The Concept of Support

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THE CONCEPT OF SUPPORT 13

The Conceptof Support

Definition ofSupport

Support inhealthcare is the verbal or nonverbal communication betweenrecipients and providers that reduces uncertainty about the situationat hand, the self, others and enhancement of perception of personalcontrol in one’s life experience. Support in health care is basedon three main defining features. First is the need to fosterindependence to the recipients of support, second is that the supportgivers have both professional and unprofessional care, while thethird is that support is wide as it involves both health care andsocial care (Philips, 1999).Takingthis definition in mind, a support worker is therefore the person whoworks to foster independence to the recipient of care, givesassistance to the recipient and provides activities that seek toenhance the wellbeing of the recipient.

SupportProviders.

The supportproviders mostly include family, friends, community members, andhealth care workers such as doctors, nurses, counselors,psychologists and psychiatrists, community health workers, clergy,support groups and other organizations. This team is responsible foroffering a network for the patient and psychological, physical andfinancial help to the patient. At the same time, families providesupport depending on different ethnicities. In a study by Almeida etal (2008), they noted that, “Eachethnic minority group reported lower perception of friend supportcompared to non-Latino whites.”

Whiledifferent support workers focus on different services, there isalways an overlap of the roles that the support workers provide andthat the health care workers provide. This is because the servicesprovided by one group of health care workers fall on the side ofsocial support, while other services falls on the side of theprofessional health care support. It is worth noting that differentstudies focusing on various nursing homes realized that someprofessionals do not differentiate between the two sides when givingtheir support services. At the same time, there is a sense ofuncertainty among health care workers when providing services on whatside their specific support activities fall.

Types ofSupport

The maintypes of support include emotional support, esteem support, networksupport, information support and tangible support.

EmotionalSupport

Emotionalsupport involves communication that settles the patient’s emotionalor affective needs at the time. The support provider makesexpressions of care and concern to the patient using a compassionateand empathetic tone (Philips,1999). Suchexpressions are not necessarily made to solve the problem at hand,but they give an elevation of the patient’s mood. For example, acancer patient may need continuous emotional support to increase theeffect and courage required to undergo intensive treatment modalitiessuch as radiotherapy, chemotherapy or surgery. Such support makes thepatient feel loved and cared for and provides the motivation requiredto overcome the illness.

EsteemSupport

Esteemsupport includes all the communications that bolster or increases thepatient’s self-esteem and beliefs in their capability to handle andcontrol the disease condition at hand. The support entails constantencouragement of the patient to take charge of the situation bytaking all the needed actions. It also entails convincing them thatthey have the ability to confront and handle the problem adequately.For example, a diabetic and hypertensive patients who are obese needssupport to encourage them that they have the capability of stickingto an exercise schedule. The constant reminder is paramount to createthe desired self-esteem.

NetworkSupport

This supportis very important, because it is the communication gives the patienta sense. It bolsters their need to recognize that they belong to acertain network and that the network is willing to advance any helpthe patient may require. Network support reminds the patients thatthey are not alone in the situation, and they can count on thenetwork to support them. Almeida (2008) states that, “Socialsupport is most often treated as an independent variable. However, aswith disease risk factors, which are not randomly distributed,health-promoting resources such as social support are alsosystematically patterned” (Almeida, 2008). Thenetwork can be made up of friends, family, relatives, workcolleagues, neighbors, company/organization affiliation, church, andwell-wishers. This support varies with different ethnic and racialbackgrounds. According to Almeida (2008), “inthe USA, family support is thought to be high among Latinos, MexicanAmericans in particular” (Almeida, 2008)

InformationSupport

This is acommunication which is very important to the patient and provides thevital and needed information. This information is useful because itgives a patient a chance to make informed decisions. Failure to knowand understand the details of the disease process, treatmentmodalities, alternative treatments, costs, possible prognosis, andoutcomes can cause a lot of stress to the patient. Healthcareproviders are best suited to provide such information by gettinginformed consent from the patient. This means that they have tocarefully and keenly give all the needed information to the patientto let them make informed choices of the treatment they may want tohave.

Informationsupport is also provided by the family. Many chronically ill andbedridden patients need to be reassured that their families are doingokay and that the illness is not causing any harm to the family. Thepatient needs to be constantly reassured with adequate informationabout everything that is going on in his other social, economic andpolitical life. This is very necessary because it fosters motivationand energy to fight the illness.

TangibleSupport

This is anyphysical support given to the individual patient by others. Thisincludes all things which make the life of the patient as comfortableas possible. Financial support is important in the patient in orderto meet the medical bills, food budgets, and transport fees (Wonget al, 2002).Help regarding materials like clothes, cleaning of homes when thepatient is in the hospital, taking care of the patient’s childrenand property are all included here.

HealthBenefits of Support

The bestsupport is the one that prioritizes and optimizes on the patient’sneeds. Patients are humans and have multiple needs. The patient’sneeds should be prioritized and given the most suitable remedies in adescending order of hierarchy.

Socialsupport helps the patients feel better and aids them in coping withchallenges that affect them. This support results in improved health,that is, overall wellbeing, psychological health, and physicalhealth. Having the necessary social support is important in order toachieve a healthy life. Some major health benefits of social supportinclude psychosocial adjustment improved efficacy better copingwith the disease process resistance to disease early recovery fromdisease and reduced mortality rates.

According toresearch on elderly patient’s recovery from a hip fracture, it wasfound that the patients who received adequate social support werelikely to survive longer over five years than those who did notreceive such support (Mortimore et al., 2008). According to Anderson,Winett and Wojcik (2007), patients who received adequate socialsupport achieved the highest levels of self-efficacy regarding thechoice and preparation of nutritional foods. The support from theirfamilies and friends gave them the necessary nutritional informationas well as the confidence to choose healthy foods.

Techniques ofOffering Support

Socialsupport should be given according to particular techniques thatreflect the patient’s needs. The various techniques includeperson-centered communication, advice giving, and social networkintegration.

Person-centeredcommunication includes the knowledge about the patient requiringsupport and giving subjective, relational and affective support. Thecommunication messages should be considerate of the person indistress, the extent of the situation, the control the patient has onthe situation and emotional undertones of the situation (Macgeorge,Clark &amp Gillihan, 2002). The peer communication is morepronounced among women than in men. In a study, Macgeorge, Clark andGillihan (2002) noted that, “Compared to men, women producedemotional support messages with a higher level of person centerednessand reported greater self‐efficacyin the domain of providing emotional support” (Macgeorge, Clark &ampGillihan, 2002). This person-centered communication must be centeredon helping the individual process as well as making sense of thesituation and patient’s feelings about the situation (Jones, 2004).

This type ofcommunication will involve asking of probing questions to get thenecessary information on what may be disturbing the patient as wellas encouraging the patient to think about the situation. This willalso involve taking the patients perspective and creating competingperspectives that increase knowledge of the disease process to thepatient as well as furthering his/her understanding of the disease.

It is verycommon when the support givers are uncomfortable and unsure of whatthey have to do or say to the patient especially those with intenselystressful illnesses. The support givers may ultimately result ingeneric expressions that only show concern and sympathy. Suchfeelings uncomfortable and clueless on what to do or say emerge whenthe support groups have very little knowledge about the patient ornature of the illness. Such feelings of generic expressions andconcern are nit effective in support giving since they lack theperson-centeredness (Egbert, 2003).

Advice givingis another technique of giving support. Advice can be both a positiveface work and a negative one. In the positive side, the patient mayaccept and heed to the advice given by the support giver. Thisprotects the patient’s desires to be evaluated positively inresponse to others (Wong et al,2002).On the negative side, the patient only wants a sympathetic ear andnot any advice. This is because they want to be given the autonomy tomake decisions independently. Advice can be a threat to patient’srecovery especially on the negative face work because such advicetends to question the ability of the patient to make their decisionson handling the situation (Wonget al, 2002).Advice should therefore be given carefully with keen scrutiny of thepatient’s desires and face work. It should therefore, offer anexpression of solidarity, include an expression of uncertainty ordeferment and give off-record advice.

Much of theadvice and person-communication come from the social networks webelong. Social networks are determined by the patient’s socialintegration, that is, extent of individual participation in varioussocial relationships (Philips,1999). Socialnetworks includes family, spouses, friends and formal organizationssuch as clubs, religious groups, jobs and support groups the patientbelong. The more the social relationships the patient have, the morethe social integration and therefore, the more the support they canachieve from the networks. Patients with good social networkintegration are also exposed to behavioral changes that might promotetheir health such as healthy eating, exercise, avoidance of alcoholand drug abuse and verbal encouragement amongst the peers (Almeida etal., 2009). He states, “

Socialsupport seeking behavior from the various support givers isinfluenced by a number of factors. Individual and cultural factorstake the center stage. These factors include Perceptions ofTrustworthiness stigma attached to the issue proximity to thesources of support availability of support gender norms andcultural norms (William &amp Mickelson, 2008).

Supportgroups are also very important and involve individuals with the sameproblem or stressor such as drug addicts or people with same chronicillness (Wong et al, 2002).They come together in anonymous self-groups to share theirexperiences with the condition and the milestones they have taken tofight the situation. These types of support groups are very necessaryand important. They provide the needed encouragement and esteem totriumph over the illness or the stressor.

Role ofNurses in Healthcare Support

Nurses play avery vital role in the management of sick patients. They are the mainsupport givers in inpatient wards, ICU, hospices and home-riddenpatients. Nursing officers are responsible for nursing the patients(Almeida et al., 2009). This involves all the necessary procedurethat makes the patient as comfortable as possible as they struggle torecuperate from their disease conditions. Some notable roles ofnurses in giving support to patients includes compassionate patientcare emotional support informational support esteem support andpsychosocial support.

CompassionatePatient Care

Nursingofficers are responsible for the compassionate care of patients toalleviate any pain and suffering. They provide all the necessarymedications required by the patients. These include pain medicationsand other prescription drugs (Philips,1999).They also carry out all the wound dressings change of beddingbathing the patients, especially the elderly and terminally illdressing the patients and creating an environment that is comfortableand clean for patients. All these procedures should be done in acompassionate manner, taking into account the feelings of thepatients and their desire of better health. According to Philips(2003),nurses communicate to the patient humbly and seek to inquire of anydiscomforts and troubles they may be having. Compassionate care isparamount and ensures patients are treated as humans and with all thedecency.

EmotionalSupport

The nurseprovides the required emotional support to their patients throughregular encouragements and good will wishes. Nurses strive to keeptheir patients full of spirit and hope for better health. This adviceis also seen in peer messages from family and friends, and is morepronounced in women than men (Macgeorge, Clark &amp Gillihan, 2002).This is seen mostly in terminally ill patients who always are in needof emotional support. Nursing officers are responsible for thisadvice and makes the patients feel worthy and motivated.

Nursesincrease the patient’s self-esteem and beliefs in their capabilityto handle and control the disease condition at hand. The supportentails constant encouragement of the patient to take charge of thesituation by taking all the needed actions. It also entailsconvincing them that they have the ability to confront and handle theproblem adequately.

Psychosocialand Informational Support

Nursingofficers are also responsible for the psychosocial support for theirpatients. Many patients feel that they cannot take it any longer dueto the misery caused by their illnesses. Nurses take the opportunityof encouraging them of the likelihood of recovery and good prognosis.They provide advice and a sense of self-worth to their patients whoare about to go into surgery or cancer treatments (Philips,1999).The motivation created to these patients makes them to undergo therequired treatment modalities with the hope of living a better life.They also give details of the disease process, treatment modalities,alternative treatments, costs, possible prognosis, and outcomes cancause a lot of stress to the patient (Wonget al, 2002).Nurses are best suited to provide such information by gettinginformed consent from the patient.

Conclusion

Support inhealth care is a concept that is not well defined because it covers awide range of services and care for the patients from both the healthworkers and non-medical groups. Support in health care brings the keyfeatures of support which are: communication uncertainty reductionand enhanced control. Support, therefore, includes all types ofcommunications that help the individuals in need to feel more certainabout their health and thus feel in control over the disease process.

References

Anderson, E. S., Winett, R. A.,&amp Wojcik, J. R. (2007). Self-regulation, self-efficacy, outcomeexpectations, and social support: Social cognitive theory andnutrition behavior. Annalsof Behavioral Medicine,34, 304–312

Almeida, J., Molnar, B. E., Kawachi, I., &ampSubramanian, S. V. (2009). Ethnicity and nativity status asdeterminants of perceived social support: Testing the concept offamilism. Social Science &ampMedicine, 68, 1852–1858

Egbert, N. (2003). Support provider mood andfamiliar versus unfamiliar events: An investigation of social supportquality. Communication Quarterly, 51,209–224

Jones, S. (2004). Putting the person intoperson-centered and immediate emotional support: Emotional change andperceived helper competence as outcomes of comforting in helpingsituations. Communication Research,31, 338–360

Macgeorge, E. L., Clark, R. A., &amp Gillihan,S. J. (2002). Sex differences in the provision of skillful emotionalsupport: The mediating role of self-efficacy. CommunicationReports, 15, 17–28

Mortimore, E., Haselow, D., Dolan, M., Hawkes,W. G., Langenberg, P., Zimmerman, S., &amp Magaziner, J. (2008).Amount of social contact and hip fracture mortality. Journalof the American Geriatrics Society,56, 1069–1074

Philips, C. (2003). Family-centeredMaternity Care. Burlington,Ma: Jones &amp Bartlett Learning

Williams, S. L., &amp Mickelson, K. D. (2008).A paradox of support seeking and rejection among the stigmatized.Personal Relationships,15, 493–509

Wong, L., Perry, M., &amp Hockenberry, M., etal. (2002). Maternal Child Nursing Care. Maryland Heights: MosbyPublishing.