Functional Social Support Questionnaire

Abstract

The Duke-UNC Functional Social Support Questionnaire (DUFSS) is an 8-item self-report instrument designed to assess perceived social support in clinical and research settings. Developed by Broadhead and colleagues in 1988, the DUFSS specifically focuses on the functional aspects of support—the perceived availability of emotional and instrumental resources—rather than the structural size of the social network. It is widely used in primary care research to examine the relationship between social resources and health outcomes or healthcare utilization patterns.

Keywords

Functional Social Support Questionnaire, DUFSS, Social Support, Psychometrics, Family Medicine, Perceived Support, Instrumental Support, Affective Support.

Authors

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

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Purpose

The primary purpose of the DUFSS is to provide a concise and reliable measure of functional social support, particularly within primary care and family medicine patient populations. The scale was developed to assess the perceived quality and availability of support resources, which researchers hypothesize are more strongly linked to health status and healthcare utilization than structural measures of social networks alone.

Its brevity and ease of administration make it a practical tool for screening patients for potential deficits in social resources that may contribute to psychological distress or poor management of chronic health conditions.

Construct

The DUFSS measures the psychological construct of functional social support. This construct assesses the perceived availability of specific supportive behaviors and resources that an individual can access when needed. The items cover several critical aspects of support, which are generally categorized into two primary sub-domains:

• Affective (Emotional) Support: Items related to love, affection, caring, and opportunities for confidential trust and discussion of personal problems.

• Instrumental (Practical) Support: Items related to practical aid, such as help when sick, useful advice about life decisions, and assistance with work or money matters.

The overall score reflects the respondent’s satisfaction with the availability of these specific supportive functions in their life.

Validity

Studies examining the DUFSS have demonstrated strong evidence of validity across various clinical settings. Construct validity is supported by the scale’s ability to differentiate between individuals with varying levels of perceived social resources and its expected correlation with measures of psychological well-being, such as depression and anxiety.

Furthermore, criterion validity has been established through consistent findings showing that lower DUFSS scores correlate significantly with increased health care utilization, higher rates of illness, and poorer self-reported health outcomes, particularly in primary care settings, thus confirming the scale’s utility in predicting health-related behaviors.

Reliability

The internal consistency of the DUFSS has been consistently high across diverse adult populations, often yielding Cronbach’s alpha coefficients in the 0.80 to 0.90 range, indicating excellent reliability. This high level of internal consistency suggests that the 8 items are strongly interrelated and measure a single, cohesive underlying construct of functional social support.

In addition to internal consistency, Test-retest reliability has also been supported in longitudinal studies, showing stability of scores over short periods, confirming the scale’s consistency when administered multiple times to the same individuals.

Factor Analysis

Initial factor analysis conducted during the scale development suggested a strong single-factor structure, supporting the use of a total summary score to represent overall functional social support. This single-factor model is the most commonly employed method for scoring the DUFSS in research.

While some subsequent psychometric analyses have identified potential two-factor models (often dividing the items into the emotional/affective support and instrumental/practical support sub-domains), the primary clinical and research application relies on the robust general factor score due to the limited number of items.

Instrument

Test Type: Self-report questionnaire.

Format: 8 items, typically scored on a 5-point Likert-type scale assessing the frequency or perceived satisfaction with the availability of support. The response set ranges from “Much less than I would like” to “As much as I would like.”

Language Available: English (original); translations exist in various languages for international research.

Population Group: Adults, particularly those in clinical or primary care settings.

Age Group: 18 years and older.

Population Details: Originally developed and validated among patients receiving care in a Family Medicine outpatient practice at Duke University and the University of North Carolina (UNC).

Test Methodology: The scale is brief, requiring minimal time for completion, and is designed for rapid self-administration, making it highly suitable for integration into clinical assessments and large epidemiological studies.

Keywords

Affective support, Instrumental support, Perceived availability, Healthcare utilization, Medical Care, Broadhead, Psychometric scale.

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Authors

Author ORCID Identifier: N/A (Information not provided in original source).

Affiliation Email addresses: N/A (Information not provided in original source).

Correspondence Address: N/A (Information not provided in original source).

Permissions & Fee and Test Year

The scale was first published in 1988. Due to its age and widespread use in academic and clinical settings, the Functional Social Support Questionnaire is generally considered non-proprietary and is often utilized without direct fees, though researchers must always cite the original publication by Broadhead et al. (1988).

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.

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

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Items of the Functional Social Support Questionnaire

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