The Portuguese formal social support for autonomy and dependence in pain inventory (FSSADI_PAIN): A preliminary validation study

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Development and preliminary validation of a Portuguese measure of perceived Formal Social Support for Autonomy and Dependence in Pain (FSSADI_PAIN).


One hundred and fifty-one older adults (88.1% women), between 56 and 94 years of age (M = 75.41; SD = 9.11), who attended one of the following institutions – day care centre (33.1%), nursing home (36.4%) and senior university (30.5%) – were recruited for this study. Along with the FSSADI_PAIN, participants filled out the Portuguese versions of the Brief Pain Inventory (Azevedo et al., 2007, Dor, 15, 6) and the Social Support Scale of Medical Outcomes Survey (Pais-Ribeiro & Ponte, 2009, Psicologia, Saúde & Doença, 10, 163).


The factorial structure reflected the functions of perceived promotion of (1) dependence and (2) autonomy, showing good internal consistency (α > .70) and sensitivity indices. The FSSADI_PAIN showed good content, discriminant and criterion validity; it differentiated the perceptions of promotion of dependence/autonomy according to individual's pain severity and disability, as well as the type of institution.


These preliminary findings suggest that the FSSADI_PAIN is an innovative and promising measure of perceived formal social support adapted to pain-related contexts.

Statement of contribution

What is already known on this subject? Some studies with Chronic Pain patients suggest a negative relationship between perceived social support (PSS) and pain interference and severity (e.g., Evers, Kraaimaat, Geenen, Jacobs & Bijlsma, 2003; Turk, Kerns & Rosenberg, 1992), avoidance of daily activities and associated physical disability (e.g., Cohen & Wills, 1985; Jamison & Virts, 1990) and emotional distress (e.g., depression, anxiety; Zyrianova et al., 2006). Moreover, evidence shows that the higher the PSS, the less frequent the adoption of passive coping strategies, like physical and social activity avoidance or relational withdrawal (e.g., Katz, Ritvo, Ivine & Jackson, 1996). Overall, these studies emphasize the benefits of high PSS in chronic pain patients.

Statement of contribution

What does this study add? This study brings theoretical and methodological innovations: The conceptualization and operationalization of the functions of perceived promotion of autonomy and perceived promotion of dependence (PPD). Our results stress the importance of taking into consideration and differentiating these functions of PSS. Highlights the central role of PPD among older adults with chronic pain.

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