The Impact of Family Behaviors and Communication Patterns on Chronic Illness Outcomes: A Systematic Review
Journal of Behavioral Medicine
Appendix A: Family Behavior Measurement Instrument Details with References
Ann-Marie Rosland, MD MS,1,2 Michele Heisler, MD MPA,1,2,3,4 John D. Piette, PhD1,2
1Department of Veterans Affairs, Ann Arbor VA Center for Clinical Management Research, Ann Arbor, MI
2 University of Michigan Medical School, Department of Internal Medicine, Ann Arbor, MI
3 Robert Wood Johnson Clinical Scholars Program, Ann Arbor, MI
4 University of Michigan School of Public Health, Department of Health Behavior and Health Education, Ann Arbor, MI
Communication can be directed to Dr. Rosland at:
Table 3.1 (Expanded Version)
General Family Behaviors and Communication Techniques Examined in Included Studies
Family Behavior Theme / Other Studied Behaviors Included in Themea / Explanation of Family Behavior Themeb / Instruments Used to Measure BehaviorcPositive Effects Expected
Good Marital/Family Function / Marital Satisfaction
Marital Adjustment
Marital Quality
Positive-Negative
Interaction Ratio
Family Function / General composite of satisfaction including:
happiness with relationship
handling practical issues
emotional and physical intimacy
communication
accommodation
respect
support / Dyadic Adjustment Scale (DAS)[1]
DAS Martial Satisfaction subscale
DAS positive vs. negative items [2]
Marital Satisfaction Scale[3]
Locke Wallace Marital Adjustment Test[4]
Druley et al. scale[5]
Family Adaptability, Partnership, Growth, Affection, Resolve (APGAR)[6, 7]
Family Adaptability and Cohesion Evaluation Scale (FACES) I, II, or III[8]
McMaster Model modified[9]
Family Cohesion / Marital Cohesion
Marital Intimacy
Family Cohesion-amount
Family Cohesion-balance / common interests
sharing ideas
sharing emotional experiences
closeness
commitment / DAS subscale
Personal Assessment of Intimacy in Relationships (PAIR)[10]
Family Environment Scale Subscale[11]
FACES Subscale[8]
Fisher et al. scale[12]
Family Expression / Couple Expressiveness / demonstrating affection
expressing emotional state / DAS subscale
Fisher et al. scale[13]
FES Subscale
Family Autonomy Encouragement / Family World View / encourage reliance on self
believe world is comprehensible and manageable / Control Encouragement[14, 15]
Family Coherence Scale[16]
Table 3.1 (Expanded Version), Continued
Family Behavior Theme / Other Studied Behaviors Included in Themea / Explanation of Family Behavior Themeb / Instruments Used to Measure Behaviorc
Negative Effects Expected
Negative Interactions / Negative Spouse Behavior
Negative Dyadic Adjustment / General composite of negative interactions including:
frequent conflicts
excessive demands
critical interactions
lack of common interests / Druley et al. scale[5]
Waltz et al. scale[17]
DAS negative items[2]
Biographical List of Problems (BIOPRO)[18]
Wake Forest Social Strain Scale[19]
Family Criticism / Spouse Criticism
Family Conflict / expressing disapproval, resentment, irritation, impatience / Manne et al. scale [20]
Perceived Criticism Item[21]
FES Subscale
Mixed Effects Expected
Family Achievement Orientation / casting activities into an achievement-oriented or competitive framework / FES Subscale
Family Activity / participating in social and recreational activities / FES Subscale
Family Control / setting rules and procedures to run family life / FES Subscale
Family Structure/Organization / Family Organization / emphasizing orderliness, structure, and similarity to one another / FES Subscale
Organized Cohesiveness Scale[22]
Togetherness Scale[23]
Family Sex-Role Traditionalism / supporting traditional sex roles, such as women working inside the home / Family Sex-Role Traditionalism[24]
Note. aNames for family behaviors used by included studies. bAdapted from psychometric instruments used to measure the family behavior theme. cInstruments in italics measure family behaviors, regular type measure spouse/partner behavior.
Table 3.2 (Expanded Version)
Disease-Specific Family Behaviors and Communication Techniques Examined in Included Studies
Family Behavior Theme / Other Studied Behaviors Included in Themea / Explanation of Family Behavior Themeb / Instruments Used to Measure BehaviorcPositive Effects Expected
Disease Respect / Spouse Respect / In disease-related matters:
taking person with illness seriously
trying to understand chronically ill person’s point of
view
respecting independence / Fisher et al. scale[13]
Useful Illness Discussion / Concordance on Pain Rating / frequent useful discussions about illness / Coyne et al. scale[25]
Attentive Disease Response / focusing on symptoms
asking how to help sufferer / West Haven–Yale Multidimensional Pain Inventory(WHYMPI) subscale[26]
“We” Talk About Disease / Proportion of first-person plural (“we, us, our”) pronouns of total pronouns when discussing illness management
Negative Effects Expected
Disease Criticism / Spouse Criticism / in disease-related matters expressing disapproval, resentment, irritation, impatience / # critical remarks in Camberwell Family Interview[27]
Kraaimaat et al. scale[28]
Disease Overprotection / Partner Overprotection
Solicitous Disease Response / discounting person’s ability to handle disease and symptoms, taking over self-management tasks / Overprotection[29-31]
Punishing Disease Response / anger in response to symptom / WHYMPI subscale[26]
Table 3.2 (Expanded Version), Continued
Family Behavior Theme / Other Studied Behaviors Included in Themea / Explanation of Family Behavior Themeb / Instruments Used to Measure Behaviorc
Distracting Disease Response / Spouse Distraction / distracting from symptoms by bringing up other topic or activity / WHYMPI subscale[26]
Kraaimaat et al. scale[28]
Expressed Emotion / Combination of 3 concepts:
hostility towards person with illness
emotional over-involvement: family blames selves
making critical comments / Camberwell Family Interview[27]
Disease Conflicts Unresolved / Spouse Conflict Resolution
Family Emotion Management / conflicts about disease remain unresolved
discussing disease-related issues avoided / Conflict Resolution Scale[32]
Unresolved Conflict Scale[23]
Fisher et al. scale[12]
Mixed Effects Expected
Social Control / using behavioral control (rewards, threats, sense of obligation) to “correct” people who are unsuccessful or unwilling to make healthy behavior changes / Franks et al. scale[33]
Note. aNames for family behaviors used by included studies. bAdapted from psychometric instruments used to measure the family behavior theme. cInstruments in italics measure family behaviors, regular type measure spouse/partner behavior
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