Hostname: page-component-7dd5485656-g8tfn Total loading time: 0 Render date: 2025-10-31T00:42:58.487Z Has data issue: false hasContentIssue false
  • English
  • Français

Measuring social support in patients with advanced medical illnesses: An analysis of the Duke–UNC Functional Social Support Questionnaire

Published online by Cambridge University Press:  09 September 2014

Rebecca Saracino ,
Elissa Kolva ,
Barry Rosenfeld  and
William Breitbart
Rebecca Saracino*
Affiliation:
Department of Psychology, Fordham University, Bronx, New York Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
Elissa Kolva
Affiliation:
Department of Psychology, Fordham University, Bronx, New York
Barry Rosenfeld
Affiliation:
Department of Psychology, Fordham University, Bronx, New York Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
William Breitbart
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
*
Address correspondence and reprint requests to: Rebecca Saracino, Fordham University, 226 Dealy Hall, 441 East Fordham Road, Bronx, New York 10458. E-mail: rjames11@fordham.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To date, no measure of social support has been developed specifically for either palliative care or oncology settings. The present study examined the psychometric properties of the Duke–University of North Carolina Functional Social Support Questionnaire (DUFSS) in order to (1) assess the adequacy of the scale in the context of severe medical illness and (2) evaluate whether a brief subset of items might generate roughly comparable utility.

Method:

The 14-item DUFSS was administered to 1,362 individuals with advanced cancer or AIDS. Classical test theory (CTT) and item response theory (IRT) analyses were utilized to develop an abbreviated version of the DUFSS that maintained adequate reliability and validity and might increase the feasibility of its administration in a palliative care setting. The reliability and concurrent validity of the DUFSS-5 were evaluated in a separate validation sample of patients with advanced cancer.

Results:

Analyses generated a five-item version of the DUFSS (the DUFSS-5) that collapsed response levels into only three options, instead of five. Correlations between the DUFSS-5 and measures of depression, quality of life, and desire for hastened death, as well as regression models testing the main-effect and buffering models of social support, provided support for the utility of the DUFSS-5.

Significance of results:

Both the DUFSS and the abbreviated DUFSS-5 appear to have adequate reliability and validity in this setting. Moreover, the DUFSS-5 represents a potentially important option for healthcare researchers, particularly for those working in palliative care settings where issues of patient burden are paramount. Such analyses are critical for advancing the development and refinement of psychosocial measures, but have often been neglected.

Keywords

Social supportPalliative careItem response theory

Information

Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 5 , October 2015 , pp. 1153 - 1163
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

REFERENCES

Ahumada, L., Bailón, E., Luna, J., et al. (1991). Validation of a functional social support scale for use in the family doctor's office. Atención Primaria, 8, 688–692.Google Scholar
Barth, J., Schneider, S. & Von Känel, R. (2010). Lack of social support in the etiology and prognosis of coronary heart disease: A systematic review and meta-analysis. Psychosomatic Medicine, 72, 229–238.CrossRefGoogle ScholarPubMed
Beck, A.T., Steer, R.A., Ball, R., et al. (1996). Comparison of Beck Depression Inventories 1A and II in psychiatric outpatients. Journal of Personality Assessment, 67, 588–597.CrossRefGoogle Scholar
Breitbart, W., Rosenfeld, B., Pessin, H., et al. (2000). Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. The Journal of the American Medical Association, 284, 2907–2911.CrossRefGoogle ScholarPubMed
Breitbart, W., Rosenfeld, B., Gibson, C., et al. (2009). Meaning-centered group psychotherapy for patients with advanced cancer: A pilot randomized controlled trial. Psycho-Oncology, 19, 21–28.CrossRefGoogle Scholar
Breitbart, W., Poppito, S., Rosenfeld, B., et al. (2012). Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer. Journal of Clinical Oncology, 30, 1304–1309.CrossRefGoogle ScholarPubMed
Broadhead, W.E., Gehlbach, S.H., DeGruy, F.V., et al. (1988). The Duke–UNC Functional Social Support Questionnaire: Measurement of social support in family medicine patients. Medical Care, 26, 709–723.CrossRefGoogle ScholarPubMed
Broadhead, W.E., Gehlbach, S.H., DeGruy, F.V., et al. (1989). Functional versus structural social support and health care utilization in a family medicine outpatient practice. Medical Care, 27, 221–233.CrossRefGoogle Scholar
Cella, D., Yount, S., Rothrock, N., et al. (2007). The Patient Reported Outcomes Measurement Information System (PROMIS): Progress of an NIH Roadmap Cooperative Group during its first two years. Medical Care, 45(5), S3–S11.CrossRefGoogle ScholarPubMed
Clark, L. & Watson, D. (1995). Constructing validity: Basic issues in objective scale development. Psychological Assessment, 7, 309–319.CrossRefGoogle Scholar
Cohen, S. & McKay, G. (1984). Social support, stress, and the buffering hypothesis: A theoretical analysis. In Handbook of psychology and health. Baum, A. et al. (eds.), pp. 253–269. Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
Cohen, S. & Syme, S.L. (1985). Issues in the study and application of social support. In Social support and health. Cohen, S. & Syme, S.L. (eds.), pp. 3–22. New York: Academic Press.Google Scholar
Cohen, S. & Wills, T.A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357.CrossRefGoogle ScholarPubMed
Cohen, S.R., Mount, B.M., Strobel, M.G., et al. (1995). The McGill Quality of Life Questionnaire: A measure of quality of life appropriate for people with advanced disease. A preliminary study of validity and acceptability. Palliative Medicine, 9, 207–219.CrossRefGoogle ScholarPubMed
DiMatteo, M.R. (2004). Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology, 23, 207–218.CrossRefGoogle ScholarPubMed
Eom, C.S., Shin, D.W., Kim, S.Y., et al. (2012). Impact of perceived social support on the mental health and health-related quality of life in cancer patients: Results from a nationwide, multicenter survey in South Korea. Psycho-Oncology, 22(6), 1283–1290.CrossRefGoogle ScholarPubMed
Ferketich, S. (1991). Focus on psychometrics: Aspects of item analysis. Research in Nursing & Health, 14(2), 165–168.CrossRefGoogle ScholarPubMed
Folstein, M., Folstein, S. & McHugh, P. (1975). Mini-mental state: A practical method of grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
González, A., Fernández, C., García, G., et al. (2002). Quality of life parameters in terminal oncological patients in a home care unit. Psychology in Spain, 6, 68–76.Google Scholar
Hann, D.M., Oxman, T.E., Ahles, T.A., et al. (1995). Social support adequacy and depression in older patients with metastatic cancer. Psycho-Oncology, 4, 213–221.CrossRefGoogle Scholar
Karnofsky, D.A. & Burchenal, J.H. (1949). The clinical evaluation of chemotherapeutic agents in cancer. In Evaluation of chemotherapeutic agents. MacLeod, C.M. (ed.), p. 196. New York: Columbia University Press.Google Scholar
Kolva, E., Rosenfeld, B., Pessin, H., et al. (2011). Anxiety in terminally ill cancer patients. Journal of Pain and Symptom Management, 42, 691–701.CrossRefGoogle ScholarPubMed
Kroenke, C., Kubzansky, L., Schernhammer, E.S., et al. (2006). Social networks, social support, and survival after breast cancer diagnosis. Journal of Clinical Oncology, 24, 1105–1111.CrossRefGoogle ScholarPubMed
Kroenke, C., Michael, Y., Tindle, H., et al. (2012). Social networks, social support and burden in relationships, and mortality after breast cancer diagnosis. Breast Cancer Research and Treatment, 133, 375–385.CrossRefGoogle ScholarPubMed
Nelson, C.J., Rosenfeld, B., Breitbart, W., et al. (2002). Spirituality, religion, and depression in the terminally ill. Psychosomatics, 43, 213–200.CrossRefGoogle ScholarPubMed
Olden, M., Rosenfeld, B., Pessin, H., et al. (2009). Measuring depression at the end of life: Is the Hamilton Depression Rating Scale a valid instrument? Assessment, 16(1), 43–54.CrossRefGoogle Scholar
Oren, M.L., Carella, M. & Helma, T. (1996). Diabetes support group: Study results and implications. Employee Assistance Quarterly, 11, 1–20.CrossRefGoogle Scholar
Orth-Gomér, K., Rosengren, A. & Wilhelmsen, L. (1993). Lack of social support and incidence of coronary heart disease in middle-aged Swedish men. Psychosomatic Medicine, 55(1), 37–43.CrossRefGoogle ScholarPubMed
Pessin, H., Gallieta, M., Nelson, C.J., et al. (2007). Burden and benefit of psychosocial research at the end of life. Journal of Palliative Medicine, 11, 627–632.CrossRefGoogle Scholar
Pinquart, M. & Duberstein, P. (2010). Associations of social networks with cancer mortality: A meta-analysis. Critical Reviews in Oncology/Hematology, 75, 122–137.CrossRefGoogle ScholarPubMed
Portenoy, R.K., Thaler, H,T,, Kornblith, A.B., et al. (1994). The Memorial Symptom Assessment Scale: An instrument for the evaluation of symptom prevalence, characteristics and distress. European Journal of Cancer, 30A(9), 1326–1336.CrossRefGoogle ScholarPubMed
Reis, H.T. (1984). Social interaction and well-being. In Personal relationship. Vol. 5: Repairing personal relationships. Duck, S. (ed.), pp. 21–45. London: Academic Press.Google Scholar
Ringdal, G.I., Ringdal, K., Jordhøy, M.S., et al. (2007). Does social support from family and friends work as a buffer against reactions to stressful life events such as terminal cancer? Palliative & Supportive Care, 5, 61–69.CrossRefGoogle ScholarPubMed
Rosenfeld, B., Breitbart, W., Stein, K., et al. (1999). Measuring desire for death among patients with HIV/AIDS. American Journal of Psychiatry, 156, 94–100.CrossRefGoogle ScholarPubMed
Rosenfeld, B., Breitbart, W., Gibson, C., et al. (2006). Desire for hastened death among patients with advanced AIDS. Psychosomatics, 47, 504–512.CrossRefGoogle ScholarPubMed
Rosenfeld, B., Pessin, H., Lewis, C., et al. (2011). Assessing hopelessness in terminally ill cancer patients: Development of the Hopelessness Assessment in Illness Questionnaire (HAI). Psychological Assessment, 23, 325–336.CrossRefGoogle Scholar
Saameño, J.A., Sánchez, A., Castillo, J.D., et al. (1996). Validity and reliability of the Duke–UNC-11 questionnaire of functional social support. Atención Primaria, 18, 158–163.Google Scholar
Samejima, F. (1969). Estimation of latent ability using a response pattern of graded scores. Psychometric Monograph No. 17. Richmond, VA: Psychometric Society. Available at http://www.psychometrika.org/journal/online/MN17.pdf.CrossRefGoogle Scholar
Thoits, P.A. (1985). Social support processes and psychological well-being: Theoretical possibilities. In Social support: Theory, research and applications. Sarason, I.G. & Sarason, B. (eds.), pp. 51–72. The Hague: Martinus Nijhoff.CrossRefGoogle Scholar
Uchino, B.N. (2009). What a lifespan approach might tell us about why distinct measures of social support have differential links to physical health. Journal of Social and Personal Relationships, 26, 53–62.CrossRefGoogle ScholarPubMed
Uchino, B.N., Cacioppo, J.T. & Kiecolt-Glaser, J.K. (1996). The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychological Bulletin, 119, 488–531.CrossRefGoogle ScholarPubMed
Vangelisti, A.L. (2009). Challenges in conceptualizing social support. Journal of Social and Personal Relationships, 26, 39–51.CrossRefGoogle Scholar