Saracino Rebecca, Kolva Elissa, Rosenfeld Barry, Breitbart William
Department of Psychology,Fordham University,Bronx,New York.
Department of Psychiatry and Behavioral Sciences,Memorial Sloan Kettering Cancer Center,New York,New York.
Palliat Support Care. 2015 Oct;13(5):1153-63. doi: 10.1017/S1478951514000996. Epub 2014 Sep 9.
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.
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.
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.
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.
迄今为止，尚未专门针对姑息治疗或肿瘤学环境开发社会支持测量方法。本研究检验了杜克大学-北卡罗来纳大学功能性社会支持问卷（DUFSS）的心理测量特性，以便（1）评估该量表在严重疾病背景下的适用性，以及（2）评估一个简短的项目子集是否可能产生大致相当的效用。
对1362名晚期癌症或艾滋病患者施测14项的DUFSS。运用经典测试理论（CTT）和项目反应理论（IRT）分析来开发一个DUFSS的简化版本，该版本要保持足够的信度和效度，并可能提高其在姑息治疗环境中施测的可行性。在一个单独的晚期癌症患者验证样本中评估了DUFSS-5的信度和同时效度。
分析得出了一个5项版本的DUFSS（DUFSS-5），该版本将反应水平合并为仅三个选项，而非五个。DUFSS-5与抑郁、生活质量和加速死亡愿望的测量指标之间的相关性，以及检验社会支持主效应和缓冲模型的回归模型，为DUFSS-5的效用提供了支持。
在这种情况下，DUFSS和简化后的DUFSS-5似乎都具有足够的信度和效度。此外，DUFSS-5对医疗保健研究人员来说是一个潜在的重要选项，特别是对于那些在患者负担问题至关重要的姑息治疗环境中工作的研究人员。此类分析对于推进心理社会测量方法的开发和完善至关重要，但往往被忽视。
