Del-Pino-Casado Rafael, Frías-Osuna Antonio, Palomino-Moral Pedro A, Ruzafa-Martínez María, Ramos-Morcillo Antonio J
Department of Nursing, Faculty of Health Sciences, University of Jaén, Jaén, Spain.
Department of Nursing, Faculty of Nursing, University of Murcia, Murcia, Spain.
PLoS One. 2018 Jan 2;13(1):e0189874. doi: 10.1371/journal.pone.0189874. eCollection 2018.
Despite the generally accepted belief that social support improves caregiver adjustment in general and subjective burden in particular, the literature shows mixed findings, and a recent review concluded that the predictive strength of caregiver social support in determining caregiver burden is less evident, due to the conceptual diversity of this determinant.
The purpose of this review is to analyse the relationship of perceived and received social support with subjective burden among informal caregivers of an adult or older adult.
A systematic search was carried out up to September 2017 in the following databases: MEDLINE (PubMed), CINAHL, EMBASE, PsycINFO), Scopus and ISI Proceedings, and a meta-analysis was performed with the results of the selected and included studies.
Fifty-six studies were included in the meta-analysis, which provided 46 independent comparisons for perceived support and 16 for received support. Most of these studies were cross-sectional. There was a moderate, negative association of perceived social support on subjective burden (r = -0.36; CI 95% = -0.40, -0.32) and a very small, negative association of received support on subjective burden (r = -0.05; CI 95% = -0.095, -0.001).
Our findings broadly support interventions promoting social support in caregivers to prevent or alleviate subjective burden, and specifically, to intervene on the promotion of perceived social support more than on the promotion of received social support when preventing or alleviating burden.
尽管人们普遍认为社会支持总体上能改善照料者的适应状况，尤其是减轻主观负担，但文献研究结果不一。最近一项综述得出结论，由于这一决定因素的概念多样性，照料者社会支持在决定照料者负担方面的预测强度不太明显。
本综述旨在分析成年或老年非正式照料者所感知到的社会支持和实际获得的社会支持与主观负担之间的关系。
截至2017年9月，在以下数据库进行了系统检索：医学文献数据库（PubMed）、护理学与健康领域数据库（CINAHL）、荷兰医学文摘数据库（EMBASE）、心理学文摘数据库（PsycINFO）、Scopus数据库和ISI会议录数据库，并对所选及纳入研究的结果进行荟萃分析。
荟萃分析纳入了56项研究，其中有46项针对感知到的支持进行独立比较，16项针对实际获得的支持进行独立比较。这些研究大多为横断面研究。感知到的社会支持与主观负担之间存在中度负相关（r = -0.36；95%置信区间 = -0.40，-0.32），实际获得的支持与主观负担之间存在非常小的负相关（r = -0.05；95%置信区间 = -0.095，-0.001）。
1）感知到的支持和实际获得的支持并非冗余概念；2）社会支持与主观负担之间的关系取决于社会支持是作为感知到的还是实际获得的来衡量；3）感知到的社会支持与主观负担之间的效应量比实际获得的社会支持更大，实际获得的支持与主观负担之间的关系在临床上不具有相关性；4）感知到的社会支持可能是主观负担的良好预测指标。
我们的研究结果广泛支持旨在促进照料者社会支持以预防或减轻主观负担的干预措施，具体而言，在预防或减轻负担时，干预重点应更多地放在促进感知到的社会支持上，而非实际获得的社会支持上。
