Advertisement

Community Mental Health Journal

, Volume 43, Issue 6, pp 591–607 | Cite as

The Questionnaire of Family Functioning: A Preliminary Validation of a Standardized Instrument to Evaluate Psychoeducational Family Treatments

  • Rita Roncone
  • Monica Mazza
  • Donatella Ussorio
  • Rocco Pollice
  • Ian R.H. Falloon
  • Pierluigi Morosini
  • Massimo Casacchia
Article

Abstract

The aim of the study was to develop and preliminarily validate a self-completed questionnaire that could help in the assessment of families before and during psycho-educational interventions. The questionnaire was developed according to the cognitive-behavioural psycho-educational model. From an initial 38-item version of the questionnaire, a final shorter 24-item version was derived. The validation study of the final version was conducted on relatives of schizophrenic and schizoaffective patients: 31 for the test–retest reliability study and 92 for the confirmation of the subscales and convergent validity study vs. SF-36 and the questionnaire on Family Problems, PF. The final questionnaire showed good psychometric properties. The three-core dimensions of Problem-Solving, Communication Skills, and Personal Goals were clearly outlined in the items correlation analysis. The association with family burden and health-related quality of life was as expected. The FF provides a promising assessment of the family functioning pattern that is the object of psychoeducational family interventions. Further studies are needed to confirm the validity of the instrument, that could be helpful both in planning and in monitoring psycho-educational interventions and in mental health promotion projects.

Keywords

family functioning questionnaire validation psychoeducation problem solving. 

References

  1. Anderson J., & Hinojosa J. (1984). Parent and therapists in a professional partnership. American Journal of Occupational Therapy, 38 (7), 452–461.PubMedGoogle Scholar
  2. Apolone G., & Mosconi P. (1998). The Italian SF-36 health survey: Translation, validation and norming. Journal of Clinical Epidemiology, 51 (11), 1025–1036.PubMedCrossRefGoogle Scholar
  3. Barrowclough C., Tarrier N., Lewis S., Sellwood W., Mainwaring J., Quinn J., & Hamlin C. (1999). Randomised controlled effectiveness trial of a needs-based psychosocial intervention service for carers of people with schizophrenia. British Journal of Psychiatry, 174, 505–511.PubMedGoogle Scholar
  4. Brooker C., Falloon I. R. H., Butterworth A., Goldberg D., Graham-Hole V., & Hillier V. (1994). The outcome of training community psychiatric nurses to deliver psychosocial intervention. British Journal of Psychiatry, 165, 222–230.PubMedGoogle Scholar
  5. Brown G. W., Birley J. L. T., & Wing J. K. (1972). Influence of family life on the course of schizophrenic disorders: a replication. British Journal of Psychiatry, 121, 241–258.PubMedCrossRefGoogle Scholar
  6. Brown G. W., & Rutter M. L. (1966). The measurement of family activities and relationship. Human Relation, 19, 241–267.CrossRefGoogle Scholar
  7. Casacchia M., & Roncone R. (1999). I trattamenti psicoeducativi familiari nella schizofrenia: Esterofilia o applicazione di trattamenti basati sull’evidenza? Epidemiologia e Psichiatria Sociale, 8(3), 183–189.PubMedGoogle Scholar
  8. Doane J. A., Falloon I. R. H., Goldstein M. J., & Mintz J. (1985). Parental affective style and the treatment of schizophrenia: Predicting course of illness and social functioning. Archives of General Psychiatry, 42, 34–42.PubMedGoogle Scholar
  9. Doane J. A., West K. L., Goldstein M. J., Rodnick E. H., & Jones J. E. (1981). Parental communication deviance and affective style: Predictors of subsequent schizophrenia spectrum disorders in vulnerable adolescents. Archives of General Psychiatry, 38, 679–685.PubMedGoogle Scholar
  10. Epstein N., Baldwin L., & Bishop D. (1983). The McMaster family assessment device. Journal of Marital and Family Therapy, 9, 171–180.CrossRefGoogle Scholar
  11. Falloon I. R. H. (2001). Stress management and schizophrenia. British Journal of Psychiatry, 179, 76–77.PubMedCrossRefGoogle Scholar
  12. Falloon I. R. H., Boyd J. L., & McGill C. W. (1984). Family care of schizophrenia. A problem-solving approach to the treatment of schizophrenia. New York: Guilford Press.Google Scholar
  13. Falloon I. R. H., Boyd J. L., McGill C. W., Razani J., Moss H. B., & Gilderman A. M. (1982). Family management in the prevention of exacerbations of schizophrenia: A controlled study. New England Journal of Medicine, 306, 1437–1440.PubMedCrossRefGoogle Scholar
  14. Falloon I. R. H., Graham-Hole V., & Woodroffe R. (1993). Stress and health of informal carers of people with chronic mental disorders. Journal of Mental Health, 2, 165–173.Google Scholar
  15. Falloon I. R. H., Held T., Roncone R., Coverdale J. H., & Laidlaw T. M. (1998) Optimal treatment strategies to enhance recovery from schizophrenia. Australia and New Zealand Journal of Psychiatry, 32(1), 43–49.CrossRefGoogle Scholar
  16. Falloon I. R. H., Magliano L., Graham-Hole V., & Woodroffe R. W. (1996). The stress of caring for disabled patients in a community rehabilitation service. Journal of Nervous and Mental Diseases, 184, 381–384.CrossRefGoogle Scholar
  17. Falloon I. R. H., Roncone R., Held T., Coverdale J. H., & Laidlaw T. M. (2002). An international overview of family intervention: Developing effective treatment strategies and measuring their benefits to patients, carers and community. In H. P. Lefley, & D. L. Johnson (Eds.), Family interventions in mental illness: international perspectives (pp. 3–24). Westport CT: Greenwood Publishing Group Inc.Google Scholar
  18. Glynn S. M., Randolph E. T., Eth S., Paz G. G., Leong G. B., Shaner A. L., & Van Vort W. (1992). Schizophrenic symptoms, work adjustment, and behavioral family therapy. Rehabilitation Psychology, 37(4), 323–338.Google Scholar
  19. Gottschalk L. A., & Gleser G. C. (1969). The measurement of psychological states through analysis of verbal behavior. Berkeley: University of California Press.Google Scholar
  20. Hahlweg K., Durr H., & Müller U. (1995). Familienbetreuung schizophrener Patienten. Weinheim, Germany: Psychologie Verlags Union.Google Scholar
  21. Hahlweg K., Hemmati-Weber M., Heusser A., Lober H., Winkler H., Muller U., Feinstein E., & Dose M. (1990). Process analysis in behavioral family therapy. Behavior Modification, 14, 441–456.PubMedCrossRefGoogle Scholar
  22. Hahlweg K., Revensdorf D., & Schindler L. (1984). Effects of behavioral marital therapy on couples’ communication and problem solving skills. Journal of Consulting and Clinical Psychology, 52, 553–566.PubMedCrossRefGoogle Scholar
  23. Held T. (1995). Schizophreniebehandlung in der Familie. Frankfurt am Main: Peter Lang.Google Scholar
  24. Kavanagh D., Clark D., Manicavasagar V., Piatkowska O., O’Halloran P., & Rosen A. (1993). Application of cognitive-behavioural family intervention for schizophrenia in multidisciplinary teams: What can the matter be? Australian Psychologist, 28(3), 181–188.CrossRefGoogle Scholar
  25. Keitner G. I., Ryan C. E., Miller I. W., Kohn R., Bishop D., & Epstein N. B. (1995). Role of the family in recovery and major depression. American Journal of Psychiatry, 152(7), 1002–1008.PubMedGoogle Scholar
  26. Kuipers L., Birchwood M., & McCreadie R. G. (2002). Psychosocial family intervention in schizophrenia: a review of empirical studies. British Journal of Psychiatry, 160, 272–275.CrossRefGoogle Scholar
  27. Lancashire S., Haddock J., Tarrier N., Baguley I., Butterworth C., & Brooker C. (1997). Effects of training in psychosocial intervention for community psychiatric nurses. Psychiatric Services, 48(1), 39–43.PubMedGoogle Scholar
  28. Linszen D., Dingemans P., & Van der Does J. (1996). Treatment, expressed emotion and relapse in recent onset schizophrenic disorders. Psychological Medicine, 26, 333–342.PubMedCrossRefGoogle Scholar
  29. Magana A. B., Goldstein M. J., Karno M., Miklowitz D. J., Jenkins J., & Falloon I. R. H. (1986). A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatric Research, 17, 203–212.CrossRefGoogle Scholar
  30. McFarlane W. R., Lukens E., Link B., Dushay R., Deakins S. A., Newmark M., Dunne E. J., Horen B., & Toran J. (1995) Multiple-family groups and psychoeducation in the treatment of schizophrenia. Archives of General Psychiatry, 52, 679–687.PubMedGoogle Scholar
  31. McFarlane W. R., McNary S., Dixon L., Hornby H., & Cimett E. (2001). Predictors of dissemination of family psychoeducation in community mental health centers in Maine and Illinois. Psychiatric Services, 52(7), 935–942.PubMedCrossRefGoogle Scholar
  32. Miklowitz D. J., Simoneau T. L., George E. L., Richards J. A., Kalbag A., Sachs-Ericsson N., & Suddath R. (2000). Family-focused treatment of bipolar disorder: One-year effects of a psychoeducational program in conjunction with pharmacotherapy. Biological Psychiatry, 48, 582–592.PubMedCrossRefGoogle Scholar
  33. Miller I., Epstein N., Bishop D., & Keitner G. (1985). The McMaster Family Assessment Device: reliability and validity. Journal of Marital Family Therapy, 2, 345–356.CrossRefGoogle Scholar
  34. Moos R. H., & Moos S. (1981). Family environment scale manual. Palo Alto, California: Consulting Psychologists Press.Google Scholar
  35. Morosini P., Roncone R., Veltro F., Palomba U., & Casacchia M. (1991) Routine assessment tool in psychiatry: a case of questionnaire of family attitude and burden. Italian Journal of Psychiatry and Behavioural Sciences, 1(1), 95–102.Google Scholar
  36. Randolph E. T., Eth S., Glynn S. M., Paz G. C., Leong G. B., Shaner A. L., Strachan A., van Vort W., Escobar J. I., & Liberman R. P. (1994). Behavioural family management in schizophrenia: Outcome of a clinic-based intervention. British Journal of Psychiatry, 164, 501–506.PubMedGoogle Scholar
  37. Roncone R., Rossi L., Muliebre E., Impallomeni M., Matteucci M., Giacomelli R., Tonietti G., & Casacchia M. (1998). The Italian version of the family assessment device. Social Psychiatry and Psychiatric Epidemiology, 33, 451–461.PubMedCrossRefGoogle Scholar
  38. Schene A. H., Tessler R. C., & Gamache G. M. (1994). Instruments measuring family or caregiver burden in severe mental illness. Social Psychiatry and Psychiatric Epidemiology, 29, 228–240.PubMedCrossRefGoogle Scholar
  39. Schooler N. R., Keith S. J., Severe J. B., Matthews S. M., Bellack A. S., Glick I. D., Hargreaves W. A., Kane J. M., Ninan P. T., Frances A., Jacobs M., Lieberman J. A., Mance R., Simpson G. M., & Woerner M. G. (1997). Relapse and rehospitalization during maintenance treatment of schizophrenia. The effects of dose reduction and family treatment. Archives of General Psychiatry, 54, 453–463.PubMedGoogle Scholar
  40. Spanier G. B. (1979). The measurement of marital quality. Journal of Sex Marital Therapy, 5(3), 288–300.PubMedGoogle Scholar
  41. Spiegel D., & Wissler T. (1986). Family environment as a predictor of psychiatric rehospitalization. American Journal of Psychiatry, 143, 56–60.PubMedGoogle Scholar
  42. Tarrier N., Barrowclough C., Porceddu K., & Fitzpatrick E. (1994). The Salford family intervention project: Relapse rates of schizophrenia at five and eight years. British Journal of Psychiatry, 165(6), 829–832.PubMedGoogle Scholar
  43. Telles C., Karno M., Mintz J., Paz G., Arias M., Tucker D., & Lopez S. (1995). Immigrant families coping with schizophrenia: behavioral family intervention v case management with low-income Spanish-speaking populations. British Journal of Psychiatry, 167, 473–479.PubMedGoogle Scholar
  44. Vaughn C. E., & Leff J. P. (1976). The measurement of expressed emotion in the families of psychiatric patients. British Journal of Social and Clinical Psychology, 15, 157–165PubMedGoogle Scholar
  45. Ware J. E. Jr, & Sherbourne C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.PubMedCrossRefGoogle Scholar
  46. Zastowny T. R., Lehman A. F., Cole R. E., & Kane C. (1992). Family management of schizophrenia: a comparison of behavioral and supportive family treatment. Psychiatric Quartely, 63, 159–186.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Rita Roncone
    • 1
  • Monica Mazza
    • 1
  • Donatella Ussorio
    • 1
  • Rocco Pollice
    • 1
  • Ian R.H. Falloon
    • 1
    • 2
  • Pierluigi Morosini
    • 3
  • Massimo Casacchia
    • 1
  1. 1.Department of Experimental Medicine-PsychiatryUniversity of L’AquilaL’AquilaItaly
  2. 2.Department of PsychiatryUniversity of AucklandAucklandNew Zealand
  3. 3.National Health InstituteNational Center for Epidemiology, Surveillance, and Health PromotionRomaItaly

Personalised recommendations