The role of perceived social support in recovery from musculoskeletal injury

2016-12-18T23:29:42Z (GMT) by Khic-Houy Prang
Musculoskeletal injuries (MSI) are the most commonly occurring injury following road traffic crashes. MSI places a significant burden on the injured person because of pain and disability, and on society due to increased healthcare costs, disability payments and loss of work productivity. Recovery from MSI varies considerably, ranging from rapid recovery to lengthy rehabilitation periods. Due to varying rates of recovery following MSI, there is a need to identify modifiable prognostic factors associated with recovery. Social support has been identified as a significant amenable factor in facilitating better health outcomes. The overall aim of the current research project is to investigate the role of perceived social support as a coping resource in supporting recovery from compensable MSI.
   Social support is a meta-construct consisting of several sub-constructs including perceived support, received support, structural support and functional support. Social support is also a bidirectional interactive process between the provider and the recipient. Past research examining the relationship between social support and recovery has yielded mixed results. This was due, in part, to past research failing to account for the various elements of social support and the impact of broader issues impacting social support such as healthcare service use. In an attempt to address these issues, this research project employed a mixed methods research design, comprising of three components. By means of a systematic literature review, the first component investigated whether perceived social support in the family and workplace improved recovery following MSI. Using quantitative research design, the second component examined the impact of social support within social networks on compensable MSI outcomes by analysing cross-sectional survey data and linking this information to administrative claims and payments data. Using qualitative research design, the final component explored the impact of social support on the injured persons as well as interactions and impact of compensable MSI in the context of the family, significant others and friends.
   The findings of the systematic review conducted in the first component revealed that the literature describing an association between family support or work-related support and MSI outcomes was inconclusive. In contrast, the findings from the second component demonstrated that the structure and the sources of social support had a positive impact on post-injury physical health, pain and return to work. The strength of the associations between social support and each outcome varied across structure and sources of support. There were also significant gender differences, indicating that men and women experienced different benefits and gaps in social support. The findings also indicated that the source of social support had direct and modifying effects on healthcare service utilisation. Specifically, family support was associated with less use of allied healthcare services whilst support from friends was associated with less use of allied and mental healthcare services. Family support was also found to modify the association between socioeconomic indexes for areas and mental healthcare service use. Finally, the findings from the third component identified three themes related to the perception and experiences of social support and recovery from MSI: 1) key sources and types of support received, 2) relationship development and 3) challenges of providing and receiving support.
   This research project provides a greater understanding of the role of perceived social support in recovery from compensable MSI. In particular, the findings contribute to the literature by identifying which characteristics and sources of support are associated with MSI outcomes, whilst also accounting for broader issues impacting social support and recovery such as healthcare service  use and the effects of bi-directional relationships on recovery from the perspective of the person with MSI and their informal social network. The findings have several primary and tertiary preventions implications: the use of social support as a prevention resource, the collection of socio-demographic information to identify those at the greatest risk of poor support, the development of informal and formal support interventions for those who lack support, and the provision of support for informal social network members engaged in the recovery process.