Effects of Social Support Provided by Disabled Older Adults to Others on Their Own Depressive Symptoms: A Moderated Mediation Model

Abstract

Yi Fang,1 Yuqi Jiang,2 Linlin Ma,1 Huixian Chen,1 Zhi Li,1 Fen Luo,1 Wen Jiang,1 Shuya Cai,1 Qiaoqiao Guo,3 Zhiqin Yin1,4 1School of Nursing, Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China; 2The First Hospital of Jiaxing City, Jiaxing City, Zhejiang Province, People’s Republic of China; 3College of Renji, Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China; 4Wenzhou Health Promotion Research Center, Wenzhou City, Zhejiang Province, People’s Republic of ChinaCorrespondence: Zhiqin Yin; Qiaoqiao Guo, Email [email protected]; [email protected]: While previous studies have extensively examined the impact of receiving positive social support during social support interactions on depressive symptoms among older adults, adverse effects experienced, such as being rejected or ignored, are often overlooked. Moreover, there has been limited discussion on the effects of giving social support to others. Thus, this study investigates the impacts of social support given by disabled older adults to others on their own depressive symptoms, as well as the mediating role of receiving social support (both positive and negative aspects) and the moderating effect of the activity of daily living (ADL).Patients and Methods: This cross-sectional, community-based study was conducted in Wenzhou and Jiaxing City, China, from September 2021 to September 2022, with a total of 255 disabled older adults meeting the inclusion and exclusion criteria. The data were collected face-to-face using a structured questionnaire. The participants were asked to complete the Barthel Index Scale, the Chinese version of the Positive and Negative Social Exchange Scale, the Giving Social Support questionnaire, and the Short Form Chinese Geriatric Depression Scale to measure disability, receiving positive and negative social support, giving social support, and depressive symptoms, respectively. Descriptive statistical analysis, correlation analysis, mediation effect tests, and moderation effect tests were used to analyse the questionnaire data.Results: The social support provided by disabled older adults to others primarily involved companionship and care. The positive aspect of social support received was largely emotional support, while the negative aspect was mainly characterised by failure to obtain help and unsympathetic behaviour. Providing social support was found to be associated with a potential beneficial effect on depressive symptoms, linked to lower severity, with this effect fully mediated by receiving social support. Specifically, receiving emotional support accounted for 56.63% of the effect size, while failure to obtain help and unsympathetic behaviour contributed 21.55%, and rejection and neglect collectively accounted for 21.83%. Additionally, the effect was partially moderated by ADL, with older adults exhibiting lower ADL scores showing a greater benefit from both giving and receiving social support compared to those with higher ADL scores.Conclusion: It is imperative to recognise and encourage disabled older adults to provide social support to others, especially emotional support, while reducing negative feedback, such as neglect and unnecessary blame. This could alleviate their depressive symptoms and promote psycho-social well-being.Keywords: disabled older adults, social support, social exchange, depressive symptoms, ADL

Keywords

• disabled older adults
• social support
• social exchange
• depressive symptoms
• adl