The quantitative measurement of family quality of life: a review of available instruments

Family Quality of Life Perceived by Mothers of Children with ASD and ADHD

Existing research has compared Family Quality of Life (FQOL) in autism spectrum disorder (ASD) populations and typically developing populations but has not yet explored differences in FQOL across ASD, attention-deficit/hyperactivity disorder (ADHD), and comorbid ASD and ADHD populations (ASD + ADHD). In the present study, 117 North American mothers of 92 sons and 25 daughters (ages 6-11) with ASD, ADHD, or ASD + ADHD completed an online survey exploring FQOL. An ANOVA failed to show group differences in overall FQOL, however, mothers of children with ASD + ADHD reported significantly lower family Emotional Well-being than mothers of children with ASD only. The results of this study provide insight into FQOL in families of children with ASD and/or ADHD. Greater research is needed in this area to understand how mothers of children with ASD, ADHD, or ASD + ADHD experience FQOL. The COVID-19 pandemic, which ran concurrent with this study, potentially influenced results.

Participants' Bias in Disability Research on Family Quality of Life during the 0-6 Years Stage

BACKGROUND

Over the past two decades, various research teams have designed and applied instruments to measure the quality of life of families with a member who has a disability. A recent systematic review on the state of the Family Quality of Life in early care identified that many of these studies collected data only from the mothers. The present study aimed to investigate whether there is a bias in participant selection in these types of studies.

METHOD

A systematic review of the scientific literature was conducted in three databases-Scopus, Web of Science, Eric-from 2000 to 2022. A total of 72 empirical studies were identified.

RESULTS

The findings indicate that most studies examining the Family Quality of Life were based on the information of a single informant per family unit. The profiles of participants according to the research objective are quite similar. In one-third of studies, the authors reported that family members who participate cannot be represented by only mothers or one participant per household.

CONCLUSIONS

Given the dynamic and collective nature of the construct, the application of a systemic approach is necessary.

Development and preliminary validation of a health-related family quality of life instrument

The researchers' aims for this preliminary study was to develop an instrument, guided by the Theory of Health-related Family Quality of Life, to measure health-related family quality of life (HR-FQoL) as perceived by women with cancer. The researchers used a two phase design for instrument development: (1) establishing face validity of a 38-item instrument with an expert panel and patient review, and (2) focusing on the internal structure and construct validity of the instrument with responses from female patients (N = 236) with a cancer diagnosis (breast, gynecologic). The researchers identified a final 25-item HR-FQoL instrument with four sub-scales that each captured multiple concepts within the Theory of HR-FQoL. The resulting instrument maybe used by researchers and clinicians to assess various aspects of health-related family quality of life among female breast and gynecological cancer survivors.

Job satisfaction and well-being among college-educated Bedouin Arab and ultra-Orthodox women in the Israeli workforce: the roles of individual, familial, communal, and organizational resources

Over the past two decades, increasing numbers of Bedouin Arab and ultra-Orthodox women have been integrated into the Israeli labor market. The integration of these women from traditional and minority communities into the general workforce involves significant coping on the practical, social, and emotional levels. This study examined factors that may facilitate the integration of college-educated Bedouin Arab and ultra-Orthodox women in the Israeli labor market. The sample included 304 ultra-Orthodox women and 105 Bedouin Arab women, who were employed in a variety of fields. Participants completed questionnaires designed to collect data on demographics, sense of personal coherence (SOC), family quality of life, sense of community coherence (SOCC), diversity climate, inclusive management, job satisfaction, and well-being. The ultra-Orthodox women reported higher levels of most of the resources; whereas the Bedouin Arab women reported higher levels only of inclusive management. Hierarchical regressions showed that income, SOC, and inclusive management each contributed significantly to job satisfaction. Levels of well-being were explained by SOC, family quality of life, and inclusive management. This study highlights the importance of individual, familial, and organizational resources for the integration into the workforce of female members of minority groups.

Relationship between parental perceptions, family income and support received with family quality of life in families with a child with an intellectual disability

Research has shown that families raising a child with intellectual disability (ID) face many challenges and need to implement adaptation strategies. Some authors suggest that positive parental perceptions and perceived control could reduce emotional impact and promote family wellbeing. Nevertheless, there are few studies about the relationship between parental perceptions and family quality of life (FQoL) in those families. In this study, we used data from a sample of 251 Spanish parents whose children have ID. Positive perceptions scale and control perceptions scale, Spanish FQoL scale under 18 years-old and a sociodemographic questionnaire were administered to those families. The results of bivariate analysis showed that some dimensions of positive perceptions were related to different areas of FQoL, for example, social inclusion and family accommodation. FQoL was associated with family income and support received. To predict the FQoL level, a multivariate linear regression analysis was conducted. Results indicated that FQoL scores can be predicted by a linear combination of positive perceptions and family income. Practical implications for promoting FQoL in these families are discussed.

Examination of a Telehealth-Based Parent Training Program in Rural or Underserved Areas for Families Impacted by Autism

Families of children with disabilities in rural areas face challenges accessing services due to location and lack of health-care providers. Telehealth-based intervention can mitigate challenges in accessing services. The present study sought to replicate and extend the telehealth-based, behavioral parent-training program, the Online and Applied System for Intervention Skills (OASIS), utilizing a multiple-baseline approach. Four parent-child dyads participated, with all children diagnosed with autism spectrum disorder. All dyads resided in rural/underserved areas. All dyads demonstrated an improvement on skill and knowledge assessments. The mean gain from baseline-to-treatment completion on skills assessments was 80.9% (range: 67.6%-95.5% points). The mean gain on knowledge assessments was 35.3% (range: 19.0%-49.0% points). It should be noted that parent skill gains were maintained over time. The present results provided additional empirical evidence demonstrating the effectiveness of OASIS, a telehealth-based parent-training model.

Measuring Family Quality of Life: Scoping Review of the Available Scales and Future Directions

The lack of quality of life is a key issue for families with children with an intellectual disability. While the quality of life for people with disabilities has previously been researched as an individual variable, this has now shifted to include family members. The purpose of this study was to conduct a review of the studies measuring the quality of life of families with an intellectually disabled member, in order to identify the most commonly used scales and their psychometric properties.

METHOD

Data were collected from six databases (ERIC, Web of Science, Scopus, CINAHL, MedLine, and Google Scholar), and this search yielded 3948 studies. One hundred and twenty studies that met the inclusion criteria were included in this study.

RESULTS

Nine scales were used in the last years to measure the quality of life for families with individuals with an intellectual disability. The Beach Center scale was the most common scale, followed by the Family Quality of Life Survey and the World Health Organization's quality of life assessment (WHOQoL-BREF). The results showed that the included studies in the review lack the consideration of a broader population representing the different types of cultures with different socioeconomic backgrounds. Key aspects used to assess the FQoL are environmental factors (proximal and distal factors), as well as economic factors.

CONCLUSION

Although the operationalization of the FQoL often incudes several subthemes, a general agreement regarding which domains of the FQoL need to be included in the measurements, and these do not exist right now. Moreover, multidimensional scales are still rare.

The conditional effect of family resilience on family quality of life during the Covid-19 pandemic

Introduction: The Covid-19 pandemic has brought unprecedented challenges, both economically and psychologically, to most families across the world. Yet, little study has been done on this topic in Indonesia, even after the second year of the pandemic. This study examines how the Covid-19 economic impact and parental stress are related to the family quality of life (FQOL) and how the relation is moderated by family resilience. Methods: To this end, we employed previously tested measures to assess the level of parental stress, family resilience and FQOL. Especially for the latter, we modified the measure, developed by Beach Center on Disability, by including only four domains (i.e., family interaction, parenting, emotional well-being, and material well-being) to adjust to our research context. Results: Based on 169 participants, our confirmatory factor analysis (CFA) displays that all employed measures in the study are valid and reliable. Our regression analysis shows that there are significant direct relations of parental stress & family resilience with FQOL. However, we find that family resilience only positively moderates the relation between the Covid-19 economic impact and FQOL but not the relation between parental stress and FOQL; indicating that high family resilience can only buffer the effect of economic impact on FQOL. Discussion: This study presents a view on how the Covid-19 pandemic affects the way families live and hence, their quality of life. In addition, the findings suggest the importance of family relationship and support in times of crisis, not limited to the Covid-19 pandemic.

The conditional effect of family resilience on family quality of life during the Covid-19 pandemic

Introduction This study examines how the Covid-19 economic impact and parental stress are moderated by family resilience to relate to the family quality of life (FQOL). Methods We modify the measure of FQOL, developed by Beach Center on Disability, by including only four domains (i.e., family interaction, parenting, emotional well-being, and material well-being) to adjust to our research context. Results Based on 169 participants, our CFA displays that all employed measures in the study are valid and reliable. Our regression analysis shows that there are significant direct relations of parental stress & family resilience with family quality of life. However, we find that family resilience only positively moderates the relation between the Covid-19 economic impact and family quality of life. Discussion This study presents a view on how the Covid-19 pandemic affects the way families live and hence, their quality of life.

The conditional effect of family resilience on family quality of life during the Covid-19 pandemic

Introduction: The Covid-19 pandemic has brought unprecedented challenges, both economically and psychologically, to most families across the world. Yet, little study has been done on this topic in Indonesia, even after the second year of the pandemic. This study examines how the Covid-19 economic impact and parental stress are related to the family quality of life (FQOL) and how the relation is moderated by family resilience. Methods: To this end, we employed previously tested measures to assess the level of parental stress, family resilience and FQOL. Especially for the latter, we modified the measure, developed by Beach Center on Disability, by including only four domains (i.e., family interaction, parenting, emotional well-being, and material well-being) to adjust to our research context. Results: Based on 169 participants, our CFA displays that all employed measures in the study are valid and reliable. Our regression analysis shows that there are significant direct relations of parental stress & family resilience with family quality of life. However, we find that family resilience only positively moderates the relation between the Covid-19 economic impact and family quality of life. Discussion: This study presents a view on how the Covid-19 pandemic affects the way families live and hence, their quality of life. In addition, the findings suggest the importance of family relationship and support in times of crisis, not limited to the Covid-19 pandemic.

Ultra-Orthodox Women in the Job Market: What Helps Them to Become Healthy and Satisfied?

This study explored the mental health and job satisfaction of Ultra-Orthodox women who work in different cultural environments. Data were gathered from 304 Ultra-Orthodox women who belong to various streams in this society and who were recruited by the Midgam research panel. The participants filled out self-reported questionnaires that assessed their family quality of life, community sense of coherence, diversity climate, inclusive leadership, job satisfaction, and mental health. The participants ranged in age between 19 and 64 years (M = 30.86, SD = 8.71); 43.1% worked within the Ultra-Orthodox enclave, while 22.4% worked with both Ultra-Orthodox and secular individuals and 34.5% worked in mainly secular environments. We observed differences and similarities among the three groups of women. Community sense of coherence was weakest among those who worked outside the enclave, while diversity perception and inclusive leadership were highest among that group. In all three groups, family and community were the most important resources for mental health. Both traditional resources (i.e., family and community) and other resources (i.e., perception of diversity climate and inclusive leadership) were important for job satisfaction.

Multidimensional and intergenerational impact of Severe Mental Disorders

BACKGROUND

Severe Mental Disorders (SMDs) affect multiple generations although this is poorly studied. The aim of this study was to investigate the intergenerational and multidimensional impacts of SMD in rural Ethiopia.

METHODS

This comparative study was nested within an existing population-based cohort study. We collected data from a total 5762 family members of 532 households (266 households with at least one family member with SMD and 266 sex and age matched mentally well controls from the neighborhood) in 2019. The main outcomes were multidimensional poverty, mortality, food insecurity, and family satisfaction.

FINDINGS

Multidimensional poverty Index was higher in the households of persons with SMD (74·44%) than the comparison households (38·35%). School attendance was lower in children of people with SMD (63·28%) than children of the comparisons (78·08%). The median years of schooling was also lower among children of people with SMD than the controls. This lower attendance was also true among siblings of people with SMD (35·52%) than the comparisons (49·33%). Over the course of 20 years, family members who have a person with SMD in their household had 23% increased risk of death compared to family members who did not have a person with SMD in their household. Severe food insecurity was also higher in the SMD households (20·68%) than the comparison (13·53%) while family satisfaction was lower.

INTERPRETATION

Families of people with SMD experience pervasive multidimensional and intergenerational impacts. Interventions should consider the broader family social and healthcare needs of the broader family.

Quality of life: Guidelines for the care of people with spina bifida

Quality of Life (QOL) and Health-Related Quality of Life (HRQOL) are important concepts across the life span for those with spina bifida (SB). This article discusses the SB Quality of Life Healthcare Guidelines from the 2018 Spina Bifida Association's Fourth Edition of the Guidelines for the Care of People with Spina Bifida. The focus of these QOL Guidelines was to summarize the evidence and expert opinions on how to mitigate factors that negatively impact QOL/HRQOL or enhance the factors positively related to QOL/HRQOL, the measurement of QOL/HRQOL and the gaps that need to be addressed in future research.

Service Quality in Early Intervention Centres: An Analysis of Its Influence on Satisfaction and Family Quality of Life

Early Intervention (EI) is a set of interventions focused on responding to the needs of children with or at risk of developmental problems. This study aimed to investigate the relationships between the perceived quality of service, satisfaction and family quality of life.

METHODS

to conduct a multi-centre, transversal study with a non-probabilistic sample. The participants (N = 1551) were families from 24 Early Intervention Centres (EICs) located in Spain.

RESULTS

The results indicated an adequate fit of the measurement and structural models, with the latter showing a capacity of 73% to predict the family quality of life. The structural model established that the perceived service quality was a positive and significant predictor of satisfaction (β = 0.85; p < 0.001). Both the perceived quality of service (β = 0.28; p < 0.001) and satisfaction (β = 0.33; p < 0.001) obtained a similar positive and significant relationship with family quality of life, which was slightly stronger than satisfaction.

CONCLUSIONS

This study provided a better understanding of the importance of the services offered in EICs and their influence on the satisfaction and family quality of life of their users. Thus, delving into these relationships was highly relevant for decision-making in the context of EI.

Transcultural adaptation and psychometric properties of Family Quality of Life Survey for caregivers of people with neurodegenerative disease: a study of Spanish families who live in the rural Spain-Portugal cross-border

BACKGROUND

Neurodegenerative diseases (NDs) are one of the main causes of disability and dependence that have a great impact both on the quality of life of people with disabilities and their families. A majority of people with NDs receive care and support from the family, but there is no tool in Spain with which to measure whole-family QOL. The aim of this study was the translation, cultural adaptation, and validation of the FQOLS-Dementia into Spanish to assess FQOL among family members of individuals with NDs who live in the Spain-Portugal cross-border area.

METHOD

The Spanish version was translated and adapted following the international guidelines for cross-cultural adaptation tests. A sample of 300 family caregivers was interviewed, applying an adapted version of the Family Quality Survey (FQOLS-Dementia). Confirmatory factor analysis was performed to validate the factor structure, and convergent validity was examined with Pearson's correlation coefficients of the global FQOL with the domains. Internal consistency reliability was determined using Cronbach's alpha.

RESULTS

The domain structure of the FQOLS-ND showed a good fit. In the convergent validity, it was found that the total score and the subscale domain scores were associated with the global FQOL score, except for the Values domain. Internal consistency of nine domain subscales was strong (α = 0.80 to 0.91), and excellent for the total FQOL (α = 0.85) and the global FQOL (α = 0.87).

CONCLUSION

The FQOLS-ND presented good validity and reliability in caregiver families with individuals with ND, so its application shows its usefulness in detecting areas of improvement and intervention strategies for FQOL in the Spain-Portugal cross-border area.

Satisfaction and Quality of Life of Families Participating in Two Different Early Intervention Models in the Same Context: A Mixed Methods Study

Early intervention is developed following different types of service organization, which in turn require different professional and family roles. The aim of this study was to compare the perceived satisfaction and family quality of life amongst families receiving early intervention developed at centers in comparison to those receiving the routines-based early intervention in families' homes, that is a family centered intervention in ecological environments. Under a transformative paradigm, a mixed methods design was used, using the Consumer Report Effectiveness Scale (CRES-4) and the Beach Center Family Quality of Life Scale (FQOLS) and two focus groups as data collection instruments. The sample comprised 166 parents in the quantitative phase and 16 parents in the qualitative phase. Results showed that families receiving routines-based early intervention had greater satisfaction with the service although both groups showed similar scores for family quality of life in most of the analyzed domains. Three dimensions were identified throughout the qualitative phase: problem solving, professional team and service organization. Both the models analyzed have an impact on family quality of life and parents are in general satisfied. Strengths and weaknesses were found related to the problem-solving process, the role of the professional team, family empowerment and the service's organization. The areas requiring further development are the effective training of professionals focused on family practices, the exchange of information with the family and a more participatory organization that takes parent's perspectives into consideration. The value given to a combined model is another aspect highlighted in this study, as well as the need for a more agile assessment period to avoid unnecessary delays.

Beyond the Motor Domain: Exploring the Secondary Effects of a Fundamental Motor Skill Intervention for Children With Autism Spectrum Disorder

Early motor skill interventions have been shown to improve the motor skill proficiency of children with autism spectrum disorder; however, little is known about the secondary effects associated with these types of interventions (e.g., influence on behavior, social skills, family dynamics). The purpose of this qualitative study was to (a) investigate parents' perceptions of the child-level benefits associated with a fundamental motor skill intervention for their 4-year-olds with autism spectrum disorder and (b) explore how child-level benefits influenced the family unit. Eight parents (N = 8) were interviewed (semistructured) about their experiences with the intervention for their child(ren); the study was grounded in phenomenology. Five main child-level benefits emerged, including improvements with (a) motor skills, (b) social skills, (c) listening skills, (d) turn-taking skills, and (e) transition skills. The child-level benefits then extended to family members in a number of ways (e.g., more positive sibling interactions). These findings highlight several important secondary effects that should be investigated in future research.

The Spanish Family Quality of Life Scales under and over 18 Years Old: Psychometric Properties and Families' Perceptions

BACKGROUND

Family quality of life (FQoL), just like individual quality of life, has become a priority outcome in the policies and services received by persons with intellectual and developmental disabilities (IDD) and their families. Conceptualizing, measuring, and theorizing FQoL has been the object of investigation in recent decades. The goal of this paper is to present a revision of the Spanish Family Quality of Life Scales, the CdVF-E < 18 and the CdVF-E >18, and describe the FQoL of Spanish families with a member with IDD.

METHODS

The sample included a total of 548 families with a member under 18 years old and 657 families with a member over 18. Based on an Exploratory Factor Analysis (EFA) firstly and a Confirmatory Factor Analysis (CFA) secondly, the two scales' psychometric properties were explored.

RESULTS

The CdVF-ER < 18 and the CdVF-ER > 18 comprise 5 dimensions, containing 35 and 32 items, respectively, and they show good validity and reliability. The families obtained a high FQoL score, although some differences exist between the dimensions on which families with children under and over 18 score highest and lowest.

CONCLUSION

The characteristics of the revised scales facilitate their use by professionals, administrations, and services.

State of the Art of Family Quality of Life in Early Care and Disability: A Systematic Review

Background: In recent years, there has been a growing international interest in family quality of life The objective of this systematic review is to understand and analyze the conceptualization of the quality of life of families with children with disabilities between 0 and 6 years of age, the instruments for their measurement and the most relevant research results. Method: A bibliographic search was conducted in the Web of Science, Scopus and Eric databases of studies published in English and Spanish from 2000 to July 2019 focused on "family quality of life" or "quality of family life" in the disability field. A total of 63 studies were selected from a total of 1119 and analyzed for their theoretical and applied contributions to the field of early care. Results: The functional conceptualization of family quality of life predominates in this area, and a nascent and enriching holistic conceptualization is appreciated. There are three instruments that measure family quality of life in early care, although none of them is based on unified theory of FQoL; none of them focus exclusively on the age range 0-6 nor do they cover all disabilities. Conclusions: The need to deepen the dynamic interaction of family relationships and to understand the ethical requirement that the methods used to approach family quality of life respect the holistic nature of the research is noted.

Experiences of Parents of Infants Diagnosed With Mild or Severe Grades of Congenital Muscular Torticollis

PURPOSE

The primary purpose of this study was to describe the experiences of parents of infants diagnosed with congenital muscular torticollis (CMT). A secondary purpose was to compare the experiences of parents of infants with mild grades versus severe grades of involvement based on the CMT severity classification system.

METHODS

Through semistructured interviews, a qualitative phenomenological approach of inquiry was used to investigate the lived experiences of 12 parents.

RESULTS

Eight themes common to both groups of parents were identified. Findings indicated having an infant with CMT has a significant effect on the parents and other caregivers. Two themes were unique to parents of the infants with severe CMT.

CONCLUSIONS

Parents are faced with a diagnosis that requires regular therapy visits and a challenging home program. A multimodal approach by clinicians for teaching and supporting parents during the episode of care may best address their unique challenges and stresses.

Family quality of life: perceptions of parents of children with developmental disabilities in Bosnia and Herzegovina

The goal of the present study was to assess the family quality of life (FQOL) in families with children with developmental disabilities in Bosnia and Herzegovina. We examined the FQOL in relation to parents' demographic variables (gender, age, employment status), children's gender and age, type of children's disability (mild and moderate intellectual disability, autism spectrum disorder) and parent's depression, anxiety, and stress levels. The sample consisted of 270 parents of children with disabilities; 90 parents of children with autism spectrum disorder, 90 parents of children with mild intellectual disability, and 90 parents of children with moderate intellectual disability. We also included a control group of 90 parents of typically developing children. The results of this study showed that parents of children with autism spectrum disorder and parents of children with moderate intellectual disability had statistically significantly lower FQOL than parents of children with mild intellectual disability and parents of typically developing children. Child's gender had a significant effect on FQOL. Also, depression, anxiety and stress levels significantly affected FQOL, while the parents' gender, age, and employment status did not have a significant effect. Implications of these findings are discussed and some measures on supporting parents are proposed.

Evaluating the cross-cultural validity of three family quality of life sub-scales

BACKGROUND

Families of children with disabilities often face unique challenges. Developed in a U.S. context, the Beach Center Family Quality of Life measure assesses the effectiveness of supports and services that families receive. This study examines whether items from three sub-scales of the Beach Center instrument perform similarly for two samples, one from Lusaka, Zambia, and the second from a Midwestern U.S. state.

METHODS

This cross-sectional research used secondary data and completed hierarchical ordinal regression analyses on item-level performance within the sub-scales.

RESULTS

Only one item flagged for potential item bias with remaining items performing similarly when controlling for overall sub-scale scores.

CONCLUSIONS

This study extends existing research on the cultural and linguistic appropriateness of the Beach Center measure, providing additional validity evidence about the internal structure of the scales. Findings indicate that these items are acceptable outcome measures for policy and programme evaluations in Zambia.

Family well-being is valued more than personal well-being: A four-country study

Well-being is recognized as a fundamental human goal and a universal human aspiration. However, some cross-country studies suggest that the desirability of the most often studied concept of well-being—personal life satisfaction—varies across countries, and we know little about the desirability of other types of well-being. Extending this novel area of research, we argue that focusing on the family (as compared to the individual) as the subject of well-being may be another important distinction in how well-being is conceptualized and valued. With data collected in four countries that tend to occupy different positions in rankings of personal life satisfaction (i.e., Canada, Colombia, Japan, and Poland), we document that, irrespective of cultural context, family well-being is valued over personal well-being. These findings suggest that policy makers and scientists may need to pay more attention to family well-being than they currently do.

A psychometric study of the Family Resilience Assessment Scale among families of children with autism spectrum disorder

Background

The family system represents a critical context within which children develop. Although raising a child with a disability may represent a challenge to this dynamic system, research demonstrates that families have the capacity to demonstrate both maladaptation and resilience in the face of related stressors. In the current study, we examined the psychometric properties of the Family Resilience Assessment Scale (FRAS) among families of children with autism spectrum disorder (ASD). This tool is the only measure of family resilience that seeks to identify within-family protective factors, including the extent to which they rely on adaptive belief systems, organizational patterns, and communication processes. Identifying protective processes utilized by those who show resilience is critical within both clinical practice and research, as it aligns with a strength-based perspective that builds on what families are doing well.

Methods

Participants included 174 caregivers of individuals with ASD (84% mothers). Caregivers completed the FRAS, as well as the Beach Center Family Quality of Life Scale. The 54-item FRAS was submitted to an exploratory factor analysis, using the iterated principal factor method with a promax rotation.

Results

Fifty-one items across 3 factors (Family Communication and Problem Solving, Utilizing Social and Economic Resources, Family Spirituality) were retained, explaining 52% of the total variance. The final scale demonstrated convergent validity with the Family Quality of Life assessment tool.

Conclusions

It is our hope that identifying the optimal scale structure will encourage other researchers to utilize this measure with families of children with ASD, thus continuing to advance the study of family resilience within this unique context.

Qualidade de Vida Familiar na Deficiência Intelectual: Revisão Sistemática de Estudos

Resumo A qualidade de vida familiar (QdVF) em famílias de pessoas com deficiência intelectual (DI) tem interessado investigadores, sugerindo potencialidades em termos de avaliação e intervenção. O presente artigo realizou uma revisão sistemática dos estudos empíricos que analisam a QdVF em famílias de pessoas com DI. Efetuou-se uma pesquisa bibliográfica num portal de bases de dados e recorreu-se a critérios de inclusão previamente definidos. Do total de 32 estudos selecionados, 15 recorreram ao instrumento FQOLS-2006, focando-se na análise das dimensões e domínios da mesma; 11 ao Beach Center FQOL Survey, relacionando o constructo com diversas variáveis; e seis a outras formas de avaliação, essencialmente qualitativas. Assim, a QdVF mostra-se pertinente para compreender e intervir com famílias de pessoas com DI.

Psychometric Properties of the Beach Center Family Quality of Life in French-Speaking Families With a Preschool-Aged Child Diagnosed With Autism Spectrum Disorder

The Beach Center Family Quality of Life Scale (Beach Center FQOL) is used to evaluate and develop family-centered intervention services. However, its use with families of children with autism spectrum disorder (ASD) and in non-English speaking populations requires further investigation. The present study sought to assess the psychometric properties of a French translation of this scale on 452 parents of children aged 5 and under who were recently diagnosed with ASD. The resulting Satisfaction and Importance scales presented excellent internal consistency at the scale level and acceptable internal consistency at the subscale level. Theoretical model positing 5 dimensions of FQOL generally fit the data acceptably. Satisfaction ratings were found to be sensitive to changes and were negatively correlated with parenting stress.

The Mandarin Chinese version of the Beach Centre Family Quality of Life Scale: development and psychometric properties in Taiwanese families of children with developmental delay

BACKGROUND

Early intervention (EI) practitioners provide individualised family-centred services to enhance the quality of life (QOL) of families of children with developmental delay (DD). Family QOL (FQOL) could be an important outcome indictor for EI, but there is no measurement tool for FQOL in Mandarin Chinese. The purpose of this study was to translate the Beach Centre FQOL Scale (BCFQOL) into Mandarin Chinese and to examine the psychometric properties of the scale in families of children with DD.

METHODS

Two independent translations were performed by two bilingual professors whose mother tongue was Mandarin, and two back-translations were performed by two bilingual professionals whose mother tongue was English. The translated and back-translated questionnaires were reviewed to revise the questionnaire. Five experts assessed the accuracy, equivalence and cultural appropriateness of the scale, and 10 parents of children with DD were interviewed to examine its readability, clarity and cultural appropriateness. From July to November 2014, we recruited 360 primary caregivers of children with DD who were receiving EI in northern Taiwan to validate the scale. The participants completed the BCFQOL as well as a one item overall ratings of their FQOL.

RESULTS

Item analysis was performed to assess each item. Confirmatory factor analysis supported the following five-factor structure as in the original scale: family interaction, parenting, emotional well-being, physical/material well-being and disability-related support. The scale exhibited excellent internal consistency reliability (Cronbach's alpha = 0.96) and test-retest reliability at a 2-week interval (intra-class correlation coefficient = 0.92). Contrasted group validity was supported by significantly higher BCFQOL scores in the top quartile of the overall FQOL rating than the lowest quartile. The convergent validity was supported by the significant correlation between the FQOL item and the BCFQOL (r = 0.608, p < 0.01).

CONCLUSIONS

This study showed that the Mandarin Chinese version of the BCFQOL is reliable and valid for Taiwanese families of children with DD. The instrument could be applied to assess FQOL in families of children with DD who are receiving EI in order to evaluate family services and supports.

Confirmatory Factor Analysis of a Family Quality of Life Scale for Taiwanese Families of Children With Intellectual Disability/Developmental Delay

The Beach Center Family Quality of Life Scale is an internationally validated instrument for measuring family outcomes. To revise the scale for better alignment with the Family Quality of Life theory, the authors excluded non-outcome items in this revision. In this study, we examined reliability and validity of the revised scale (i.e., the FQoL Scale-21) and its scores for Taiwanese families of children and youth with intellectual disability and developmental delay (age 0-18). Results from 400 Taiwanese respondents suggested that the FQoL Scale-21 has the potential to be used as an indicator of positive outcomes in intervention evaluation, policy making, and service delivery.

South African families raising children with autism spectrum disorders: relationship between family routines, cognitive appraisal and family quality of life

BACKGROUND

The purpose of this study was to investigate the relationship between family routines, cognitive appraisal of the impact of autism spectrum disorders (ASD) on the family and family quality of life (FQOL) in families raising children with ASD in South Africa.

METHODS

A sample of 180 families of young children with ASD who were receiving disability-related services in the Gauteng province of South Africa completed a self-administered survey. Structural equation modelling was used to examine the direct relationship between the regularity of family routines and FQOL, and the mediating effect of cognitive appraisal on this relationship.

RESULTS

The results suggested a direct, positive relationship between the regularity of family routines and families' satisfaction with their FQOL. Furthermore, cognitive appraisal of the impact of ASD on the family mediated this relationship in a partial manner.

CONCLUSION

A higher frequency of regular family routines was strongly associated with a higher satisfaction level of FQOL. Also, cognitive appraisal of the impact of ASD acted as a mechanism through which the regularity of family routines influenced FQOL. We discuss the research and clinical implications of these findings.

Development and psychometric evaluation of a psychosocial quality-of-life questionnaire for individuals with autism and related developmental disorders

This study investigated the psychometric properties of the Child and Family Quality of Life scale, a measure of psychosocial quality of life in those with autism and related developmental disorders. Parents of 212 children suspected of autism spectrum disorder completed the Child and Family Quality of Life prior to a diagnostic evaluation. Results indicated that the Child and Family Quality of Life measured six unique quality-of-life constructs (child, family/caregiver, financial, external support, partner relationship, and coping), had good reliability across score ranges and exhibited expected patterns of convergent validity. Caregivers of autism spectrum disorder-affected children reported reduced family quality of life prior to the time of diagnosis relative to caregivers of children with other developmental disabilities. The Child and Family Quality of Life is a brief, reliable measure for assessing psychosocial quality of life in families affected by developmental disability. This study is the first to demonstrate impairments in family quality of life early in the developmental course of autism spectrum disorder, prior to formal diagnosis. In addition to traditional child-focused intervention strategies, families with autism spectrum disorder-affected children require early, broad intervention strategies that positively impact the whole family.

Family Quality of Life During the Transition to Adulthood for Individuals With Intellectual Disability and/or Autism Spectrum Disorders

Recognizing the prominent role of parents in supporting their children with intellectual and developmental disabilities (IDD), improving quality of life for these families is an essential endeavor. While much attention has focused on the experiences of families with younger children with IDD, little is known about the family quality of life (FQOL) among families with transition-age youth and young adults. We examined the FQOL ratings of 425 parents with a child between 13-21 years of age with intellectual disability or autism to understand FQOL and the factors that may shape it. Overall satisfaction with FQOL was somewhat high for this sample, with some variability across domains. Higher FQOL ratings were predicted by lower frequency of challenging behaviors, lower support needs, and higher strength of parental religious faith. We present recommendations for research and practice focused on promoting quality of life during the transition period.

Families supporting a child with intellectual or developmental disabilities: the current state of knowledge

This IASSIDD Position Paper provides a concise authoritative summary of (i) existing scientific knowledge regarding the situation, challenges and wellbeing of families that include a child with intellectual and/or developmental disabilities, and (ii) priorities for future research. IASSIDD (www.iassidd.org) is the leading global organisation for researchers and research centres that seek to improve the understanding of and improve the lives of people with intellectual or developmental disabilities, their families and those who support them. The paper and the recommendations it contains have been developed through an iterative process led by IASSIDD’s Families Special Interest Research Group (SIRG). During this process, all members of the Families SIRG and all members of IASSIDD’s ruling council have had the opportunity to comment on drafts of this paper. The final Position Paper was adopted by the Council of IASSIDD on 9 July 2012.

Spanish family quality of life scales: under and over 18 years old

BACKGROUND

Researchers, professionals, and families have shown increasing concern with the family quality of life (FQoL) of people with intellectual disability (ID) and their families. The goals of this research were (a) to explore how Spanish families understand FQoL by developing 2 different measurement tools for families with a member with ID under and over 18 years old, and (b) to provide 2 diagnostic instruments that will be useful for designing action plans.

METHOD

The study comprised 4 stages: (a) focus groups, (b) expert assessment, (c) pilot study, and (d) normalisation and standardisation. The data were collected in 5 regions in Spain, and 1,205 families with a member with ID took part in the normalisation and standardisation of the scales.

RESULTS

Both FQoL scales were consistent and have valid psychometric characteristics.

CONCLUSIONS

The scales have a diagnostic purpose for use in designing action plans aimed at producing significant changes in families' lives.

Living Quality

The purpose of this article is to set forth the humanbecoming paradigm and the phenomenon living quality, which better expresses the notion of quality of life from this paradigmatic perspective. The three inherent core knowings of living quality are described and explained in light of the community change concepts. Living quality with sciencing and living the art of humanbecoming are also discussed.