Quality of Life Research

, Volume 24, Issue 4, pp 787–794 | Cite as

Factor analyses of a social support scale using two methods

  • Yu Yu
  • Cheng-Shi Shiu
  • Joyce P. Yang
  • Mingjiong Wang
  • Jane M. Simoni
  • Wei-ti Chen
  • Joy Cheng
  • Hongxin Zhao



Evaluation and comparison of the factor structure of the Medical Outcomes Study Social Support Survey (MOS-SSS) using both confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) with two samples of people living with HIV/AIDS in China.


Secondary analyses were conducted with data from two comparable samples of 320 people living with HIV/AIDS from the same hospital using the same inclusion criteria. The first sample of 120 was collected in 2006, and the second sample of 200 was collected in 2012. For each sample, CFA was first performed on the original four-factor structure to check model fit, followed by EFA to explore other factor structures and a subsequent CFA for model fit statistics to be compared to the original four-factor CFA.


In both samples, CFA on the originally hypothesized four-factor structure yielded an acceptable model fit. The EFA yielded a two-factor solution in both samples, with different items included in each factor for the two samples. Comparison of CFA on the a priori four-factor structure and the new two-factor structure in both samples indicated that both factor structures were of acceptable model fit, with the four-factor model performing slightly better than the two-factor model.


Factor structure of the MOS-SSS is method-dependent, with CFA supporting a four-factor structure, while EFA yielded a two-factor structure in two separate samples. We need to be careful in selecting the analytic method when applying the MOS-SSS to various samples and choose the factor structure that best fits the theoretical model.


Medical Outcomes Study Social Support Survey Factor analysis CFA EFA Chinese 


Ethical standard

This is a secondary data analysis on two studies that were approved by the Institutional Review Boards of the University of Washington and Ditan Hospital and were performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All participants in the two studies gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study were omitted and all data collected were unidentified.


  1. 1.
    Cohen, S., & Wills, T. A. (1985). Stress, social support and the buffering hypothesis. Psychological Bulletin, 98(2), 310–357.CrossRefPubMedGoogle Scholar
  2. 2.
    Arriola, K. J., Spaulding, A. C., Booker, C. A., Williams, C., Avery, A., Porter, N. J. et al. (2013). Understanding the relationship between social support and physical and mental well-being among jail detainees living with HIV. Journal of Health Psychology, 1–10. doi: 10.1177/1359105313496447
  3. 3.
    House, J. S., Robbins, C., & Metzner, H. L. (1982). The association of social relationships and activities with mortality: Prospective evidence from the Tecumseh Community Health Study. American Journal of Epidemiology, 116(1), 123–140.PubMedGoogle Scholar
  4. 4.
    Lam, P. K., Naar-King, S., & Wright, K. (2007). Social support and disclosure as predictors of mental health in HIV-positive youth. AIDS Patient Care STDS, 21(1), 20–29.CrossRefPubMedGoogle Scholar
  5. 5.
    Liu, L., Pang, R., Sun, W., Wu, M., Qu, P., Lu, C., et al. (2013). Functional social support, psychological capital, and depressive and anxiety symptoms among people living with HIV/AIDS employed full-time. BMC Psychiatry, 13, 324.CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    Reich, W. A., Lounsbury, D. W., Zaid-Muhammad, S., & Rapkin, B. D. (2010). Forms of social support and their relationships to mental health in HIV-positive persons. Psychology, Health & Medicine, 15(2), 135–145.CrossRefGoogle Scholar
  7. 7.
    Dimkovic, N., & Oreopoulos, D. G. (2000). Chronic peritoneal dialysis in the elderly: A review. Peritoneal Dialysis International, 20(3), 276–283.PubMedGoogle Scholar
  8. 8.
    Huynh, A. K., Kinsler, J. J., Cunningham, W. E., & Sayles, J. N. (2013). The role of mental health in mediating the relationship between social support and optimal ART adherence. AIDS Care, 25(9), 1179–1184.CrossRefPubMedCentralPubMedGoogle Scholar
  9. 9.
    Bekele, T., Rourke, S. B., Tucker, R., Greene, S., Sobota, M., Koornstra, J., et al. (2013). Direct and indirect effects of perceived social support on health-related quality of life in persons living with HIV/AIDS. AIDS Care, 25(3), 337–346.PubMedGoogle Scholar
  10. 10.
    Jakobsson, U., & Hallberg, I. R. (2002). Pain and quality of life among older people with rheumatoid arthritis and/or osteoarthritis: A literature review. Journal of Clinical Nursing, 11(4), 430–443.CrossRefPubMedGoogle Scholar
  11. 11.
    Jia, H., Uphold, C. R., Zheng, Y., Wu, S., Chen, G. J., Findley, K., et al. (2007). A further investigation of health-related quality of life over time among men with HIV infection in the HAART era. Quality of Life Research, 16(6), 961–968.CrossRefPubMedGoogle Scholar
  12. 12.
    Cuijpers, P. (2001). Mortality and depressive symptoms in inhabitants of residential homes. International Journal of Geriatric Psychiatry, 16(2), 131–138.CrossRefPubMedGoogle Scholar
  13. 13.
    Sherbourne, C. D., & Stewart, A. L. (1991). The MOS social support survey. Social Science and Medicine, 32(6), 705–714.CrossRefPubMedGoogle Scholar
  14. 14.
    Heinonen, H., Volin, L., Uutela, A., Zevon, M., Barrick, C., & Ruutu, T. (2001). Quality of life and factors related to perceived satisfaction with quality of life after allogeneic bone marrow transplantation. Annals of Hematology, 80(3), 137–143.CrossRefPubMedGoogle Scholar
  15. 15.
    Kornblith, A. B., Herndon, J. E, 2nd, Weiss, R. B., Zhang, C., Zuckerman, E. L., Rosenberg, S., et al. (2003). Long-term adjustment of survivors of early-stage breast carcinoma, 20 years after adjuvant chemotherapy. Cancer, 98(4), 679–689.CrossRefPubMedGoogle Scholar
  16. 16.
    Griep, R. H., Chor, D., Faerstein, E., Werneck, G. L., & Lopes, C. S. (2005). Construct validity of the Medical Outcomes Study’s social support scale adapted to Portuguese in the Pro-Saude Study. Cadernos de Saúde Publica, 21(3), 703–714.CrossRefPubMedGoogle Scholar
  17. 17.
    Soares, A., Biasoli, I., Scheliga, A., Baptista, R. L., Brabo, E. P., Morais, J. C., et al. (2012). Validation of the Brazilian Portuguese version of the Medical Outcomes Study-Social Support Survey in Hodgkin’s lymphoma survivors. Supportive Care in Cancer, 20(8), 1895–1900.CrossRefPubMedGoogle Scholar
  18. 18.
    Costa-Requena, G., Salamero, M., & Gil, F. (2007). Validity of the questionnaire MOS-SSS of social support in neoplastic patients. Medicina Clínica (Barcelona), 128(18), 687–691.CrossRefGoogle Scholar
  19. 19.
    Costa-Requena, G., Ballester, A. R., & Gil, F. (2013). Perceived social support in spanish cancer outpatients with psychiatric disorder. Stress Health, 29(5), 421–426.CrossRefPubMedGoogle Scholar
  20. 20.
    Anderson, D., Bilodeau, B., Deshaies, G., Gilbert, M., & Jobin, J. (2005). French-Canadian validation of the MOS Social Support Survey. Canadian Journal of Cardiology, 21(10), 867–873.PubMedGoogle Scholar
  21. 21.
    Robitaille, A., Orpana, H., & McIntosh, C. N. (2011). Psychometric properties, factorial structure, and measurement invariance of the English and French versions of the Medical Outcomes Study social support scale. Health Reports, 22(2), 33–40.PubMedGoogle Scholar
  22. 22.
    Mahmud, W. M., Awang, A., & Mohamed, M. N. (2004). Psychometric Evaluation of the Medical Outcome Study (MOS) Social Support Survey Among Malay Postpartum Women in Kedah, North West of Peninsular Malaysia. Malaysian Journal of Medical Sciences, 11(2), 26–33.PubMedCentralPubMedGoogle Scholar
  23. 23.
    Yu, D. S., Lee, D. T., & Woo, J. (2004). Psychometric testing of the Chinese version of the medical outcomes study social support survey (MOS-SSS-C). Research in Nursing & Health, 27(2), 135–143.CrossRefGoogle Scholar
  24. 24.
    Lee, D. T., Thompson, D. R., Yu, D. S., & Woo, J. (2005). Reliability and validity of the Medical Outcomes Study Social Support Survey (Chinese version). Journal of the American Geriatrics Society, 53(5), 920–921.CrossRefPubMedGoogle Scholar
  25. 25.
    Shyu, Y. I., Tang, W. R., Liang, J., & Weng, L. J. (2006). Psychometric testing of the social support survey on a Taiwanese sample. Nursing Research, 55(6), 411–417.CrossRefPubMedGoogle Scholar
  26. 26.
    Li., H. (2012). Psychometric measurement of the simplified Chinese medical outcomes study social support survey (MOS-SSS-C) and its application in HIV/AIDS patients. Unpublished PhD thesis. Central South University, China.Google Scholar
  27. 27.
    Thompson, D. R., Ski, C. F., Watson, R., & Wang, W. (2014). Mokken scaling of the Chinese version of the Medical Outcomes Study Social Support Survey. Quality of Life Research, 23(2), 581–584.CrossRefPubMedGoogle Scholar
  28. 28.
    Wang, W., Zheng, X., He, H. G., & Thompson, D. R. (2013). Psychometric testing of the Chinese Mandarin version of the Medical Outcomes Study Social Support Survey in patients with coronary heart disease in mainland China. Quality of Life Research, 22(8), 1965–1971.CrossRefPubMedGoogle Scholar
  29. 29.
    Gjesfjeld, C. D., Green, C. G., & Kim, K. H. (2008). A confirmatory factor analysis of an abbreviated social support instrument: The MOS-SSS. Research on Social Work Practice, 18(3), 231–237.CrossRefGoogle Scholar
  30. 30.
    Westaway, M. S., Seager, J. R., Rheeder, P., & Van Zyl, D. G. (2005). The effects of social support on health, well-being and management of diabetes mellitus: A black South African perspective. Ethnicity Health, 10(1), 73–89.CrossRefPubMedGoogle Scholar
  31. 31.
    Chen, W. T., Shiu, C. S., Yang, J. P., Simoni, J. M., Fredriksen-Goldsen, K. I., Lee, T. S., et al. (2013). Antiretroviral therapy (ART) side effect impacted on quality of life, and depressive symptomatology: A mixed-method study. Journal of AIDS & Clinical Research, 4, 218.Google Scholar
  32. 32.
    Nunnally, J. C. (1994). Psychometric theory (3rd ed.). New York: Mc Graw-Hill Inc.Google Scholar
  33. 33.
    Mueller, R. O. (1996). Basic principles of structural equation modeling: An introduction to LISREL and EQS. New York: Springer.CrossRefGoogle Scholar
  34. 34.
    Munro, B. H., Duffy, M. E., Brancato, V., Newton, S., & Talbot, L. (2005). Statistical methods for health care research (5th ed.). Philadelphia: Lippincott Williams & Wilkins Co.Google Scholar
  35. 35.
    Kline, R. B. (2010). Principles and practice of structural equation modeling (3rd ed.). New York: Guilford Press.Google Scholar
  36. 36.
    MacCallum, R. C., Browne, M. W., & Sugawara, H. M. (1996). Power analysis and determination of sample size for covariance structure modeling. Psychological Methods, 1996(1), 130–149.CrossRefGoogle Scholar
  37. 37.
    Bollen, K. A., & Long, J. S. (1993). Testing structural equation models. Thousand Oaks, CA: Sage Publications.Google Scholar
  38. 38.
    Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55.CrossRefGoogle Scholar
  39. 39.
    Hurley, A. E., Scandura, T. A., Schriesheim, C. A., Brannick, M. T., Seers, A., Vandenberg, R. J., et al. (1997). Exploratory and confirmatory factor analysis: Guidelines, issues, and alternatives. Journal of Organizational Behavior, 18(6), 667–683.CrossRefGoogle Scholar
  40. 40.
    Tamaka, J. S. (1987). How big is big enough? Sample size and goodness of fit in structural equation models with latent variables. Child Development, 58(1), 134–146.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Yu Yu
    • 1
    • 2
  • Cheng-Shi Shiu
    • 3
  • Joyce P. Yang
    • 4
  • Mingjiong Wang
    • 5
  • Jane M. Simoni
    • 4
  • Wei-ti Chen
    • 6
  • Joy Cheng
    • 7
  • Hongxin Zhao
    • 8
  1. 1.Department of Social Medicine and Health Management, Public Health SchoolCentral South UniversityChangshaChina
  2. 2.Department of Global Health, Public Health SchoolUniversity of WashingtonSeattleUSA
  3. 3.School of Social WorkUniversity of WashingtonSeattleUSA
  4. 4.Department of PsychologyUniversity of WashingtonSeattleUSA
  5. 5.Department of Traditional Chinese MedicineChangsha Medical SchoolChangshangChina
  6. 6.Yale School of NursingYale UniversityOrangeUSA
  7. 7.Mott Women Healthcare PLLCNew YorkUSA
  8. 8.Center for Infectious Diseases, Ditan HospitalCapital Medical UniversityBeijingChina

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