Interpersonal Factors - Client’s Response to Illness

INTERPERSONAL FACTORS

Sense of Belonging

A sense of belonging is the feeling of connectedness with or involvement in a social system or environment of which a person feels an integral part. Abraham Maslow described a sense of belonging as a basic human psychosocial need that involves feelings of both value and fit. Value refers to feeling needed and accepted. Fit refers to feeling that one meshes or fits in with the system or environment. This means that when a person belongs to a system or group, he or she feels valued and worthwhile within that support system. Exam-ples of support systems include family, friends, coworkers, clubs or social groups, and even health-care providers.

A person’s sense of belonging is closely related to his or her social and psychological functioning. A sense of belong-ing was found to promote health, whereas a lack of belong-ing impaired health. An increased sense of belonging alsowas associated with decreased levels of anxiety. Persons with a sense of belonging are less alienated and isolated, have a sense of purpose, believe they are needed by others, and feel productive socially. Hence, the nurse should focus on interventions that help increase a client’s sense of belong-ing (Granerud & Severinsson, 2006).

Social Networks and Social Support

Social networks are groups of people whom one knows and with whom one feels connected. Studies have found that having a social network can help reduce stress, dimin-ish illness, and positively influence the ability to cope and to adapt (Chanokruthai, Williams, & Hagerty, 2005). Social support is emotional sustenance that comes from friends, family members, and even health-care providers who help a person when a problem arises. It is different from social contact, which does not always provide emo-tional support. An example of social contact is the friendly talk that goes on at parties.

Persons who are supported emotionally and function-ally have been found to be healthier than those who are not supported (Vanderhorst & McLaren, 2005). Meaningful social relationships with family or friends were found to improve the health and well-being outcomes for older adults. An essential element of improved outcomes is that family or friends respond with support when it is requested. In other words, the person must be able to count on these friends or family to help or support him or her by visiting or talking on the phone. Thus, the primary components of satisfactory support are the person’s ability and willingness to request support when needed and the ability and willingness of the support system to respond.

Two key components are necessary for a support sys-tem to be effective: the client’s perception of the support system and the responsiveness of the support system. The client must perceive that the social support system bol-sters his or her confidence and self-esteem and provides such stress-related interpersonal help as offering assistance in solving a problem. The client also must perceive that the actions of the support system are consistent with the cli-ent’s desires and expectations—in other words, the support provided is what the client wants, not what the supporter believes would be good for the client. Also, the support system must be able to provide direct help or material aid (e.g., providing transportation or making a follow-up appointment). Some people have the capacity to seek help when needed, whereas a lack of well-being may cause oth-ers to withdraw from potential providers of support. The nurse can help the client to find support people who will be available and helpful and can teach the client to request support when needed.

Family Support

Family as a source of social support can be a key factor in the recovery of clients with psychiatric illnesses. Although family members are not always a positive resource in men-tal health, they are most often an important part of recov-ery. Health-care professionals cannot totally replace family members. The nurse must encourage family members to continue to support the client even while he or she is in the hospital and should identify family strengths, such as love and caring, as a resource for the client (Reid, Lloyd, & de Groot, 2005).