Table 1.

Articles investigating the impact of social support on COPD PROMs.

Author/Date	Study Type	Setting	Social Support Measure	PROMs Measure	Main Findings
Arabyat et al. (2019) [26]	Cross-sectional	n = 1.261 participants (U.S.)	Behavioral Risk Factor Surveillance System (BRFSS); the domain of one question: “How often do you get the social/emotional support you need?”	Behavioral Risk Factor Surveillance System (BRFSS); three questions about health-related quality of life	Over one-third of COPD patients reported rarely/never receiving social/emotional support. COPD patients who were not adequately supported socially/emotionally were significantly different in baseline characteristics in comparison to those who received sufficient support. COPD patients who expressed a lack of social/emotional support were at a higher risk of experiencing physical and mental health issues, including depression, whereas adequate social support was associated with decreased depressive symptoms. Inadequate social/emotional support was found to be associated ** with a decline in HRQoL and an increased likelihood of experiencing depression and disability.
Bonsaksen et al. (2014) [27]	Prospective	n = 60 participants (Norway)	Participant response to one question: “I think I have enough support from people with whom I have a close relationship.”	Short Form 12, version 2 (SF-12v2) for quality of life (physical component summary scores (PCS) and mental component summary scores (MCS)). Brief Illness Perception Questionnaire (BIPQ) for illness perception.	Initial findings showed a positive correlation between higher social support and higher MCS scores at baseline. However, this correlation *** no longer existed 1 year after the patient education program. Social support did not mediate the correlations * between illness perceptions and HRQoL.
Chen et al. (2016) [28]	Cross-sectional	n = 19 participants (Taiwan)	Qualitative method through in-depth interviews. The topics included questions about social support.	Qualitative method through in-depth interviews. The topics included questions about experience of illness and psychological status.	Patients indicated being provided with positive support from both their family members and healthcare professionals. Thematic analysis based on Miles and Huberman’s (1994) [29] guidelines was performed and showed that social support had a significant effect on COPD self-management. Factors including physical and psychological well-being, disease-related cognition, and social support influenced the self-management efficacy of COPD participants.
Chen et al. (2017) [30]	Longitudinal	n = 282 participants (USA)	Participant response to four questions: (1) whether participants live alone or live with others, (2) whether they are partnered, (3) the number of close friends and relatives they have, and (4) the presence of a family/friend caregiver (“Which family member or friend is most involved in your care now?”) for structural social support. Medical Outcomes Social Support Scale (MOSSS) for functional social support.	Hospital Anxiety and Depression Scale (HADS) for psychological symptoms. Participants’ response to four questions about carelessness, forgetting, stopping medication when feeling better, and using less of the medication than prescribed when feeling better in the past 3 months for adherence to inhaler.	High levels of structural and functional social support, as the majority had a supportive environment. Participants with a spouse or partner as their caregiver had 11 times greater odds ** of participating in pulmonary rehabilitation compared to those without a caregiver. Neither structural nor functional support appeared to have * any impact on adherence to inhaler.
Corchon et al. (2021) [31]	Cross-sectional	n = 1.788 participants (Spain and Colombia)	Duke-UNC Functional Social Support questionnaire (DUFSS) for perceived functional social support.	Living with Chronic Illness Scale (LW-CI Scale) for complex process of living with long-term conditions (LTC). Satisfaction Life Scale (SLS-6) for satisfaction with life during the process of living with an LTC. Patient-Based Global Impression of Severity Scale (PGIS) for self-perception of disease severity.	Satisfaction with life and social support were highlighted as key contributors to the overall experience of individuals living with LTCs, such as COPD patients. There was a positive correlation * between social support and improved general and emotional health, as well as overall well-being.
Halding et al. (2010) [32]	Prospective-interventional	n = 18 participants (Norway)	Qualitative method through in-depth interviews. The topics included questions about social support. Participants responded to questions regarding family life, sources for support, experiences from contact with peers in the last year, and how the participant perceives current everyday life.	Participants responded to questions about experiences in everyday life with COPD prior to pulmonary rehabilitation, symptoms, problems, impact on everyday activities, and psychosocial changes associated with the illness.	The participants emphasized that social integration in rehabilitation groups and support from peers and health-care personnel are important dimensions regarding pulmonary rehabilitation (PR). The support of social groups encouraged mutual trust, support, increased self-confidence, and motivation for self-care. The support of social groups and integration in those groups had a positive effect * on quality of life. The support provided by health professionals relieved the patients’ symptoms.
Jun et al. (2023) [19]	Cross-sectional	n = 202 participants (Korea)	Multidimensional Scale of Perceived Social Support (MSPSS) for social support.	Memorial Symptom Assessment Scale (MSAS) for experience of symptoms. Coping Strategy Indicator (CSI) for coping. Functional Performance Inventory—Short Form (FPI-SF) for functional performance.	High levels of social support were associated * with a decrease in experiencing symptom. The more social support individuals received, the better their coping mechanisms were. Higher levels of social support were significantly associated * with lower symptom experience and higher functional performance.
McCathie et al. (2002) [33]	Cross-sectional	n = 92 participants (Australia)	Illness-Specific Social Support Scale (ISSS) for social support.	Coping Illness Questionnaire (CWIQ) for coping. Beck Depression Inventory (BDI) for depression. State Trait Anxiety Inventory for anxiety. St. George’s Respiratory Questionnaire (SGRQ) for quality of life.	Positive social support was identified as a factor contributing * to decreased levels of depression and anxiety, whereas negative social support was identified as a factor contributing * to increased levels of depression and anxiety. No significant relationship * was found between high levels of positive or negative social support and quality of life.
Sarwar et al. (2021) [34]	Prospective cohort	n = 406 participants (United Kingdom)	Socio-demographic characteristics included questions about family support.	Participant response to questions about self-reported general health. Control, autonomy, self-realization (CASP-19) for quality of life.	Poor family and social support were found to be significantly correlated with a decrease in QoL score. The traits of depression and poor family and social support had the most pronounced impact * on the decline in QoL.
Tang et al. (2022) [35]	Cross-sectional	n = 170 participants (China)	Social Support Rating Scale for social support.	Patient Activation Measure (PAM-13) for patient activation. Brief Illness Perception Questionnaire (BIPQ) for illness perception. Hospital Anxiety and Depression Scale (HADS) for anxiety and depression. COPD Assessment Test (CAT) for health status.	Social support demonstrated a strong and positive connection * to patient activation.

* Beta coefficients (β); ** odds ratio; *** univariate correlation coefficients (Pearson’s r).