European Journal of Ageing

, Volume 14, Issue 3, pp 257–268 | Cite as

Older adults’ preferences for formal social support of autonomy and dependence in pain: development and validation of a scale

  • Sónia F. Bernardes
  • Marta Matos
  • Liesbet Goubert
Original Investigation


Chronic pain among older adults is common and often disabling. Pain-related formal social support (e.g., provided by staff at day-care centers, nursing homes), and the extent to which it promotes functional autonomy or dependence, plays a significant role in the promotion of older adults’ ability to engage in their daily activities. Assessing older adults’ preferences for pain-related social support for functional autonomy or dependence could contribute to increase formal social support responsiveness to individuals’ needs. Therefore, this study aimed at developing and validating the preferences for formal social support of autonomy and dependence in pain inventory (PFSSADI). One hundred and sixty-five older adults with chronic musculoskeletal pain (M age = 79.1, 67.3% women), attending day-care centers, completed the PFSSADI, the revised formal social support for autonomy and dependence in pain inventory, and a measure of desire for (in)dependence; the PFSSADI was filled out again 6 weeks later. Confirmatory factor analyses showed a structure of two correlated factors (r = .56): (a) preferences for autonomy support (α = .99) and (b) preferences for dependence support (α = .98). The scale showed good test–retest reliability, sensitivity and discriminant and concurrent validity; the higher the preferences for dependence support, the higher the desire for dependence (r = .33) and the lower the desire for independence (r = −.41). The PFSSADI is an innovative tool, which may contribute to explore the role of pain-related social support responsiveness on the promotion of older adults’ functional autonomy when in pain.


Pain Social support preferences Functional autonomy/dependence Older adults Scale development and validation 



We would like to thank Prof. Helena Carvalho for her help with statistics. This study was partially funded by Fundação para a Ciência e Tecnologia (SFRH/BD/79145/2011). We declare that there were no financial or other relationships that lead to conflicts of interest in the development of this research.


  1. American Psychological Association (2010) Ethical principles of psychologists and code of conduct: including 2010 Amendments. American Psychological Association website Accessed Jan 2014
  2. Azevedo LF, Pereira AC, Dias C, Agualusa L, Lemos L, Romão J, Castro-Lopes JM (2007) Tradução, adaptação cultural e estudo multicêntrico de validação de instrumentos para rastreio e avaliação do impacto da dor crónica. Dor 15:6–56Google Scholar
  3. Beaton D, Bombardier C, Guillemin F, Ferraz M (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 25:3186–3191CrossRefGoogle Scholar
  4. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D (2006) Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 10:287–333. doi: 10.1016/j.ejpain.2005.06.009 CrossRefGoogle Scholar
  5. Campbell P, Wynne-Jones G, Dunn KM (2011) The influence of informal social support on risk and prognosis in spinal pain: a systematic review. Eur J Pain 15:444.e1–444.e14. doi: 10.1016/j.ejpain.2010.09.011 Google Scholar
  6. Campbell P, Wynne-Jones G, Muller S, Dunn KM (2013) The influence of employment social support for risk prognosis in nonspecific back pain: a systematic review and critical synthesis. Int Archiv Occup Environ Health 86:119–137CrossRefGoogle Scholar
  7. Cohen S, Underwood L, Gottlieb B (2000) Social support measurement and intervention: a guide for health and social scientists. Oxford University Press, OxfordCrossRefGoogle Scholar
  8. DeVellis RF (2012) Scale development: theory and applications, 3rd edn. SAGE Publications, Thousand OaksGoogle Scholar
  9. Ferreira PL (2000a) Criação da versão portuguesa do MOS SF-36. Parte I—Adaptação cultural e linguística. Acta Med Port 13:55–66Google Scholar
  10. Ferreira PL (2000b) Criação da versão portuguesa do MOS SF-36. Parte II—testes de validação. Act Med Port 13:119–127Google Scholar
  11. Ferrel BA (1995) Pain evaluation and management in the nursing home. Ann Intern Med 123:681–687. doi: 10.7326/0003-4819-123-9-199511010-00007 CrossRefGoogle Scholar
  12. Gibson SJ (2007) IASP global year against pain in older persons: highlighting the current status and future perspectives in geriatric pain. Expert Rev Neurother 7:627–635CrossRefGoogle Scholar
  13. Hadjistavropoulos T, Craig KD, Duck S, Cano AM, Goubert L, Jackson P, Mogil J, Rainville P, Sullivan M, de Williams AC, Vervoort T, Fitzgerald T (2011) A biopsychosocial formulation of pain communication. Psychol Bull 137:910–939CrossRefGoogle Scholar
  14. Hair JRJF, Anderson RE, Tatham RL, Black WC (1995) Multivariate date analysis with readings. Prentice Hall, New JerseyGoogle Scholar
  15. Harris-Kojetin L, Sengupta M, Park-Lee E, Valverde R (2013) Long-term care services in the United States: 2013 overview. National Center for Health Statistics. Vital Health Stat 3:37Google Scholar
  16. Hébert R, Guilbault J, Desrosiers J, Dubuc N (2001) The functional autonomy measurement system (SMAF): a clinical-based instrument for measuring disabilities and handicaps in older people. Geriatr Today 4:141–147Google Scholar
  17. Helme RD, Gibson SJ (1997) Pain in the elderly. In: Jensen TS, Turner JA (eds) Proceedings of the 8th world congress on pain. IASP Press, Seattle, pp 919–944Google Scholar
  18. Helme RD, Gibson SJ (2001) The epidemiology of pain in elderly people. Clin Geriatr Med 17:417–431CrossRefGoogle Scholar
  19. Herr KA, Garand L (2001) Assessment and measurement of pain in older adults. Clin Geriatr Med 17:457–463CrossRefGoogle Scholar
  20. Hu LT, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model Multidiscip J 6:1–55CrossRefGoogle Scholar
  21. Ibarra-Rovillard MS, Kuiper N (2011) Social support and social negativity findings in depression: perceived responsiveness to basic psychological needs. Clin Psychol Rev 31:342–352CrossRefGoogle Scholar
  22. Kiejna A, Frydecka D, Adamowski T, Bickel H, Reynish E, Prince M, Caracciolo B, Fratiliglioni L, Geoges J (2011) Epidemiological studies of cognitive impairment and dementia across Eastern and Middle European countries. Int J Geriatr Psychiatry 26:111–117CrossRefGoogle Scholar
  23. Krahé C, Springer A, Weinman JA, Fotopoulou A (2013) The social modulation of pain: others as predictive signals of salience—a systematic review. Front Hum Neurosci 386:1–21Google Scholar
  24. Leeuw M, Goossens ME, Linton SJ, Crombez G, Boersma K, Vlaeyen JW (2007) The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med 30:77–94. doi: 10.1007/s10865-006-9085-0 CrossRefGoogle Scholar
  25. Leonard MT, Cano A, Johansen AB (2006) Chronic pain in a couples context: a review and integration of theoretical models and empirical evidence. J Pain 7:377–390CrossRefGoogle Scholar
  26. Maisel NC, Gabel SL (2009) The paradox of received social support: the importance of responsiveness. Psychol Sci 20:928–932. doi: 10.1111/j.1467-9280.2009.02388.x CrossRefGoogle Scholar
  27. Makris UE, Higashi RT, Marks EG, Fraenkel L, Sale JE, Gill TM, Reid MC (2015) Ageism, negative attitudes, and competing co-morbidities: why older adults may not seek care for restricting back pain—a qualitative study. BMC Geriatr 15(39):1–9Google Scholar
  28. Matos M, Bernardes SF (2013) The Portuguese formal social support for autonomy and dependence in pain inventory (FSSADI_PAIN): a preliminary validation study. Br J Health Psychol 18:593–609. doi: 10.1111/bjhp.12006 CrossRefGoogle Scholar
  29. Matos M, Bernardes SF, Goubert L, Carvalho H (2015) The revised formal social support for autonomy and dependence in pain inventory (FSSADI_PAIN): confirmatory factor analysis and validity. J Pain 16:508–517. doi: 10.1016/j.jpain.2015.02.006 CrossRefGoogle Scholar
  30. Matos M, Bernardes SF, Goubert L (2016) The relationship between perceived promotion of autonomy/dependence and pain-related disability in older adults with chronic pain: the mediating role of self-reported physical functioning. J Behav Med 39:704–715. doi: 10.1007/s10865-016-9726-x CrossRefGoogle Scholar
  31. McWilliams LA, Saldanha KM, Dick BD, Watt MC (2009) Development and psychometric evaluation of a new measure of pain-related support preferences: the Pain Response Preference Questionnaire. Pain Res Manage 14:461–469. doi: 10.1155/2009/429767 CrossRefGoogle Scholar
  32. Merskey H, Bogduk N (1994) Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms, 2nd edn. IASP Press, SeattleGoogle Scholar
  33. Molton IR, Terrill AL (2014) Overview of persistent pain in older adults. Am Psychol 69:197–207CrossRefGoogle Scholar
  34. Nagurney A, Reich JW, Newsom JT (2004) Gender moderates the effects of independence and dependence desires during the social support process. Psychol Aging 19:215–218CrossRefGoogle Scholar
  35. Newton-John TRO (2002) Solicitousness and chronic pain: a critical review. Pain Rev 9:7–27CrossRefGoogle Scholar
  36. Newton-John TR, Williams AC (2006) Chronic pain couples: perceived marital interactions and pain behaviors. Pain 123:53–63CrossRefGoogle Scholar
  37. Philip LJ (2014) Social isolation and the perceived importance of in-person care amongst rural older adults with chronic pain: a review and emerging research agenda. J Pain Manag 7:13–21Google Scholar
  38. IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM CorpGoogle Scholar
  39. Reyes-Gibby CC, Aday LA, Cleeland CS (2002) Impact of pain on self-related health in the community-dwelling older adults. Pain 95:75–82. doi: 10.1016/S0304-3959(01)00375-X CrossRefGoogle Scholar
  40. Selcuk E, Ong AD (2013) Perceived partner responsiveness moderates the association between received emotional support and all-cause mortality. Health Psychol 32:231–235CrossRefGoogle Scholar
  41. Stubbs B, Binnekade TT, Soundy A, Schofield P, Huijnen IP, Eggermont LH (2013) Are older adults with chronic musculoskeletal pain less active than older adults without pain? A systematic review and meta-analysis. Pain Med 14:1316–1331CrossRefGoogle Scholar
  42. Sullivan MJL, Bishop S, Pivik J (1995) The Pain Catastrophizing Scale: development and validation. Psychol Assess 7:524–532CrossRefGoogle Scholar
  43. Thomsen AB, Sorensen J, Sjogren P, Eriksen J (2002) Chronic non-malignant pain patients and health economic consequences. Eur J Pain 6:341–352CrossRefGoogle Scholar
  44. Torrance N, Smith BH, Bennett MI, Lee AJ (2006) The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey. J Pain 7:281–289CrossRefGoogle Scholar
  45. Turk DC (2002) Chronic non-malignant pain patients and health economic consequences. Eur J Pain 6:353–355CrossRefGoogle Scholar
  46. Union European (2012) Long-term care for the elderly: provisions and providers in 33 European countries. Publications Office of the European Union, LuxembourgGoogle Scholar
  47. United Nations, Department of Economic and Social Affairs, Population Division (2013). World Population Ageing 2013. ST/ESA/SER.A/348Google Scholar
  48. Vlaeyen JWS, Linton SJ (2012) Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain 153:1144–1147CrossRefGoogle Scholar
  49. Wilkie R, Tajar A, McBeth J (2013) The onset of widespread musculoskeletal pain is associated with a decrease in healthy ageing in older people: a population-based prospective study. PLoS ONE 8:e59858. doi: 10.1371/journal.pone.0059858 CrossRefGoogle Scholar
  50. Yamada E, Thomas DC (2011) Common musculoskeletal diagnoses of upper and lower extremities in older patients. Mt Sinai J Med 78:546–557CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Sónia F. Bernardes
    • 1
    • 2
  • Marta Matos
    • 1
    • 2
  • Liesbet Goubert
    • 3
  1. 1.Department of Social and Organizational PsychologyInstituto Universitário de Lisboa (ISCTE-IUL)LisbonPortugal
  2. 2.Centro de Investigação e Intervenção Social (CIS-IUL)LisbonPortugal
  3. 3.Department of Experimental-Clinical and Health PsychologyGhent UniversityGhentBelgium

Personalised recommendations