Brief version of the coping health inventory for parents (CHIP) among family caregivers of children with chronic diseases.

BACKGROUND: The Coping Health Inventory for Parents (CHIP) has demonstrated good psychometric properties in several language forms and has been used to assess the coping behaviors of families facing disease. However, the CHIP has not been validated in Mexico among families of children with chronic conditions, where it could be useful for research and intervention. The objectives of this instrumental study were to obtain a version of the CHIP for the Spanish language in Mexico, establish the factor structure of the Mexican version of the CHIP, probe its internal consistency reliability, and assess its concurrent construct validity. METHODS: A nonprobability sample of 405 family caregivers of children with chronic diseases responded to a battery of measurement instruments that included the CHIP, the Beck Anxiety Inventory, and the Beck Depression Inventory. The sample was randomly divided into two parts. In one subsample (190 participants), an exploratory factor analysis was performed using a principal component analysis and oblique rotation. In the second subsample (215 participants), a confirmatory factor analysis was performed using maximum likelihood estimation. RESULTS: The scale was reduced to 16 items (CHIP-16) with factorial loads greater than .50. The empirical criteria used to determine the number of factors converged on the following five factors: belief and trust (McDonald ω = .85), spouse/partner relationship (ω = .79), home care (ω = .77), family involvement (ω = .75), and security/stability (ω = .79). The overall internal consistency was good (ω = .88). The five-factor model showed acceptable fit indices and high parsimony. The mean CHIP-16 scores and the Spouse/partner relationship scores among the caregivers with anxiety were greater than those among the caregivers without anxiety. The mean home-care scores among the women were greater than those among men. CONCLUSIONS: The 16-item version of the CHIP showed good internal consistency and construct validity; thus, the CHIP-16 is a useful instrument for measuring and assessing coping in family caregivers of children with chronic diseases.

Psychometric study of the Portuguese version of the Family Distress Index (FDI).

INTRODUCTION: The current study examined the psychometric properties of the Portuguese version of the Family Distress Index (FDI). The FDI is an 8-item self-report measure that assesses family maladaptation, providing an index of family outcomes within the resiliency model of family stress, adjustment, and adaptation. METHOD: Participants were 459 adults, who completed measures of family distress (FDI) and family functioning (Systemic Clinical Outcome Routine Evaluation; SCORE-15). RESULTS: Exploratory and confirmatory factor analyses supported a unidimensional factorial structure. Results also indicated that the FDI has good internal consistency and temporal stability. The positive and significant correlation between FDI and SCORE-15' scores demonstrated its convergent validity. Through receiver operating characteristic (ROC) analysis, we determined a cut-off score of 12 for identifying probable family distress. DISCUSSION: In sum, the Portuguese version of the FDI is a valid and reliable instrument, which can foster the development of future empirical studies focused on family adaptation in diverse contexts of adversity, namely in health care settings. (PsycINFO Database Record

Validity and reliability of the Mexican resilience measurement scale in families of children with chronic conditions.

BACKGROUND: The resilience to face disease is a process of positive adaptation despite the loss of health. It involves developing vitality and skills to overcome the negative effects of adversity, risks, and vulnerability caused by disease. In Mexico, the Mexican Resilience Measurement Scale (RESI-M) has been validated with a general population and has a five-factor structure. However, this scale does not allow evaluation of resilience in specific subpopulations, such as caregivers. METHOD: This study investigated the psychometric properties of RESI-M in 446 family caregivers of children with chronic diseases. A confirmatory factor analysis (CFA) was performed, internal consistency values were calculated using Cronbach's alpha coefficient, and mean comparisons were determined using t-tests. RESULTS: The expected five-factor model showed an adequate fit with the data based on a maximum likelihood test. The internal consistency for each factor ranged from .76 to .93, and the global internal consistency was .95. No average difference in RESI-M and its factors was found between women and men. CONCLUSION: The RESI-M showed internal consistency and its model of five correlated factors was valid among family caregivers of children with chronic diseases.

Discrimination and obesity among Native Hawaiians.

Among ethnic populations in Hawai'i, Native Hawaiians continue to be over-represented with the highest rates in: morbidity and mortality, chronic health conditions, and the health risks of being overweight and obese. Focused on these two health risks, the investigation reported in this article has a specific aim of empirically determining whether social stigma as manifested in the form of perceived overt or covert discrimination is a contributing factor. Current studies focused on select ethnic populations, particularly African Americans point to discrimination as an important but understudied predictor of adverse health outcomes. Acknowledging the paucity of research on discrimination and its role in the health of Native Hawaiians, this investigation utilizes data from the 2007 Hawaiian Health Survey which was coordinated by the Department of Health, and the Office of Health Status Monitoring and implemented by SMS Hawai'i. The weighted sample of Hawai'i adults included measures of race/ethnicity and of everyday discrimination and the BMI (Body Mass Index). Logistic regression analyses were applied to determine if: (a) discrimination was significantly related to being overweight and/or obesity; and (b) whether this relationship remained a salient predictor after key demographic factors of gender, age, education, income, and length of time in the Islands were taken into account. This study confirmed the negative influence of overt discrimination as well as the protective nature of covert discrimination in explaining the variability in obesity/overweight in Native Hawaiians. The implications of this study for strategic interventions and research are discussed.

Native Hawaiians and psychology: the cultural and historical context of indigenous ways of knowing.

This article reviews psychological research on Native Hawaiians conducted in the 19th through the 21st centuries. The rationale is to provide a historical orientation to this indigenous group, to increase awareness of the complexities of research about Native Hawaiians, and to draw attention to emerging issues, practices, and challenges of psychological research emphasizing indigenous health and well-being. This article lays a historical foundation for future research with a renewed emphasis on indigenous knowledge and its holistic view of psychology in relationship to the land, spiritual beliefs, cultural practices, language, and community.

Predictors of adult quality of life for foster care alumni with physical and/or psychiatric disabilities.

INTRODUCTION: This study used quality of life and resilience as theoretical frameworks for evaluating predictors of outcomes for adults who received foster care services alumni of foster care and were diagnosed with a physical or psychiatric disability while in foster care. METHOD: First, outcomes for foster care alumni with and without physical and psychiatric disabilities (N=1,087) were compared according to quality of life variables. Second, using only participants with disabilities (N=578), stepwise regression analyses were performed to determine whether risk and protective factors were associated with specific outcomes. RESULTS: Alumni with disabilities had significantly lower economic (p=.020) and health (p=.001) outcomes; and reported lower educational attainment (p=.002), more difficulty paying monthly bills (p=.026), more psychiatric diagnoses (p=.006), lower self-esteem (p=.013), and worse physical health (p=.001) than those without disabilities. For alumni with disabilities, receiving special education services and experiencing sexual abuse while in foster care were significant risk factors for poor self-esteem; conversely, receiving services and resources that prepared foster care alumni for leaving foster care (e.g., protective factors) predicted better outcomes. CONCLUSIONS: By expanding the quality of life outcomes analyses to investigate the impact of risk and protective factors on outcomes of foster care alumni with disabilities, this study fills a gap in the literature by assessing outcome differences within the foster-care population. The study found protective factors were associated with more educational attainment and higher self-esteem in adulthood. Conversely, those who received special education services and experienced sexual abuse while in foster care may be at the greatest risk of poor self-esteem and therefore, could benefit from services that enhance self-esteem.

The role of Indigenous family ethnic schema on well-being among Native Hawaiian families.

Despite assertions of the importance of family in Indigenous cultures and its impact on psychological and physical health, there remains a paucity of research and a lack of measurement on Indigenous families' worldviews and their respective impact on well-being. The purpose of this investigation was to determine the relationship between Indigenous family ethnic schema and individual well-being. The sample consisted of 81 older adults (average age was 60.94 years old) with 77 Native Hawaiian and part-Native Hawaiian participants, and two Caucasian and two Asian participants with a Hawaiian partner or spouse. Family ethnic schema focusing on Indigenous values, beliefs, expectations and priorities was found to explain higher levels of individual well-being independent of age, income and gender. Clinical implications of family ethnic schema in terms of help-seeking behavior, treatment and adherence to treatment are discussed.

Resilience, family adversity and well-being among Hawaiian and non-Hawaiian adolescents.

BACKGROUND: Minorities and indigenous peoples are likely to have poor mental health and physical outcomes. This study examines resiliency indicators in Hawaiian adolescents. AIMS: Multiple resiliency indicators were examined across different domains including individual, family and community in relation to increased psychological well-being. METHODS: Existing data from the Native Hawaiian Mental Health Research Development Program (NHMHRDP) were used. These data included information from a community sample of five high schools on three islands from the state of Hawai'i. The sample included 1,832 students, where 64% were Native Hawaiian and 36% were non-Hawaiian. RESULTS: This study found that Native Hawaiian youth experienced more family adversity compared with non-Hawaiians, but Native Hawaiians were also more likely to have higher levels of family support. For internalizing symptomatology, the most robust resiliency factors were family support and physical fitness/ health for Native Hawaiian and non-Hawaiian adolescents. For externalizing symptomatology, achievement and family support were consistently strong resiliency factors. The indicator for physical fitness and health was more influential among Native Hawaiians than non-Hawaiians for externalizing symptoms, while academic achievement was more influential among non-Hawaiians than for Native Hawaiians for the protection against internalizing symptoms. CONCLUSIONS: Our findings support the need for intervention programs designed to promote resilience in adolescents, including highlighting the importance of the family. Further research is needed to design and evaluate programs that promote well-being, enhance resilience and improve mental health in culturally appropriate ways.