Psychometric properties of the Chinese version of the Family Questionnaire among the caregivers of people with schizophrenia

Yanan Peng; Enhe Xiong; Yan Li; Lanjun Song; Juzhe Xi

doi:10.3389/fpubh.2023.1200130

Psychometric properties of the Chinese version of the Family Questionnaire among the caregivers of people with schizophrenia

Front Public Health. 2023 Jul 14:11:1200130. doi: 10.3389/fpubh.2023.1200130. eCollection 2023.

Authors

Yanan Peng¹, Enhe Xiong¹, Yan Li¹, Lanjun Song², Juzhe Xi¹

Affiliations

¹ Shanghai Key Laboratory of Mental Health and Psychological Crisis, Affiliated Mental Health Center (ECNU), Positive Education China Academy (PECA) of Han-Jing Institute for Studies in Classics, Juzhe Xi's Master Workroom of Shanghai School Mental Health Service, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.
² Shanghai Changning Mental Health Center, Shanghai, China.

Abstract

Introduction: Expressed emotion refers to relatives' attitudes and emotional behaviors toward mentally ill family members. It is a robust predictor of patients' illness outcomes and caregivers' wellbeing in a wide range of mental disorders. However, expressed emotion has not been fully explored in the Chinese context. One reason is the lack of reliable and cost-effective measurements. A reliable, valid, and user-friendly instrument is needed to support the research and clinical practice based on expressed emotion in China. This study aimed to translate, adapt, and examine the psychometric properties (factorial structure, measurement invariance, internal consistency reliability, and concurrent validity) of a Chinese version of the Family Questionnaire.

Methods: A total of 248 caregivers participated in the study. A translation and back-translation procedure was applied to translate the Family Questionnaire into Chinese. We compared two models to examine the factor structure of the questionnaire by performing confirmatory factor analysis. We also conducted measurement invariance analysis to test whether the factor structure of the tool is invariant across male and female groups. Reliability was evaluated with Cronbach's α. The concurrent validity was examined by testing the predictivity of the expressed emotion on relevant outcomes with path analysis. We used the STROBE checklist to report.

Results: The item-total correlation coefficients of the scale ranged from 0.375 to 0.752. The confirmatory factor analysis indicated that the Chinese version of the Family Questionnaire displays the original two-factor structure (emotional overinvolvement and criticism; X² = 335.50, df = 169, X²/df = 1.985, RMSEA = 0.063, SRMR = 0.058, CFI = 0.913, and TLI = 0.902). In addition, the two-factor structure was invariant across the male and female groups. The two subscales showed excellent internal consistency, with Cronbach's alpha of 0.92 for both emotional overinvolvement and criticism. The concurrent validity of the Chinese version was supported by the good predictivity of the two subscales to care burden, family function, and quality of life. All path coefficients were significant, and the absolute values of path coefficients ranged from 0.23 to 0.72.

Conclusion: The Chinese version of the Family Questionnaire is a valid and reliable measurement of expressed emotion in the Chinese context.

Keywords: caregivers; expressed emotion; psychometrics; schizophrenia; validation study.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Caregivers / psychology
Female
Humans
Male
Psychometrics
Quality of Life
Reproducibility of Results
Schizophrenia*
Surveys and Questionnaires

Grants and funding

This study was supported by the National Social Science Foundation of China (grant number: 18BSH1292), Special Project of Shanghai Municipal Education Commission “Research on Caring for Students in Primary and Secondary Schools and Kindergartens” (Runxin Project) (grant number: 2023RX07), the Research Project of Shanghai Science and Technology Commission (grant number: 20DZ2260300), and the Project on the Construction of Family Civilization in Shanghai (grant number: 2023JTWM03).