Skip to main content

Advertisement

Log in

Enhancing Social Support Among People with Cardiovascular Disease: a Systematic Scoping Review

  • Psychological Aspects of Cardiovascular Diseases (A Steptoe, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The presence of social support is a major determinant of positive health outcomes among people with cardiovascular disease (CVD); however, little is known about the most effective strategies for enhancing social support among this population. The aim of this scoping review was to describe the effectiveness of interventions seeking to enhance social support among people living with CVD and synthesize the evidence.

Recent Findings

A systematic search for articles that (a) reported on interventions which may enhance social support and (b) included a measure of social support revealed 21 studies. Interventions to enhance social support were diverse and included cognitive behavioural therapy, mindfulness, peer support, and multi-faceted cardiac rehabilitation programmes. Most studies were of fair to good quality according to the PEDro criteria. With the exception of caregiver-oriented interventions, few studies reported significant changes in social support measures.

Summary

Early evidence suggests that caregiver-oriented strategies may offer a promising avenue for enhancing social support; however, more research of higher quality is required to determine the optimal strategies to enhance support among those living with CVD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Berkman LF. The role of social relations in health promotion. Psychosom Med. 1995;57(3):245–54.

    Article  CAS  PubMed  Google Scholar 

  2. Reifman A. Social relationships, recovery from illness, and survival: a literature review. Ann Behav Med Publ Soc Behav Med. 1995;17(2):124–31.

    Article  CAS  Google Scholar 

  3. Cohen, S. Social support measurement and intervention: a guide for health and social scientists [Internet]. Oxford University Press; [cited 2019]. Available from: https://www.oxfordclinicalpsych.com/view/10.1093/med:psych/9780195126709.001.0001/med-9780195126709.

  4. Hogan BE, Linden W, Najarian B. Social support interventions: do they work? Clin Psychol Rev. 2002;22(3):383–442.

    Article  PubMed  Google Scholar 

  5. Valtorta NK, Kanaan M, Gilbody S, Ronzi S, Hanratty B. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart Br Card Soc. 2016;102(13):1009–16.

    CAS  Google Scholar 

  6. Compare A, Zarbo C, Manzoni GM, Castelnuovo G, Baldassari E, Bonardi A, et al. Social support, depression, and heart disease: a ten year literature review. Front Psychol. 2013;4:384.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Uchino BN, Trettevik R, Kent de Grey RG, Cronan S, Hogan J, BRW B. Social support, social integration, and inflammatory cytokines: a meta-analysis. Health Psychol. 2018;37(5):462–71.

    Article  PubMed  Google Scholar 

  8. Berkman LF, Leo-Summers L, Horwitz RI. Emotional support and survival after myocardial infarction. A prospective, population-based study of the elderly. Ann Intern Med. 1992;117(12):1003–9.

    Article  CAS  PubMed  Google Scholar 

  9. Pfeiffer PN, Heisler M, Piette JD, Rogers MAM, Valenstein M. Efficacy of peer support interventions for depression: a meta-analysis. Gen Hosp Psychiatry. 2011;33(1):29–36.

    Article  PubMed  Google Scholar 

  10. • Khaledi GH, Mostafavi F, Eslami AA, Rooh Afza H, Mostafavi F, Akbar H. Evaluation of the effect of perceived social support on promoting self-care behaviors of heart failure patients referred to the cardiovascular research center of Isfahan. Iran Red Crescent Med J [Internet]. 2015 [cited 2019 May 31];17(6). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552959/. This study, alongside Shahriari et al. (30) demonstrated that a caregiver-only heart failure management education and communication skills program can improve perceived social support among loved-ones with cardiovascular disease.

  11. Dunbar SB, Clark PC, Quinn C, Gary RA, Kaslow NJ. Family influences on heart failure self-care and outcomes. J Cardiovasc Nurs. 2008;23(3):258–65.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Dunbar SB, Clark PC, Deaton C, Smith AL, De AK, O’Brien MC. Family education and support interventions in heart failure: a pilot study. Nurs Res. 2005;54(3):158–66.

    Article  PubMed  Google Scholar 

  13. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5(1):69.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Sherrington C, Herbert RD, Maher CG, Moseley AM. PEDro. A database of randomized trials and systematic reviews in physiotherapy. Man Ther. 2000;5(4):223–6.

    Article  CAS  PubMed  Google Scholar 

  15. Foley NC, Bhogal SK, Teasell RW, Bureau Y, Speechley MR. Estimates of quality and reliability with the physiotherapy evidence-based database scale to assess the methodology of randomized controlled trials of pharmacological and nonpharmacological interventions. Phys Ther. 2006;86(6):817–24.

    Article  PubMed  Google Scholar 

  16. Foley NC, Teasell RW, Bhogal SK, Speechley MR. Stroke rehabilitation evidence-based review: methodology. Top Stroke Rehabil. 2003;10(1):1–7.

    Article  PubMed  Google Scholar 

  17. Blom M, Georgiades A, Janszky I, Alinaghizadeh H, Lindvall B, Ahnve S. Daily stress and social support among women with CAD: results from a 1-year randomized controlled stress management intervention study. Int J Behav Med. 2009;16(3):227–35.

    Article  PubMed  Google Scholar 

  18. Davidson P, Digiacomo M, Zecchin R, Clarke M, Paul G, Lamb K, et al. A cardiac rehabilitation program to improve psychosocial outcomes of women with heart disease. J Womens Health. 2002. 2008 Jan 1;17:123–34.

    Article  Google Scholar 

  19. Sakakibara BM, Chakrabarti S, Krahn A, Mackay MH, Sedlak T, Singer J, et al. Delivery of peer support through a self-management mHealth intervention (healing circles) in patients with cardiovascular disease: protocol for a randomized controlled trial. JMIR Res Protoc. 2019;8(1):e12322.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Colella TJ, King-Shier K. The effect of a peer support intervention on early recovery outcomes in men recovering from coronary bypass surgery: a randomized controlled trial. Eur J Cardiovasc Nurs J Work Group Cardiovasc Nurs Eur Soc Cardiol. 2018;17(5):408–17.

    Google Scholar 

  21. •• Berkman LF, Blumenthal J, Burg M, Carney RM, Catellier D, Cowan MJ, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial. JAMA. 2003;289(23):3106–16 This study, while dated, is the largest and most rigorous assessment of an intervention designed to improve perceived social support among those with cardiovascular disease. The cognitive-behavioural therapy intervention led to significant albeit marginal improvements in perceived social support and yielded no changes in cardiovascular outcomes at long term follow up suggesting alternative modalities must be explored.

    Article  PubMed  Google Scholar 

  22. • Heo S, McSweeney J, Ounpraseuth S, Shaw-Devine A, Fier A, Moser DK. Testing a holistic meditation intervention to address psychosocial distress in patients with heart failure: a pilot study. J Cardiovasc Nurs. 2018;33(2):126–34 Despite being only a pilot, this study indicates that alternate intervention modalities such as group mindfulness meditation-based programs may offer promising avenues to enhance social support among those with cardiovascular disease.

    Article  PubMed  Google Scholar 

  23. Boese A, Bock S, Kielblock B, Siegmund-Schultze E, Kröner-Herwig B, Herrmann-Lingen C. Randomised controlled trial of a telephone-based peer support intervention to reduce depressive symptoms and improve social support in women with CHD. J Psychosom Res. 2013;74:539.

    Article  Google Scholar 

  24. Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the multidimensional scale of perceived social support. J Pers Assess. 1990;55(3–4):610–7.

    Article  CAS  PubMed  Google Scholar 

  25. Berkman LF, Syme SL. Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. Am J Epidemiol. 1979;109(2):186–204.

    Article  CAS  PubMed  Google Scholar 

  26. Riegel B, Carlson B. Is individual peer support a promising intervention for persons with heart failure? J Cardiovasc Nurs. 2004;19(3):174–83.

    Article  PubMed  Google Scholar 

  27. Heisler M, Halasyamani L, Cowen ME, Davis MD, Resnicow K, Strawderman RL, et al. Randomized controlled effectiveness trial of reciprocal peer support in heart failure. Circ Heart Fail. 2013;6(2):246–53.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Sakakibara BM, Ross E, Arthur G, Brown-Ganzert L, Petrin S, Sedlak T, et al. Using mobile-health to connect women with cardiovascular disease and improve self-management. Telemed J E-Health Off J Am Telemed Assoc. 2017;23(3):233–9.

    Google Scholar 

  29. Rywik T, Kurjata P, Broda G, Leszek P, Margaret F-L, Targoński R, et al. Level of social support in heart failure patients—effects of caregivers participation in a simple national disease management programme. Eur J Heart Fail. 2013;12:S19.

    Google Scholar 

  30. Aliabad HO, Vafaeinasab M, Morowatisharifabad MA, Afshani SA, Firoozabadi MG, Forouzannia SK. Maintenance of physical activity and exercise capacity after rehabilitation in coronary heart disease: a randomized controlled trial. Glob J Health Sci. 2014;6(6):198–208.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Safabakhsh L, Jahantigh M, Nosratzehi S, Navabi S. The effect of health promoting programs on patient’s life style after coronary artery bypass graft-hospitalized in Shiraz hospitals. Glob J Health Sci. 2015;8(5):154–9.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Shahriari M, Alimohammadi N, Ahmadi M. Effects of a family centered program on perceived social support in patients with congestive heart failure: an interventional study. J Educ Health Promot. 2016;5:6.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Aldana SG, Greenlaw R, Thomas D, Salberg A, DeMordaunt T, Fellingham GW, et al. The influence of an intense cardiovascular disease risk factor modification program. Prev Cardiol. 2004;7(1):19–25.

    Article  PubMed  Google Scholar 

  34. Aldana SG, Whitmer WR, Greenlaw R, Avins AL, Thomas D, Salberg A, et al. Effect of intense lifestyle modification and cardiac rehabilitation on psychosocial cardiovascular disease risk factors and quality of life. Behav Modif. 2006;30(4):507–25.

    Article  PubMed  Google Scholar 

  35. Pischke CR, Scherwitz L, Weidner G, Ornish D. Long-term effects of lifestyle changes on well-being and cardiac variables among coronary heart disease patients. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2008;27(5):584–92.

    Google Scholar 

  36. Carlson JJ, Norman GJ, Feltz DL, Franklin BA, Johnson JA, Locke SK. Self-efficacy, psychosocial factors, and exercise behavior in traditional versus modified cardiac rehabilitation. J Cardpulm Rehabil. 2001;21(6):363–73.

    Article  CAS  Google Scholar 

  37. Younge JO, Wery MF, Gotink RA, Utens EMWJ, Michels M, Rizopoulos D, et al. Web-based mindfulness intervention in heart disease: a randomized controlled trial. PLoS One. 2015;10(12):e0143843.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  38. Gotink RA, Younge JO, Wery MF, Utens EMWJ, Michels M, Rizopoulos D, et al. Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial. PLoS One. 2017;12(5):e0175923.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  39. Bakan G, Akyol AD. Theory-guided interventions for adaptation to heart failure. J Adv Nurs. 2008;61(6):596–608.

    Article  PubMed  Google Scholar 

  40. Niebauer J, editor. Cardiac rehabilitation manual [Internet]. 2nd ed. Springer International Publishing; 2017 [cited 2019 Jun 8]. Available from: https://www.springer.com/gp/book/9783319477374

  41. Ades PA, Savage PD, Tischler MD, Poehlman ET, Dee J, Niggel J. Determinants of disability in older coronary patients. Am Heart J. 2002;143(1):151–6.

    Article  PubMed  Google Scholar 

  42. Pinto BM, Goldstein MG, Papandonatos GD, Farrell N, Tilkemeier P, Marcus BH, et al. Maintenance of exercise after phase II cardiac rehabilitation: a randomized controlled trial. Am J Prev Med. 2011;41(3):274–83.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Welstand J, Carson A, Rutherford P. Living with heart failure: an integrative review. Int J Nurs Stud. 2009;46(10):1374–85.

    Article  PubMed  Google Scholar 

  44. Parry M, Watt-Watson J. Peer support intervention trials for individuals with heart disease: a systematic review. Eur J Cardiovasc Nurs J Work Group Cardiovasc Nurs Eur Soc Cardiol. 2010;9(1):57–67.

    Google Scholar 

  45. Dale JR, Williams SM, Bowyer V. What is the effect of peer support on diabetes outcomes in adults? A systematic review. Diabet Med J Br Diabet Assoc. 2012;29(11):1361–77.

    Article  CAS  Google Scholar 

  46. Baig AA, Benitez A, Quinn MT, Burnet DL. Family interventions to improve diabetes outcomes for adults. Ann N Y Acad Sci. 2015;1353(1):89–112.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Dale J, Caramlau I, Sturt J, Friede T, Walker R. Telephone peer-delivered intervention for diabetes motivation and support: the telecare exploratory RCT. Patient Educ Couns. 2009;75(1):91–8.

    Article  PubMed  Google Scholar 

  48. Heisler M, Vijan S, Makki F, Piette JD. Diabetes control with reciprocal peer support versus nurse care management: a randomized trial. Ann Intern Med. 2010;153(8):507–15.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Hibbard MR, Cantor J, Charatz H, Rosenthal R, Ashman T, Gundersen N, et al. Peer support in the community: initial findings of a mentoring program for individuals with traumatic brain injury and their families. J Head Trauma Rehabil. 2002;17(2):112–31.

    Article  PubMed  Google Scholar 

  50. Ashbury FD, Cameron C, Mercer SL, Fitch M, Nielsen E. One-on-one peer support and quality of life for breast cancer patients. Patient Educ Couns. 1998;35(2):89–100.

    Article  CAS  PubMed  Google Scholar 

  51. Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. J Consult Clin Psychol. 2010;78(2):169–83.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Zeidan F, Johnson SK, Gordon NS, Goolkasian P. Effects of brief and sham mindfulness meditation on mood and cardiovascular variables. J Altern Complement Med N Y N. 2010;16(8):867–73.

    Article  Google Scholar 

  53. Ospina MB, Bond K, Karkhaneh M, Tjosvold L, Vandermeer B, Liang Y, et al. Meditation practices for health: state of the research. Evid ReportTechnology Assess. 2007;155:1–263.

    Google Scholar 

  54. Olivo EL, Dodson-Lavelle B, Wren A, Fang Y, Oz MC. Feasibility and effectiveness of a brief meditation-based stress management intervention for patients diagnosed with or at risk for coronary heart disease: a pilot study. Psychol Health Med. 2009;14(5):513–23.

    Article  PubMed  Google Scholar 

  55. Barnes S, Brown KW, Krusemark E, Campbell WK, Rogge RD. The role of mindfulness in romantic relationship satisfaction and responses to relationship stress. J Marital Fam Ther. 2007;33(4):482–500.

    Article  PubMed  Google Scholar 

  56. Wachs K, Cordova JV. Mindful relating: exploring mindfulness and emotion repertoires in intimate relationships. J Marital Fam Ther. 2007;33(4):464–81.

    Article  PubMed  Google Scholar 

  57. Dekeyser M, Raes F, Leijssen M, Leysen S, Dewulf D. Mindfulness skills and interpersonal behaviour. Personal Individ Differ. 2008;44(5):1235–45.

    Article  Google Scholar 

  58. Schellekens MPJ, Tamagawa R, Labelle LE, Speca M, Stephen J, Drysdale E, et al. Mindfulness-based cancer recovery (MBCR) versus supportive expressive group therapy (SET) for distressed breast cancer survivors: evaluating mindfulness and social support as mediators. J Behav Med. 2017;40(3):414–22.

    Article  PubMed  Google Scholar 

  59. Kleine A-K, Hallensleben N, Mehnert A, Hönig K, Ernst J. Psychological interventions targeting partners of cancer patients: a systematic review. Crit Rev Oncol Hematol. 2019;140:52–66.

    Article  PubMed  Google Scholar 

  60. Robinson BC. Validation of a caregiver strain index. J Gerontol. 1983;38(3):344–8.

    Article  CAS  PubMed  Google Scholar 

  61. Pinquart M, Sörensen S. Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2007;62(2):126–37.

    Article  Google Scholar 

  62. Aggarwal B, Mosca L. Heart disease risk for female cardiac caregivers. Female Patient. 2009;34(2):42–5.

    Google Scholar 

  63. Aggarwal B, Liao M, Christian A, Mosca L. Influence of caregiving on lifestyle and psychosocial risk factors among family members of patients hospitalized with cardiovascular disease. J Gen Intern Med. 2009;24(1):93–8.

    Article  PubMed  Google Scholar 

  64. Feeney BC, Collins NL. New look at social support: a theoretical perspective on thriving through relationships. Personal Soc Psychol Rev Off J Soc Personal Soc Psychol Inc. 2015;19(2):113–47.

    Google Scholar 

  65. Uchino BN, Bowen K, Carlisle M, Birmingham W. Psychological pathways linking social support to health outcomes: a visit with the “ghosts” of research past, present, and future. Soc Sci Med. 1982. 2012 Apr;74(7):949–57.

    Article  Google Scholar 

Download references

Funding

B.M Sakakibara is supported by a Michael Smith Foundation for Health Research Scholar Award.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Brodie Sakakibara.

Ethics declarations

Conflict of Interest

C.T. Clayton, C. Motley, and B.M. Sakakibara declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Psychological Aspects of Cardiovascular Diseases

Appendix

Appendix

Table 2 Medline search strategy

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Clayton, C., Motley, C. & Sakakibara, B. Enhancing Social Support Among People with Cardiovascular Disease: a Systematic Scoping Review. Curr Cardiol Rep 21, 123 (2019). https://doi.org/10.1007/s11886-019-1216-7

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11886-019-1216-7

Keywords

Navigation