Family functioning in students of health sciences in four Latin American countries: a study of the structure and factorial invariance of the FACES III scale. A cross-sectional study

Abstract Background Psychometric studies of the FACES III scale in Spanish-speaking countries show a lack of agreement on the factorial structure of the scale. In addition, most of the studies have only performed exploratory analyses of its factorial structure. Objective The objective of the present study was to confirm the structure and factorial invariance of the FACES III scale in nursing and obstetric students from Chile, Colombia, Peru, and Mexico. Methods A total of 3303 students from the four countries participated in this study (Colombia = 1559, Chile = 1224, Peru = 215, Mexico = 305). Results The results of the study showed that the Bi-factor model presents the best-fit indexes to the data from Colombia, Chile, and Mexico, but not from Peru. In addition, it was found that this model showed evidence of being strictly invariant among the three countries in the sequence of the invariance models proposed: metric invariance (ΔRMSEA = .000), scalar (ΔRMSEA = .008), and strict (ΔRMSEA = .008). The bi-factor model also showed adequate reliability indexes in the three countries. Conclusion It is concluded that the FACES III scale shows adequate psychometric performance under a bi-factor model in nursing and obstetric students from Colombia, Chile, and Mexico. The lack of fit of the model in Peru could be associated with the small sample size.

Variables clínicas asociadas a Adaptabilidad y Cohesión familiar en pacientes con lesión medular / Clinical variables associated with Family Adaptability and Cohesion in patients with spinal cord injury

Antecedentes: Vivir con una persona portadora de lesión medular afecta al entorno y su medio, sobre todo por el grado en que el paciente depende de los familiares. El presente estudio, descriptivo comparativo, examinó la asociación entre las variables clínicas y adaptabilidad y cohesión familiar en pacientes con Lesión Medular. Método: Se utilizó la Escala de evaluación de la cohesión y la adaptabilidad familiar de D. Olson - FACES III. La muestra estuvo constituida por 100 pacientes del Instituto Nacional de Rehabilitación, en su mayoría varones (77%). Resultados: No se evidenciaron diferencias estadísticamente significativas de cohesión y adaptabilidad familiar en cuanto a las variables clínicas (etiología de la lesión, nivel de la lesión, tipo de lesión y tiempo de evolución). Se encontró un tamaño del efecto pequeño en cuanto a adaptabilidad familiar y tiempo de evolución de la lesión (d = 0.36). Conclusión: Inicialmente, las familias, que conviven con un paciente con lesión medular, presentan dificultades respecto a la cohesión y adaptabilidad familiar. Sin embargo, al transcurrir el tiempo, las familias tienden a adaptarse a una nueva condición.

Background: Living with a person with a spinal cord injury affects the family environment and context, especially due to the degree to which the patient depends on the family members. The present study, descriptive and comparative, examined the association between the clinical variables to family functioning in patients with Spinal Cord Injury. Method: The sample was constituted by 100 patients of the National Institute of Rehabilitation, most were males (77%). Results: There were no statistically significant differences in family cohesion and adaptability in terms of clinical variables (etiology of the lesion, level of the lesion, type of lesion and time of evolution). A small effect size was found in terms of family adaptability and time of evolution of the lesion (d = 0.36). Conclusion: Initially, families, who live with a patient with spinal cord injury, present difficulties regarding family cohesion and adaptability. However, as time goes by, families tend to adapt to a new condition.

Análisis factorial de las escalas FACES (Family Adaptability and Cohesion Evaluation Scales) con familias en situación de riesgo psicosocial / Factor analysis of FACES (Family Adaptability and Cohesion Evaluation Scales) with Families at Psychosocial Risk

Resumen En este artículo se presenta un análisis factorial de las escalas FACES III con una muestra de familias en situación de riesgo psicosocial (N= 324). Los resultados no replican la estructura bidimensional original de la prueba, e indican que solo la escala de cohesión (prescindiendo de tres ítems) obtiene propiedades psicométricas aceptables en esta muestra. Las significativas relaciones de las puntuaciones de esta escala con las de otras dimensiones relevantes del microsistema familiar ofrecen algunas evidencias de la validez de esta solución. Se discute la necesidad de revisar la escala de adaptabilidad propuesta por los autores y reformularla para poder evaluar empíricamente este constructo formulado teóricamente desde el modelo circumplejo del funcionamiento familiar.

Abstract In this article a factor analysis of FACES III with a sample of families at psychosocial risk (N= 324) is presented. The original two-factor structure is not found, and only the cohesion scale (deleting three items) shows adequate psychometric properties with this sample. Significant correlations between the obtained scale and other dimensions of family dynamics (i.e., family self-esteem, parenting alliance and marital satisfaction) evidence validity. The need for reviewing and reformulating the adaptability scale proposed by the authors is discussed, in order to empirically evaluate this theoretical construct from the circumplex model of family functioning.

Descripción de la estructura familiar de una muestra de pacientes con hemofilia. Comparación Argentina-México1 / Description of a Sample of Hemophilia Patients' Family Structures: A Comparison Between Argentina and Mexico

Resumen: Las enfermedades crónicas como la hemofilia rebasan los marcos institucionales sanitarios y abarcan tanto la vida cotidiana de la persona como su entorno social. Esta situación se agudiza cuando el afectado es un hijo de edad pediátrica. El objetivo de este trabajo fue describir y comparar la estructura de 50 familias que tienen algún miembro que padece hemofilia. Método. Participaron 50 madres y padres de pacientes pediátricos con hemofilia de diferente tipo y grado clínico (27 familias mexicanas y 23 argentinas), quienes respondieron el cuestionario FACES III en un estudio transversal exploratorio descriptivo y correlacional. Resultados. Se en contró en los índices de cohesión que el 86% de las familias presentan una estructura familiar semirrelacionada; respecto a la adaptación, el 88% presentó una estructura rígida. En la comparación entre países, no hay diferen cias significativas en los índices de cohesión; sin embargo, en cuanto a la adaptación, el 100% de las familias mexicanas, presentan una estructura rígida. Discusión. Es necesario un trabajo integral y sostenido desde la perspectiva psicológica que promueva un reequilibro saludable para mejorar la calidad de vida familiar.

Abstract: Chronic diseases such as hemophilia go beyond the containment of institutional health care systems and in volve not only a patient's personal daily life but also their social networks. This situation deteriorates when the affected patient is a child. This paper aims to describe and compare the family structure of 50 families who have a child with hemophilia. Method: The participants were 50 parents of pediatric hemophilia pa tients of different types and severity. Twenty-seven Mexican families and 23 Argentine families answered the FACES III questionnaire for a transversal, exploratory, descriptive and co-relational study. Results: Among the Argentine families, the cohesion indices indicated that 86% of the families have a semi-related structure; regar ding adaptability, 88% showed a rigid structure. Comparing countries, no significant differences were found in the cohesion indexes. For adaptability, on the other hand, 100% of the Mexican families presented a rigid structure. Discussion: We believe that to recover a healthy balance and improve family life quality, integrated and sustained psychological intervention is required.

FACES III in the Korean adolescents

BACKGROUND: This study was intended to look into the characteristics and problems when FACES III are used as tools to evaluate family function of adolescents. METHODS: From May to June 1996, self-reported questionnaires for FACES III were conducted on 2,430 middle school and high school students (males:1,190, females:1,240) in Seoul and Yangpyung, Kyunggi-Do. There were eight schools (four middle schools, four high schools) in Seoul and two schools (one middle school, one high school) in Yangpyung, Kyunggi-Do in this study. Also, educational level of parents, occupational status of parents, family types (extended/nuclear), number of family member and numbers of siblings were assessed. RESULTS: The mean values of adaptability were significantly higher in Seoul students, in females, and in nuclear families. The mean values were higher in single sibling than two or more and in parents with higher education. The mean values of cohesion were significantly higher in Seoul students, in middle school students and in family members of 5 and under. The mean values were higher in those without a sibling and in those with above college education. In stepwise regression analysis, educational level of parents, gender, area, occupational status of mother and grade were associated significantly with the mean values of adaptability and educational level of parents, grade and numbers of siblings were significantly associated with the mean values of cohesion. CONCLUSIONS: We consider that there are problems in deciding the cut-off point and in the questionnaires of survey when the FACES III is used as a tool for evaluating family function of adolescents. Trials of combining other tools of family function or consideration of lower concepts are needed in other to be applicable to the individual conversation and the clinical surroundings.

A study on family function of the patients with psychiatric disorders

BACKGROUND: Psychiatric disorders have been known to occur by the interaction of biologic, psychologic and social factors. A family can affect the occurrence of psychiatric disorders as a primary social factor. On the other hand, psychiatric disorders can affect family function. There fore, we studied to compare family function between the families of psychiatric inpatients and those of normal persons, using Family APGAR and FACES III. METHODS: Between July 1, 1999 and August 31, 1999, we examined the subject group as 40 relatives to visit psychiatric inpatient and the control group as 40 persons whose family members did not have chronic diseases or psychiatric disorders, using questionnaire of socio-demographic factors and family function. RESULTS: Family APGAR scores in subject group were lower than those of control group, but not statistically different. But the degrees of 'Partnership' of the Family APGAR in subject group were significantly lower than those of control group.(P<0.05) Adaptability scores of FACES III in two groups were not different. Cohesion scores of FACES III in subject group were lower than those of control group but not statistically different. The Family APGAR scores in the families of the schizophrenics were significantly lower than those of control group. The duration of psychiatric disorders did not affect family function. CONCLUSION: The family function of subject group was worsened but not statistically different. But in the families of the schizophrenics, the Family APGAR scores were significantly lower than those of control group. Therefore, we should consider serious family dysfunction in the families of schizophrenics.

Validity and reliability of Faces III ad a tool of middle school student's family function evaluation-When student himself only responses

BACKGROUND: FACES III is a useful instrument for the evaluation of family function. It was translated with evaluation of it's validity and reliability and used in many researches in Korea. But following studies for validity and realiability of FACES III didn't show consistent results. And for the evaluation of family function of middle school students, FACES III can be a useful tool. But it is important to reinvestigate the validity and reliability of FACES III to apply this instrument to them. METHODS: In 1997, self-report instrument FACES III questionnaires were distributed to all members of one boys' middle school students in Inchon. The 1150 questionnaires except incomplete questionnaires from 1249 students were analyzed. RESULTS: The Cronbach's alpha coefficients for internal consistency reliability were 0.71 for adaptability and 0.80 for cohesion. The Pearson's correlation coefficient between cohesion and adaptability for construct validity was 0.59. Correlations between total scores and each item scores were moderate to strong, correlations between items in subcategory were weak. In factor analysis, there were many items that were not compatible with factors according to concept of FACES III. CONCLUSION: The validity and reliability of FACES III can not be guaranteed when applied to the evaluaton of middle school students' family function.