Families, Social Support, and Self-Care among Older African-American Women with Chronic Illness

PURPOSE: This study describes the specific type and extent of social support provided by family members to older African-American women managing chronic disease. DESIGN: Qualitative study with multiple in-depth interviews conducted over a 2-year time period. SETTING: Participants were interviewed in their homes in a large Midwestern city. PARTICIPANTS: This was a purposeful study group of 12 middle-aged and older African-American women with diagnosed early-stage heart disease and other comorbidities. METHODS: Data were collected on women's beliefs about their heart disease and their descriptions of how family members helped or inhibited their self-care practices. Women's descriptions of family social support were analyzed as to the type and influence. RESULTS: Most women lived in interdependent, multigenerational situations with family members providing: instrumental support; a passive form of informational support based on family history of heart disease that was used to make health comparisons and evaluate heart health; and behavioral support, which emerged, in terms of reinforcement or discouragement of lifestyle behavior changes, as a sometimes significant barrier to practicing chronic illness self-care. CONCLUSION: These findings, while not statistically representative, demonstrate the significant influence that family members have on older women's chronic illness self-care activities. The positive and sometimes negative effects of living with multiple generations suggest the need for culturally relevant, family-based, chronic illness interventions for African-Americans.