حمایت اجتماعی و سلامت روان: مطالعه ای در میان نابینایان و کم بینایان شهر کاشان (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
سلامت روان نابینایان و کم بینایان، به وضعیت عمومی و عاطفی اشاره دارد که فرد را به واسطه آسیب بینایی در معرض افزایش استرس و اضطراب، احساس تنهایی و احساس ناتوانی قرار می دهد. در این شرایط، برخورداری از حمایت های اجتماعی به عنوان یکی از مهم ترین تعیین کننده های اجتماعی سلامت روان به شمار می رود. هدف اصلی پژوهش حاضر مطالعه رابطه بین حمایت اجتماعی و سلامت روان نابینایان و کم بینایان شهر کاشان است. روش این پژوهش از نوع پیمایشی و جامعه آماری آن شامل اعضای جامعه نابینایان و کم بینایان شهر کاشان (برابر با 652 نفر) است، که از این میان تعداد 211 نفر به عنوان حجم نمونه آماری انتخاب شده اند. نتایج آزمون فرضیه ها نشان می دهد که بین متغیرهای «حمایت خانواده»، «حمایت دوستان»، «حمایت دیگران مهم» و «حمایت اجتماعی (مجموع ابعاد)» با متغیر «سلامت روان» ارتباط مستقیمی در سطح اطمینان 99 درصد وجود دارد. همچنین، نتایج حاصل از تحلیل چندمتغیره رگرسیونی، بیان گر تأثیر مستقیم «حمایت دوستان»، «حمایت خانواده» و «حمایت دیگران مهم» بر متغیر سلامت روان بود که به طور کلی توانسته اند 34 درصد از واریانس مغیر وابسته را تبیین نمایند. به علاوه، نتایج مدل یابی معادله ساختاری واریانس محور بیان گر آن است که حجم اثر متغیر «حمایت دوستان» در حد متوسط و سایر متغیرها در حد کم است. در مجموع، توان پیش بینی کنندگی مدل در سطح متوسط ارزیابی شده است. این مقاله با ارائه پیشنهادهایی جهت تقویت حمایت های اجتماعی از نابینایان و کم بینایان و نیز ارتقاء سطح سلامت روان آن ها به پایان می رسد.Social Support and Mental Health: A Study Among the Visually Impaired and Low Vision People in Kashan City
Introduction Without visual perception, an individual's perception of their surrounding society will be different. This difference can lead to emotional, behavioral, and social problems such as incompatibility, limited social activity, lack of love and intimacy towards others, depression, and a weak sense of self-worth, which can threaten their mental health. Based on social cognitive approaches to health, mental health is not just a biological or psychological phenomenon but also has social dimensions. The main objective of this study is to investigate the theoretical and empirical relationship between social support and mental health among blind and visually impaired individuals in Kashan city. Accordingly, the questions of this research are: What is the level of mental health among blind and visually impaired individuals in Kashan city? To what extent are blind and visually impaired individuals in Kashan city receiving various types of social support? And can social support have an impact on the mental health of blind and visually impaired individuals in Kashan city? In general, the hypotheses of this study are that there is a positive relationship between “family support”, “friend support”, “significant other support”, and “social support (total dimensions)” and “mental health” among blind and visually impaired individuals. Literature Review Previous empirical studies have shown a relationship between the concepts of social support and the mental health of individuals. According to sociological approaches, supportive actions from family, friends, and others can significantly enhance the social aspect of mental health, thereby leading to emotional and psychological well-being. A review of previous studies in Iran indicates that despite the high prevalence of research on mental health, there has been limited empirical research on the mental health of blind and visually impaired individuals. Furthermore, the existing studies have primarily focused on psychological analyses and explanations from a micro-level perspective, while paying less attention to the social determinants of mental health for individuals with visual impairments. Methodology The survey method was employed to answer the research questions and test the hypotheses. The target population included all blind and visually impaired individuals who were members of the blind community in Kashan city during the data collection period (summer 2022), totaling 652 individuals. Using Sample Power software, a sample size of 211 was determined and selected. The research instrument was a researcher-made questionnaire. After establishing face validity, reliability was estimated using Cronbach's alpha and composite reliability coefficients. For this purpose, 35 questionnaires were used in the preliminary test phase. Since the obtained coefficients for all variables were above 0.7, it can be concluded that the questionnaire used in this study was a reliable and valid tool. Results The descriptive findings indicate that the mean of the variables “family support”, “significant other support,” and “mental health” were higher than the median, indicating that these variables are reported at an above-average level. However, the mean of the variables “friend support”, and “social support (total dimensions)” were lower than the median, indicating a below-average situation for these variables. The results of hypothesis testing show that there is a significant and direct relationship between the variables of “family support”, “friend support”, “significant other support”, and “social support (total dimensions)”, on the one hand, and “mental health”, on the other, at a confidence level of 99%. Moreover, the results of multiple regression analysis indicate that three independent variables out of four that had a significant correlation with mental health in the correlation test are present in the regression equation. These variables are, in order, “friend support”, “family support”, and “significant other support”. Overall, considering the standardized beta coefficients, the effect of “friend support” (β = .38) was the strongest, followed by “family support” (β = .23), and “significant other support” (β = .16). Therefore, the variable “friend support” has the highest direct effect, and the variable “significant other support” has the lowest direct effect among the significant independent variables in the regression model. To develop the empirical model, a structural equation modeling approach was used. In this model, the variables of “family support” (with 4 items); “friend support” (with 4 items); “significant other support” (with 4 items); “social support” (with 12 items from all dimensions); “emotional well-being” (with 3 items); “mental well-being” (with 6 items); “social well-being” (with 5 items); and “mental health” (with 14 items from all dimensions) were present, and most of the factor loadings of the items exceeded 0.5 (Figure 1). Then, using the bootstrapping method, the significance of the estimated path coefficients for each variable was examined. Figure 1. Structural Model of the Relationship Between Social Support and Mental Health Table 1. Evaluation of the Internal Model of the Research Based on the Significance of Direct Effects Variables Path coefficients T Sig. Result Friend support 0.363 5.989 0.000 Confirmed Family support 0.223 3.066 0.002 Confirmed Significant other support 0.187 2.410 0.016 Confirmed Results show that all path coefficients are significant. Additionally, the estimate of effect size (f 2 ) and predictive power (Q 2 ) of the structural model indicate that the effect size of the variable “friend support” is moderate (0.175) and other variables have a low effect size. Furthermore, the predictive power of the model is moderate with a value of 0.164. Finally, the general fit index of the model (SRMR) is 0.09, indicating a good fit. Conclusion Overall, the evidence obtained confirms all research hypotheses, which is consistent with previous studies and theoretical discussions. In particular, the variable of social support is of great importance. This indicates that friends, through their tangible support in providing suggestions and information, and by creating a sense of reassurance, strengthen the individual's sense of worth and help improve their mental health. This can be rooted in the tendency of visually impaired individuals towards intra-group interactions and friendships, especially among members of their community. In other words, here we are faced with the link and cohesion of visually impaired individuals and individuals with low vision as a factor in mutual understanding. Therefore, the results suggest that social support and peer support have a significant impact on this group. Acknowledgments The researchers of this article would like to express their utmost gratitude and appreciation to the blind and visually impaired community of Kashan city, as well as all questionnaire respondents and participants in this study. Keywords : Mental Health, Social Support, Family Support, Friend Support, Significant Others Support.
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