| Object:Develop the Family Resilience Scale(FRS)for the disabled elderly at home and use the scale to evaluate the current situation of family resilience of the disabled elderly at home in minority areas of Xinjiang and analyze the influencing factors.To make a thorough inquiry about the approach that the effect of fundamental factors on family resilience,in the hope of providing a scientific foundation for carrying out a research on the family resilience of the localized disabled elderly at home in the future.Methods:(1)Literature research:To understand the current research status of family resilience of the disabled elderly,and initially construct the first-level and second-level indexes of family resilience;(2)Semi-structured interview:Dig out the true connotation of family resilience of the disabled elderly at home,further supplement and verify the second-level indexs of family resilience constructed through literature research;(3)Systematic review:Systematically search for the measurement tools related to the family resilience of the elderly disabled at home,and some items that meet reliability and validity test were selected as the source of three-level indicators for compiling the family resilience;(4)Delphi expert letter inquiry method:Invite experts to evaluate the preliminarily formed indicators at all levels to form a pre-test scale for family resilience;(5)Site investigation:A survey was conducted among 390 families of the elderly with disabled at home,checking the reliability and validity of the Family Resilience Scale of the disabled elderly at home;Empirical analysis method:A survey was conducted among 431 families of the disabled elderly at home,analyzing the current situation and influencing factors of the family resilience of the disabled elderly at home in Xinjiang minority areas,and explore the mechanism of the influencing factors.Results:1.Development of the Family Resilience Scale for the disabled elderly at home(1)The construction of all levels of indicators of the family resilience scale for the disabled elderly at home:① The literature research constructs 4 first-level indicators and 11 second-level indicators;②Basis on literature research,the semi-structured interview verified 4 first-level indicators and 10 second-level indicators obtained from the literature research;③ 55 third-level indicators were constructed by systematic evaluation;④ Based on literature research and semi-structured interviews,through the project group’s discussion,the original evaluation index system of family resilience of the disabled elderly at home included 4 first-level indicators,10 second-level indicators and 43 third-level indicators;⑤ Through the Delphi method,the effective recovery rates of the two rounds of correspondence questionnaires were 92.0%and 95.0%,respectively.The expert authority coefficients were 0.861 and 0.867,and the Kendall’s coefficients of concordance were 0.212～0.476.Four items of second-level indicators were revised,four items of third-level indicators were deleted,13 items were revised,and 7 items were increased.Finally,a family resilience pre-test scale for the disabled elderly at home was constructed,including 4 first-level indicators(family cognition and concept,family management and organization,family resources and utilization,family communication and problem solving),10 second-level indicators(family cognition,family concept,family management,organizational activities,family endowment,social support,problem solving)and 46 third-level indicators. (2)The reliability and validity of the Family Resilience Scale for the disabled elderly at home:Item analysis ① The CR value of each item of the scale was>3.0,the difference is statistically significant(P<0.001);② Except for item 35,the Pearson correlations between each item and the total score of the scale were all>0.3.Validity analysis ① Content validity:The content validity of each item(I-CVI)of the scale was 0.80-1.00,and the total content validity of the scale(S-CVI)was 0.93;② Structural validity: For exploratory Factor analysis,KMO=0.934,Bartlett’s test of sphericity value was 6585.707,P<0.001,suitable for factor analysis.Factor analysis extracted 7 factors with eigenvalues>1,and the cumulative variance contribution rate was 73.179%.For confirmatory factor analysis,the first-order model fitting index χ 2/df=2.733,RMR=0.049,RMSEA=0.068,IFI=0.902,CFI=0.901,PGFI=0.690,PNFI=0.766;the second-order model fitting index was revised χ2/df=2.475<3.00,RMR=0.049,RMSEA=0.062,IFI=0.916,CFI=0.915,PGFI=0.714,PNFI=0.784,all within the acceptable range,the model fits well;③Convergent validity and discriminant validity:The combined reliability of each dimension of the scale was 0.778～0.922,and the average variance extraction was 0.497～0.693.Reliability analysis①Internal consistency reliability:The Cronbach’s α coefficient of the total scale was 0.951,and the Cronbach’s α coefficient of each dimension was 0.775～0.920;② The split-half reliability:The Spearman-Brown coefficient of the scale was 0.846,and the Spearman-Brown coefficients of each dimension were 0.734～0.912:③Test-retest reliability:The test-retest reliability of the total scale was 0.950,and the test-retest reliability of each dimension were 0.773～0.906. 2.The current situation and influencing factors of the family resilience of the disabled elderly in Xinjiang minority areas (1)Among the disabled elderly,223(51.70%)had higher family resilience and 208(48.30%)had lower family resilience;(2)The degree of disability of the elderly,family burden of diseases,family type,family function,monthly family income and whether the elderly receive social welfare or not,the six variables were the influencing factors of the family resilience of the disabled elderly at home,there was a moderately strong correlation between the independent variable and the dependent variable(Cox-Snell R2=0.524,Nagelkerke R2=0.699);(3)The family burden of disease,family function,and family resilience of the disabled elderly were correlated;(4)The mediating effect of the family function of the disabled elderly at home between the family burden of disease and family resilience accounted for 57.71%of the total effect,indicating that the burden of disease family of the disabled elderly mainly affects their family resilience through family function;(5)The standardized regression coefficient β=-0.100(P<0.05)of the interaction term between the family burden of disease and family function of the disabled elderly at home,the regression equation with family resilience as the dependent variable,after introducing the interaction effect,ΔR2=0.009(P<0.05),indicating that family function plays a certain role in regulating the family burden of disease and family resilience.Conclusions:1.Based on the theoretical framework of family resilience constructed in this study,a Family Resilience Scale for the disabled elderly at home developed in our study based on the theoretical and empirical research and had been witnessed better reliability and validity for inquiries. 2.The degree of disability of the elderly,family burden of diseases,family type,family function,monthly family income and whether the elderly receive social welfare are the influencing factors of the family resilience of the disabled elderly at home.The family function of the disabled elderly at home plays a part of the mediating effect and moderating effect between the family burden of disease and family resilience. |
PDF Full Text Request