The effect of social support on depression in African American women diagnosed with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) affects more African American women than any other group, and with greater level of morbidity and mortality. There are a myriad of challenges facing the African American woman diagnosed with SLE and there have been very few studies that addressed these challenges. Socio-economic factors such as education, occupation, income, and lifestyles play a significant role the misdiagnosis, delayed diagnosis, and poor disease management, placing the African American female at greater risk for earlier and more serious organ system involvement than other groups living with SLE. The magnitude of depression in SLE is not fully known because of the many factors impeding clear understanding. Yet, there have been few studies that examined SLE and depression in relation to social support. This study was undertaken to examine perceptions of the relationship between social support and depression among African American women living with SLE and to explore the relationship among depression, social support and the frequency and intensity of SLE flares. A purposeful sample of ten African American women between 30 and 50 years old, diagnosed with SLE for at least two years, and experiencing mild to severe depression as determined by the Beck Depression Inventory-II, were recruited from members of two community-based lupus support groups in a large metropolitan area. The lived experience of depression from the perspective of the African American women is unique and can be fully understood only through the lens of the individuals living with SLE. Depression is poorly understood and is often mistaken as a part of the SLE rather than a comorbid condition. As such it can remain untreated, placing the individual at a greater risk for more frequent SLE flares and further deepened the depression. Grounded theory was used to collect and analyze data from semi-structured interviews with the participants. Data analysis revealed many of the challenges experienced by African American women living with SLE. Additionally, participants reported using a variety of coping strategies to confront the challenges of living with SLE. The study's findings indicate that social support plays an important role in the development of coping strategies in the management of SLE and depression in African American women. Limitations of the study include the small sample size and homogeneity of the participants. However, although the study's findings cannot be generalized beyond the present sample, there was wide agreement among the participants on the challenges of living with SLE and helpful coping strategies. The study's findings provide an opportunity to explore the experiences of African American women living with SLE and elucidate potential interventions for this group and health care professionals who work with them.