Social support is especially important for the elderly, as they are more likely to be exposed to numerous stressors later in life, such as the start of chronic diseases and functional limits, the loss of sources of income, and the death of spouses and loss of confidants [26]. Happiness is an essential factor for healthy aging. The elderly population in receiving emotional and instrumental support can enhance their happiness level [27]. Various social and health-related factors such as social support, chronic conditions, and self-rated health have previously been associated with level of morale in old age [28]. Therefore, community mental health nurses must pay close attention to the elderly, give essential support, investigation and assess their wants in all aspects of life.
The aim of this study was to investigate the relationship between morality, happiness, and social support among elderly people. The findings generally answered the research questions.
The current study results showed that more than half of studied elderly were female, married, had higher education and living with husband/wife. Less than three-quarters of them were not working and most of them were depending on pension as a source of income; this may be due to that the majority of studied elders had previously governmental job and more than half of them aged 65 years or more and in Egypt the official retirement age in civil servants is 60 years. In the same line, Ibrahim and Ali [26], who carried out a study in Damanhour and Alexandria, found that more than half of the participants were women, married, and one-third of them lived with their husband, and approximately two-thirds of the seniors investigated relied only on their pension.
The present study results revealed that the elders’ mean age was 65.8 ± 5.1, more than half of studied elderly were living with husband/wife, and more than three quarters of studied elderly had chronic diseases. The mean number of medication taken was 3.1 ± 2.9, and near half of them had hypertension, followed by slightly less than one-third had diabetes and arthritis chronic diseases. In similar studies as that conducted in Turkey by Unsar et al. [29], who explored the social support and quality of life of Turkish older individuals and concluded that an association between social support and quality of life was found, that the mean age of the group was 68.0 ± 5.90, and more than half of them were living with their husband. However, most of them had health issues; the mean number of daily oral medications was found as 3.3 ± 2.3. Similarly Ibrahim and Ali [26] found that the bulk of the seniors were suffering from health issues. Hypertension and diabetes mellitus were the greatest common disorders stated by the seniors (denoted 70% and 55.3% correspondingly) which were much higher than percentages of the current study.
The current study findings showed that the elders’ overall perceived social support mean score was 45.4 ± 17 with range of 12 to 84, which are higher than those reported in the study of Dai et al. [30] who studied social support and the self-rated health of older people as a comparative study, in Tainan Taiwan and Fuzhou Fujian province, which found that, the mean total social support was 36.54 ± 7.38 out of a range of 17–54. This may be due to the use of a different social support scale that was applied on a different population in this study.
The present study results revealed that slightly less than half of studied elderly had moderate level of social support which is lower than the percentage revealed by Ibrahim and Ali [26] who in a similar study, stated that higher than two-thirds (68.8%) of the studied elders had moderate perceived social support. As well, this result disagreed with that of Thiratanachaiyakul [31] who carried out a study in Thailand and reported that the participants had high level of social support.
The current study results revealed that a statistically significant relation was found between elders’ perceived social support level and their gender which means that perceived social support decreased in males comparing with females. This may be related to that collection of data from the Social Club whose visitors had relation with each other and most of the participants were female. This result is similar to that of Hosieni et al. [32] who stated that there was a significant variance between the old male and female with deference to social support. Moreover, Ibrahim and Ali [26] found that there was a statistically significantly positive relation between elders’ gender and social support.
In this study, a statistically significant relation was found between elders’ perceived social support level and their marital status; however, the relation was highly statistically significantly related with income. This means that elders who had low perceived social support were single or divorced, and had no sufficient income. These results might be interpreted as marriage can produce a sense of affection, love, and empathy, which are forms of social support. These results were consistent with those of Ibrahim and Ali [26] who found that there were statistically significantly positive relation between marital status, income, and multidimensional measure of perceived social support. As well, according to Moeini et al. [10], their study results revealed that marital status exposed a significant association with social support and Dai et al. [30] who reported that social support was significantly correlated with marital status (r = 0.326, p < 0.001).
The current study results revealed statistically significant relation between elders’ perceived social support and chronic diseases; elders who had low perceived social support had chronic diseases. Social support may be particularly beneficial for supporting health behaviors. In a similar previous study, Bélanger et al. [19] clarified that robust social networks with high levels of social support usually denote a defensive factor for preserving good wellbeing and quality of life in later life.
This study finding indicated that less than three-fifths of elders had moderate level in feeling of happiness. It may be related to that about two-thirds of the participants do not had work, and that most of them had moderate social support, which means that the increasing social support led to increase feeling of happiness. These results disagreed with those of Thiratanachaiyakul [31] who in a very recent study, carried out in Thailand, found that the participants had low average score level of happiness. This may be due to different sample size used in this study, and different culture of population.
The current study result showed statistically significant relation between elders’ happiness level and income; this means that elders who had insufficient income were unhappy. This may be related to that most of the elders under study were not working and also they are required to have many responsibilities and obligations toward their families and their health that led to more stress which interferes with happiness. Similarly, Shah et al. [33], who recently studied factors associated with happiness among Malaysian elderly, found that happiness was significantly connected with high household income. Additionally, Moeini et al. [10], who previously studied the association between social support and happiness among elderly in Iran, detected that happiness was significantly positively related with income.
Statistically significant relations were detected between elders’ happiness level and working condition, income, and with whom they live; the explanation for these findings is that elders not working had not sufficient income, and elders living with sons or relatives had lower happiness level; this may be due to the Egyptian culture, where parents remain responsible for their sons and relatives until the end of their lives. This result was consistent with that of Thiratanachaiyakul [31] who recently studied the influence of social support and quality of life on happiness of elderly people in Bangkok, and found that the elders’ happiness is mostly produced by employment, having adequate income, and having consistent income, which allow them to care for themselves and their families. Additionally, having love, stable family, and strong family relations also contributes to the elders’ happiness.
Concerning elders’ total morality level, the current study results revealed that slightly less than half of them had moderate level of morality. This finding could be explained by the fact that the elders investigated are involved in major activities such as caring for their grandkids or a family member; this raises the moral value of self-worth, purpose in life, and altruism in the elderly. Furthermore, more than half of the studied elders stated that they have sufficient family income; their financial support is influenced by their pension or children’s assistance. This could raise the moral value of self-sufficiency and being loved by others. This result was congruent with that of Ibrahim and Ali [26] who found that more than half of the participants had medium level of morality.
The current study result showed that statistically significant relation was found between elders’ morality and their age which means that elders aged 65 or more were low in morale state. This result was in accordance with that of Nasman et al. [34] which showed that elder period was independently related with subordinate morale. Additionally, De Guzman et al. [35] previously stated that elder period was connected with inferior morale (age span 65 to 85+).
Highly statistically significant relation was found between elders’ morality and income. This means that morale state was less among studied elderly who had lower income. This result was in agreement with that of Ibrahim and Ali [26] who found that there was a significantly positive relation between elders’ income and moral score.
Statistically significant relations were found between elders’ morality and chronic diseases. This means that elderly who had chronic diseases were having less morale state; this might be due to having feelings that they are a burden to others and they need special care. Similarly, Loke et al. [28] who studied assessment of factors influencing morale in the elderly, in Malaysia, they reported that a chronic disease has a robust effect on morale in the elders. As well, De Guzman et al. [35] who stated that chronic disorders have earlier been connected with level of morale in elderly.
The current study result revealed that highly statistically significantly positive correlation was found between elders’ total perceived social support score and total morality score. This may be interpreted as when an elderly person perceived social support, help in creating feelings of love, care, self-esteem, and value among the elders this will automatically enhance his/her morality level. This result was congruent with that of Ibrahim and Ali [26] who revealed that there is a significant relation between elders’ perceived social support and their level of morality. In line with earlier scattered researches, as those of Nasman et al. [34] and De Guzman et al. [35], which indicated that social interactions and social support were related with morale. In the same line, Loke et al. [28] found that a robust and significant relation was detected between social support and morale among elderly.
Highly statistically significantly positive correlation was found between total perceived social support and total happiness. This could be interpreted in that elders suffer from problems such as loneliness, depression, anxiety, and ultimately physical and mental problems due to “automated” life, so elders need social support to solve their problems and allow them to have a sense of happiness. As well, values for happiness show cultural differences, such as the importance of individual achievement in Western cultures versus relationships in Eastern ones [36]. People in Eastern cultures seek happiness in more socially involved ways, such as spending time with family or friends, and happiness motivation predicted high levels of well-being in East Asia, but not in the USA or Germany [37].
These results were consistent with those of Beygzadeh et al. [38] who concluded that there was significantly positive association between social support and life fulfillment with happiness. However, Shah et al. [33] highlighted that elder individuals receiving emotional support showed a more positive opinion of happiness, as well, Thiratanachaiyakul [31] found that social support factors affect happiness at a high level, and Shahsavar et al. [39] in Iran reported that perceived social support had positively and significantly resulted on happiness (p < .05), and similarly, Brailovskaia et al. [40] who carried out of study in the USA and Russia found that significantly positive correlation between social support and happiness.
The current study result revealed that highly statistically significantly positive correlation was found between elders’ perceived social support subscale and total happiness. This result could be interpreted as social support is helping them achieve goals, satisfaction with life, and consequently, happiness. Similarly, Rey et al. [41] who studied clarifying the links between perceived emotional intelligence and well-being in older people, in Spain, found that the three subscales of social support were positively correlated with life fulfillment and happiness (r ranging from .31 to .47, p < .01).
The present study results revealed that elders’ social support subscales (social support by others, family, and friends) were highly positively statistically significantly correlated with total morality; this explains that elderly individuals in this stage of age are in need for being revered and respected by family and friends who assist them to coping with everyday life. This result was consistent with that of Ibrahim and Ali [26] who concluded that there is a significant relationship between morals and multi-dimensions perceived social support in public seniors’ residences.
Finally, the present study results showed that significant predictors of elders’ morality score were happiness score, and social support score. This explains that those who receive more social support enjoy higher levels of happiness which consequently affects the level of morality. Moreover, levels of interaction and social support in comparing this result with that of Pourtaghi et al. [13] who studied relationship between depression and social support and morale in the elderly, in Iran, and found that social support was a statistically significantly reverse and direct association with morale among elderly. As well, Dogruel et al. [42] clarified that the presence of belonging to a family with social support can enrich the elders’ moral values as acceptability, reliability, collaboration, life fulfillment, and happiness. In accordance with the previous researches’ findings, Lambert et al. [43] reported that happiness as a moral value in elder people can be obtained with a lot of social support.
