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Cultural adaptation and psychometric properties of the family questionnaire in a Brazilian sample of relatives of schizophrenia outpatients

Authors

  • Ana CG Zanetti PhD, RN,

    Professor, Corresponding author
    • University of São Paulo at Ribeirão Preto College of Nursing, World Health Organization (WHO), Collaborating Centre for Nursing Research Development, Ribeirão Preto, Brazil
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  • Georg Wiedemann MD,

    Senior Lecturer
    1. Department of Psychiatry and Psychotherapy, University of Tubingen, Tubingen, Germany
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  • Rosana AS Dantas PhD, RN,

    Professor
    1. University of São Paulo at Ribeirão Preto College of Nursing, World Health Organization (WHO), Collaborating Centre for Nursing Research Development, Ribeirão Preto, Brazil
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  • Miyeko Hayashida PhD, RN,

    Nurse
    1. University of São Paulo at Ribeirão Preto College of Nursing, World Health Organization (WHO), Collaborating Centre for Nursing Research Development, Ribeirão Preto, Brazil
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  • João M de Azevedo-Marques PhD,

    Psychiatrist Doctor
    1. Faculty of Medicine of Ribeirão Preto, University Hospital, University of São Paulo, Ribeirão Preto, Brazil
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  • Sueli AF Galera PhD, RN

    Professor
    1. University of São Paulo at Ribeirão Preto College of Nursing, World Health Organization (WHO), Collaborating Centre for Nursing Research Development, Ribeirão Preto, Brazil
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Correspondence: Ana CG Zanetti, Professor, University of São Paulo at Ribeirão Preto College of Nursing, World Health Organization (WHO), Collaborating Centre for Nursing Research Development, Avenida Bandeirantes 3900, sala 94, Ribeirão Preto, Brazil. Telephone: +55 16 3602 3425.

E-mail: carolzanettieerp@gmail.com

Abstract

Aims and objectives

To evaluate the internal reliability and validity of the Brazilian Portuguese version of the Family Questionnaire among families of schizophrenia outpatients.

Background

The main studies about the family environment of schizophrenia patients are related to the concept of Expressed Emotion. There is currently no instrument to evaluate this concept in Brazil that is easily applicable and comparable with studies from other countries.

Design

Methodological and cross-sectional research design.

Method

A convenience sample of 130 relatives of schizophrenia outpatients was selected. The translation and cultural adaptation of the instrument involved experts in mental health and experts in the German language and included back translation, semantic evaluation of items and pretesting of the instrument with 30 relatives of schizophrenia outpatients. The psychometric properties of the instrument were studied with another 100 relatives, which fulfilled the requirements for the Brazilian Portuguese version of the instrument. The psychometric properties of the instrument were assessed by construct validity (using an analysis of its key components, comparisons between distinct groups–convergent validity with the Antonovsky's Sense of Coherence Scale) and reliability (checking the internal consistency of its items and its test–retest reproducibility).

Results

The analysis of main components confirmed dimensionality patterns that were comparable between the original and adapted versions. In two domains of the instrument, critical comments and emotional over-involvement had moderate and significant correlations, respectively, with Antonovsky's Sense of Coherence Scale, appropriate values of Cronbach's alpha and strong and significant correlations, respectively, in test–retest reproducibility. We observed significant differences between distinct groups of parents in the category of emotional over-involvement.

Conclusion

We conclude that the Portuguese-adapted version of the Family Questionnaire is valid and reliable for the study sample.

Relevance to clinical practice

This study provided evidence that the Family Questionnaire is a reliable and valid instrument for assessing expressed emotion. It is easy and practical to use and is acceptable for use in a Brazilian cultural population.

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