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Rodríguez-Rabassa M, Appleton AA, Rosario-Villafañe V, Repollet-Carrer I, Borges-Rodríguez M, Dedós-Peña L, González M, Velázquez-González P, Muniz-Rodriguez K, Mántaras-Ortiz C, Rivera-Amill V, Olivieri-Ramos O, Alvarado-Domenech LI. Associations between the social environment and early childhood developmental outcomes of Puerto Rican children with prenatal Zika virus exposure: a cross-sectional study. BMC Pediatr 2024; 24:342. [PMID: 38755525 PMCID: PMC11100158 DOI: 10.1186/s12887-024-04806-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Prenatal exposure to the Zika virus can lead to microcephaly and adverse developmental outcomes, even in children without evident birth defects. The social environment plays a crucial role in infant health and developmental trajectories, especially during periods of heightened brain plasticity. The study aimed to assess socioenvironmental factors as predictors of developmental outcomes of 36-month-old children exposed to Zika virus prenatally. STUDY DESIGN This cross-sectional study included 53 mothers and 55 children enrolled in the Pediatric Outcomes of Prenatal Zika Exposure cohort study in Puerto Rico. The study performs follow-up developmental assessments of children born to mothers with confirmed and probable Zika virus infection during pregnancy. Mothers completed socioenvironmental questionnaires (e.g., Perceived Neighborhood Scale and US Household Food Insecurity Survey). Children's developmental outcomes were assessed with the Bayley Scales of Infant and Toddler Development: Third Edition, the Ages and Stages Questionnaires: Third Edition, the Ages and Stages Questionnaire-Socioemotional: Second Edition, and the Child Adjustment and Parent Efficacy Scale. RESULTS Linear regression models, adjusting for a child's sex and age and maternal education, revealed that early life exposure to food insecurity and maternal pregnancy stressors were significantly associated with poorer developmental outcomes in Zika virus-exposed children at 36 months of age. Maternal resilience representation of adaptive ability was associated with the preservation of adequate developmental outcomes in children. CONCLUSIONS Pregnancy and early childhood are critical life periods for ensuring optimal brain development in children. While the mechanisms in the interaction of children with their environment are complex, the risk and protective factors identified in the study are modifiable through public policy and preventive initiatives. Implementation of comprehensive strategies that improve access to social support programs, educational and nutritional interventions, and mental health services during pregnancy and early childhood can enhance the developmental potential of vulnerable children.
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Affiliation(s)
- Mary Rodríguez-Rabassa
- Department of Pediatrics, Ponce Health Sciences University, Ponce, PR, Puerto Rico.
- RCMI Center for Research Resources, Ponce Health Sciences University, Ponce, PR, Puerto Rico.
- Clinical Psychology Program, Ponce Health Sciences University, Ponce, PR, 00732-7004, Puerto Rico.
| | - Allison A Appleton
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, NY, USA
| | | | | | | | - Lydiet Dedós-Peña
- Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, Puerto Rico
| | - Marielly González
- Clinical Psychology Program, Ponce Health Sciences University, Ponce, PR, 00732-7004, Puerto Rico
| | - Paola Velázquez-González
- Clinical Psychology Program, Ponce Health Sciences University, Ponce, PR, 00732-7004, Puerto Rico
| | | | - Claudia Mántaras-Ortiz
- Clinical Psychology Program, Ponce Health Sciences University, Ponce, PR, 00732-7004, Puerto Rico
| | - Vanessa Rivera-Amill
- RCMI Center for Research Resources, Ponce Health Sciences University, Ponce, PR, Puerto Rico
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Domínguez-Martínez T, Sheinbaum T, Fresán A, Nieto L, López SR, Robles R, Lara MDC, de la Fuente-Sandoval C, Barrantes-Vidal N, Saracco R, Franco-Paredes K, Díaz-Reséndiz F, Rosel M. Psychosocial factors associated with the risk of developing psychosis in a Mexican general population sample. Front Psychiatry 2023; 14:1095222. [PMID: 36873227 PMCID: PMC9979221 DOI: 10.3389/fpsyt.2023.1095222] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023] Open
Abstract
Epidemiological evidence has linked an array of sociodemographic and psychosocial factors with an increased risk of developing psychosis. However, research in samples from low- and middle-income countries is still scarce. This study used a Mexican sample to explore (i) sociodemographic and psychosocial differences between individuals with and without a positive screen for Clinical High-Risk for psychosis (CHR), and (ii) sociodemographic and psychosocial factors associated with screening positive for CHR. The sample consisted of 822 individuals from the general population who completed an online survey. Of the participants, 17.3% (n = 142) met the CHR screening criteria. Comparisons between those who screened positive (CHR-positive group) and those who did not (Non-CHR group) showed that participants in the CHR-positive group were younger, had a lower educational level, and reported more mental health problems than the Non-CHR group. Furthermore, relative to the Non-CHR group, the CHR-positive group had a greater prevalence of medium/high risk associated with cannabis use, a higher prevalence of adverse experiences (bullying, intimate partner violence, and experiencing a violent or unexpected death of a relative or friend), as well as higher levels of childhood maltreatment, poorer family functioning, and more distress associated with the COVID-19 pandemic. Groups did not differ in sex, marital/relationship status, occupation, and socio-economic status. Finally, when examined in multivariate analyses, the variables associated with screening positive for CHR were: having an unhealthy family functioning (OR = 2.75, 95%CI 1.69-4.46), a higher risk associated with cannabis use (OR = 2.75, 95%CI 1.63-4.64), a lower level of education (OR = 1.55, 95%CI 1.003-2.54), having experienced a major natural disaster (OR = 1.94, 95%CI 1.18-3.16), having experienced a violent or unexpected death of a relative or friend (OR = 1.85, 95%CI 1.22-2.81), higher levels of childhood emotional abuse (OR = 1.88, 95%CI 1.09-3.25), physical neglect (OR = 1.68, 95%CI 1.08-2.61), and physical abuse (OR = 1.66, 95%CI 1.05-2.61), and higher COVID-related distress (OR = 1.10, 95%CI 1.01-1.20). An older age was a protective factor for screening positive for CHR (OR = 0.96, 95%CI 0.92-0.99). Overall, the findings highlight the importance of examining potential psychosocial contributors to psychosis vulnerability across different sociocultural contexts to delineate risk and protective processes relevant to specific populations and better target preventive intervention efforts.
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Affiliation(s)
- Tecelli Domínguez-Martínez
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz"-UNAM, Mexico City, Mexico
| | - Tamara Sheinbaum
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Ana Fresán
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | - Lourdes Nieto
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz"-UNAM, Mexico City, Mexico
| | - Steven R López
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Rebeca Robles
- Centro de Investigación en Salud Mental Global, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz"-UNAM, Mexico City, Mexico
| | - Ma Del Carmen Lara
- Facultad de Medicina, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | | | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.,Sant Pere Claver - Fundació Sanitària, Barcelona, Spain.,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Ricardo Saracco
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico
| | | | | | - Mauricio Rosel
- Clínica de Esquizofrenia, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", Mexico City, Mexico
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Abstract
AIMS Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors. METHODS 8996 healthcare workers evaluated on 5 May-7 September 2020 (baseline) were invited to a second web-based survey (October-December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview. RESULTS 4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar. CONCLUSIONS Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565.
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Cong CW, Tan SA, Nainee S, Tan CS. Psychometric Qualities of the McMaster Family Assessment Device-General Functioning Subscale for Malaysian Samples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042440. [PMID: 35206628 PMCID: PMC8875097 DOI: 10.3390/ijerph19042440] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 01/09/2023]
Abstract
Family functioning has been associated with psychological well-being and physical health. The 12-item McMaster Family Assessment Device–General Functioning Subscale (FAD-GF) has been widely used to assess individuals’ overall level of family functioning. However, it has shown an inconsistent factor structure across various studies. The present study investigated its psychometric qualities in two studies with two different adult samples in Malaysia. In Study 1 (N = 417, 55.3% females, 19 to 26 years old), exploratory factor analyses were conducted, and four models were found: a three-factor model with 11 items, a two-factor model with 12 items, and one-factor models with six negatively worded items and six positively worded items, respectively. Study 2 (N = 358, 65.1% females, 18 to 60 years old) compared models found in past studies and those found in Study 1 through confirmatory factor analyses on another sample of adults. Among the six competing models, the two-factor model with three positively worded and three negatively worded items (i.e., FAD-GF-SF) is preferable because it did not require modification and showed a clear-cut result of goodness of fit. The subscales demonstrated satisfactory internal consistency. In conclusion, the FAD-GF-SF is a useful instrument for measuring family functioning in the Malaysian context.
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Family Functioning and Risky Behaviors Among Female Adolescents: Mediating Role of Emotion Dysregulation and Decision-Making Styles. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02799-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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6
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Galán-González E, Martínez-Pérez G, Gascón-Catalán A. Family Functioning Assessment Instruments in Adults with a Non-Psychiatric Chronic Disease: A Systematic Review. NURSING REPORTS 2021; 11:341-355. [PMID: 34968211 PMCID: PMC8608094 DOI: 10.3390/nursrep11020033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/27/2021] [Accepted: 05/06/2021] [Indexed: 12/25/2022] Open
Abstract
There is little information on the evaluation of family functioning in adult patients with chronic non-psychiatric illness. The objective of this systematic review was to identify family functioning assessment instruments of known validity and reliability that have been used in health research on patients with a chronic non-psychiatric illness. We conducted a search in three biomedical databases (PubMed, Science Direct, and Web of Science), for original articles available in English or Spanish published between 2000 and 2019. The review was conducted in accordance with PRISMA guidelines. Fourteen articles were included in the review. The instruments Family Assessment Device, Family Adaptability and Cohesion Evaluation Scales, Family Functioning Health and Social Support, Family APGAR, Assessment of Strategies in Families-Effectiveness, Iceland Expressive Family Functioning, Brief Family Assessment Measure-III, and Family Relationship Index were identified. All of them are reliable instruments to evaluate family functioning in chronic patients and could be very valuable to help nurses identify families in need of a psychosocial intervention. The availability and clinical application of these instruments will allow nurses to generate knowledge on family health and care for non-psychiatric chronic conditions, and will eventually contribute to the health and wellbeing of adults with a non-psychiatric chronic disease and their families.
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Affiliation(s)
| | | | - Ana Gascón-Catalán
- Department of Physiatry and Nursing, University of Zaragoza, 50009 Zaragoza, Spain;
- Correspondence:
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7
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González-Ochoa R, Calleja N, Hernández-Pozo MR, Campos-Uscanga Y, Barranca-Enríquez A, Romo-González T. Design and Psychometric Analysis of the Stressors and Modulators of Gestational Stress Inventory (SMGSI). THE SPANISH JOURNAL OF PSYCHOLOGY 2020; 23:e26. [PMID: 32662375 DOI: 10.1017/sjp.2020.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Gestational stress is associated with many maternal and child complications, however, this association must be taken with care, since there are studies that find inconsistent results between stress measures and maternal complications. It is believed that the lack of convergence is due to the way in which gestational stress is evaluated.The aim of the present study was to design and validate an instrument based on a bio-psycho-social model of gestational stress. The design and validation process of the inventory was divided into four phases: (a) Construction of the items bank and content validity, (b) construct validity, (c) inventory reliability and (d) convergent and discriminant validity with psychometric instruments that have been used in other investigations to evaluate gestational stress.A valid and reliable Stressors and Modulators of Gestational Stress Inventory (SMGSI) conformed by two scales was developed: (a) Gestational stressors, which is formed by two factors, the psychological stressors and social stressors with a variance of 48.5% and 51.8% and a reliability of .79 and .67, respectively; and (b) gestational stress modulators integrated by 8 items that explain 55.2% of the variance and with a reliability of .92. In conclusion, a valid and reliable tool was obtained that measures gestational stress from a bio-psycho-social perspective. This inventory allows for the identification of allostatic and pantostatic stress, making it useful as a diagnostic tool to prevent maternal and childhood complications that are associated with chronic gestational stress.
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8
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Rodríguez-González M, Schweer-Collins M, Bell CA, Sandberg JG, Rodríguez-Naranjo C. Family Functioning, Family Structure, and Differentiation of Self in Heterosexual Spanish Couples: An Actor-Partner Analysis. JOURNAL OF COUNSELING AND DEVELOPMENT 2019. [DOI: 10.1002/jcad.12251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Martiño Rodríguez-González
- Department of Developmental and Educational Psychology; University of Santiago de Compostela; Santiago de Compostela Spain
- Now at Institute for Culture and Society; University of Navarra; Pamplona Spain
| | - Maria Schweer-Collins
- Department of Counseling Psychology and Human Services; University of Oregon; Eugene
| | - Chance A. Bell
- The Albert and Jessie Danielsen Institute; Boston University
| | | | - Carmen Rodríguez-Naranjo
- Department of Personality, Evaluation and Psychological Treatment; University of Málaga; Málaga Spain
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9
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Kazak AE, Hwang WT, Chen FF, Askins MA, Carlson O, Argueta-Ortiz F, Vega G, Barakat LP. Validation of the Spanish Version of the Psychosocial Assessment Tool (PAT) in Pediatric Cancer. J Pediatr Psychol 2018; 43:1104-1113. [PMID: 29982606 DOI: 10.1093/jpepsy/jsy046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/07/2018] [Indexed: 11/14/2022] Open
Abstract
Objective Family psychosocial risk screening is an important initial step in delivering evidence-based care and in addressing health disparities. There is currently no validated measure of family psychosocial risk in Spanish. The Psychosocial Assessment Tool (PAT) is a brief parent report screener based on the trilevel Pediatric Preventative Psychosocial Risk Model (PPPHM; Universal, Targeted, and Clinical). The current article validates a Spanish version of the PAT (Version 3.0) in pediatric oncology. Method Spanish-speaking Hispanic primary caregivers of 79 children newly diagnosed with cancer participated in this 4-institution multisite investigation, completing Spanish versions of the PAT and validation measures using REDCap. Results Over 60% of the sample had a high school or lower level of education and they primarily identified as Hispanic in terms of acculturation. Internal consistency for the total score (KR20 = 0.76) and the Social Support, Child Problems, Sibling Problems, and Family Problems subscales was strong (KR20 = 0.69-0.79). Stress Reactions, Family Structure, and Family Beliefs subscales were lower (KR20 = 0.43-0.55). Moderate to strong correlations with the criteria measures provided validation for the total and subscale scores. Nearly two-thirds of the sample scored in the Targeted or Clinical range of the PPPHM. The PAT was successful in identifying clinical cases. Conclusions The Spanish version of the PAT can be used with families of children newly diagnosed with cancer. Elevated psychosocial risks were found and warrant particular attention in providing psychosocial care attentive to the needs of Spanish-speaking families.
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Affiliation(s)
- Anne E Kazak
- Nemours Children's Health System.,Sidney Kimmel Medical School, Thomas Jefferson University
| | | | - Fang Fang Chen
- Nemours Children's Health System.,Sidney Kimmel Medical School, Thomas Jefferson University
| | | | | | | | | | - Lamia P Barakat
- Perelman School of Medicine, University of Pennsylvania.,The Children's Hospital of Philadelphia
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10
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Tsamparli A, Petmeza I, McCarthy G, Adamis D. The Greek version of the McMaster Family Assessment Device. Psych J 2018; 7:122-132. [DOI: 10.1002/pchj.218] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 04/14/2018] [Accepted: 04/24/2018] [Indexed: 11/05/2022]
Affiliation(s)
| | - Ioanna Petmeza
- Department of Education, Faculty of Early Childhood Education; National and Kapodistrian University of Athens; Athens Greece
| | - Geraldine McCarthy
- Department of Psychiatry; Mental Health Services Sligo; Sligo Ireland
- Sligo Medical Academy; National University of Ireland Galway; Sligo Ireland
| | - Dimitrios Adamis
- Department of Psychiatry; Mental Health Services Sligo; Sligo Ireland
- Department of Psychiatry; Research and Academic Institute of Athens; Athens Greece
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Timmerby N, Cosci F, Watson M, Csillag C, Schmitt F, Steck B, Bech P, Thastum M. A confirmative clinimetric analysis of the 36-item Family Assessment Device. Nord J Psychiatry 2018; 72:268-272. [PMID: 29411685 DOI: 10.1080/08039488.2018.1435721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The Family Assessment Device (FAD) is a 60-item questionnaire widely used to evaluate self-reported family functioning. However, the factor structure as well as the number of items has been questioned. A shorter and more user-friendly version of the original FAD-scale, the 36-item FAD, has therefore previously been proposed, based on findings in a nonclinical population of adults. AIMS We aimed in this study to evaluate the brief 36-item version of the FAD in a clinical population. METHODS Data from a European multinational study, examining factors associated with levels of family functioning in adult cancer patients' families, were used. Both healthy and ill parents completed the 60-item version FAD. The psychometric analyses conducted were Principal Component Analysis and Mokken-analysis. RESULTS A total of 564 participants were included. Based on the psychometric analysis we confirmed that the 36-item version of the FAD has robust psychometric properties and can be used in clinical populations. CONCLUSIONS The present analysis confirmed that the 36-item version of the FAD (18 items assessing 'well-being' and 18 items assessing 'dysfunctional' family function) is a brief scale where the summed total score is a valid measure of the dimensions of family functioning. This shorter version of the FAD is, in accordance with the concept of 'measurement-based care', an easy to use scale that could be considered when the aim is to evaluate self-reported family functioning.
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Affiliation(s)
- Nina Timmerby
- a Psychiatric Research Unit, Psychiatric Centre North Zealand , University of Copenhagen , Hillerød , Denmark
| | - Fiammetta Cosci
- b Department of Health Sciences , University of Florence , Florence , Italy
| | - Maggie Watson
- c Pastoral and Psychological Care , The Royal Marsden Hospital , Sutton , UK
| | - Claudio Csillag
- a Psychiatric Research Unit, Psychiatric Centre North Zealand , University of Copenhagen , Hillerød , Denmark
| | - Florence Schmitt
- d Child Psychiatry Clinic , Turku University Hospital, Turku , Finland
| | - Barbara Steck
- e Child and Adolescent Psychiatry and Psychotherapy , University of Basel, Basel , Switzerland
| | - Per Bech
- a Psychiatric Research Unit, Psychiatric Centre North Zealand , University of Copenhagen , Hillerød , Denmark
| | - Mikael Thastum
- f Department of Psychology and Behavioural Sciences , Aarhus University , Aarhus , Denmark
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Cosci F, Svicher A, Bech P. The Family Assessment Device: A Clinimetric Analysis. PSYCHOTHERAPY AND PSYCHOSOMATICS 2017; 85:241-3. [PMID: 27230868 DOI: 10.1159/000445438] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 03/12/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy
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13
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Beierlein V, Bultmann JC, Möller B, von Klitzing K, Flechtner HH, Resch F, Herzog W, Brähler E, Führer D, Romer G, Koch U, Bergelt C. Measuring family functioning in families with parental cancer: Reliability and validity of the German adaptation of the Family Assessment Device (FAD). J Psychosom Res 2017; 93:110-117. [PMID: 28107886 DOI: 10.1016/j.jpsychores.2016.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/18/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The concept of family functioning is gaining importance in psycho-oncology research and health care services. The Family Assessment Device (FAD) is a well-established measure of family functioning. Psychometric properties inherent in the German 51-item adaptation of the FAD are examined in different samples of families with parental cancer. METHODS Acceptance, reliability, and validity of FAD scales are analysed in samples from different study settings (N=1701 cancer patients, N=261 partners, N=158 dependent adolescent children 11 to 18years old). RESULTS Missing items in the FAD scales (acceptance) are rare for adults (<1.1%) and adolescent children (<4.4%). In samples of adults and older adolescents (15 to 18years), all FAD scales except for the Roles scale are significantly reliable (0.75≤Cronbach's α≤0.88). The scales correlate highly (0.46≤Pearson's r≤0.59) with the criterion satisfaction with family life (convergent validity), and have smaller correlations (0.16≤r≤0.49) with measures of emotional distress and subjective well-being (divergent validity). In most FAD scales, adults seeking family counselling report worse family functioning (0.24≤Cohen's d≤0.59) than adults in other samples with parental cancer (discriminative validity). CONCLUSION Overall, the German 51-item adaptation of the FAD reveals good acceptance, reliability, and validity for cancer patients and their relatives. Particularly the scale General Functioning shows excellent psychometric properties. The FAD is suitable in the assessment of families with parental cancer for adults and adolescents older than 11years.
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Affiliation(s)
- Volker Beierlein
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany.
| | | | - Birgit Möller
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Muenster, Germany.
| | - Kai von Klitzing
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Leipzig University Hospital, Germany.
| | - Hans-Henning Flechtner
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, Otto-von-Guericke-University, Magdeburg, Germany.
| | - Franz Resch
- Department of Child and Adolescent Psychiatry; Heidelberg University Hospital, Germany.
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, Heidelberg University, Germany.
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, Leipzig University Hospital, Germany; Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Germany.
| | - Daniel Führer
- Department of Child and Adolescent Psychiatry, Psychosomatic s and Psychotherapy, Charité University Medicine Berlin, Germany.
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Muenster, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany.
| | - Uwe Koch
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany.
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany.
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Temple JL, Struchen MA, Pappadis MR. Impact of pre-injury family functioning and resources on self-reported post-concussive symptoms and functional outcomes in persons with mild TBI. Brain Inj 2016; 30:1672-1682. [PMID: 27740864 DOI: 10.3109/02699052.2015.1113561] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study investigates the contribution of pre-injury family functioning and resources on self-reported post-concussive symptoms and functional outcomes in persons with mild TBI (mTBI). DESIGN Participants with uncomplicated or complicated mTBIs were recruited from consecutive admissions to the emergency department of a level 1 trauma centre. Patients completed baseline assessments within 2 weeks of injury and an outcomes assessment at 3 months post-injury. METHODS AND PROCEDURES One hundred and sixty-six adults with mTBI were included. Baseline measures of pre-injury history, family functioning and resources were obtained. Functional status assessments and self-reported measures of health, common TBI symptoms and psychological problems were administered at 3-months post-injury. RESULTS Data reduction of outcome measures using principle components analysis revealed two factors: self-reported post-concussive symptoms and current functional/participation status, explaining 60.53% of the variance. Family resources (β = -0.239, t(150) = -2.84, p = 0.005) and age (β = -0.170, t(150) = -2.19, p = 0.030), but not family functioning, were significant predictors of self-reported post-concussive symptoms at follow-up, R2 = 0.051, F(5, 150) = 4.09, p = 0.002. Neither family resources nor functioning predicted current functional/participation status. CONCLUSIONS Fewer family resources and younger age were associated with increased self-reported post-concussive symptoms. Fewer resources may be a potential risk factor to heightened perception of post-concussive symptoms. Providing low-cost counselling or resource facilitation services may improve outcomes for those with limited resources after mTBI.
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Affiliation(s)
- Jessica Lynn Temple
- a Department of Psychology and Neuropsychology , TIRR Memorial Hermann , Houston , TX , USA.,b Department of Physical Medicine and Rehabilitation , Baylor College of Medicine , Houston , TX , USA
| | - Margaret A Struchen
- a Department of Psychology and Neuropsychology , TIRR Memorial Hermann , Houston , TX , USA.,b Department of Physical Medicine and Rehabilitation , Baylor College of Medicine , Houston , TX , USA
| | - Monique R Pappadis
- c Division of Rehabilitation Sciences , The University of Texas Medical Branch at Galveston , Galveston , TX , USA.,d Brain Injury Research Center, TIRR Memorial Hermann , Houston , TX , USA
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Bylund A, Årestedt K, Benzein E, Thorell A, Persson C. Assessment of family functioning: evaluation of the General Functioning Scale in a Swedish Bariatric Sample. Scand J Caring Sci 2015; 30:614-22. [DOI: 10.1111/scs.12269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 07/01/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Ami Bylund
- School of Health and Caring Sciences; Linnaeus University; Kalmar Sweden
- Department of Surgical Science; Karolinska Institute; Danderyd Hospital; Stockholm Sweden
- Department of Surgery; Ersta Hospital; Stockholm Sweden
| | - Kristofer Årestedt
- Center for Collaborative Palliative Care; School of Health and Caring Sciences; Linnaeus University; Kalmar Sweden
- Division of Nursing Science; Department of Medical and Health Sciences; Linköping University; Linköping Sweden
| | - Eva Benzein
- School of Health and Caring Sciences; Linnaeus University; Kalmar Sweden
- Center for Collaborative Palliative Care; School of Health and Caring Sciences; Linnaeus University; Kalmar Sweden
| | - Anders Thorell
- Department of Surgical Science; Karolinska Institute; Danderyd Hospital; Stockholm Sweden
- Department of Surgery; Ersta Hospital; Stockholm Sweden
| | - Carina Persson
- School of Health and Caring Sciences; Linnaeus University; Kalmar Sweden
- Center for Collaborative Palliative Care; School of Health and Caring Sciences; Linnaeus University; Kalmar Sweden
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16
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Staccini L, Tomba E, Grandi S, Keitner GI. The evaluation of family functioning by the family assessment device: a systematic review of studies in adult clinical populations. FAMILY PROCESS 2015; 54:94-115. [PMID: 25154959 DOI: 10.1111/famp.12098] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
A large body of research, documenting the impact of a family's functioning on health outcomes, highlights the importance of introducing the evaluation of patients' family dynamics into clinical judgment. The Family Assessment Device (FAD) is a self-report questionnaire designed to assess specific dimensions of family functioning. This qualitative systematic review, which follows PRISMA guidelines, aimed to identify the FAD's clinimetric properties and to report the incremental utility of its inclusion in clinical settings. A thorough literature search was performed, using both computerized and manual searches, yielding a total of 148 studies that were included in this review. The FAD has been extensively used in a variety of research contexts. In the majority of studies it was able to discriminate between clinical populations and controls and among groups of patients with different illnesses. The FAD also showed good test-retest and concurrent reliability, and modest sensitivity to change after treatment. FAD-dysfunctional family functioning was related to several patient clinical outcomes, including lower recovery rates and adherence to treatment, longer recovery time, poorer quality of life, and increased risk of relapse and drop-out. The present review demonstrates that the FAD is a suitable instrument for the evaluation of family functioning both in clinical and research settings.
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Affiliation(s)
- Laura Staccini
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy
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17
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Flink IJE, Restrepo MH, Blanco DP, Ortegon MM, Enriquez CL, Beirens TMJ, Raat H. Mental health of internally displaced preschool children: a cross-sectional study conducted in Bogotá, Colombia. Soc Psychiatry Psychiatr Epidemiol 2013; 48:917-26. [PMID: 23124480 DOI: 10.1007/s00127-012-0611-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 10/12/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Ongoing armed conflicts, like the one in Colombia, have forcibly displaced millions of people including many young children. This study aimed to assess the mental health of internally displaced preschoolers in Bogotá Colombia and to identify correlates of mental health in these children. METHODS Cross-sectional study conducted among 279 children attending four kindergartens in a deprived neighbourhood in Bogotá. Child mental health was assessed with the Child Behaviour Checklist (CBCL) 1.5-5 years, a parent-report. Univariate analyses and multivariate logistic regressions were performed to assess the association between displacement and child mental health and to identify correlates of mental health in displaced children. RESULTS Displaced children (n = 90) more often met borderline cut-off scores for the CBCL scales than non-displaced children (n = 189) (e.g. total problems 46.7 vs. 22.8 %; p < 0.001). The association between displacement and presence of CBCL total problems remained after adjustment for socio-demographic factors (Adjusted OR 3.3, 95 % CI 1.5; 6.9). Caretaker's mental health partly explained the association. In displaced children, caretaker's mental health (p < 0.01) and family functioning (p < 0.01) were independently associated with child mental health. Exposure to traumatic events and social support was also associated with child mental health; however, associations were not independent. CONCLUSION In this deprived neighbourhood in Bogotá, preschool children registered as internally displaced presented worse mental health than non-displaced peers. Family functioning and caretaker's mental health were strongly and independently associated with displaced children's mental health.
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Affiliation(s)
- Ilse J E Flink
- Department of Public Health, Erasmus University Medical Centre, Room Ae 029, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
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18
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Ulus Y, Tander B, Akyol Y, Ulus A, Tander B, Bilgici A, Kuru O, Akbas S. Functional disability of children with spina bifida: its impact on parents' psychological status and family functioning. Dev Neurorehabil 2013; 15:322-8. [PMID: 22712551 DOI: 10.3109/17518423.2012.691119] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the impact of functional disability of Turkish children with spina bifida (SB) on parents' psychological status and family functioning. METHODS Fifty-four children with SB and parents were included. The Functional Measure for Children (WeeFIM), Beck Depression Inventory (BDI), and Family Assessment Device (FAD) were used. RESULTS Mothers' BDI scores were significantly higher than fathers' (p < 0.001). No significant effects of the knowledge of having children with SB before birth and the number of children in families on BDI scores and FAD sub-scores were found (p > 0.05). According to multiple regression analysis; significant correlations with fathers' BDI were problem-solving (p = 0.012) and general functioning (p = 0.037) and with mothers' BDI was roles (p = 0.018). Only childrens age was found to be an influential variable on WeeFIM scores (p < 0.001). CONCLUSION Spina bifida healthcare should include psychological support to parents of these children and this support should be independent from disability level of children.
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Affiliation(s)
- Yasemin Ulus
- Department of Physical Medicine and Rehabilitation, Ondokuz Mayis University, Samsun, Turkey.
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19
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Wang J, Zhao X. Perceived family functioning in depressed Chinese couples: A cross-sectional study. Nurs Health Sci 2012; 15:9-14. [PMID: 23078006 DOI: 10.1111/j.1442-2018.2012.00707.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 04/15/2012] [Accepted: 04/20/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Jikun Wang
- Department of Psychosomatic Medicine; Shanghai East Hospital; Tongji University School of Medicine; Shanghai; China
| | - Xudong Zhao
- Department of Psychosomatic Medicine; Shanghai East Hospital; Tongji University School of Medicine; Shanghai; China
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20
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Vicente B, Saldivia S, de la Barra F, Kohn R, Pihan R, Valdivia M, Rioseco P, Melipillan R. Prevalence of child and adolescent mental disorders in Chile: a community epidemiological study. J Child Psychol Psychiatry 2012; 53:1026-35. [PMID: 22646991 DOI: 10.1111/j.1469-7610.2012.02566.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND In Latin America, there is limited research on the prevalence of mental disorders in children and adolescents. This Chilean survey is the first national representative survey in the Latin American region to examine the prevalence of diagnostic and statistical manual-IV (DSM-IV) psychiatric disorders in the region in children and adolescents. METHODS Subjects aged 4-18 were selected using a stratified multistage design. The diagnostic interview schedule for children version IV (DISC-IV) was used to obtain 12-month DSM-IV diagnoses of affective, anxiety, conduct and substance use disorders, and supplemented with questionnaires examining family risk factors, family income, and service utilization. The parent or the primary caretaker was interviewed for children, aged 4-11, using the DISC-IV; however, adolescents, aged 12-18, were directly interviewed. RESULTS A sample of 1558 children and adolescents was evaluated. Using the most stringent DISC-IV impairment algorithm, the prevalence rate for any psychiatric disorders was 22.5% (19.3% for boys and 25.8% for girls). The prevalence rate was higher among the children, aged 4-11, in comparison with adolescents, aged 12-18 (27.8% and 16.5%, respectively). Less than half of the subjects in need of services sought some form of assistance. Nearly a quarter of those using services did not present with a psychiatric diagnosis in the past year. Comorbidity was found in 24.8% of those with a disorder, but only 6.3% had three or more diagnoses. CONCLUSIONS The prevalence of psychiatric disorders in Chile is high among children and adolescents. This study highlights the increasing need to reevaluate mental health services provided to children and adolescents in Latin America.
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Affiliation(s)
- Benjamín Vicente
- Department of Psychiatry of Mental Health, University of Concepción, Concepción, Chile Mental Health Department, Medical School of the University of Chile, Santiago, Chile.
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21
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Speranza M, Guénolé F, Revah-Levy A, Egler PJ, Negadi F, Falissard B, Baleyte JM. The French version of the Family Assessment Device. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2012; 57:570-7. [PMID: 23073035 DOI: 10.1177/070674371205700908] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To validate a French version of the Family Assessment Device (FAD), a well-known self-report questionnaire assessing family functioning in clinical and research settings. METHODS A French adaptation of the FAD was administered to 3 groups of subjects: a nonclinical group (n = 115), relatives of psychiatric patients (n = 102), and medical patients and their relatives (n = 106). Temporal stability was assessed by test-retest intraclass correlations. Internal consistency was measured by Cronbach alpha reliability coefficients. Discriminant validity was explored, comparing the scores of the 3 groups, using a covariance analysis (ANCOVA). The dimensional structure of the instrument was explored using a principal component analysis, with promax oblique rotation, on the entire sample. RESULTS The French FAD showed good temporal stability and good discriminant validity across groups. Internal consistency was satisfactory only for the General Functioning (GF) subscale. Factor analysis yielded a 3-factor model. The GF subscale was highly correlated with all of the other subscales. CONCLUSIONS The French version of the FAD provides a valuable tool for assessing family functioning. However, our study failed to identify the theoretical structure of the FAD and suggests that the GF subscale could be used as a better overall indicator of family functioning.
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Affiliation(s)
- Mario Speranza
- Child and Adolescent Psychiatrist, Centre Hospitalier de Versailles, Service de Pédopsychiatrie, Le Chesnay, France.
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Sveinbjarnardottir EK, Svavarsdottir EK, Hrafnkelsson B. Psychometric development of the Iceland-Expressive Family Functioning Questionnaire (ICE-EFFQ). JOURNAL OF FAMILY NURSING 2012; 18:353-377. [PMID: 22752795 DOI: 10.1177/1074840712449204] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Instruments that are able to capture changes related to an intervention are of great value to the scientific as well as to the clinical community. The Iceland-Expressive Family Functioning Questionnaire (ICE-EFFQ) measures expressive emotions, collaboration, problem solving, communication, and behavior in families experiencing a chronic or an acute illness. The conceptual framework of the Calgary Family Assessment Model (Wright & Leahey, 2009) was used to construct the original questionnaire of 45 items and 10 subcategories. A total of 557 family members with a recent illness experience of a close relative answered the ICE-EFFQ in three different studies. Principal component factor analysis reduced the original questionnaire to 22 items with five factors emerging and a total Cronbach's alpha coefficient of α = 0.912 accounting for 60.3% of the total variability. Confirmatory factor analysis from two studies produced the final version of the questionnaire consisting of 17 items and four factors.
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