Validity and reliability of the Lubben Social Network Scale (LSNS-6) in Thai older adults with non-communicable diseases

Wanich Suksatan

doi:10.2478/FON-2026-0020

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Validity and reliability of the Lubben Social Network Scale (LSNS-6) in Thai older adults with non-communicable diseases

Frontiers of Nursing

Volume 13 (2026): Issue 2 (June 2026)

By: Wanich Suksatan

Open Access

|Jul 2026

Abstract

Objective

This study aimed to evaluate the construct validity and reliability of the Thai version of the Lubben Social Network Scale-6 (LSNS-6) among older adults with non-communicable diseases (NCDs), a population particularly vulnerable to social isolation due to mobility limitations, functional decline, and frequent healthcare needs.

Methods

A cross-sectional study was conducted among 250 older adults (≥60 years) with NCDs from urban and rural areas in northeastern Thailand. The LSNS-6 was translated and culturally adapted, and an expert panel assessed content validity. Confirmatory factor analysis (CFA) was used to test the hypothesized two-factor structure (family and friends). Internal consistency was evaluated using Cronbach’s alpha, composite reliability (ρc), and average variance extracted (AVE).

Results

CFA indicated an excellent fit for the two-factor model: χ ²/df = 1.82, RMSEA = 0.045, SRMR = 0.038, CFI = 0.981, and TLI = 0.970. Factor loadings ranged from 0.80 to 0.84, with R² values between 0.64 and 0.70. Cronbach’s alpha was 0.87 for the total scale, and ≥0.85 for subscales. ρc was 0.85, and AVE was 0.67.

Conclusions

The Thai LSNS-6 is a valid and reliable instrument for assessing social networks in older adults with NCDs. It holds practical value for home health care providers to identify socially isolated individuals, develop tailored interventions, and promote improved health outcomes.

References

Department of Older Persons. Situation of the Thai Older Persons 2023. Bangkok: Department of Older Persons, Ministry of Social Development and Human Security; 2024.
Search in Google Scholar Back to article
Suksatan W, Teravecharoenchai S, Sarayuthpitak J. Determinants of the health-promoting behaviors among community-dwelling older adults with noncommunicable diseases during the post-Covid-19 era. J Nurs Midwif Sci. 2024;11:e144587.
Search in Google Scholar Back to article
Suksatan W, Prabsangob K, Choompunuch B. Association between health literacy, self-care behavior, and blood sugar level among older patients with Type 2 diabetes in rural Thai communities. Ann Geriatr Med Res. 2021;25:318–323.
Search in Google Scholar Back to article
Simons M, Reijnders J, Peeters S, Janssens M, Lataster J, Jacobs N. Social network sites as a means to support personal social capital and wellbeing in older age: an association study. Computers in Human Behavior Reports. 2021;3:100067.
Search in Google Scholar Back to article
Pechrapa K, Yodmai K, Kittipichai W, Charupoonpol P, Suksatan W. Health literacy among older adults during COVID-19 pandemic: a cross-sectional study in an urban community in Thailand. Ann Geriatr Med Res. 2021;25:309–317.
Search in Google Scholar Back to article
Donovan NJ, Blazer D. Social isolation and loneliness in older adults: review and commentary of a national academies report. Am J Geriatr Psychiatry. 2020;28:1233–1244.
Search in Google Scholar Back to article
National Academies of Sciences E, Medicine, Division of B, et al. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. National Academies Press (US); 2020.
Search in Google Scholar Back to article
Leigh-Hunt N, Bagguley D, Bash K, et al. An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health. 2017;152:157–171.
Search in Google Scholar Back to article
Lubben J, Blozik E, Gillmann G, et al. Performance of an abbreviated version of the Lubben Social Network Scale among three European communitydwelling older adult populations. Gerontologist. 2006;46:503–513.
Search in Google Scholar Back to article
Chang Q, Sha F, Chan CH, Yip PSF. Validation of an abbreviated version of the Lubben Social Network Scale (“LSNS-6”) and its associations with suicidality among older adults in China. PLoS One. 2018;13:e0201612.
Search in Google Scholar Back to article
Myagmarjav S, Burnette D, Goeddeke F Jr. Comparison of the 18-item and 6-item Lubben Social Network Scales with community-dwelling older adults in Mongolia. PLoS One. 2019;14: e0215523.
Search in Google Scholar Back to article
Buckley TD, Becker TD, Burnette D. Validation of the abbreviated Lubben Social Network Scale (LSNS-6) and its association with self-rated health amongst older adults in Puerto Rico. Health Soc Care Community. 2022;30:e5527–e5538.
Search in Google Scholar Back to article
Suksatan W, Teravecharoenchai S, Sarayuthpitak J. Health-promoting behaviors among older adults with noncommunicable diseases in rural and urban areas during the new normal post-COVID-19 era: a structural equation modeling analysis. Nutrients. 2023;15:101.
Search in Google Scholar Back to article
Brislin RW. Back-Translation for cross-cultural research. J Cross-Cultural Psychol. 1970;1:185–216.
Search in Google Scholar Back to article
Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary J. 1999;6:1–55.
Search in Google Scholar Back to article
Kline RB. Principles and Practice of Structural Equation Modeling. Guilford publications; 2023.
Search in Google Scholar Back to article
Hair JF, Risher JJ, Sarstedt M, Ringle CM. When to use and how to report the results of PLS-SEM. European Business Review. 2019;31:2–24.
Search in Google Scholar Back to article
Yodmai K, Somrongthong R, Nanthamongkolchai S, Suksatan W. Effects of the older family network program on improving quality of life among older adults in Thailand. J Multidiscip Healthc. 2021;14:1373–1383.
Search in Google Scholar Back to article
Scholtes VA, Terwee CB, Poolman RW. What makes a measurement instrument valid and reliable? Injury. 2011;42:236–240.
Search in Google Scholar Back to article
Aung TNN, Lorga T, Moolphate S, et al. Towards cultural adequacy of experience-based design: a qualitative evaluation of community-integrated intermediary care to enhance the family-based long-term care for Thai older adults. Healthcare. 2023;11:2217.
Search in Google Scholar Back to article
Alsarrani A, Hunter RF, Dunne L, Garcia L. Association between friendship quality and subjective wellbeing among adolescents: a systematic review. BMC Public Health. 2022;22:2420.
Search in Google Scholar Back to article