Can better social support improve your health in SLE?

We know that having a network of friends and relatives to count on - good social support - makes us feel better emotionally. But can it have an impact on disease if you have lupus? And if so, can a psychologically oriented educational program for people with lupus and their partners make a difference? Those were the questions Boston researchers explored - and reported on at the recent American College of Rheumatology meeting.

In previous research, the researchers had shown that self-efficacy and social support could affect outcomes - how people functioned - in SLE. (Self-efficacy is your sense of competence in your ability to handle things.) The absence of self-efficacy and social support are risk factors for bad outcomes that might be modified. In this study, they sought to improve both through a program of partner support¹.

Their theory: better social support is associated with improved coping in lupus and better health - and partners could collaborate towards this goal.

A total of 122 SLE patients plus their partners (spouses or family members) were enrolled in the study. Half were randomly assigned to the "experimental" group. Half were randomly assigned to the "control" group.

Those in the experimental group participated in a psychologically oriented educational program. The program was conducted by a nurse educator in a one-hour session, and followed by monthly telephone counseling for six months. It was designed to enhance their sense of self-efficacy, as well as their social support and problem solving ability.

Participants were taught to look more clearly at their problems and assess alternative solutions. They learned to plan more effectively. They learned how to spot situations when they had different beliefs from their partners - and how to deal with those differences.

Those randomized to the control group received a similar amount of attention from a professional, but without any counseling - a "placebo" form of attention.

By six months, significant improvement was seen in couples communication and problem-focused coping.

At 12 months (6 months after the intervention had ended), the differences were dramatic:

• self efficacy remained at baseline for the control group but had risen in the experimental group;
  
  
• mental health status declined in the control group and rose in the experimental group;
  
  
• physical function improved by 7 points in the experimental vs. control group;
  
  
• there was a significant decrease in fatigue in the experimental group.

This research suggests that if you don't have good social support systems - and if you have difficulty with problem-solving, self-esteem, and other social issues - it might be a good idea to ask your doctor for referral to a social worker or psychologist who may be able to help you. Improving your coping strategies and social support systems may be able to improve your overall health, improve your physical function, and reduce fatigue - even without changing your medications.