Development and validation of the family management scale for children with asthma (FMSCA)

Development and psychometric evaluation of the needs assessment questionnaire for family caregivers of end-of-life older adults in home hospice care

As care moves from disease-centered to family-centered, meeting the needs of caregivers becomes more and more important. The study was to develop and validate a family caregiver needs assessment questionnaire for home hospice care of the end-of-life older adult in Mainland China. Based on the guidance of Harmony Nursing Theory, 48 initial questionnaire items were initially drafted through literature review, interviews with 12 family caregivers of the end-of-life older adult, and group discussions among research team members. Two rounds of expert review and small sample testing resulted in a 36-item prediction questionnaire. From October to December 2023, 223 family caregivers of the end-of-life older adult in Jinzhou City, Liaoning Province were selected to verify the questionnaire. The final questionnaire included 34 items. With a cumulative variance contribution rate of 71.281%, the exploratory factor analysis identified six common factors. The questionnaire's total Cronbach coefficient was 0.910, and the retest reliability was 0.868. Its content validity index was 0.982, and the items' content validity index ranged from 0.83 to 1.00. The questionnaire items compilation and screening methods are scientifically reliable. In the future, healthcare can utilize the questionnaire to fully assess the needs of family caregivers of older adult patients end-of-life at home.

Development and Validation of the Home Hospice Care Needs Questionnaire for the Dying Old Adult (HHCNQ-DE) in Mainland China

Context: Home hospice needs assessment is the key to the development of home hospice services. Therefore, there is a need to develop assessment tools in mainland China to meet the comprehensive needs of the old adult at the end of life. Objective: To develop and validate a tool to assess Chinese mainland palliative care needs of the dying old adult at home. Methods: Using the Harmony Nursing Theory as a theoretical framework, through reference to the China home hospice care needs scale, literature research, in-depth conversations with the dying old adult, and group discussions among members of the research team, 43 original questionnaire items were preliminarily drafted. A 31-item predictive questionnaire was formed through 2 rounds of expert review and small sample testing. From April to September 2023, 199 old adult at the end of life at home in Jinzhou, Liaoning Province were investigated to determine the reliability and validity of the questionnaire. Results: The final questionnaire included 31 items. Exploratory factor analysis extracted 5 common factors, and the cumulative variance contribution rate was 68.811%; the Cronbach's alpha coefficient of the total questionnaire was 0.832, and the re-test reliability was .806; the content validity index of the questionnaire was 0.982, and the content validity index of the items was 0.83-1.00. Conclusion: The construction method of the HHCNQ-DE is scientific and reliable, with good reliability and validity, and it can be used as a tool to measure the needs of home hospice care in mainland China in the future.

Development and validation of the parental health literacy scale for children with asthma (PHLSCA)

OBJECTIVE

This study aimed to develop and validate an instrument to assess the health literacy of parents of children with asthma in a Chinese context.

METHODS

The preliminary Parental Health Literacy Scale for Children with Asthma (PHLSCA) was developed based on a literature review and refined to 45 items through two rounds of expert consultation using the Delphi method. A total of 481 parents of children with asthma were recruited from seven hospitals across four provinces in China between February and April 2019. Principal component analysis (PCA) and confirmatory factor analysis were conducted to evaluate the structural and construct validity of the scale.

RESULTS

The development and validation processes led to a 38 items scale comprising three subscales, namely: Health Knowledge (11 items), Health Skills (19 items) and Health Behavior (8 items). The scale demonstrated good reliability, with an internal consistency of Cronbach's α = 0.956 and a split-half reliability of r = 0.887 (p < 0.01). The Item Content Validity Index (I-CVI) ranged from 0.81 to 1.00, and the Scale-CVI was 0.842. The correlation coefficients and factor analysis results indicated good construct validity, with the factors explaining 59.33% to 62.90% of the variance in each subscale.

CONCLUSIONS

The final version of the questionnaire (PHLSCA) has been demonstrated to be a valid and reliable tool for assessing the health literacy of parents of Chinese children with asthma.

Family management styles for children with asthma: A latent profile analysis

AIM

To identify the latent profiles and predictors of family management styles for children with asthma.

DESIGN

This is a secondary data analysis. The demographic data of 506 primary caregivers of children with asthma and their scores of the Family Management Scale in a cross-sectional study were used. Latent profile analysis and multiple logistic regression analyses were employed.

RESULTS

Three family management styles were identified: Thriving (Profile 1), Accommodating (Profile 2), and Enduring (Profile 3) Family Management Style. The child's age, gender, mother's education level, family structure, influence of illness on parents' work and family life, whether they had follow-up plans and whether their parents had read disease and health knowledge pamphlets were found to be the predictors of different styles.

CONCLUSION

Three distinct family management styles exist for children with asthma. Future interventions designed to enhance family management for children with asthma should be based on their demographic characteristics and family management styles.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

The precise classification of family management styles in this study can serve as a guide to form multi-disciplinary teams of physicians and nurses to provide individualized care and conduct in-depth research to explore the mechanisms of biomedicine and the social psychology of asthma in the future.

IMPACT

This paper aims to identify the latent profiles and predictors of family management styles of children with asthma. Thriving, accommodating, and enduring family management styles were identified in this paper. Child's characteristics, family and organizational factors were the predictors of different family management styles. Findings of this paper provide guidance for physicians and nurses to offer individualized care and conduct in-depth research to explore the mechanisms of biomedicine and the social psychology of asthma in the future.

REPORTING METHOD

The article was reported according to the STROBE Checklist.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Psychometric test of the Turkish version of the Family Management Scale for Children with Asthma (FMSCA)

INTRODUCTION

Asthma is the most common chronic disease among children. The management of asthma in children requires ongoing effort and is heavily dependent on the effectiveness of family management. This study aimed to evaluate the validity and reliability of the Family Management Scale for Children with Asthma (FMSCA) by adapting it to Turkish.

METHODS

This methodological research comprised 293 parents between December 2020 and May 2021. Inclusion criteria were having a child with a diagnosis of asthma for more than six months, being literate, and not having problems in communication. FMSCA was examined for language, content and construct validity. Internal consistency was calculated using Cronbach's α coefficient, item-total correlation, and test-retest equivalence. Ethical principles were adhered to.

RESULTS

The content validity index scores of the items in the FMSCA ranged from 0.90 to 1.0. The Kaiser-Meyer-Olkin value was determined to be 0.965 and the Bartlett's Test of Sphericity value was χ2 = 18,296.335 (p ≤ .001). Many indices were used to examine the fit of the FMSCA model. Of these, the χ2/SD value was determined to be 1.61. The total FMSCA Cronbach α coefficient was 0.981. The relationship between the test-retest results was statistically significant, high, and positive (p < .05).

CONCLUSION

FMSCA is a valid and reliable tool that can be used to objectively evaluate family management in families with children with asthma and to determine the effectiveness of interventions.

Quality of life and its influencing factors on children with asthma in China: a comparative study before and during the COVID-19 pandemic

OBJECTIVE

This study compares the level of quality of life (QoL) and its influencing factors on children with asthma before and during the COVID-19 pandemic.

METHODS

The study carried out cross-sectional surveys on children with asthma and their parents in China before and during the epidemic. Data were collected using a demographic questionnaire, the Family Management Scale for Children with Asthma (FMSCA), and the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Participants from before the epidemic were matched by their propensity score in a 1:1 ratio with individuals from during the epidemic. The level of QoL of children with asthma was subsequently analyzed. Both univariate analysis and multiple linear regression were employed to identify the influencing factors.

RESULTS

Compared to their level before the epidemic, the total score of PAQLQ and its three dimensions decreased during the epidemic. Regression analysis revealed that before the epidemic, the total score of PAQLQ was significantly associated with follow-up visits, attendance of asthma lectures, and the total score of FMSCA (p < 0.05). During the epidemic, the total score of the PAQLQ was significantly associated with three dimensions of the FMSCA (future expectation, children identity, and views of condition), and two classifications of the family management styles (FMS) (enduring and accommodating) (p < 0.05).

CONCLUSION

The QoL of children with asthma deteriorated during the epidemic. Influencing factors changed during the epidemic, with more emphasis on the family environment. Future intervention strategies need to take into account the development of interactions between children and environmental forces.

Validation of the index for the core competence of nurses leading discharge planning for older patients in China†

Objective

With the continuous advancement of aging in China, the number of older inpatients has increased sharply. Older patients have a high demand for planning their discharge services. Nurses serve as the leader of discharge planning for patients; there is a lack of reliable evaluation tool to evaluate the core competitiveness of nurses who implement discharge planning for older patients in China. The purpose of this study was to validate the index for the core competence of nurses who lead discharge planning for older patients developed by a project team through the Delphi method in the early stage.

Methods

A cross-sectional questionnaire survey with 3-stage stratified sampling was used to select 1075 nurses from 17 public general hospitals in Ningxia, China.

Results

The index consists of 4 first-level indicators, 13 second-level indicators, and 57 third-level indicators. The results show that 57 third-level indicators had good discrimination. With exploratory factor analysis (EFA), 4 common factors that explained 72.79% of the total variance were extracted. The Cronbach’s α was 0.98, and the retest reliability within a 14-d interval was 0.86. The confirmatory factor analysis (CFA) results show that the fit of the index structure was good. The criterion validity was 0.73.

Conclusions

The index presented excellent psychometric properties and can be used to measure the core competence of nurses in implementing discharge planning for older patients in China.

Factors Affecting Family Management Among Chinese Parents of Children With Leukemia: A Multisite Study

BACKGROUND

Effective family management can improve the ability of children's families to cope with the disease. However, the family management styles of children with leukemia are unknown.

OBJECTIVE

This study used a family management style framework and structural equation model to determine the direct and indirect predictors of family management of children with leukemia.

METHODS

A total of 496 parents of children with leukemia completed the Family Management Measure, the Feetham Family Functioning Survey, the Social Support Rating Scale, and a demographic family information form. We used structural equation modeling to explore the direct and indirect effects of the study variables on family management styles.

RESULTS

Family functioning, family income, parental education level, and geographic location affect family management directly, among which family functioning has the most significant coefficient in the model (0.53). Siblings and social support can affect family management through the mediating effect of family functioning. Employment change can directly affect family management (-0.27) and indirectly affect family functioning (-0.08).

CONCLUSIONS

Our results support the family management style framework. Individual and family factors such as family income, parental education level, geographic location, employment change, siblings, and social support contribute to the ease or difficulty of family management. In addition, family functioning can also mediate between contextual influences and family management styles.

IMPLICATIONS FOR PRACTICE

Family functioning plays a vital role in relationships between contextual influences and family management. We can construct family management interventions according to family management influencing factors.

The factors of family management affecting asthma control status in school-age children with asthma in China

OBJECTIVE

To identify the factors of family management affecting asthma control status in school-age children with asthma in China.

METHOD

The cross-sectional descriptive study was conducted among 139 children with asthma and their parents. The age range of the children was 7 to 14 years of age (M_age = 9.85; 76.26% boys). Eight dimensions (Children Identity, View of Condition, Management Mindset, Parental Mutuality, Parenting Philosophy, Management Approach, Family Focus, Future Expectation) of the Family Management Scale for Children with Asthma (FMSCA) were used as factors of family management. The Asthma Control Test (ACT) and the Children Asthma Control Test (C-ACT) were used to measure the asthma control status of children. A parental questionnaire was used to collect information regarding demographic data of familial socioeconomic status, general data about the child, and medical services status (Follow-Up Plan, received manual of asthma education, attended a lecture on asthma) received from medical institutions. A multivariate ordinal logistic regression model was performed.

RESULTS

Factors significantly associated with asthma control were "Follow-Up Plan" (OR, 2.004; 95% CI, 1.009-3.981), "Attended a Lecture on asthma" (OR, 2.586; 95% CI, 1.103-6.066) and two dimensions of the FMSCA, "Children Identity" (OR = 1.133; 95% CI, 1.024-1.254) and "Family Focus" (OR = 1.114; 95% CI, 1.007-1.232).

CONCLUSION

This study shows that asthma control status of school-age children in China is related to the parents' views of their child as having a "normal condition" and the parents' satisfaction with the balance between asthma related management and other aspects of family life.

Association between family management and asthma control in children with asthma

PURPOSE

The purpose of this study is to investigate the association between family management and asthma control in children with asthma.

DESIGN AND METHODS

This cross-sectional descriptive study recruited 142 children with asthma and their parents. We used the Family Management Measure (FaMM), the Childhood Asthma Control Test (C-ACT), and fractional exhaled nitric oxide (FeNO) detectors to assess family management and asthma control. The McNemar's test was used to determine the proportional difference between C-ACT and FeNO in evaluating asthma control. Pearson correlation analysis and multiple linear regression analysis were used to assess the relationship between family management and asthma control in children with asthma.

RESULTS

There was no significant difference in the proportion of C-ACT and FeNO in evaluating asthma control (McNemar's test p = .593). Child's Daily Life, Condition Management Ability, and Parental Mutuality were positively correlated with C-ACT (r = 0.398 to 0.655; all p < .05) and negatively correlated with FeNO (r = -0.245 to -0.402; all p < .05); Condition Management Effort, Family Life Difficulty, and View of Condition Impact were negatively correlated with C-ACT (r = -0.416 to -0.672; all p < .05) and positively with FeNO (r = 0.248 to 0.427; all p < 0.05). Child's Daily Life, Condition Management Effort, and View of Condition Impact dimensions significantly predicted the C-ACT results, and the Condition Management Effort and View of Condition Impact dimensions significantly predicted the FeNO results (p < .05).

PRACTICAL IMPLICATIONS

Pediatric nurses could provide family management education for parents to improve asthma control in children. In addition, pediatric nurses might assess asthma control condition of asthmatic children in combination with C-ACT and FeNO levels.