Duke-UNC Functional Social Support Questionnaire (DUFSS)

Abstract

The Duke-UNC Functional Social Support Questionnaire (DUFSS) is a brief, self-administered instrument designed to measure an individual’s perception of the quality and availability of social support. Developed primarily for use in clinical settings, particularly among family medicine patients, the scale focuses specifically on functional social support—the actual helpful behaviors and resources received, rather than merely the structural presence of social relationships. It consists of eight items covering different domains of perceived support, utilized to assess the relationship between social resources and health outcomes or utilization of medical services.

Keywords

Functional Social Support, Social Support, Psychometrics, Quality of Life, Family Medicine, Health Outcomes, Questionnaire, DUFSS, Perceived Support.

Authors

W.E. Broadhead, S.H. Gehlbach, F.V. de Gruy, B. H. Kaplan.

Purpose

The primary purpose of the DUFSS is to provide a quick and reliable measure of perceived functional social support in clinical populations. Its development was motivated by the need for an instrument sensitive enough to capture the complex dimensions of support relevant to patient health management and outcomes within primary care settings. The scale was specifically utilized in studies to differentiate the impact of functional support from structural support (e.g., marital status, network size) on health care utilization patterns.

The instrument is valuable for researchers and clinicians interested in understanding how a patient’s perception of available emotional, tangible, and informational support influences their adherence to treatment, overall well-being, and frequency of visits to the primary care physician. It serves as a predictive tool for identifying patients who may be at risk due to inadequate social resources.

Construct

The DUFSS measures the psychological construct of Functional Social Support, defined as the perceived availability of resources provided by one’s social network. This construct is generally divided into two main domains, both represented within the eight items: Affective Support and Instrumental Support. Affective support relates to emotional resources, such as love, affection, and caring (Items 1, 2). Instrumental support relates to tangible or informational aid, such as advice, help when sick, or opportunities to discuss practical problems (Items 3, 5, 7, 8).

The scale assumes that the subjective perception of support availability is a more critical determinant of health outcomes than the objective existence of a social network structure. The scoring yields a single total score reflecting the overall adequacy of perceived support, making it an efficient measure for large-scale epidemiological or clinical screening studies.

Validity

Initial validation studies conducted by Broadhead et al. (1988) demonstrated strong evidence for the construct validity of the DUFSS. The scale was shown to correlate meaningfully with other established measures of social support and inversely correlate with measures of psychological distress, such as depression and anxiety, consistent with established literature linking robust social support to better mental health.

Furthermore, criterion validity was supported by findings that scores on the DUFSS predicted health care utilization. Specifically, lower levels of functional social support were associated with increased frequency of primary care visits, suggesting that the lack of adequate social resources may lead individuals to seek medical assistance for problems that might otherwise be managed through their social network. This finding highlights the practical utility of the instrument in medical research concerning resource allocation and patient risk assessment.

Reliability

The DUFSS exhibits acceptable levels of internal consistency, a key measure of reliability. The original studies reported a high Cronbach’s alpha coefficient, typically in the range of 0.80 to 0.90, indicating that the eight items consistently measure the same underlying construct of functional social support. This high coherence suggests the scale is highly dependable for clinical assessment.

Although specific test-retest reliability figures are often dependent on the population and time interval studied, the instrument has been widely adopted in longitudinal studies, suggesting its scores remain stable over short periods, confirming its utility for measuring stable individual differences in perceived support availability.

Factor Analysis

Although the DUFSS is often treated as a unidimensional scale yielding a single total score, initial factor analysis conducted during its development suggested that functional social support, as measured by the DUFSS, might comprise two primary factors. These factors generally align with the theoretical domains: Affective/Emotional Support (items related to caring and affection) and Instrumental/Tangible Support (items related to advice, help when sick, and discussing practical matters).

However, due to the brevity of the instrument and the high correlation between these potential subscales, researchers typically recommend using the overall total score, as the primary goal is a rapid assessment of overall perceived support adequacy rather than a highly detailed breakdown of support dimensions.

Instrument

Test Type: Self-report questionnaire / Psychological test

Format: 8 items, typically scored on a 5-point Likert scale (ranging from “As much as I would like” to “Much less than I would like”).

Language Available: Primarily English (translated versions may exist in research settings).

Population Group: Clinical and General Adult Populations.

Age Group: Adults (18+).

Population Details: Originally validated in primary care and family medicine outpatient settings, suitable for individuals seeking medical care.

Test Methodology: Respondents rate how much of each type of support they receive compared to how much they would like to receive. The scale is typically reversed-scored so that higher scores indicate greater perceived functional social support.

Keywords

Affective Support, Instrumental Support, Primary Care, Health Care Utilization, Broadhead, de Gruy, Measurement, Likert Scale.

Authors

Author ORCID Identifier: N/A

Affiliation Email addresses: N/A

Correspondence Address: N/A (Historically linked to the original research institutions: Duke University and UNC Chapel Hill).

Permissions & Fee and Test Year

The DUFSS was first published and validated in 1988. As a brief, widely published academic instrument, it is generally considered to be in the public domain for non-commercial research and clinical use, though researchers should always cite the original Broadhead et al. (1988) publication. No specific fee is typically required for its use.

The original PDF can be downloaded here: www.a4ebm.org/sites/default/files/Measuring%20Health.pdf

Reference’s

Broadhead, W.E., Gehlbach, S.H., de Gruy, F.V., Kaplan, B. H. (1988). The Duke-UNC Functional Social Support Questionnaire: measurement of social support in family medicine patients. Medical Care, 26(7) :709–723.

Broadhead, W.E., Gehlbach, S.H., de Gruy, F.V., Kaplan, B. H. (1989). Functional versus structural social support and health care utilization in a family medicine outpatient practice. Medical Care, 27(2):221–233.

McDowell, Ian. (2006). Measuring Health: A Guide to Rating Scales and Questionnaires, Third Edition. OXFORD UNIVERSITY PRESS.

Items of the Duke-UNC Functional Social Support Questionnaire (DUFSS)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

I get . . .

• 1. people who care what happens to me
• 2. love and affection
• 3. chances to talk to someone about problems at work or with my housework
• 4. chances to talk to someone I trust about my personal and family problems
• 5. chances to talk about money matters
• 6. invitations to go out and do things with other people
• 7. useful advice about important things in life
• 8. help when I’m sick in bed

Response anchors:

As much as I would like ____________________ Much less than I would like