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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 26, No 1, January/February 2015
AFRICA
31
a family member who had suffered complications were not
associated with good compliance. On the other hand, having
friends who were concerned about the respondent’s hypertension
or who were helpful in reminding the respondent about taking
medication were associated with good compliance. A higher
proportion of those whose friends were very concerned about
their hypertension reported good compliance than those who did
not get such support from their friends (
p
≤ 0.0001). Similarly,
a higher proportion of respondents whose friends were very
helpful in reminding them about their hypertension medication
reported good compliance than those who did not get such
support from their friends (
p
≤ 0.0001) (Table 2).
Factors associated with receiving social support
Having found a significant association between some aspects of
social support (from friends) and good treatment compliance,
we investigated socio-demographic factors influencing receiving
social support. As shown in Table 3, a higher proportion of
older respondents (
>
55 years) rather than younger respondents
reported receiving social support from family (
p
<
0.0001).
Gender was not significantly associated with respondents getting
social support. On the other hand, there was a significant
association between those who were currently married at the
time of the study and support from family (
p
=
0.0006) and
support from friends (
p
=
0.009).
It is of interest also to note that both religion and educational
level of respondents were significantly associated with getting
social support from both family and friends. A higher proportion
of respondents of the Islamic faith (in contrast to Christians)
received social support from family and friends, respectively,
while respondents with no formal education (in contrast to those
with some education) received social support from members of
their families.
Discussion
Social support is a construct that describes the structure of a
person’s social environment and the tangible, instrumental and
emotional resources the social environment provides. A wealth
of data, particularly from large, long-term, observational studies,
has shown that higher levels of social support, whether measured
by instrumental, tangible or emotional indices, are associated
with reduced cardiovascular morbidity and mortality.
9,17-19
The
disease-related protective effects of social support were first
described in the 1970s.
20
From that time, there has been great
interest in the relationship of social support to health, and in
particular to cardiovascular disease.
21
However, there is scarcity
of such studies from Africa.
The issue of social support for health issues in African
societies warrants close study, given some of the characteristics
of these societies. For example, there is an emphasis on the
family and community rather than the individual, and many
individuals live in extended (rather than nuclear) family set-ups.
This often means that an individual’s problems (including health
issues) are not his/hers alone but that of the family. On the other
hand, individuals may conceal medical diagnoses for various
reasons (e.g. stigma, fear of being considered ‘different’ or of
the family being perceived as ‘tainted’ or cursed), which means
family members and friends may be unaware and cannot provide
support.
Table 1. Demographic characteristics of respondents
Characteristic
Number
Percentage
Smoking
15
3.4
Alcohol use
Beer
10
2.3
Wine
13
3.0
Whisky
10
2.3
Other liquor
8
1.8
Religion
Islam
270
61.4
Christianity
169
38.4
Traditional
1
0.2
Ethnic group
Yoruba
434
98.6
Ibo
5
1.2
Isoko
1
0.2
Educational level
No formal education
225
51.1
Primary education
86
19.5
Secondary education
49
11.1
Post-secondary education
77
17.5
Other (Arabic school)
3
0.7
Occupation
Trading
220
50.0
Artisan
49
11.1
Teaching/civil servant
43
9.8
Retired/not working
113
25.7
Religious teachers
15
3.4
Taking antihypertensive medication
257
58.5
Table 2. The association between social support and good
treatment compliance in hypertension
Variable
Response
Good compliance
n
(%)
χ
2
p
Has a family member
with hypertension
Yes
36 (49.3)
6.233 0.044*
No
206 (61.7)
Don’t know 15 (45.5)
Has a family member
who has serious
health problems from
hypertension
Yes
12 (36.4)
9.064 0.011*
No
230 (61.2)
Don’t know 15 (48.4)
Family members
concerned about
respondents hyper-
tension
Not very
10 (47.6)
4.128 0.248
Don’t know 43 (50.6)
Very
201 (61.1)
Extremely
3 (60.0)
Family members
helpful in reminding
about medication
Not very
12 (54.6)
5.132 0.162
Don’t know 43 (48.3)
Very
198 (61.5)
Extremely
4 (57.1)
Friends concerned
about respondent’s
hypertension
Not very
95 (49.0) 35.700
<
0.0001*
Don’t know 59 (50.9)
Very
102 (80.3)
Extremely
1 (33.3)
Friends helpful in
reminding about
medication
Not very
96 (49.2) 41.738
<
0.0001*
Don’t know 40 (44.0)
Very
119 (79.3)
Extremely
2 (50.0)
*
p
<
0.05.