Psychosocial support and change in the health status of physically disabled people.

Evidence is presented on the relationship between psychosocial support (social contact and emotional intimacy) and changes in health status (physical, psychosocial and emotional functioning) experienced by 583 adults age 45-75 years living at home with a preexisting physical illness. Data were used from a panel study of physically disabled adults in London, England to provide a test of the buffer and direct effects hypotheses concerning social support and adverse life events. Controlling for age, sex and initial level of health status, the analyses showed that a low level of social contact was associated significantly with deterioration in psychosocial and emotional functioning only in the presence of adverse life events. A similar but non-significant pattern existed for physical functioning. A high level of social contact had a more protective effect on the physical functioning of respondents with arthritis or heart trouble who also reported depression, except among women age 45-64. Level of emotional intimacy was not a significant influence on reported health status change. Confiding relationships do not appear important for adults with preexisting illnesses who are not at significant risk of developing stress-related conditions. Social participation outside the home would help to reduce deterioration in psychosocial and emotional functioning, important outcomes for improving and maintaining quality of life.