Mortality was related to social support in a nine-year follow-up study of a random sample of 2,229 men and 2,496 women between the ages of 30 and 69 were included in a nine-year follow-up study. In this study, social support was measured by marital status; contacts with close friends and relatives (measured by three questions); church membership; and informal and formal group association. Mortality data were collected from the Death Registry. All but 302 respondents were accounted for and for this group of 302 were not found to differ in their health profile from the larger sample.
A chi square was used to analyze the data. Men who were married had a significantly lower death rate than those who were not (p < . 001). There was no significant difference with women. More friends and relatives combined with a higher number of contacts were related to a significantly lower number of deaths (p , . 001). Church membership also was related to a lower number of deaths than non-church membership (p, . 05). Group membership was related to a significantly lower death rate in women only (p<. 05).
The association between social ties and mortality was found to be independent from socioeconomic status, smoking, alcohol consumption, utilization of preventive health services, year of death, and self-reported physical health status. This study is important because it taps such a large sample. As with any study of this size, potentially important details, such as quality of social contacts, are difficult to obtain. Kiecold-Glazer, Gardner, et al. , (1994) compared psychological modifiers to immunocompetence.
They compared blood counts of natural killer cells (NK) (part of the immune system specific to antitumor and antiviral activity) were compared to scores on the UCLA Loneliness Scale and the Social Adjustment Rating Scale. The subjects were first year medical students, with a mean age of 23. Blood samples were taken one moth after a major exam at the first day of final exam week. The tests were administered at the first or presumably low stress contact. An analysis of variance was used to analyze the results.
A significant change in NK activity was noted between the first and second blood tests (F = 9. 87, P<. 001). Subjects with high life events scores had significantly lower NK activity (F = 8. 19, P < . 006) and those who scored high on loneliness also had low NK activity. The authors concluded that stressful life events and loneliness both appear to be associated with NK activity. They also concluded that immunosuppression is associated with increased distress in a young and otherwise healthy population.
Lifestyle Several health habits are well established as contributors to overall health and prolongation of life. The most conclusive health habits are sleeping seven to eight hours per day; eating a balanced, well-timed diet, including breakfast; maintaining a near-prescribed weight; not smoking; and regular physical activity (Califano, 1997). We do not know for sure that these same factors are relevant in healing, but we can speculate that their importance may apply there, as well. Meaning Through Illness
Several theories have been proposed that relate to finding meaning in illness. Potentially relevant to the healing process is the concept, “health within illness. ” Instead of regarding one’s illness as a totally negative experience, one can find meaning in their illness; use it as an opportunity for their reflection and growth. Illness can be a catalyst for feeling more alive or having more of a sense of connection with the whole. Chick and Meleis (1996) discussed transitions as a passage or movement from one life phase, conditions or status to another.
These transitions are positive and include a period of disconnectedness with confusions and distress, with potential changes in self-concept, self-esteem and role performance and leading to a sense of new beginning. As transitions can occur during illness or recovery the concept may be relevant to healing. Steeves and Kahn (1997) explored a concept of meaning within suffering. In their contacts with hospice patients, they repeatedly heard patients about experiences of becoming aware of something they considered greater than themselves and that these experiences fundamentally changed the patient’s view of reality.
This change was often a profoundly positive experience helping them to view their suffering differently, but more important changing their sense of themselves in the world. These people were dying and were having a different experience than people who are expected to recover but some elements are similar, such as anxiety, pain and changes in functioning. Finding meaning may be a part of the illness experience.