Adequate social support has reportedly been associated with reduced distress, anxiety
and depression. However, little information is available about the potential association
between social support and social difficulties amongst patients with ESKD. Here we
assess the association between social support and social difficulties amongst patients
In a cross-sectional, convenience sample of patients on maintenance dialysis in several
outpatient dialysis units in Toronto, we used the MOS Social Support Survey to assess
social support. The outcome variable was the 16-item Social Difficulty Inventory (SDI).
Social difficulty was defined as a score of ?10 on the SDI. The association between
clinically relevant social difficulties and tertiles of overall social support was assessed
using Pearson?s Chi-Square and multivariable-adjusted logistic regression.
272 patients were recruited, 66% (179) were male and 47% (127) were Caucasians. 40%
(108) of participants were diabetic with a mean (SD) age was 55 (13). A weak negative
correlation was seen between the overall social support and SDI scores (Spearman?s
rho=-0.24, p<0.001). Social difficulties were present in 34% of respondents. Of the
participants with low, moderate and high social support, 51, 30 and 20% had social
difficulties (p=0.001). The relationship between social support, represented by tertiles of
the score, and social difficulties remained significant in a multivariable logistic regression
model after adjusting for sociodemographic and clinical values (OR=0.42; 95% CI=0.25-
Patients with a lower level of social support demonstrated greater social difficulties and
may benefit from additional assistance from healthcare providers.