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PERCEIVED SOCIAL SUPPORT AS A PREDICTOR OF SOCIAL AND OCCUPATIONAL FUNCTIONING- A STUDY ON PERSONS WITH SCHIZOPHRENIA

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Indian Journal of Health Social Work

PERCEIVED SOCIAL SUPPORT AS A PREDICTOR OF SOCIAL AND OCCUPATIONAL FUNCTIONING- A STUDY ON PERSONS WITH SCHIZOPHRENIA

Pomi Mahanta1, Indrajeet Banerjee2 & Sonia P. Deuri3

1PhD Scholar, Department of Psychiatric Social Work, LGB Regional Institute of Mental Health, (Govt. Of India, Ministry of Health and Family Welfare), Tezpur, Assam. 2Assistant Professor, Department of Psychiatric Social Work, LGB Regional Institute of Mental Health, (Govt. Of India, Ministry of Health and Family Welfare), Tezpur, Assam. 3Professor & Head, Department of Psychiatric Social Work, LGB Regional Institute of Mental Health, (Govt. of India, Ministry of Health and Family Welfare), Tezpur, Assam

Correspondence: Pomi Mahanta, e- mail: pomimahanta1@gmail.com

ABSTRACT

Background: Schizophrenia is a chronic illness which can lead to functional impairment and dysfunction in interpersonal relationships. Aims and objectives: The present study aims to explore perceived social support, social and occupational functioning among persons with schizophrenia and to find out the association between them. Methods: Descriptive study design was used to select sample. A total of 60 persons with Schizophrenia (ICD-10) were selected using purposive sampling, fulfilling the inclusion criteria and consents were taken for assessment. Socio-demographic data sheet, Brief Psychiatric Rating Scale (BPRS), Multi-dimensional Scale of Perceived Social Support (MSPSS) and Social and Occupational Functioning scale (SOFS) were administered. The present study was undertaken with the permission of scientific and institute ethics committee. Collected data were analyzed using the software (Statistical Packages for the Social Sciences, SPSS 25.0). Results: 60% of persons with schizophrenia experience moderate to severe impairment in social and occupational functioning with 60% moderate level of perceived social support. There is significant negative correlation between perceived social support and social and occupational functioning [r= -367**, (p= 0.01)] and in regression analysis perceived social support is a strong contributor to the variance of social and occupational functioning in persons with schizophrenia (Beta=.401, t=-3.184, p=.002). Conclusion: An enhanced social support will help the better the social and  Occupational functioning.

Key words: Schizophrenia, social support, social and occupational functioning, mental health professionals.

INTRODUCTION

The lifetime and current prevalence of schizophrenia and other psychotic disorders were 1.53% and 0.50% (NMHS, 2016).Social and occupational functioning is the overall functional outcome and the ability of the individual to live in a community of which he or she is a part (Saraswat et al. 2006).Perceived social support is an important psychosocial factor for mental health and wellbeing. Perceived social support in this research is related to support from significant others, family and friends. Persons with schizophrenia can experience loss of support from family, friends, resulting in impairment in social and occupational functioning. Social support has received national attention as a key component of the mental health recovery paradigm for people with severe mental illness (Hogan, 2003).Having a strong social support system is vital to maintaining mental health. A strong social support system can alleviate stress by providing individuals with another person to share their problem with. It plays an important role in the life of person living with schizophrenia and has impact on social and occupational functioning. Enhanced  social support leads to  better  social and occupational functioning. Persons with schizophrenia are often in unemployment and have to depend in other emotionally supportive network. Person with schizophrenia having negative symptoms have to completely depend on the other networks. Perceived social support is very important for person with schizophrenia to cope with effectively during the course of the illness. Lack of social support has a significant impact on the lives of person living with schizophrenia. Various aspects and areas related to schizophrenia were studied but there is  research paucity  related to perceived social support  and social and occupational functioning specially from Assam and the North-Eastern parts of the country. 

OBJECTIVES 

·  To assess the perceived social support and social and occupational functioning of  persons with schizophrenia 

·  To find out the relationship between social and occupational functioning and perceived social support of  persons with schizophrenia 

 

MATERIALS  AND  METHODS

The research design in the study was descriptive in nature. The study was conducted in the Out Patient Department. The study consisted  of persons with schizophrenia who accessed  treatment and follow up from   all over Assam and neighboring states. The sample of 60  patients was selected purposively   as per  sample size calculator (Krejcie & Morgan, 1970) from among persons  having the diagnosis of schizophrenia (F-20.0-F20.9), according to the diagnosis criteria of ICD-10 (Clinical descriptions and diagnostic guidelines). Persons with schizophrenia aged between 21-50 years of both the gender who scored less than 31 in BPRS scale with illness of at least two years duration were included. Persons with comorbid psychiatric, physical and neurological disorder, missing information’s were excluded from the study. 

Description of the tools:

1.    Socio demographic data sheet – A semi structured socio demographic data sheet was developed by the researcher for the purpose of assessing the socio demographic characteristics of persons with schizophrenia. It was validated by discipline experts.  

2.  Socio-economic status :revised Kuppuswamy scale consists of education, occupation and monthly family income was used to assess the socio economic status of the persons with schizophrenia.

3.   Brief Psychiatric Rating Scale (BPRS): consists of 18 questions which is used as a screening tool rated in the scale of 0-7. 

4.   Social and occupational functioning scale: It is used for  measuring  the social and occupational functioning of persons with schizophrenia developed by Saraswat et al. (2006) The SOFS demonstrated adequate internal consistency and retest reliability. The coefficient alpha was 0.91 for the total score. Higher scores on SOFS indicate greater impairment in social and occupational functioning. 

5.   Multidimensional scale of perceived social support (MSPSS):developed by Zimet & Farley, (1988). This questionnaire is self-rated and consists of 12 items and the participants have to rate their agreement or disagreement by selecting between seven alternatives responses. The scale attributes good internal and test-retest reliability. The scoring of the scales are comprised of low support (1-2.9), moderate support (3-5), and high support (5.1-7).

ETHICAL ISSUES

The present study was undertaken with the permission of scientific and ethics committee of LGBRIMH, Tezpur. All authors certify responsibility for this study. 

STATISTICAL ANALYSIS

After the data collection, analysis is done using the software Statistical Package for Social Sciences (SPSS 25.0) according to the objectives of the study. Data were described using mean, standard deviation, frequency and percentage, Pearson correlation and regression.

 
 
 
DISCUSSION
 
Schizophrenia is a chronic mental illness which may have lifelong impact on the individual, family and community resources.  People with schizophrenia have to struggle for support and functioning. Improvement in social and occupational functioning and perceived social support can help a person with schizophrenia to live a productive life. The  relapse rate becomes higher in persons with schizophrenia when they have serious functional deficit, and this  deficit has been considered as an important prognostic  factor (Couture et al. 2006).Therefore, evaluating social and occupational functioning is important for predicting the prognosis as well as determining effective treatments for Schizophrenia patients.
 
In the present study, it was found that among the 60 respondents, 43.3% of the respondents were found to have moderate level of impairment in social and occupational functioning, while 36.7% of the respondents have mild level of impairment , 20% of the respondents have severe level of impairment and 3.3% have no impairment. This may be because of both positive and negative symptoms of schizophrenia,  that very often  interferes with the ability to function effectively.  Similar findings have been found  in the study by  Srinivasan & Tirupati (2005), Rajni et al. (2016) indicating the there is no regional variation across India in the deficits from a long term disease like Schizophrenia.
 
Findings also revealed that (Table 2), majority of the persons with schizophrenia  have moderate to high level of perceived social support which is contradictory with the findings of Goldberg et al.& Mahmoud et al. (2017)where it was found that most have low social support.  This may be because of increasing awareness among the family members and cultural variation in comparison to other studies that report  high  family support 5.52 (SD=0.87). 
 
Findings also revealed (Table 4) that there is significant negative correlation between social and occupational functioning and perceived social support. Lower the social support, higher will be the impairment and vice versa. This has been supported by the  findings of  Sawant et al (2010) & Singh(2018).
 
The findings of the study indicate that  there is higher impairment in social and occupational functioning, despite  having good social support.  Prolonged disease  duration of schizophrenia is known to cause long term  impairment in various functional areas (Patel et al.2014). Further even with adequate social support, many persons with schizophrenia are poorly supported with inputs for rehabilitative measures for reintegration and functionality.
 
Regression table 5 defines the prediction of social and occupational functioning on the basis of perceived social support.  Perceived social support significantly predicts the social and occupational functioning of persons with schizophrenia [f(3,59)=3.707,P=0.017]. Perceived social support contributes 4.07% variance remaining 95.93%  to the variables attributed to the variables which are not included in the present study. Perceived social support is a strong contributor to the variance of social and occupational functioning in persons with schizophrenia. (Beta=.401, t=-3.184,  p=.002).
 
LIMITATIONS    AND FUTURE    DIRECTIONS
 
The study was conducted in a single tertiary mental health institute. The study included those patients who attended OPD during the data collection period. The findings of the study implicate the need for the active intervention of  Social Workers  and other helping professionals in Mental Health set -ups,  to assess social and occupational functions as a routine measure and link persons and their families for accessing services under the social welfare system and initiate rehabilitative measures as a mandatory requirement. Social and occupational functioning is one of the areas where clinicians can plan intervention with the person’s living with schizophrenia.
 
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Conflict of interest: None
Role of funding source: None 

 

ISSN: 2582-1393 (Online)
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