Enhancing Social Support Among People with Cardiovascular Disease: a Systematic Scoping Review
- 106 Downloads
Purpose of Review
The presence of social support is a major determinant of positive health outcomes among people with cardiovascular disease (CVD); however, little is known about the most effective strategies for enhancing social support among this population. The aim of this scoping review was to describe the effectiveness of interventions seeking to enhance social support among people living with CVD and synthesize the evidence.
A systematic search for articles that (a) reported on interventions which may enhance social support and (b) included a measure of social support revealed 21 studies. Interventions to enhance social support were diverse and included cognitive behavioural therapy, mindfulness, peer support, and multi-faceted cardiac rehabilitation programmes. Most studies were of fair to good quality according to the PEDro criteria. With the exception of caregiver-oriented interventions, few studies reported significant changes in social support measures.
Early evidence suggests that caregiver-oriented strategies may offer a promising avenue for enhancing social support; however, more research of higher quality is required to determine the optimal strategies to enhance support among those living with CVD.
KeywordsCardiovascular disease Social support Isolation Cardiac rehabilitation
B.M Sakakibara is supported by a Michael Smith Foundation for Health Research Scholar Award.
Compliance with Ethical Standards
Conflict of Interest
C.T. Clayton, C. Motley, and B.M. Sakakibara declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 2.Reifman A. Social relationships, recovery from illness, and survival: a literature review. Ann Behav Med Publ Soc Behav Med. 1995;17(2):124–31.Google Scholar
- 3.Cohen, S. Social support measurement and intervention: a guide for health and social scientists [Internet]. Oxford University Press; [cited 2019]. Available from: https://www.oxfordclinicalpsych.com/view/10.1093/med:psych/9780195126709.001.0001/med-9780195126709.
- 5.Valtorta NK, Kanaan M, Gilbody S, Ronzi S, Hanratty B. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart Br Card Soc. 2016;102(13):1009–16.Google Scholar
- 10.• Khaledi GH, Mostafavi F, Eslami AA, Rooh Afza H, Mostafavi F, Akbar H. Evaluation of the effect of perceived social support on promoting self-care behaviors of heart failure patients referred to the cardiovascular research center of Isfahan. Iran Red Crescent Med J [Internet]. 2015 [cited 2019 May 31];17(6). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552959/. This study, alongside Shahriari et al. (30) demonstrated that a caregiver-only heart failure management education and communication skills program can improve perceived social support among loved-ones with cardiovascular disease.
- 15.Foley NC, Bhogal SK, Teasell RW, Bureau Y, Speechley MR. Estimates of quality and reliability with the physiotherapy evidence-based database scale to assess the methodology of randomized controlled trials of pharmacological and nonpharmacological interventions. Phys Ther. 2006;86(6):817–24.PubMedGoogle Scholar
- 18.Davidson P, Digiacomo M, Zecchin R, Clarke M, Paul G, Lamb K, et al. A cardiac rehabilitation program to improve psychosocial outcomes of women with heart disease. J Womens Health. 2002. 2008 Jan 1;17:123–34.Google Scholar
- 19.Sakakibara BM, Chakrabarti S, Krahn A, Mackay MH, Sedlak T, Singer J, et al. Delivery of peer support through a self-management mHealth intervention (healing circles) in patients with cardiovascular disease: protocol for a randomized controlled trial. JMIR Res Protoc. 2019;8(1):e12322.PubMedPubMedCentralGoogle Scholar
- 20.Colella TJ, King-Shier K. The effect of a peer support intervention on early recovery outcomes in men recovering from coronary bypass surgery: a randomized controlled trial. Eur J Cardiovasc Nurs J Work Group Cardiovasc Nurs Eur Soc Cardiol. 2018;17(5):408–17.Google Scholar
- 21.•• Berkman LF, Blumenthal J, Burg M, Carney RM, Catellier D, Cowan MJ, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial. JAMA. 2003;289(23):3106–16 This study, while dated, is the largest and most rigorous assessment of an intervention designed to improve perceived social support among those with cardiovascular disease. The cognitive-behavioural therapy intervention led to significant albeit marginal improvements in perceived social support and yielded no changes in cardiovascular outcomes at long term follow up suggesting alternative modalities must be explored.PubMedGoogle Scholar
- 22.• Heo S, McSweeney J, Ounpraseuth S, Shaw-Devine A, Fier A, Moser DK. Testing a holistic meditation intervention to address psychosocial distress in patients with heart failure: a pilot study. J Cardiovasc Nurs. 2018;33(2):126–34 Despite being only a pilot, this study indicates that alternate intervention modalities such as group mindfulness meditation-based programs may offer promising avenues to enhance social support among those with cardiovascular disease.PubMedGoogle Scholar
- 23.Boese A, Bock S, Kielblock B, Siegmund-Schultze E, Kröner-Herwig B, Herrmann-Lingen C. Randomised controlled trial of a telephone-based peer support intervention to reduce depressive symptoms and improve social support in women with CHD. J Psychosom Res. 2013;74:539.Google Scholar
- 28.Sakakibara BM, Ross E, Arthur G, Brown-Ganzert L, Petrin S, Sedlak T, et al. Using mobile-health to connect women with cardiovascular disease and improve self-management. Telemed J E-Health Off J Am Telemed Assoc. 2017;23(3):233–9.Google Scholar
- 29.Rywik T, Kurjata P, Broda G, Leszek P, Margaret F-L, Targoński R, et al. Level of social support in heart failure patients—effects of caregivers participation in a simple national disease management programme. Eur J Heart Fail. 2013;12:S19.Google Scholar
- 35.Pischke CR, Scherwitz L, Weidner G, Ornish D. Long-term effects of lifestyle changes on well-being and cardiac variables among coronary heart disease patients. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2008;27(5):584–92.Google Scholar
- 36.Carlson JJ, Norman GJ, Feltz DL, Franklin BA, Johnson JA, Locke SK. Self-efficacy, psychosocial factors, and exercise behavior in traditional versus modified cardiac rehabilitation. J Cardpulm Rehabil. 2001;21(6):363–73.Google Scholar
- 40.Niebauer J, editor. Cardiac rehabilitation manual [Internet]. 2nd ed. Springer International Publishing; 2017 [cited 2019 Jun 8]. Available from: https://www.springer.com/gp/book/9783319477374
- 44.Parry M, Watt-Watson J. Peer support intervention trials for individuals with heart disease: a systematic review. Eur J Cardiovasc Nurs J Work Group Cardiovasc Nurs Eur Soc Cardiol. 2010;9(1):57–67.Google Scholar
- 45.Dale JR, Williams SM, Bowyer V. What is the effect of peer support on diabetes outcomes in adults? A systematic review. Diabet Med J Br Diabet Assoc. 2012;29(11):1361–77.Google Scholar
- 52.Zeidan F, Johnson SK, Gordon NS, Goolkasian P. Effects of brief and sham mindfulness meditation on mood and cardiovascular variables. J Altern Complement Med N Y N. 2010;16(8):867–73.Google Scholar
- 53.Ospina MB, Bond K, Karkhaneh M, Tjosvold L, Vandermeer B, Liang Y, et al. Meditation practices for health: state of the research. Evid ReportTechnology Assess. 2007;155:1–263.Google Scholar
- 57.Dekeyser M, Raes F, Leijssen M, Leysen S, Dewulf D. Mindfulness skills and interpersonal behaviour. Personal Individ Differ. 2008;44(5):1235–45.Google Scholar
- 58.Schellekens MPJ, Tamagawa R, Labelle LE, Speca M, Stephen J, Drysdale E, et al. Mindfulness-based cancer recovery (MBCR) versus supportive expressive group therapy (SET) for distressed breast cancer survivors: evaluating mindfulness and social support as mediators. J Behav Med. 2017;40(3):414–22.PubMedGoogle Scholar
- 61.Pinquart M, Sörensen S. Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2007;62(2):126–37.Google Scholar
- 64.Feeney BC, Collins NL. New look at social support: a theoretical perspective on thriving through relationships. Personal Soc Psychol Rev Off J Soc Personal Soc Psychol Inc. 2015;19(2):113–47.Google Scholar
- 65.Uchino BN, Bowen K, Carlisle M, Birmingham W. Psychological pathways linking social support to health outcomes: a visit with the “ghosts” of research past, present, and future. Soc Sci Med. 1982. 2012 Apr;74(7):949–57.Google Scholar