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Assessment of family functioning: evaluation of the General Functioning Scale in a Swedish Bariatric Sample
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Karolinska Institutet;Ersta Hospital.ORCID iD: 0000-0001-7118-4933
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.ORCID iD: 0000-0002-0961-5250
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. (Ctr Collaborat Palliat Care)ORCID iD: 0000-0002-9714-4056
Karolinska Institutet;Ersta Hospital.
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2016 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 3, p. 614-622Article in journal (Refereed) Published
Abstract [en]

BackgroundThe General Functioning Scale (GFS) was developed to assess self-perceived overall family functioning. The scale has satisfactory psychometric properties, is internationally recognised and has been used in different contexts. However, no validated Swedish version is available. Healthy family functioning can support patients and help them adhere to treatment regimens. Moreover, it maintains the physical and emotional health and that of the family as a unit. Yet, there is limited information regarding family functioning postgastric bypass surgery. Thus, it is important to use validated instruments to understand family functioning in bariatric contexts. AimTo evaluate aspects of reliability and validity in GFS in a Swedish bariatric sample, focusing on factor structure. MethodThe Swedish version of the GFS (S-GFS) was administered on two occasions to 163 participants who had undergone gastric bypass surgery 6-8 weeks prior to testing. Internal consistency, temporal stability and construct validity were assessed. ResultsData were positively skewed. The S-GFS showed good internal consistency (ordinal = 0.92) with a sufficient overall mean interitem correlation (0.500) and adequate temporal stability (intraclass correlation coefficient = 0.833). After modifying response alternatives, confirmatory factor analysis indicated acceptable fit for a one-factor model. ConclusionThe scale is a promising tool for assessing family functioning in bariatric settings. The S-GFS showed satisfactory reliability - consistent with prior research - and acceptable validity in the study sample. This study contributes to the limited research on the scale's validity. However, the S-GFS needs to be evaluated in different cultural and clinical contexts, focusing on various aspects of validity and responsiveness (sensitivity to detect significant change over time) in different samples.

Place, publisher, year, edition, pages
2016. Vol. 30, no 3, p. 614-622
Keywords [en]
family functioning, family assessment device, gastric bypass, psychometric evaluation
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-57460DOI: 10.1111/scs.12269ISI: 000383803300020PubMedID: 26555951Scopus ID: 2-s2.0-85028282792OAI: oai:DiVA.org:lnu-57460DiVA, id: diva2:1039875
Available from: 2016-10-25 Created: 2016-10-19 Last updated: 2018-12-11Bibliographically approved
In thesis
1. "Wait for us to catch up": Aspects of family functioning after gastric bypass surgery
Open this publication in new window or tab >>"Wait for us to catch up": Aspects of family functioning after gastric bypass surgery
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: To investigate aspects of family functioning when a family member has undergone Gastric Bypass surgery (GBP).

Methods: Study I explored experiences of family functioning three months after GBP, based on nine family interviews, analyzed using Gadamerian hermeneutics. Using Classic grounded theory, Study II focused on how families resolve their primary concerns after GBP, through interviews with 16 families. Study III evaluated the reliability and validity of the General Functioning Scale (GFS) based on 163 self-reported questionnaires, and used psychometric analyses. Study IV explored associations between family functioning, weight loss, sex and Health Related-Quality of Life (HR-QoL), based on self-reported questionnaires from 153 participants and utilized descriptive statistics and binary logistic regression.

Results: Study I revealed a process of three intertwined changes in family functioning three months after GBP: Living in ambiguous relationship, rewriting family patterns and strengthening family cohesion. Study II showed that families shared a main concern of unexpected change after GBP, resulting in the theory Stabilizing family life, explained as a social process to decrease uncertainty and find stability and well-being in family interactions. This resulted in attaining unity, returning to old family patterns or disconnecting. Study III suggested GFS as a promising tool for assessing family functioning in a Swedish bariatric sample, showing satisfactory reliability and validity. Study IV showed associations between family functioning and the mental dimensions of HR-QoL, two years after GBP. Percent weight loss was associated with the physical dimension. Sex showed no associations to HR-QoL.

Conclusion: Families experienced unexpected challenges after GBP affecting family functioning. Mutual remodeling of family life to incorporate changes was seen. Families underwent a social process, indicating that families may represent a resource in bariatric nursing care. A family-system nursing perspective as complement to standard care may be beneficial. As family functioning influence HR-QoL identifying available family resources and giving tailored information to support self-care strategies after GBP, may result in sustainable family functioning and individual health. Studies aimed at identify families that may benefit from family-system nursing interventions are suggested for future inquiry. 

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2017. p. 166
Series
Linnaeus University Dissertations ; 272/2017
Keywords
Family functioning, Family system theory, Obesity, Gastric bypass, Family Interviews, Self-reported Questionnaires
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-60684 (URN)978-91-88357-53-3 (ISBN)
Public defence
2017-01-20, V159, Storken, Kalmar, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2017-02-15 Created: 2017-02-15 Last updated: 2018-12-11Bibliographically approved

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Bylund, AmiÅrestedt, KristoferBenzein, EvaPersson, Carina

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