The Development and Psychometric Testing of an Inventory to Measure Health-Focused Perceived Family Support and Communication Behaviors with Chronic Disease Patients: A Three-Phase Study

Abstract

Hospitals and policymakers acknowledge the importance of the family in improved healthcare outcomes. Although there has been an increase in policies and research to bring families into planning, delivery, and evaluation of healthcare, there has not been a means to assess health-focused perceived support and communication behaviors. Without a means of assessing these factors, healthcare professionals cannot succinctly evaluate support and communication in a family system or provide recommendations for engaging family members in providing beneficial health-focused support and communication. This study involved the creation of the Inventory for Family Health-Focused Perceived Support and Communication Behaviors (Family HF-PSCB). Informed by family systems theory, social support literature, and health communication behaviors research, this three-phase study consisted of (a) generating items for the Family HF-PSCB, (b) establishing test-retest reliability, and (c) establishing a factor structure and convergent validity. Because of the increase of chronic disease in the United States, the Family HF-PSCB was created and tested with samples of individuals having chronic disease(s). Using a mixed methods approach, in-depth interviews with 12 participants generated 91 items for psychometric analysis. These items were tested through expert content review, and in pilot testing (n = 23), the remaining 84 items demonstrated test- retest and internal reliability. Through factor analysis (n = 209), two factors emerged to explain 72.1% of the variance. The final Family HF-PSCB contains 13 items, which indicates an individual’s perception of family health-focused support and communication behaviors. The factor explaining 63.2% of the variance has 8 items demonstrating healthfocused communication behaviors, and the second factor has 5 items demonstrating health-focused instrumental support. The developed scale suggests that family healthfocused communication behaviors may be a more explanatory variable in the family system for someone with chronic disease(s). The 13-item Family HF-PSCB demonstrates convergent validity through significant correlations with the Perceived Social Support Family Scale and the General Functioning Scale of the McMaster Family Assessment Device. Future studies should explore the correlation of the Family HF-PSCB with health outcomes attributed to symptom management in populations of chronic disease patients.