Healthcare System and Social Support What is Social Support?

The concept of social support is multifaceted, encompassing various dimensions and constructs that influence an individual’s ability to cope with stress and maintain overall well-being. Social support can be broadly defined as the perceived comfort, care, assistance, or information one receives from others. It includes the function, source, and structure of the support provided.

1. Function of Social Support: This refers to the type of support offered, such as emotional, instrumental, informational, and social companionship (Cohen & Wills, 1985).
   • Emotional Support: Involves providing love, care, empathy, and encouragement. It helps individuals feel valued and understood, which can reduce feelings of anxiety and loneliness.
   • Instrumental Support: Includes tangible aid such as financial assistance, material resources, and services that can directly address a problem or need.
   • Informational Support: Also known as appraisal support, provides guidance or advice to help individuals understand and manage problematic situations.
   • Social Companionship: Involves engaging in shared activities and spending time with others for recreation and leisure.
2. Source of Support: Refers to the people or entities providing support, such as coworkers, supervisors, family members, or healthcare professionals (Hobfoll & Vaux, 1993).
3. Structure of Support: Includes the network (e.g., family, friends, colleagues) and the frequency of social interactions. A robust social network can provide consistent and reliable support, which is crucial in times of stress or crisis.

The majority of social support studies were conducted in the 1980s and early 1990s, partly due to a growing interest in occupational stress and its management during the late 1970s. Social support emerged as a key approach in mitigating stress and promoting mental health and well-being.

Social Support and Nursing Care

Nursing is widely recognized as a highly stressful profession, where occupational stressors can significantly impact the psychological and physiological capacities of the individual. These stressors include high workloads, emotional demands, shift work, exposure to traumatic situations, and conflicts with patients or colleagues.

Research indicates that if these stressors are not managed effectively, they can lead to adverse outcomes such as burnout, job dissatisfaction, low productivity, absenteeism, and turnover. Additionally, unresolved stress can result in physical and mental health problems, including stomach disorders, high blood pressure, headaches, depression, and emotional outbursts (Lawrence & Lawrence, 1987/88).

A significant factor contributing to occupational stress among nurses is the lack of emotional support and alienation from peers and supervisors. According to Maslach and Pines (1978), social isolation and lack of support can lead to feelings of frustration, low morale, and reduced job satisfaction. Therefore, social support is essential in mitigating the effects of occupational stress and enhancing overall job performance and satisfaction.

Models of Social Support

Two primary models of social support are widely discussed in the literature: the Direct Effect Model and the Stress Buffering Model (Cohen & Wills, 1985).

1. Direct Effect Model: Suggests that social support positively impacts certain variables, such as job performance, job satisfaction, and well-being, regardless of the level of stress. This model posits that social support directly improves outcomes by providing resources, reducing loneliness, and promoting a sense of belonging.
2. Stress Buffering Model: Proposes that social support mitigates the negative effects of stress on specific outcomes. According to this model, social support acts as a buffer that protects individuals from the adverse effects of stress by providing emotional and practical resources to cope with challenging situations.

Research in healthcare settings has examined the direct and buffering effects of social support on organizational outcomes, such as burnout, job satisfaction, and retention among nurses.

Effects of Social Support and Outcome

The literature consistently shows that social support has a direct positive effect on various outcomes, including burnout, job performance, job satisfaction, and the intention to remain in a job. Emotional social support, in particular, has been found to be negatively associated with burnout, indicating that higher levels of emotional support can reduce the likelihood of burnout among healthcare workers (Hare, Pratt, & Anderaw, 1988).

For example, AbuAl-Rub (2004) found that increased social support was associated with improved job performance among nurses. Similarly, McCloskey (1990) reported that social integration (support from coworkers) positively correlated with job satisfaction, work motivation, organizational commitment, and the intention to stay. Social integration also buffered the negative effects of low autonomy, with statistically significant interactions for intent to stay, organizational commitment, and job satisfaction at follow-up periods.

Buffering Effect of Social Support

While the direct effects of social support are well-documented, the literature shows mixed results regarding its buffering effect. For instance, LaRocco, House, and French (1980) tested the buffering effect of social support on the relationships between stress, strain, and health outcomes. They found that:

• Social support did not buffer the impact of job stress on job strain.
• Social support buffered the effect of job stress on overall mental health.
• Social support buffered the impact of job strain on mental health.

AbuAlRub (2004) found that social support did not buffer the relationship between job stress and job performance. In other words, as perceived job stress increased, nurses with high social support did not perform better than those with less support.

These findings suggest that while social support may provide some protection against the negative effects of stress, it may not always mitigate the impact of stress on specific outcomes such as job performance.

Effects of Social Support

Research by Stewart and Barling (1996) examined the effect of social support on the stress-performance relationship. Their findings indicated that only informational social support moderated or buffered the subjective stress-performance relationship, meaning that increased informational support reduced the negative impact of stress on job performance.

Fong (1990) studied the relationship between stress, support, and burnout among nursing faculty. The results showed that support from supervisors and coworkers was positively correlated with all dimensions of burnout. However, support from these sources did not moderate or buffer the stress-burnout relationship. That is, individuals with high support experienced the same levels of burnout as those with less support when stress increased.

Buffering Effect of Social Support: Further Research Needed

Given the inconsistent findings in the literature, further research is needed to better understand the buffering effect of social support. Future studies should use diverse designs and methodologies to test this effect, controlling for individual differences and other job-related variables that may obscure the relationship between social support and outcomes.

Hospitals and healthcare organizations invest significant resources in recruiting and orienting new staff. Retaining these employees is crucial for maintaining the quality of care provided to patients. Research provides evidence for the direct effect of social support on organizational outcomes, such as reduced job stress, improved job performance, and increased job satisfaction. Consequently, peer and superior support programs are essential for enhancing the well-being and satisfaction of healthcare staff.

Social Support and Healthcare Systems

The healthcare system is a complex environment where various factors, including social support, play a significant role in determining the quality of care provided to patients and the well-being of healthcare workers. Healthcare professionals, particularly nurses, are at the forefront of patient care, and their work environment significantly impacts their job satisfaction, performance, and retention.

1. Importance of Social Support for Healthcare Workers: Nurses and other healthcare professionals often face high levels of stress due to the nature of their work. Providing adequate social support can help mitigate the adverse effects of stress, improve job satisfaction, and enhance the quality of care provided to patients.
2. Peer Support Programs: Peer support programs can foster a sense of community and belonging among healthcare workers. By providing a platform for employees to share experiences, offer emotional support, and discuss challenges, peer support programs can reduce feelings of isolation and burnout.
3. Supervisor Support: Support from supervisors is crucial in fostering a positive work environment. Supervisors can provide guidance, resources, and encouragement to help employees manage stress and maintain job satisfaction. Regular feedback, recognition of achievements, and opportunities for professional development can enhance the overall work experience.
4. Organizational Interventions: Healthcare organizations can implement various interventions to promote social support, such as team-building activities, mentorship programs, and stress management workshops. These initiatives can create a supportive work environment where employees feel valued and motivated to perform their best.

Buffering Effect of Social Support in Healthcare

The buffering effect of social support is particularly relevant in healthcare settings, where high levels of stress and burnout are common. Social support can help healthcare workers cope with stress by providing emotional reassurance, practical assistance, and guidance on managing challenging situations.

1. Emotional Reassurance: Healthcare workers who receive emotional support from colleagues and supervisors are more likely to feel valued and understood. This support can help reduce feelings of anxiety, frustration, and burnout, promoting a positive work environment.
2. Practical Assistance: Instrumental support, such as assistance with tasks or access to resources, can help healthcare workers manage their workload more effectively. This support can reduce the perceived burden of work and enhance job performance.
3. Guidance and Advice: Informational support provides healthcare workers with the knowledge and skills needed to handle complex situations. Access to training, mentorship, and professional development opportunities can help employees feel more confident and capable in their roles.

Conclusion

Social support is a critical factor in promoting the well-being of healthcare workers and enhancing the quality of care provided to patients. The direct effects of social support, such as improved job satisfaction, performance, and retention, are well-established. However, the buffering effect of social support in mitigating the adverse effects of stress remains a complex and nuanced area of research.

Healthcare organizations should prioritize implementing support programs for both peers and supervisors to create a supportive work environment that fosters employee well-being and job satisfaction. Further research is needed to explore the mechanisms through which social support influences outcomes in healthcare settings and to develop evidence-based interventions that effectively leverage social support to enhance the healthcare workforce’s resilience and performance.