO and Scopus were searched for relevant studies published between 1995 and 2016. Data was extracted on study and participants' characteristics, independent and dependent variables, used measures and effects sizes of associations between social relationships and mental health or wellbeing. A narrative review was performed to synthesize findings along the constructs social support, social networks, negative social interactions, family functioning and relationship quality.
Of the 63 included studies, 47 were cross-sectional and 16 longitudinal. Most studies included a measure of social support (n = 58), while other concepts were less often studied (social networks n = 6; negative social interaction n = 3; family functioning n = 2; relationship quality n = 1). Over half of studies included depression as outcome (n = 33), followed by wellbeing (n = 14), composite mental health measures (n = 10), anxiety (n = 8), psychological distress (n = 7), posttraumatic stress disorder (n = 3), and hopelessness (n = 1). Although trends for associations of social support with mental health and wellbeing were consistent, around a quarter of studies failed to report significant associations. Social networks were related to depression, but not to other mental health or wellbeing measures. Family functioning, negative social interactions and relationship quality showed consistent associations with mental health and wellbeing, however, only few studies were available.
This review indicates that social relationships play an important role in mental health and wellbeing in persons with disabilities, although findings are less consistent than in general populations and strength of associations vary between constructs. Integrating persons with disabilities into social networks seems not sufficient and rehabilitation professionals together with affected persons and their peers should ensure that high quality relationships and tailored support are available.
研究一直发现，与近端社会环境进行良好互动对心理健康和幸福感均有积极影响。身体残疾的成年人可能较少有进行良好互动的机会，因此对其心理健康和幸福感的影响可能不那么有利。本研究的目的是系统回顾探索身体残疾者社会关系与心理健康和幸福感之间关联的定量研究。
在PubMed、PsycINFO和Scopus数据库中检索1995年至2016年间发表的相关研究。提取有关研究和参与者特征、自变量和因变量、所使用的测量方法以及社会关系与心理健康或幸福感之间关联的效应量的数据。进行叙述性综述，以综合社会支持、社会网络、负面社会互动、家庭功能和关系质量等结构方面的研究结果。
在纳入的63项研究中，47项为横断面研究，16项为纵向研究。大多数研究纳入了社会支持测量（n = 58），而其他概念的研究较少（社会网络n = 6；负面社会互动n = 3；家庭功能n = 2；关系质量n = 1）。超过一半的研究将抑郁作为结果（n = 33），其次是幸福感（n = 14）、综合心理健康测量（n = 10）、焦虑（n = 8）、心理困扰（n = 7）、创伤后应激障碍（n = 3）和绝望感（n = 1）。虽然社会支持与心理健康和幸福感之间关联的趋势是一致的，但约四分之一的研究未报告显著关联。社会网络与抑郁有关，但与其他心理健康或幸福感测量无关。家庭功能、负面社会互动和关系质量与心理健康和幸福感显示出一致的关联，然而，相关研究较少。
本综述表明，社会关系在残疾人的心理健康和幸福感中起着重要作用，尽管研究结果不如在普通人群中那样一致，且各结构之间关联的强度有所不同。将残疾人融入社会网络似乎并不足够，康复专业人员应与受影响者及其同伴共同确保提供高质量的关系和量身定制的支持。
