Well-Being and Institutional Care in Older Adults: Cross-Sectional and Time Effects of Provided and Received Support

Aleksandra Kroemeke; Ewa Gruszczynska

doi:10.1371/journal.pone.0161328

Abstract

Background

The aim of the study was to examine the cross-sectional and longitudinal effects of provided and received support on older adults’ subjective well-being (positive affect and depression) and to examine whether being a recipient of institutional care moderates these effects.

Methods

Social support (provided and received), positive affect, and depressive symptoms were assessed twice (at baseline and 1 month later) for 277 older adults (age 77.39 ± 9.20 years, 67.50% women, 65% residents of an institutional care facility).

Findings

Two structural equation models were analyzed: cross-sectional (at baseline) and longitudinal (after 1 month). The first model revealed a significant positive relationship between providing and receiving support and positive affect, and a negative relationship between receiving support and depression. However, being a recipient of institutional care appeared to be a significant moderator in the longitudinal model. Specifically, the findings indicated effects of both providing and receiving support on positive affect but only for noninstitutionalized older adults.

Discussion

Although both types of support may be beneficial for older adults, their effects depend on the nature of social exchange and the dimensions of well-being. This suggests that such factors should be systematically investigated in future research.

Citation: Kroemeke A, Gruszczynska E (2016) Well-Being and Institutional Care in Older Adults: Cross-Sectional and Time Effects of Provided and Received Support. PLoS ONE 11(8): e0161328. https://doi.org/10.1371/journal.pone.0161328

Editor: Kewei Chen, Banner Alzheimer's Institute, UNITED STATES

Received: December 30, 2015; Accepted: August 3, 2016; Published: August 22, 2016

Copyright: © 2016 Kroemeke, Gruszczynska. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information files.

Funding: The study was supported by a grant from the Polish Ministry of Education and Science for University of Social Sciences and Humanities statutory research (Grant No. 25504/E-560/M/2013), AK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Provided and received social support may have distinct consequences for individual well-being, as reflected in both theoretical developments and accompanying empirical findings. Equity theory assumes that receiving support may result in distress and guilt when it violates the reciprocity principle of social exchange; that is, when more support is received than given [1]. In contrast, according to social exchange theory, received support should be associated with greater well-being, as people strive to maximize their profits (receiving support from others) and minimize their losses (using up resources while supporting others) [2]. Finally, the esteem enhancement hypothesis suggests that supporting others is an antecedent of well-being increment [3,4].

Given these contrasting theories, it is no surprise that the results of research in this area have been incoherent. There has been more research on received support, and results show that it has a positive effect on well-being [5,6], no effect [7], or even side effects [8]. Although fewer studies have focused on provided support, the findings suggest that this type of support may have more beneficial effects than received support [9].

The effects of support in older adults are unclear too. Although some research indicates that received support is positively related to quality of life [10,11], depression [12,13], and distress [14], other research indicates that these relations can be negative [15,16]. This suggests that there are moderating factors that contextually modify the relationship between support and well-being. In addition, this relationship may vary depending on whether positive or negative dimensions of well-being are studied.

Those studies that have focused on both received and provided support suggest that they both have a beneficial effect on older adults’ well-being, but that the effect of provided support is stronger [17,18]. Interestingly, Warner et al. [19] did not confirm these findings. In their study, only providing support to others was positively related to quality of life; receiving support was negatively related to quality of life. In contrast, Li et al. [20] reported that overbenefited friendships are more strongly associated with life satisfaction than reciprocal friendships, which indicates a crucial role for received rather than provided support. However, as all these studies are cross-sectional, an alternative explanation that greater well-being promotes a coherent perception of social exchange cannot be excluded.

The results of longitudinal studies indicate that relations between social support and well-being are probably reciprocal. For example, in a community sample of people aged over 70 years, low support led to greater distress 22 months later and, within the same time lag, greater distress led to less received support [21]. Interestingly, distress appeared to be more stable than support, although for both, more variance was explained by change within time rather than by stability. This further suggests that the context of evaluation, especially the intervals between measurements, affects the results. Therefore, received support is likely to have temporary positive effects, while negative social interactions (i.e., criticizing, lack of sympathy and care) are related to long-term consequences for well-being [22]. In addition, the duration of provided support has distinct effects for the provider’s well-being: short-term support was negatively and long-term support positively related to depression [15]. Finally, one study indicates that the mortality risk among older adults was reduced by provided support and slightly increased by received support within 5 years, after controlling for possible confounders [23].

However, it is too early to draw many conclusions from these findings, as there are few studies of this kind. Additionally, most studies focus on negative, rather than positive, indices of adjustment, and thus tend to be pathogenically oriented. Finally, such studies only include samples of well-functioning older adults in their natural social surroundings. Demographic shifts, accompanied by changes in family structure [24], have resulted in increasing need for nursing and residential care [25], which makes research on social support in such institutions of special clinical importance.

The present research

The present study aims to address these gaps. It includes both older adults living at home and residents of nursing homes. We hypothesize that this difference in conditions moderates the relationship between social support and well-being. In institutional care, the support exchange, on one hand, is regulated by well-defined social roles (i.e., resident and caregiver), but on the other hand it can be facilitated by reducing social isolation [26]. Thus, as the social surroundings probably promote being a recipient of support, this is a provided support that may contribute substantially to well-being in such a context. Two mechanisms can underlie this effect. First, being a provider of support may be an exceptional behavior, compared with being a recipient of support given by others, which is perceived not only as typical but also as obligatory for institutional care. Therefore, habituation is likely to occur. Second, as a violation of the reciprocity principle results in poorer well-being (according to equity theory), provided support may act as a protective factor, even if an individual’s supportive behaviors are not present objectively, but only overestimated, to balance the ongoing social interactions.

In this study, well-being is defined in terms of positive affect (PA) and depressive symptoms; current findings indicate that over longer time periods these should be treated as two independent unipolar dimensions of affective functioning [27], including among older adults [28]. Therefore, social support may have distinct effects on these dimensions; tested in a systematic way, this could clarify the mixed research findings reported so far.

Finally, this study’s longitudinal design captures cross-sectional relations as well as the delayed relations that can serve as a proxy to explore the stability of the effects of support. There are reasons to expect that the effect of provided support may last longer than the effect of received support. Provided support requires more autonomous activity than being just a recipient of others’ supportive behaviors and it is connected with positive changes in self-evaluations [29,30]. Thus, bolstered personal resources can maintain well-being beyond the period of support provision.

To sum up, the aim of the current study is twofold:

To examine the cross-sectional and longitudinal effects of provided and received support on well-being, described by two affective dimensions.
To examine whether being a recipient of institutional care is a moderator of the abovementioned effects.

Materials and Methods

Participants and procedure

Participants were 277 elderly people (67.5% women) aged 60–100 years (M = 77.39, SD = 9.20), assessed twice: at baseline (T1) and 1 month later (T2; N = 212). Of the participants, 65% (T₁ = 180; T₂ = 138) were residents of nursing homes (range of stay from 1 to 303 months, M = 61.93 months, SD = 59.84) and 35% (T₁ = 97; T₂ = 74) attended daily seniors clubs (for about 5–6 hours each day). Inclusion criteria were as follows: age ≥60, lack of cognitive disorders (no diagnosis of dementia or mild cognitive impairments, and efficient cognitive functioning confirmed by the care facility personnel), and lack of serious acute somatic illness that may significantly affect the results. Most participants were single (unmarried, widowed, divorced; 83%), with secondary or primary education (71%), had not used medical care for the previous 6 months (63%), and described their material status as average (62%). Participants suffered from more than four coexisting chronic illnesses (0–12; M = 4.53, SD = 2.63) and took on average about six medicines per day (M = 6.42, SD = 4.47). The average functional status of participants was relatively high: the mean score on the Katz Index of Activities of Daily Living (ADL) [31] was 5.65 (SD = .88, range = 0–6, Cronbach’s α = .71), and on the Lawton Instrumental Activities of Daily Living (IADL) Scale [32] was 20.89 (SD = 3.88, range = 8–24, Cronbach’s α = .85). Subjectively assessed health status, measured by two items (“Overall, my current health is…” and “Compared with people of my age and sex, my current health is…”) rated on a five-point Likert scale from 1 (poor) to 5 (excellent), was perceived as acceptable (M = 2.54, SD = .87, Cronbach’s α = .61).

The institution did not differentiate the participants in terms of controlled variables, except for age, functional status, subjective health, and the number of administered drugs. The residents of nursing homes (M_NH = 79.14, SD = 9.07) were significantly older than those attending the daily seniors clubs (M_SC = 74.15, SD = 8.60, t₂₇₅ = −4.44, p < .001), rated both their health (M_NH = 2.44 ± .85 vs. M_SC = 2.72 ± .87, t₂₇₅ = 2.62; p = .009) and functional status (ADL: M_NH = 5.52 ± 1.04 vs. M_SC = 5.90 ± .30, t_229.67 = 4.54, p = .001; IADL: M_NH = 19.84 ± 4.12 vs. M_SC = 22.82 ± 2.41, t_273.15 = 7.57; p < .001) as worse, and took significantly more drugs daily (M_NH = 6.78 ± 4.33 vs. M_SC = 5.57 ± 4.15, t₂₇₁ = 2.22; p = .050).

The study protocol was evaluated and approved by the University of Social Sciences and Humanities ethical committee in Warsaw. Written informed consent was obtained from all participants. Participation in the study was voluntary. At both measurement points, participants completed questionnaires to evaluate social support, affect, depressive symptoms, and health indicators. Taking into consideration the specificity of the study group, abbreviated or experimental versions of the research tools were used (i.e., consisting of 2–6 items).

The sample attrition analyses indicated that data missingness was similar in the nursing home and senior club groups (approximately 23%); respondents and non-respondents did not differ on sociodemographic and medical variables except age (non-respondents were older than respondents; χ²₁ = 16.23, p < .001, odds ratio = .94). Of the main study variables, significant differences were found only for provided support, which was higher for non-respondents than for respondents, χ²₁ = 6.53, p = .011, odds ratio = .62, M = 2.89 ± .75 vs. M = 2.61 ± .78.

Measures

Social support.

Received support was measured using six items selected from the Berlin Social Support Scales (BSSS) [33]. This scale’s internal consistency ranged from α = .92 at T1 to α = .93 at T2. Provided support was measured using three questions phrased congruently with the BSSS received support items (“I comforted her/him or gave her/him encouragement,” “I gave her/his advice or information,” “I offered her/him help”). This scale’s internal consistency ranged from α = .82 at T1 to α = .84 at T2. All statements were assessed on a four-point scale from 1 (strongly disagree) to 4 (strongly agree). The indicators of received and provided support were the arithmetic means of the answers. Higher scores indicate greater levels of support. For the purposes of this study, only values from the first measurement were used.

Positive affect.

Positive affect (PA) was measured twice using three items (joy, satisfaction, optimism) from the Positive and Negative Affect Schedule (PANAS) [34]. Participants rated how they currently felt on a seven-point scale ranging from 1 (not at all) to 7 (very strongly). Internal consistency ranged from α = .79 at T2 to α = .82 at T1. Higher scores indicated greater PA.

Depressive symptoms.

Symptoms of depression were evaluated twice with 11 items from the Centre for Epidemiological Studies Depression Scale (CES-D) [35], which were assessed using a four-point scale ranging from 0 (rarely or never) to 3 (often). Higher scores indicate greater depressive symptoms. Internal consistency was α = .77 at T1 and T2.

Data analyses

Analyses were conducted using IBM SPSS (IBM Corp.; Armonk, NY) and AMOS, both versions 22. Structural equation modeling was used to examine the relations between received and provided support and well-being (i.e., PA and depressive symptoms) (see Fig 1). Two models were tested: a cross-sectional model for the relationship between support and well-being at baseline (T1), and a longitudinal model for the time effect (T1 → T2) of support, after controlling for the baseline level of well-being. For this purpose, regression standardized residuals were obtained, where values of the well-being variables at T2 were regressed on the baseline values of the same variables [36]. These residuals were then included in the structural equation modeling analyses as well-being variables in the longitudinal model. The data showed a multivariate normal distribution. The sociodemographic variables: age, gender, marital status, subjective and objective (number of diseases) health, as well as functional status (ADL, IADL), were entered into the joint models for both samples as covariates, however in the final models only those with paths significantly different from zero were included. To maximize the utilization of the data, we used multiple imputation of residuals [37] using all data in the tested models. The comparison between original (N = 212) and imputed (N = 277) data sets revealed no significant sample differences on analyzed variables. Thus, the results from the imputed file were reported.

Download:

Fig 1. Model of relationships between received and provided social support and well-being.

https://doi.org/10.1371/journal.pone.0161328.g001

Following the recommendations of Hooper, Coughlan, and Mullen [38], goodness of fit for the models was based on (1) the chi-square value (χ²), (2) the normed chi-square (χ²/df), (3) the non-normed fit index (NNFI, also known as Tucker–Lewis Index, TLI), (4) the comparative fit index (CFI), (5) the adjusted goodness-of-fit index (AGFI), and (6) the root mean square error of approximation (RMSEA). An insignificant χ² test indicates a good model fit, although its use is not free from limitations, especially for small sample sizes. Thus, the ratio of χ² to degrees of freedom was also used, with values lower than 2 assumed to be satisfactory [36]. The NNFI, CFI and AGFI threshold values of .90 indicate satisfactory fit, whereas values above .95 indicate good fit. For a well-fitting model, the RMSEA should be close to 0: values below .05 indicate a good model fit and a value of .08 represents reasonable errors of approximation. After establishing a model with a satisfactory goodness of fit, multiple group analysis was conducted to test for possible moderation effects from institutional care (nursing homes vs. seniors clubs). The goodness of fit of both constrained (i.e., assuming all regression coefficients are equal across groups) and unconstrained (assuming all the parameters were freed across groups) models were tested. Delta chi-square test (Δχ²), the Akaike information criterion (AIC), and ΔAIC were computed to compare models.

Results

Descriptive statistics

Descriptive statistics and correlations for nursing home and seniors club samples are presented in Table 1. There were moderate correlations between depressive symptoms and PA and low correlations between well-being and social support. PA decreased over time (Wilks’ lambda F_1,137 = 23.19, p < .001, partial eta² = .14), whereas depressive symptoms increased over time (Wilks’ lambda F_1,137 = 4.94, p = .028, partial eta² = .04), but only for nursing home residents. For the seniors club participants, PA and depression were stable during the study period, Wilks’ lambda F_1,73 = .51, p = .478; Wilks’ lambda F_1,73 = .67, p = .417, respectively. Additionally, the nursing home group showed less received support (F_1,229.13 = 3.93, p = .049), lower PA (T1: F_1,276 = 4.10, p = .044; T2: F_1,211 = 17.07, p < .001), and greater depressive symptoms (T1: F_1,238.24 = 10.85, p = .001; T2: F_1,211 = 10.54, p = .001) compared with the seniors club participants.

Download:

Table 1. Descriptive statistics and bivariate correlations.

https://doi.org/10.1371/journal.pone.0161328.t001

Social support and well-being: Cross-sectional and longitudinal analysis

The cross-sectional model of the relationship between social support and well-being fitted the data well (see Table 2). The effects of received social support on both PA and depressive symptoms were statistically significant and in different directions (see Fig 2). However, provided support had a significant effect only on PA. In addition, there were significant paths leading from marital status and subjective health to both dimensions of well-being, whereas functional status was positively and weakly related only to depression.

Download:

Fig 2. Resultant model of cross-sectional relationship between social support and well-being for both samples.

IADL, Lawton Instrumental Activities of Daily Living (higher scores indicate greater independence); values presented are standardized coefficients, ^*p < .05, ^**p < .01, ^***p < .001.

https://doi.org/10.1371/journal.pone.0161328.g002

Download:

Table 2. Cross-sectional and longitudinal model fit indicators: structural equation modeling results.

https://doi.org/10.1371/journal.pone.0161328.t002

The time effect model also fitted the data well (see Table 2). However, the only significant effect was that of received support on PA: the greater the support received from others, the greater the PA 1 month later, after controlling for its baseline level (see Fig 3). In addition, the effect of functional status on PA and depression was significant.

Download:

Fig 3. Resultant model of time effect of social support on well-being for both samples.

IADL, Lawton Instrumental Activities of Daily Living (higher scores indicate greater independence); values presented are standardized coefficients, ^p < .07, ^*p < .05, ^**p < .01, ^***p < .001.

https://doi.org/10.1371/journal.pone.0161328.g003

Moderation effects of institutionalization

Cross-sectional models with institutionalization as a grouping variable demonstrated a good fit (see Table 3). A model comparison (unconstrained vs. constrained) did not indicate significant differences between models (Δχ² was insignificant). The model with equal regression coefficients across groups (constrained) was more parsimonious and thus appeared to fit the data better. Therefore, a moderation effect of institutionalization was not supported.

Download:

Table 3. Moderation effect of institutionalization: group comparison.

https://doi.org/10.1371/journal.pone.0161328.t003

In the longitudinal model, multiple group analysis indicated significant differences between unconstrained and constrained models (significant Δχ², see Table 3). Both models (unconstrained and constrained) had acceptable fit indicators, but the unconstrained model showed better values. The comparison of models, expressed by significant Δχ², indicated a difference between their goodness of fit, which led us to reject the constrained model. Thus, institutional care appeared to be a moderator of the longitudinal relationship between social support and well-being. Specifically, the model showed that for the seniors club participants both the receiving and providing of social support was a positive predictor of PA 1 month later (see Fig 4). The effect of social support on depression was not significant. Covariates were unrelated to well-being in this group. In contrast, for the nursing home group, only the covariates were related to well-being; there were no longitudinal effects of social support (see Fig 5).

Download:

Fig 4. Resultant model of time effect of social support on well-being for seniors club participants.

IADL, Lawton Instrumental Activities of Daily Living (higher scores indicate greater independence); values presented are standardized coefficients, ^*p < .05, ^**p < .01, ^***p < .001.

https://doi.org/10.1371/journal.pone.0161328.g004

Download:

Fig 5. Resultant model of time effect of social support on well-being for nursing home participants.

IADL, Lawton Instrumental Activities of Daily Living (higher scores indicate greater independence); values presented are standardized coefficients, ^*p < .05, ^**p < .01, ^***p < .001.

https://doi.org/10.1371/journal.pone.0161328.g005

Discussion

The aim of the study was to examine relations between support and well-being from two temporal perspectives: cross-sectional and longitudinal, with a 1-month lag between measurement points. Both models revealed only one significant correlation: a relation between received support and PA. The greater the received support, the greater the PA. However, the moderation analysis indicated that the effect obtained in the longitudinal model can be entirely attributed to the participants from the seniors clubs, as among nursing home residents all the relations between support and well-being turned out insignificant.

These patterns differed from those revealed by the cross-sectional model, which showed the same relations for both groups. Namely, the received support was associated with both greater PA and less depression, whereas given support was not significantly related to depression, but was positively related to PA. Although the cross-sectional nature of the model prevents any inferences about the causality of these relations, they are in accord with the generally beneficial consequences of received support that are repeatedly observed in research as direct effect of support [39]. They also suggest that being a support provider is related to PA but not necessarily related to depressive symptoms, which has also been reported in a previous study [40].

Interestingly, the cross-sectional results were the same for both groups, even though the groups differed significantly on given support and well-being: the nursing home participants reported lower levels of support and well-being. Thus, the transient effects of support seem relatively context-free, but the postponed effects are probably more prone to such influences. There are at least three non-exclusive explanations of the longitudinal between-group differences. First, as was mentioned in the introduction, patients of nursing homes may get used to higher levels of support and perceive this as normal because of the nursing character of these homes [41]. Therefore, from a longer perspective, received support does not contribute greatly to their well-being. Additionally, they may perhaps perceive as supporting only those interactions exceeding the scheme of support exchange in a given institution or involving special, more spontaneous, and voluntary sources of this support (e.g., other pensioners, visiting relatives) [42]. However, such support, as it stems from interactions other than typical social exchanges, may be relatively rare and have a time-limited effect. Second, depression symptoms among nursing home residents may be too high for such institutional support to reduce them effectively. Finally, it may not be the intensity of symptoms that is crucial here, but their origin [43]. Even though the proxy of objective somatic health (expressed by number of diseases and functional state) was controlled in the models, a somatogenic etiology of depression symptoms [44] may have affected the results, limiting the corrective potential of any kind of support.

The different mechanisms underlying well-being in both groups are also indicated by the dynamics of well-being during the study period. PA decreased in nursing home residents, whereas symptoms of depression increased between the measurement points. Hence, both dimensions are negatively, though moderately, correlated (see Table 1). For the seniors club participants, levels of both well-being dimensions were stable. Thus, the relation between PA and depressive symptoms in non-clinical groups of older adults is dynamic and may be dependent on the social setting in which they live. In addition, although the lower affective well-being of nursing home residents reflects the findings of other studies [45,46], our study reveals that baseline support, regardless of its character, does not prevent their well-being reducing over time.

Finally, contrary to the assumptions of equity theory, both types of support were only weakly correlated (i.e., greater received support was not systematically accompanied by greater provided support). However, as in all studies using self-descriptive measures of social support, the lack of verification of participants’ declarations with actual behavior is a substantial limitation. Moreover, we did not analyze the relationship between the change of support intensity and the change of well-being. Neither did we take into account possible differences arising from the type of functional support. The very few studies on given emotional, instrumental, or informative support show that their effects on the support provider’s well-being may be dependent on what kind of support is given [47], who it is given to [48], and for how long [49]. The present results are in accord with previous work on received support, which indicates that different support sources modify the effectiveness of received support type [50]; this could help to explain the results obtained for nursing home participants. Thus, this issue requires further exploration. It should be also emphasized that there were different numbers of participants in each group and that the groups may be highly specific; the statistical control of sociodemographic and health-related variables does not take into consideration the mechanisms underlying such differences. For instance, people in nursing homes differ from people from seniors clubs in many sociodemographic and functional aspects; perhaps their ability to build social network is also different: participants of seniors clubs may be more active and autonomous in satisfying their social needs.

Summing up, the findings indicate that the incoherence of studies on the relationship between support and well-being may be caused by different time lags between measurement of support and its potential effects, the valence of these effects (i.e., whether they are positive or negative), and the broader social context of participant functioning, which is not always directly included in the study design. Moreover, both received and provided support seem to be important to the positive aspect of well-being, but longitudinally only for well-functioning older people. Although the percentage of explained variance for each model is low, it is similar to values reported in other studies on this subject [50,51]. Additionally, because of the control of baseline values, this may be interpreted as incremental variance due to social support (and covariates), which may be an additional contribution of the study. However, the meaning of these findings is not entirely clear. The results could be interpreted as supporting the esteem enhancement theory; however, the benefits from received support appear to confirm social exchange theory.

Finally, neither given nor received support prevented the reduction of well-being in nursing home participants. On the contrary, these participants had lower ratings of received support than did noninstitutionalized participants. This may point to a mechanism similar to that described as support deterioration [52]. Interestingly, as our findings suggest, this may be associated not only with older age but also with the specifics of functioning in nursing institutions. This phenomenon requires further study.

Supporting Information

S1 Data. Dataset for “Well-being and Institutional Care in Older Adults: Cross-Sectional and Time Effects of Provided and Received Support” in.sav format.

https://doi.org/10.1371/journal.pone.0161328.s001

(SAV)

Author Contributions

Conceptualization: AK EG.
Data curation: AK.
Formal analysis: AK.
Funding acquisition: AK.
Investigation: AK.
Methodology: AK.
Project administration: AK.
Resources: AK.
Supervision: AK.
Validation: AK EG.
Visualization: AK.
Writing - original draft: AK EG.
Writing - review & editing: AK EG.

References

1. Pritchard RD. Equity theory: A review and critique. Organ Behav Hum Perform. 1969;4: 176–211.
- View Article
- Google Scholar
2. Cropanzano R, Mitchell MS. Social exchange theory: An interdisciplinary review. J Manag. 2005;31: 874–900.
- View Article
- Google Scholar
3. Batson CD, Powell AA. Altruism and prosocial behavior. Handbook of psychology. John Wiley & Sons, Inc.; 2003.
4. Sedikides C, Strube MJ. The multiply motivated self. Pers Soc Psychol Bull. 1995;21: 1330–1335.
- View Article
- Google Scholar
5. Coombs RH. Marital status and personal well-being: A literature review. Fam Relat. 1991;40: 97.
- View Article
- Google Scholar
6. Krause N, Herzog AR, Baker E. Providing support to others and well-being in later life. J Gerontol. 1992;47: P300–311. pmid:1512435
- View Article
- PubMed/NCBI
- Google Scholar
7. Coyne JC, Bolger N. Doing without social support as an explanatory concept. J Soc Clin Psychol. 1990;9: 148–158.
- View Article
- Google Scholar
8. Revenson TA, Schiaffino KM, Majerovitz SD, Gibofsky A. Social support as a double-edged sword: the relation of positive and problematic support to depression among rheumatoid arthritis patients. Soc Sci Med. 1991;33: 807–813. pmid:1948172
- View Article
- PubMed/NCBI
- Google Scholar
9. Belcher AJ, Laurenceau J-P, Graber EC, Cohen LH, Dasch KB, Siegel SD. Daily support in couples coping with early stage breast cancer: maintaining intimacy during adversity. Health Psychol. 2011;30: 665–673. pmid:21823795
- View Article
- PubMed/NCBI
- Google Scholar
10. Lachman ME, Agrigoroaei S. Promoting functional health in midlife and old age: Long-term protective effects of control beliefs, social support, and physical exercise. PLoS ONE. 2010;5: e13297. pmid:20949016
- View Article
- PubMed/NCBI
- Google Scholar
11. Ma L, Li Y, Wang J, Zhu H, Yang W, Cao R, et al. Quality of Life Is Related to Social Support in Elderly Osteoporosis Patients in a Chinese Population. PLoS ONE. 2015;10: e0127849. pmid:26061550
- View Article
- PubMed/NCBI
- Google Scholar
12. Cherry KE, Sampson L, Nezat PF, Cacamo A, Marks LD, Galea S. Long-term psychological outcomes in older adults after disaster: relationships to religiosity and social support. Aging Ment Health. 2015;19: 430–443. pmid:25078872
- View Article
- PubMed/NCBI
- Google Scholar
13. Liang J, Krause NM, Bennett JM. Social exchange and well-being: Is giving better than receiving? Psychol Aging. 2001;16: 511–523. pmid:11554527
- View Article
- PubMed/NCBI
- Google Scholar
14. Krause N, Liang J, Keith V. Personality, social support, and psychological distress in later life. Psychol Aging. 1990;5: 315–326. pmid:2242236
- View Article
- PubMed/NCBI
- Google Scholar
15. Chao SF. Assessing social support and depressive symptoms in older Chinese adults: a longitudinal perspective. Aging Ment Health. 2011;15: 765–774. pmid:21838514
- View Article
- PubMed/NCBI
- Google Scholar
16. Hellström Y, Persson G, Hallberg IR. Quality of life and symptoms among older people living at home. J Adv Nurs. 2004;48: 584–593. pmid:15548249
- View Article
- PubMed/NCBI
- Google Scholar
17. Abolfathi Momtaz Y, Ibrahim R, Hamid TA. The impact of giving support to others on older adults’ perceived health status. Psychogeriatrics. 2014;14: 31–37. pmid:24299124
- View Article
- PubMed/NCBI
- Google Scholar
18. Thomas PA. Is it better to give or to receive? Social support and the well-being of older adults. J Gerontol. 2010;65B: 351–357.
- View Article
- Google Scholar
19. Warner LM, Schuz B, Wurm S, Ziegelmann JP, Tesch-Romer C. Giving and taking—Differential effects of providing, receiving and anticipating emotional support on quality of life in adults with multiple illnesses. J Health Psychol. 2010;15: 660–670. pmid:20603289
- View Article
- PubMed/NCBI
- Google Scholar
20. Li T, Fok HK, Fung HH. Is reciprocity always beneficial? Age differences in the association between support balance and life satisfaction. Aging Ment Health. 2011;15: 541–547. pmid:21815845
- View Article
- PubMed/NCBI
- Google Scholar
21. Matt GE, Dean A. Social support from friends and psychological distress among elderly persons: Moderator effects of age. J Health Soc Behav. 1993;34: 187. pmid:7989664
- View Article
- PubMed/NCBI
- Google Scholar
22. Newsom JT, Nishishiba M, Morgan DL, Rook KS. The relative importance of three domains of positive and negative social exchanges: a longitudinal model with comparable measures. Psychol Aging. 2003;18: 746–754. pmid:14692861
- View Article
- PubMed/NCBI
- Google Scholar
23. Brown SL, Nesse RM, Vinokur AD, Smith DM. Providing social support may be more beneficial than receiving it. Results from a prospective study of mortality. Psychol Sci. 2003;14: 320–327. pmid:12807404
- View Article
- PubMed/NCBI
- Google Scholar
24. Antonucci TC, Birditt KS, Sherman CW, Trinh S. Stability and change in the intergenerational family: a convoy approach. Ageing Soc. 2011;31: 1084–1106.
- View Article
- Google Scholar
25. Gaymu J, Ekamper P, Beets G. Who will be caring for Europe’s dependent elders in 2030? Population. 2007;62: 675–706.
- View Article
- Google Scholar
26. Grenade L, Boldy D. Social isolation and loneliness among older people: issues and future challenges in community and residential settings. Aust Health Rev Publ Aust Hosp Assoc. 2008;32: 468–478.
- View Article
- Google Scholar
27. Diener E, Emmons RA. The independence of positive and negative affect. J Pers Soc Psychol. 1984;47: 1105–1117. pmid:6520704
- View Article
- PubMed/NCBI
- Google Scholar
28. Gomez R, McLaren S. The center for epidemiologic studies depression scale: support for a bifactor model with a dominant general factor and a specific factor for positive affect. Assessment. 2015;22: 351–360. pmid:25085880
- View Article
- PubMed/NCBI
- Google Scholar
29. Krause N, Shaw BA. Giving social support to others, socioeconomic status, and changes in self-esteem in late life. J Gerontol. 2000;55: S323–333.
- View Article
- Google Scholar
30. Williamson GM, Clark MS. Providing help and desired relationship type as determinants of changes in moods and self-evaluations. J Pers Soc Psychol. 1989;56: 722–734. pmid:2724066
- View Article
- PubMed/NCBI
- Google Scholar
31. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged: The index of adl: a standardized measure of biological and psychosocial function. JAMA. 1963;185: 914–919. pmid:14044222
- View Article
- PubMed/NCBI
- Google Scholar
32. Lawton MP, Brody EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist. 1969;9: 179–186. pmid:5349366
- View Article
- PubMed/NCBI
- Google Scholar
33. Schulz U, Schwarzer R. Soziale Unterstützung bei der Krankheitsbewältigung: Die Berliner Social Support Skalen (BSSS) [Social support in coping with illness: The Berlin Social Support Scales (BSSS)]. Diagnostica. 2003;49: 73–82.
- View Article
- Google Scholar
34. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988;54: 1063–1070. pmid:3397865
- View Article
- PubMed/NCBI
- Google Scholar
35. Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1: 385–401.
- View Article
- Google Scholar
36. Tabachnick BG, Fidell LS. Using multivariate statistics. 6th ed. Boston: Pearson; 2007.
37. Graham JW. Missing data analysis: Making it work in the real world. Annu Rev Psychol. 2009;60: 549–576. pmid:18652544
- View Article
- PubMed/NCBI
- Google Scholar
38. Hooper D, Coughlan J, Mullen M. Structural equation modelling: guidelines for determining model fit. Electron J Buisness Res Methods. 2008;6: 53–60.
- View Article
- Google Scholar
39. Cohen S, Underwood LG, Gottlieb BH. Social Support Measurement and Intervention: A Guide for Health and Social Scientists: A Guide for Health and Social Scientists. Oxford University Press, USA; 2000.
40. Poulin MJ, Brown SL, Ubel PA, Smith DM, Jankovic A, Langa KM. Does a helping hand mean a heavy heart? Helping behavior and well-being among spouse caregivers. Psychol Aging. 2010;25: 108–117. pmid:20230132
- View Article
- PubMed/NCBI
- Google Scholar
41. Lin I-F, Wu H-S. Does informal care attenuate the cycle of ADL/IADL disability and depressive symptoms in late life? J Gerontol. 2011;66: 585–594.
- View Article
- Google Scholar
42. Sherman AM, de Vries B, Lansford JE. Friendship in childhood and adulthood: lessons across the life span. Int J Aging Hum Dev. 2000;51: 31–51. pmid:11130611
- View Article
- PubMed/NCBI
- Google Scholar
43. Hegeman JM, de Waal MWM, Comijs HC, Kok RM, van der Mast RC. Depression in later life: a more somatic presentation? J Affect Disord. 2015;170: 196–202. pmid:25254617
- View Article
- PubMed/NCBI
- Google Scholar
44. Katz IR. On the Inseparability of Mental and Physical Health in Aged Persons: Lessons From Depression and Medical Comorbidity. Am J Geriatr Psychiatry. 1996;4: 1–16.
- View Article
- Google Scholar
45. Seitz D, Purandare N, Conn D. Prevalence of psychiatric disorders among older adults in long-term care homes: a systematic review. Int Psychogeriatr IPA. 2010;22: 1025–1039.
- View Article
- Google Scholar
46. Thakur M, Blazer DG. Depression in long-term care. J Am Med Dir Assoc. 2008;9: 82–87. pmid:18261699
- View Article
- PubMed/NCBI
- Google Scholar
47. Strazdins L, Broom DH. The mental health costs and benefits of giving social support. Int J Stress Manag. 2007;14: 370–385.
- View Article
- Google Scholar
48. Eisenkraft N, Elfenbein HA. The way you make me feel: evidence for individual differences in affective presence. Psychol Sci. 2010;21: 505–510. pmid:20424091
- View Article
- PubMed/NCBI
- Google Scholar
49. Pavalko EK, Woodbury S. Social roles as process: caregiving careers and women’s health. J Health Soc Behav. 2000;41: 91–105. pmid:10750324
- View Article
- PubMed/NCBI
- Google Scholar
50. Chen Y, Feeley TH. Social support, social strain, loneliness, and well-being among older adults: An analysis of the Health and Retirement Study. J Soc Pers Relatsh. 2013;
- View Article
- Google Scholar
51. Bisconti TL, Bergeman CS. Perceived social control as a mediator of the relationships among social support, psychological well-being, and perceived health. The Gerontologist. 1999;39: 94–103. pmid:10028775
- View Article
- PubMed/NCBI
- Google Scholar
52. Norris FH, Kaniasty K. Received and perceived social support in times of stress: a test of the social support deterioration deterrence model. J Pers Soc Psychol. 1996;71: 498–511. pmid:8831159
- View Article
- PubMed/NCBI
- Google Scholar

[ref1] 1. Pritchard RD. Equity theory: A review and critique. Organ Behav Hum Perform. 1969;4: 176–211.
View Article
Google Scholar

[2] View Article

[3] Google Scholar

[ref2] 2. Cropanzano R, Mitchell MS. Social exchange theory: An interdisciplinary review. J Manag. 2005;31: 874–900.
View Article
Google Scholar

[5] View Article

[6] Google Scholar

[ref3] 3. Batson CD, Powell AA. Altruism and prosocial behavior. Handbook of psychology. John Wiley & Sons, Inc.; 2003.

[ref4] 4. Sedikides C, Strube MJ. The multiply motivated self. Pers Soc Psychol Bull. 1995;21: 1330–1335.
View Article
Google Scholar

[9] View Article

[10] Google Scholar

[ref5] 5. Coombs RH. Marital status and personal well-being: A literature review. Fam Relat. 1991;40: 97.
View Article
Google Scholar

[12] View Article

[13] Google Scholar

[ref6] 6. Krause N, Herzog AR, Baker E. Providing support to others and well-being in later life. J Gerontol. 1992;47: P300–311. pmid:1512435
View Article
PubMed/NCBI
Google Scholar

[15] View Article

[16] PubMed/NCBI

[17] Google Scholar

[ref7] 7. Coyne JC, Bolger N. Doing without social support as an explanatory concept. J Soc Clin Psychol. 1990;9: 148–158.
View Article
Google Scholar

[19] View Article

[20] Google Scholar

[ref8] 8. Revenson TA, Schiaffino KM, Majerovitz SD, Gibofsky A. Social support as a double-edged sword: the relation of positive and problematic support to depression among rheumatoid arthritis patients. Soc Sci Med. 1991;33: 807–813. pmid:1948172
View Article
PubMed/NCBI
Google Scholar

[22] View Article

[23] PubMed/NCBI

[24] Google Scholar

[ref9] 9. Belcher AJ, Laurenceau J-P, Graber EC, Cohen LH, Dasch KB, Siegel SD. Daily support in couples coping with early stage breast cancer: maintaining intimacy during adversity. Health Psychol. 2011;30: 665–673. pmid:21823795
View Article
PubMed/NCBI
Google Scholar

[26] View Article

[27] PubMed/NCBI

[28] Google Scholar

[ref10] 10. Lachman ME, Agrigoroaei S. Promoting functional health in midlife and old age: Long-term protective effects of control beliefs, social support, and physical exercise. PLoS ONE. 2010;5: e13297. pmid:20949016
View Article
PubMed/NCBI
Google Scholar

[30] View Article

[31] PubMed/NCBI

[32] Google Scholar

[ref11] 11. Ma L, Li Y, Wang J, Zhu H, Yang W, Cao R, et al. Quality of Life Is Related to Social Support in Elderly Osteoporosis Patients in a Chinese Population. PLoS ONE. 2015;10: e0127849. pmid:26061550
View Article
PubMed/NCBI
Google Scholar

[34] View Article

[35] PubMed/NCBI

[36] Google Scholar

[ref12] 12. Cherry KE, Sampson L, Nezat PF, Cacamo A, Marks LD, Galea S. Long-term psychological outcomes in older adults after disaster: relationships to religiosity and social support. Aging Ment Health. 2015;19: 430–443. pmid:25078872
View Article
PubMed/NCBI
Google Scholar

[38] View Article

[39] PubMed/NCBI

[40] Google Scholar

[ref13] 13. Liang J, Krause NM, Bennett JM. Social exchange and well-being: Is giving better than receiving? Psychol Aging. 2001;16: 511–523. pmid:11554527
View Article
PubMed/NCBI
Google Scholar

[42] View Article

[43] PubMed/NCBI

[44] Google Scholar

[ref14] 14. Krause N, Liang J, Keith V. Personality, social support, and psychological distress in later life. Psychol Aging. 1990;5: 315–326. pmid:2242236
View Article
PubMed/NCBI
Google Scholar

[46] View Article

[47] PubMed/NCBI

[48] Google Scholar

[ref15] 15. Chao SF. Assessing social support and depressive symptoms in older Chinese adults: a longitudinal perspective. Aging Ment Health. 2011;15: 765–774. pmid:21838514
View Article
PubMed/NCBI
Google Scholar

[50] View Article

[51] PubMed/NCBI

[52] Google Scholar

[ref16] 16. Hellström Y, Persson G, Hallberg IR. Quality of life and symptoms among older people living at home. J Adv Nurs. 2004;48: 584–593. pmid:15548249
View Article
PubMed/NCBI
Google Scholar

[54] View Article

[55] PubMed/NCBI

[56] Google Scholar

[ref17] 17. Abolfathi Momtaz Y, Ibrahim R, Hamid TA. The impact of giving support to others on older adults’ perceived health status. Psychogeriatrics. 2014;14: 31–37. pmid:24299124
View Article
PubMed/NCBI
Google Scholar

[58] View Article

[59] PubMed/NCBI

[60] Google Scholar

[ref18] 18. Thomas PA. Is it better to give or to receive? Social support and the well-being of older adults. J Gerontol. 2010;65B: 351–357.
View Article
Google Scholar

[62] View Article

[63] Google Scholar

[ref19] 19. Warner LM, Schuz B, Wurm S, Ziegelmann JP, Tesch-Romer C. Giving and taking—Differential effects of providing, receiving and anticipating emotional support on quality of life in adults with multiple illnesses. J Health Psychol. 2010;15: 660–670. pmid:20603289
View Article
PubMed/NCBI
Google Scholar

[65] View Article

[66] PubMed/NCBI

[67] Google Scholar

[ref20] 20. Li T, Fok HK, Fung HH. Is reciprocity always beneficial? Age differences in the association between support balance and life satisfaction. Aging Ment Health. 2011;15: 541–547. pmid:21815845
View Article
PubMed/NCBI
Google Scholar

[69] View Article

[70] PubMed/NCBI

[71] Google Scholar

[ref21] 21. Matt GE, Dean A. Social support from friends and psychological distress among elderly persons: Moderator effects of age. J Health Soc Behav. 1993;34: 187. pmid:7989664
View Article
PubMed/NCBI
Google Scholar

[73] View Article

[74] PubMed/NCBI

[75] Google Scholar

[ref22] 22. Newsom JT, Nishishiba M, Morgan DL, Rook KS. The relative importance of three domains of positive and negative social exchanges: a longitudinal model with comparable measures. Psychol Aging. 2003;18: 746–754. pmid:14692861
View Article
PubMed/NCBI
Google Scholar

[77] View Article

[78] PubMed/NCBI

[79] Google Scholar

[ref23] 23. Brown SL, Nesse RM, Vinokur AD, Smith DM. Providing social support may be more beneficial than receiving it. Results from a prospective study of mortality. Psychol Sci. 2003;14: 320–327. pmid:12807404
View Article
PubMed/NCBI
Google Scholar

[81] View Article

[82] PubMed/NCBI

[83] Google Scholar

[ref24] 24. Antonucci TC, Birditt KS, Sherman CW, Trinh S. Stability and change in the intergenerational family: a convoy approach. Ageing Soc. 2011;31: 1084–1106.
View Article
Google Scholar

[85] View Article

[86] Google Scholar

[ref25] 25. Gaymu J, Ekamper P, Beets G. Who will be caring for Europe’s dependent elders in 2030? Population. 2007;62: 675–706.
View Article
Google Scholar

[88] View Article

[89] Google Scholar

[ref26] 26. Grenade L, Boldy D. Social isolation and loneliness among older people: issues and future challenges in community and residential settings. Aust Health Rev Publ Aust Hosp Assoc. 2008;32: 468–478.
View Article
Google Scholar

[91] View Article

[92] Google Scholar

[ref27] 27. Diener E, Emmons RA. The independence of positive and negative affect. J Pers Soc Psychol. 1984;47: 1105–1117. pmid:6520704
View Article
PubMed/NCBI
Google Scholar

[94] View Article

[95] PubMed/NCBI

[96] Google Scholar

[ref28] 28. Gomez R, McLaren S. The center for epidemiologic studies depression scale: support for a bifactor model with a dominant general factor and a specific factor for positive affect. Assessment. 2015;22: 351–360. pmid:25085880
View Article
PubMed/NCBI
Google Scholar

[98] View Article

[99] PubMed/NCBI

[100] Google Scholar

[ref29] 29. Krause N, Shaw BA. Giving social support to others, socioeconomic status, and changes in self-esteem in late life. J Gerontol. 2000;55: S323–333.
View Article
Google Scholar

[102] View Article

[103] Google Scholar

[ref30] 30. Williamson GM, Clark MS. Providing help and desired relationship type as determinants of changes in moods and self-evaluations. J Pers Soc Psychol. 1989;56: 722–734. pmid:2724066
View Article
PubMed/NCBI
Google Scholar

[105] View Article

[106] PubMed/NCBI

[107] Google Scholar

[ref31] 31. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged: The index of adl: a standardized measure of biological and psychosocial function. JAMA. 1963;185: 914–919. pmid:14044222
View Article
PubMed/NCBI
Google Scholar

[109] View Article

[110] PubMed/NCBI

[111] Google Scholar

[ref32] 32. Lawton MP, Brody EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist. 1969;9: 179–186. pmid:5349366
View Article
PubMed/NCBI
Google Scholar

[113] View Article

[114] PubMed/NCBI

[115] Google Scholar

[ref33] 33. Schulz U, Schwarzer R. Soziale Unterstützung bei der Krankheitsbewältigung: Die Berliner Social Support Skalen (BSSS) [Social support in coping with illness: The Berlin Social Support Scales (BSSS)]. Diagnostica. 2003;49: 73–82.
View Article
Google Scholar

[117] View Article

[118] Google Scholar

[ref34] 34. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988;54: 1063–1070. pmid:3397865
View Article
PubMed/NCBI
Google Scholar

[120] View Article

[121] PubMed/NCBI

[122] Google Scholar

[ref35] 35. Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1: 385–401.
View Article
Google Scholar

[124] View Article

[125] Google Scholar

[ref36] 36. Tabachnick BG, Fidell LS. Using multivariate statistics. 6th ed. Boston: Pearson; 2007.

[ref37] 37. Graham JW. Missing data analysis: Making it work in the real world. Annu Rev Psychol. 2009;60: 549–576. pmid:18652544
View Article
PubMed/NCBI
Google Scholar

[128] View Article

[129] PubMed/NCBI

[130] Google Scholar

[ref38] 38. Hooper D, Coughlan J, Mullen M. Structural equation modelling: guidelines for determining model fit. Electron J Buisness Res Methods. 2008;6: 53–60.
View Article
Google Scholar

[132] View Article

[133] Google Scholar

[ref39] 39. Cohen S, Underwood LG, Gottlieb BH. Social Support Measurement and Intervention: A Guide for Health and Social Scientists: A Guide for Health and Social Scientists. Oxford University Press, USA; 2000.

[ref40] 40. Poulin MJ, Brown SL, Ubel PA, Smith DM, Jankovic A, Langa KM. Does a helping hand mean a heavy heart? Helping behavior and well-being among spouse caregivers. Psychol Aging. 2010;25: 108–117. pmid:20230132
View Article
PubMed/NCBI
Google Scholar

[136] View Article

[137] PubMed/NCBI

[138] Google Scholar

[ref41] 41. Lin I-F, Wu H-S. Does informal care attenuate the cycle of ADL/IADL disability and depressive symptoms in late life? J Gerontol. 2011;66: 585–594.
View Article
Google Scholar

[140] View Article

[141] Google Scholar

[ref42] 42. Sherman AM, de Vries B, Lansford JE. Friendship in childhood and adulthood: lessons across the life span. Int J Aging Hum Dev. 2000;51: 31–51. pmid:11130611
View Article
PubMed/NCBI
Google Scholar

[143] View Article

[144] PubMed/NCBI

[145] Google Scholar

[ref43] 43. Hegeman JM, de Waal MWM, Comijs HC, Kok RM, van der Mast RC. Depression in later life: a more somatic presentation? J Affect Disord. 2015;170: 196–202. pmid:25254617
View Article
PubMed/NCBI
Google Scholar

[147] View Article

[148] PubMed/NCBI

[149] Google Scholar

[ref44] 44. Katz IR. On the Inseparability of Mental and Physical Health in Aged Persons: Lessons From Depression and Medical Comorbidity. Am J Geriatr Psychiatry. 1996;4: 1–16.
View Article
Google Scholar

[151] View Article

[152] Google Scholar

[ref45] 45. Seitz D, Purandare N, Conn D. Prevalence of psychiatric disorders among older adults in long-term care homes: a systematic review. Int Psychogeriatr IPA. 2010;22: 1025–1039.
View Article
Google Scholar

[154] View Article

[155] Google Scholar

[ref46] 46. Thakur M, Blazer DG. Depression in long-term care. J Am Med Dir Assoc. 2008;9: 82–87. pmid:18261699
View Article
PubMed/NCBI
Google Scholar

[157] View Article

[158] PubMed/NCBI

[159] Google Scholar

[ref47] 47. Strazdins L, Broom DH. The mental health costs and benefits of giving social support. Int J Stress Manag. 2007;14: 370–385.
View Article
Google Scholar

[161] View Article

[162] Google Scholar

[ref48] 48. Eisenkraft N, Elfenbein HA. The way you make me feel: evidence for individual differences in affective presence. Psychol Sci. 2010;21: 505–510. pmid:20424091
View Article
PubMed/NCBI
Google Scholar

[164] View Article

[165] PubMed/NCBI

[166] Google Scholar

[ref49] 49. Pavalko EK, Woodbury S. Social roles as process: caregiving careers and women’s health. J Health Soc Behav. 2000;41: 91–105. pmid:10750324
View Article
PubMed/NCBI
Google Scholar

[168] View Article

[169] PubMed/NCBI

[170] Google Scholar

[ref50] 50. Chen Y, Feeley TH. Social support, social strain, loneliness, and well-being among older adults: An analysis of the Health and Retirement Study. J Soc Pers Relatsh. 2013;
View Article
Google Scholar

[172] View Article

[173] Google Scholar

[ref51] 51. Bisconti TL, Bergeman CS. Perceived social control as a mediator of the relationships among social support, psychological well-being, and perceived health. The Gerontologist. 1999;39: 94–103. pmid:10028775
View Article
PubMed/NCBI
Google Scholar

[175] View Article

[176] PubMed/NCBI

[177] Google Scholar

[ref52] 52. Norris FH, Kaniasty K. Received and perceived social support in times of stress: a test of the social support deterioration deterrence model. J Pers Soc Psychol. 1996;71: 498–511. pmid:8831159
View Article
PubMed/NCBI
Google Scholar

[179] View Article

[180] PubMed/NCBI

[181] Google Scholar

Figures

Abstract

Background

Methods

Findings

Discussion

Introduction

The present research

Materials and Methods

Participants and procedure

Measures

Social support.

Positive affect.

Depressive symptoms.

Data analyses

Results

Descriptive statistics

Social support and well-being: Cross-sectional and longitudinal analysis

Moderation effects of institutionalization

Discussion

Supporting Information

S1 Data. Dataset for “Well-being and Institutional Care in Older Adults: Cross-Sectional and Time Effects of Provided and Received Support” in.sav format.

Author Contributions

References