Beruflich Dokumente
Kultur Dokumente
Introduction
instruments that were appropriate for each of the cultural contexts and in such a way as to identify the needs
of families with persons with disabilities and using that
information to orient the programs, policies and services
of each country.
In this way, the current investigation aimed to answer
the following research question:
Is the FNA survey an instrument that has sufficient
psychometric properties to be considered a tool with
acceptable trustworthiness and validity for the Colombian
context?
Methods
Participants
The sample consisted of 573 participants who were residents of the
most representative cities in Colombia. All the participants were primary caregivers of children with disabilities and lived in the same
house with the children. The majority of the participants were family
members of the children, and only some participants were unrelated.
However, they were considered as the childrens primary caregivers
by the family. The children ranged in age from 1 to 17years (M=9.48
years; SD=4.60 years). All the children were diagnosed with an
intellectual disability issued by the National Council of Disability in
Colombia based on an intelligence quotient (IQ) test. Furthermore,
the participants were organized into three groups to analyze their
monthly economic income: (1) monthly income less than the minimum salary in Colombia (616,027 COP=208 US$ approximately), (2)
monthly income between 1 and 4 minimum salaries and (3) monthly
income of more than 4 minimum salaries. Table 1 shows detailed
information on the demographic variables of the participants.
Instruments
The FNA questionnaire was used. This questionnaire was designed
by a multinational team of researchers and was previously validated
with Taiwanese families [16]. It is a questionnaire oriented towards
identifying the needs of families with persons with intellectual and
development disabilities in 11 areas of family functioning: (1) family relations, (2) emotional health, (3) health, (4) family finances,
(5) social relations, (6) free time, (7) spirituality, (8) daily care, (9)
teaching, (10) access to services and (11) changes over the course of
ones life. The answer options are on a Likert-type scale and range
from 1 to 5, in which 1 corresponds to no need and 5 to very high
need.
To perform the concurrent validation, the version of the FQOL
scale validated for Colombia [Escala de Calidad de Vida Familiar
(ECVF)] was used [18]. It is a Likert-type scale with an answer range
between 1 and 5, in which 1 corresponds to low satisfaction and 5 to
very satisfied with the quality of family life. It consists of 41 items
grouped into 5 factors: (1) family interaction, (2) parental role, (3)
health and security, (4) family resources and (5) support for persons
with disabilities.
Mother
Siblings
Grandparents
Full-time work
Part-time work
Unemployed
Monthly income
Less than 616,027 (COP)
Girl
Childs age
Level of disability
Light
Moderate
Severe
Profound
Other diagnosis
Autism spectrum disorder
Physical disability
Visual disability
Auditory disability
Percentage
91
377
34
34
20
17
123
142
84
224
15.9
65.8
5.9
5.9
3.5
3
21.5
24.8
14.7
39.1
153
296
124
26.7
51.7
21.6
313
260
189
384
54.6
45.4
195
173
62
15
128
34
30
10.8
2.6
22.3
105
85
21
8
39
22
293
18.3
14.8
3.7
1.4
6.8
3.8
51.1
33
67
Statistical analysis
The participants answers were collected using the Qualtrics software
and were subsequently exported to the SPSS program. At first, data
corresponding to 590 families were collected; however, the data of 17
of these families were not included because the answers were 15%
incomplete (the participants did not reply to more than 11 items of
the FNA). Thus, the data analysis was performed using the data of
573 participants.
The analysis of the psychometric properties of the FNA questionnaire began with the confirmation of whether the empirical structure
of the scale corresponds with the theory in the Colombian context;
for this, confirmatory factorial analysis (CFA) was used, using structural equations modeling (SEM).
Prior to the EFA, the Kaiser-Mayer-Olkin (KMO) index, Bartletts
test of sphericity and the determinant were estimated. The first two
analyses aimed to create doubt around the feasibility of performing
the factorial analysis, and the third analysis allowed for the verification of the absence of multicollinearity among the different factors of
the scale [23]. In the total sample, the extraction of the factorial model
was founded on two basic principles: parsimony, which means that
the factorial solution must be simple and composed of the smallest
possible number of factors or components; the other principle consists of the necessity for the extracted factors to be statistically significant and susceptible to substantive interpretation [24].
Given that the confirmatory analysis did not provide evidence
of a good adjustment of the theoretical model of the 11 initially proposed factors, an EFA was subsequently performed to elucidate the
proper structure in the Colombian context.
The analysis of the reliability of the questionnaire was performed using the coefficient of Cronbachs alpha for the subscales,
and a high internal consistency was considered for values >0.8 [25].
Finally, the concurrent validity was estimated using an analysis of
covariance between the FNA and the ECVF. Theoretically, heightened
family needs relate to low satisfaction with the quality of family life.
Procedure
The participants were contacted through different institutions
that worked with children with intellectual disabilities. They were
informed of the objectives of the study and of the anonymous and
confidential use of the information according to the ethical norms
and criteria for research involving persons in Colombia. Subsequently, the principal caregivers of the children signed the informed
consent forms, and their questions about the study were answered.
During the FNA validation process [19], the linguistic adaptation of the items was first made in accordance with the Colombian
context. For this purpose, the instrument was submitted to the evaluation of 10 expert judges (linguists, experts in issues of disability and
family members of persons with disability) regarding quality and
relevance [20]. Subsequently, cognitive interviews were performed
with five primary caregivers of children with disabilities with the aim
of obtaining qualitative information to identify whether the items
evaluated what they intended to evaluate [9, 21].
Results
CFA of the original structure of the FNA
The goodness-of-fit statistics of the SEM for the original
structure of the FNA, which consists of 11 factors, showed
a low adjustment of the model to the data: the correlations matrix of the latent variables (factors) was singular;
thus, it was necessary to identify a new model adjusted to
the Colombian context. The comparative fit index (CFI) of
0.684 was not greater than the reference value of 0.95, and
the nono-normed fit index (NNFI) of 0.668 was also not
greater than the reference value of 0.90.
Brought to you by | University of Hong Kong Libraries
Authenticated
Download Date | 10/29/16 8:55 AM
Loading
0.530
0.607
0.634
0.657
0.634
0.551
0.667
0.548
0.700
0.644
0.692
0.638
0.661
0.648
0.618
0.695
0.741
0.527
0.720
0.646
0.759
0.537
0.658
0.674
0.655
0.593
0.511
0.690
Loading
0.621
0.734
0.745
0.646
0.630
0.630
0.611
0.692
0.729
0.640
0.599
0.732
0.684
0.775
0.666
0.668
0.667
0.694
0.722
0.680
0.625
0.723
0.722
0.698
0.300
0.600
0.498
0.708
0.390
0.496
0.317
0.513
0.641
0.551
0.610
0.525
0.595
0.426
0.680
0.736
0.469
0.698
0.792
0.583
Items removed due to low loadings on factors: 17. Helping my child(ren) reach goals during every day routines; 34. Having appropriate
care for hearing-related needs; 35. Getting regular and special resources (such as technology equipment and materials, adapted switches,
special foods) needed by family members; 53. Getting a full nights sleep; and 68. Ensuring that home and community settings are
accessible.
Number of items
26
27
13
6
Discussion
The objective of this article was to perform the validation
of the FNA scale by evaluating its psychometric properties, with the aim of determining whether it is possible
to establish it as a reliable and valid tool for Colombian
families with children with intellectual disabilities. The
FNA evaluates the needs of these families, which allows
for their identification and for generating adequate strategies to provide for them.
Cronbachs alpha
3.59 (0.77)
3.79 (0.76)
3.90 (0.69)
3.32 (1.12)
0.95
0.95
0.85
0.86
M (SD)
Rank order
3
2
1
4
Limitations
One of the limitations of this study was that all the participants were principal caregivers for the child with disabilities. Although the principal caregiver best knows the
needs of the child with disabilities, to rely only on this
persons perceptions creates methodological challenges
when establishing a representation of the needs of all
members of the family.
Similarly, in a later study, a confirmatory analysis of
the data must be performed to provide evidence on the
validity of the construct of the FNA. Additionally, future
References
1. Turnbull H, Beegle G, Stowe M. The core concepts of disability
policy affecting families who have children with disabilities.
Disabil Policy Stud 2001;12:13343.
2. Lightfoot E, La Liberte T. Parental supports for parents with
intellectual and developmental disabilities. Intellec Dev Disabil
2011;49:38891.
3. Wade C, Llewellyn G, Matthews J. Modeling contextual influences on parents with intellectual disability and their children.
Am J Intellect Dev Disabil 2011;116:41937.
4. Almasri N, Palisano R, Dunst C, Chiarello L, ONeil M, Polansky
M. Profiles of family needs of children and youth with cerebral
palsy. Child Care Health Dev 2012;38:798806.
5. Mercado E, Aizpura E, Garca L. Caractersticas, percepciones
y necesidades sociales de los nios y nias con discapacidad y
sus familias. Portularia 2012;8:6980.
6. Naciones Unidas. Convencin Internacional sobre los Derechos
de las Personas con Discapacidad y Protocolo Facultativo. 2006.
7. Ley Estatutaria 1618. Ley 1618/2013 de 27 de febrero. Diario
Oficial No. 48.717 (27-02-2013).
8. Creswell J. Research design: qualitative, quantitative, and mixed
methods approaches, 3rd ed. Thousand Oaks, CA: Sage Publications, 2009.
9. Dillman D, Smyth J, Christian L. Internet, mail and mixed-mode
surveys: the tailored design method, 3rd ed. Hoboken, NJ:
J.Wiley & Sons, Inc., 2009.
10. Michalk J. The quality of life of caregivers who care a child with
rare disease perception of changes as a result of care in the
Czech Republic. Procedia Soc Behav Sci 2014;112:114959.
11. Hoffman L, Marquis J, Poston D, Summers JA, Turnbull A.
Assesing family outcomes: Psychometric evaluation of the
Beach Center Family Quality of Life Scale. J Marriage Fam
2006;68:106983.
12. Summers J, Hoffman L, Marquis J, Turnbull A, Poston D, NelsonL.
Measuring the quality of family-professional partnership in
special education services. Except Children 2005;72:6581.
13. McCabe H. The importance of parent-to-parent support among
families of children with autism in the Peoples Republic of
China. Int J Disabil Dev Ed 2008;55:30314.
14. Ahmadi A, Sharifi E, Azizi H, Bolouk S, Amrai K. The needs
of Iranians families of children with autism spectrum
disorder, cross-cultural study. Procedia Soc Behav Sci
2011;15:3216.
15. Burton-Smith R, McVilly K, Yazbeck M, Parmenter T, Tsutsui T.
Service and support needs of Australian carers supporting a
family member with disability at home. J Intellect Dev Disabil
2009;34:23947.