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      Education and Social Support as Key Factors in Osteoarthritis Management Programs: A Scoping Review

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          Abstract

          Systematic reviews of self-management programs for osteoarthritis suggest minimal evidence of benefit and indicate substantial heterogeneity in interventions. The purpose of this scoping review was to describe the nature of self-management interventions provided to patients with osteoarthritis focusing on the inclusion and type of education and social support components. We searched PsycINFO, EMBASE, MEDLINE, and Cochrane Library databases from 1990 to 2016 to identify studies addressing community-based management strategies for osteoarthritis that included aspects of disease-specific education and ongoing social support. Results are presented as a narrative synthesis to facilitate integration of diverse evidence. Data were extracted from 23 studies that met our inclusion and exclusion criteria, describing complex, multicomponent interventions for osteoarthritis. All studies included education components, and 18 of these were osteoarthritis-specific. Social support was most often offered through peers and health care professionals, but also through exercise trainers/instructors and researchers, and lasted between 5 and 52 weeks. We charted positive social interaction offered by peers in group settings and emotional/informational support offered by health care professionals. Overall, descriptions of self-management provided limited documentation of the rationale or content of the programs. This suggests that more precise definitions of the theoretical underpinnings, components, and mechanisms would be useful for greater insight into best practices for osteoarthritis self-management programs.

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          Social support and resilience to stress: from neurobiology to clinical practice.

          Numerous studies indicate social support is essential for maintaining physical and psychological health. The harmful consequences of poor social support and the protective effects of good social support in mental illness have been well documented. Social support may moderate genetic and environmental vulnerabilities and confer resilience to stress, possibly via its effects on the hypothalamic-pituitary-adrenocortical (HPA) system, the noradrenergic system, and central oxytocin pathways. There is a substantial need for additional research and development of specific interventions aiming to increase social support for psychiatrically ill and at-risk populations.
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            Social and emotional support and its implication for health.

            Recent research findings from selected publications focusing on links between social support and physical health are summarized. Current research is extending our understanding of the influences of social support on health. Many epidemiological studies have concentrated on further linking measures of social support to physical health outcomes. A few studies are now moving into newer areas, such as emphasizing health links with support receipt and provision. Researchers are also interested in outlining relevant pathways, including potential biological (i.e. inflammation) and behavioral (i.e. health behaviors) mechanisms. Interventions attempting to apply basic research on the positive effects of social support are also widespread. Although the longer term effects of such interventions on physical health remain to be determined, such interventions show promise in influencing the quality of life in many chronic disease populations. Recent findings often show a robust relationship in which social and emotional support from others can be protective for health. The next generation of studies must explain, however, why this relationship exists and the specificity of such links. This research is in its infancy but will be crucial in order to better tailor support interventions that can impact on physical health outcomes.
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              The influence of social support on chronic illness self-management: a review and directions for research.

              A review of the empirical literature examining the relationship between social support and chronic illness self-management identified 29 articles, of which 22 were quantitative and 7 were qualitative. The majority of research in this area concerns diabetes self-management, with a few studies examining asthma, heart disease, and epilepsy management. Taken together, these studies provide evidence for a modest positive relationship between social support and chronic illness self-management, especially for diabetes. Dietary behavior appears to be particularly susceptible to social influences. In addition, social network members have potentially important negative influences on self-management There is a need to elucidate the underlying mechanisms by which support influences self-management and to examine whether this relationship varies by illness, type of support, and behavior. There is also a need to understand how the social environment may influence self-management in ways other than the provision of social support
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                Author and article information

                Contributors
                Journal
                Arthritis
                Arthritis
                ARTHRITIS
                Arthritis
                Hindawi
                2090-1984
                2090-1992
                2018
                8 May 2018
                : 2018
                : 2496190
                Affiliations
                1Faculty of Health Sciences, University of Western Ontario, 1151 Richmond St., London, ON, Canada N6A 5B9
                2Hand and Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, 268 Grosvenor St., London, ON, Canada N6A 3A8
                Author notes

                Academic Editor: Changhai Ding

                Author information
                http://orcid.org/0000-0002-4339-9467
                http://orcid.org/0000-0001-9311-7379
                Article
                10.1155/2018/2496190
                5964569
                29854457
                1a34ae43-97e2-4775-93f3-ecf2a0f9adbd
                Copyright © 2018 Shabana Amanda Ali et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 October 2017
                : 7 February 2018
                : 7 March 2018
                Funding
                Funded by: Collaborative Training Program in Musculoskeletal Health Research
                Funded by: Sam Katz Community Health and Aging Research Unit at The University of Western Ontario
                Categories
                Review Article

                Rheumatology
                Rheumatology

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