Measuring family resilience of Chinese family caregivers: Psychometric evaluation of the Family Resilience Assessment Scale

• Published date: 01 February 2022
• Author: Amanda M. Y. Chu,Jenny T. Y. Tsang,Agnes Tiwari,Helina Yuk,Mike K. P. So
• Date: 01 February 2022
• DOI: http://doi.org/10.1111/fare.12601

RESEARCH

Measuring family resilience of Chinese family

caregivers: Psychometric evaluation of the Family

Resilience Assessment Scale

Amanda M. Y. Chu

1

|Jenny T. Y. Tsang

1

|Agnes Tiwari

2

|

Helina Yuk

3

|Mike K. P. So

4

1

The Education University of Hong Kong, Tai

Po, Hong Kong

2

The University of Hong Kong and Hong

Kong Sanatorium & Hospital, Hong Kong

3

The Chinese University of Hong Kong,

Shatin, Hong Kong

4

The Hong Kong University of Science and

Technology, Clear Water Bay, Hong Kong

Correspondence

Amanda M. Y. Chu, The Education

University of Hong Kong, Hong Kong.

Email: amandachu@eduhk.hk

Funding information

This work was partially supported by the Hong

Kong University of Science and Technology

research grant “Big Data Analytics on Social

Research”, Grant/Award Number:

CEF20BM04

Abstract

Objective: To validate the Family Resilience Assessment

Scale (FRAS) in Chinese family caregivers.

Background: Caregiver burden among family caregivers is

a growing social issue. Family resilience is a crucial protec-

tive factor for easing caregiver burden. The FRAS is spe-

cifically designed to evaluate family resilience. However,

the factor structure and validity of the FRAS have not yet

been examined among Chinese family caregivers.

Method: Data were collected from 323 Chinese family

caregivers. Exploratory factor analysis (EFA) and confir-

matory factor analysis (CFA) were adopted to determine

the factor structure and model fit. Concurrent validity and

internal consistency were also studied.

Results: EFA analysis yielded a 42-item five-factor struc-

ture of the FRAS, which demonstrated satisfactory model

fit by CFA analysis. The five-factor model FRAS also

showed adequate concurrent validity and internal consis-

tency (α=0.724–0.963).

Conclusion: The proposed five-factor FRAS is likely a

valid and reliable scale for evaluating the family resilience

level of family caregivers in Chinese communities.

Implications: The present study recommends the use of the

FRAS in family caregiving research to facilitate interven-

tion development by social professionals for promoting

family resilience and reducing caregiver burden in Chinese

communities.

KEYWORDS

caregiver burden, Chinese, factor analysis, family caregiver, family

resilience

Received: 12 November 2019Revised: 11 February 2021Accepted: 25 April 2021

DOI: 10.1111/fare.12601

© 2021 National Council on Family Relations

130 Family Relations. 2022;71:130–146.wileyonlinelibrary.com/journal/fare

INTRODUCTION

Family caregiving: A growing social issue

Family caregiving is a growing social phenomenon across the globe. In the United States, an

estimated 43.5 million adults (13.6% of the U.S. adult population) were family caregivers in

2014 (National Alliance for Caregiving and AARP, 2015). On average, 13% of people age

50 yearsandoverprovidefamilycarein18countries,includingAustralia,Israel,the

United States, and 15 European countries (Organization for Economic Cooperation and

Development, 2017). Family caregivers are unpaid individuals who provide assistance with

activities of daily living for dependent family members, such as elders, spouses, and children

(Family Caregiver Alliance, 2019). In the context of an aging population, lengthening life

expectancy, increasing chronic illnesses, and diversifying family structures, the demand for fam-

ily caregivers will continue to grow (Turcotte, 2013).

Caregiver burden

Family caregivers may take a caregiver role for which they do not feel prepared, leading to

stress. The physical, psychological, emotional, social, and financial stress that individuals expe-

rience as a result of providing care is often referred to as caregiver burden (George &

Gwyther, 1986), which is commonly found among family caregivers. More than 50% of family

caregivers of older adults reported feeling burdened (Lopez Hartmann et al., 2019).

Systematic reviews and meta-analyses show that any type of family caregiving can result in

negative effects on caregivers’physical and psychological health. In a meta-analysis of 176 pub-

lished reports on caregivers’physical health, worse physical health was significantly correlated

with stressors associated with caregiver burden, including higher level of care recipients’behav-

ioral problems, higher age of caregivers, and lower level of informal support (Pinquart &

Sorensen, 2007). Family caregivers also exhibited a higher risk of physical health problems,

higher stress hormones levels, and poorer global self-reported health than non-caregivers

(Vitaliano et al., 2003). Another meta-analysis of 35 studies on caregivers’psychological health

provided convincing evidence that family caregivers demonstrated high prevalence of depres-

sion and anxiety (Del-Pino-Casado et al., 2019). Given the growing number of family care-

givers, determining appropriate interventions to ease caregiver burden is an important social

issue.

Individual and family resilience

Despite these challenges, many family caregivers are able to overcome the stress and thrive in

the caregiver role, indicating the resilience capacity of family caregivers. Resilience is defined as

effective coping and adaptation in the face of loss, hardship, or adversity. It involves using

effective coping strategies to get through crises successfully, such as using positive emotions to

cope with stressors during adversity (Tugade & Fredrickson, 2004). Modern research on resil-

ience focuses on the study of protective factors that mediate risks and enhance resilience

(Benard, 1993; Rutter, 1990; Werner & Smith, 1992).

Resilience is a complex construct, and it may be defined differently at the individual and the

family levels (Southwick et al., 2014). Individual resilience refers to personal characteristics and

adaptive behavior (Masten, 2014). Individual protective factors, such as personal mastery, self-

efficacy, and positive coping strategies (Harmell et al., 2011), allow individuals to bounce back

to healthy functioning when facing significant stressors (Masten & Obradovic, 2006).

FAMILY RESILIENCE AND FRAS EVALUATION131