Measures of the Social Environment
General family functioning was measured by the 12-item
General Functioning subscale of the Family Assessment Device (FAD). The FAD has been used in studies of medical illness [27–30] including COPD [23, 24]. Questions address aspects of family relationships such as the extent to which family members express feelings with each other, feel accepted by each other, and confide in each other. Each item has four response categories, ranging from 1 (strongly agree) to 4
(strongly disagree). Reponses are averaged, so scores for general family functioning can range from 1 to 4, with higher scores indicating less healthy family functioning. Cronbach’s alpha was 0.90 in the current sample.