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Medical Outcomes Study: Social Support Survey Instrument
People sometimes look to others for companionship, assistance, or other types of support. How often is each of the following kinds of support available to you if you need it? Circle one number on each line.
| None of the time | A little of the time | Some of the time | Most of the time | All of the time | |
| Emotional/informational support | |||||
| Someone you can count on to listen to you when you need to talk | 1 | 2 | 3 | 4 | 5 |
| Someone to give you information to help you understand a situation | 1 | 2 | 3 | 4 | 5 |
| Someone to give you good advice about a crisis | 1 | 2 | 3 | 4 | 5 |
| Someone to confide in or talk to about yourself or your problems | 1 | 2 | 3 | 4 | 5 |
| Someone whose advice you really want | 1 | 2 | 3 | 4 | 5 |
| Someone to share your most private worries and fears with | 1 | 2 | 3 | 4 | 5 |
| Someone to turn to for suggestions about how to deal with a personal problem | 1 | 2 | 3 | 4 | 5 |
| Someone who understands your problems | 1 | 2 | 3 | 4 | 5 |
| Tangible support | |||||
| Someone to help you if you were confined to bed | 1 | 2 | 3 | 4 | 5 |
| Someone to take you to the doctor if you needed it | 1 | 2 | 3 | 4 | 5 |
| Someone to prepare your meals if you were unable to do it yourself | 1 | 2 | 3 | 4 | 5 |
| Someone to help with daily chores if you were sick | 1 | 2 | 3 | 4 | 5 |
| Affectionate support | |||||
| Someone who shows you love and affection | 1 | 2 | 3 | 4 | 5 |
| Someone to love and make you feel wanted | 1 | 2 | 3 | 4 | 5 |
| Someone who hugs you | 1 | 2 | 3 | 4 | 5 |
| Positive social interaction | |||||
| Someone to have a good time with | 1 | 2 | 3 | 4 | 5 |
| Someone to get together with for relaxation | 1 | 2 | 3 | 4 | 5 |
| Someone to do something enjoyable with | 1 | 2 | 3 | 4 | 5 |
| Additional item | |||||
| Someone to do things with to help you get your mind off things | 1 | 2 | 3 | 4 | 5 |
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