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

Abstract

IntroductionExpressed 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.MethodsA 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.ResultsThe 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.ConclusionThe Chinese version of the Family Questionnaire is a valid and reliable measurement of expressed emotion in the Chinese context.

The impact of care-recipient relationship type on mental health burden of caregivers for schizophrenia patients: evidence from Beijing, China

“…Firstly, care-recipients are often the elderly, adolescents, or other minority groups, such as cancer patients, meaning that relatively few studies have focused on caregivers of schizophrenia patients ( Ferraris et al, 2022 ; Chen and Li, 2023 ). Peng et al (2023) used a Chinese version of the Family Questionnaire and found that in China, parents or spouses scored higher in emotional over involvement with schizophrenia patients compared to siblings, but no significant difference existed between fathers, mothers, or spouses. Secondly, most existing studies concentrated on the characteristics or correlations of factors influencing caregivers’ quality of life, lacking research on specific issues such as the impact of caregiver’s mental health burden ( Srivastava, 2005 ; Chua et al, 2023 ).…”