title: Structure and validity of Family Harmony Scale: An instrument for measuring harmony.
abstract: Culture plays a role in mental health, partly by defining the characteristics that are indicative of positive adjustment. In Chinese cultures, positive family relationships are considered central to well-being. The culturally emphasized characteristic of family harmony may be an important factor associated with psychopathology. This article presents the development and psychometric examination of the Family Harmony Scale (FHS), an indigenously developed 24-item instrument tapping family harmony in 17,461 Hong Kong residents from 7,791 households. A higher-order model with 1 second-order factor and 5 first-order factors fit the data well and showed factorial invariance across sex and participants in different family roles. A 5-item short form (FHS-5) was also developed, with 1 item from each first-order factor. The short scale showed, as expected, a single-factor structure with good fit. Both scales demonstrated high internal consistency, acceptable test-retest reliability, and good convergent and discriminant validity. The 24-item FHS was negatively associated with depressive symptoms after accounting for individual risk factors and general family function. Family harmony moderated the relationship between life stress and depressive symptoms such that those individuals who reported low family harmony had stronger associations between life stress and depressive symptoms. This study adds to the literature a systematically developed, multidimensional measure of family harmony, which may be an important psychological protective factor, in a large urban Chinese sample. The FHS-5 minimizes operational and respondent burdens, making it an attractive tool for large-scale epidemiological studies with Chinese populations in urban settings, where over half of China's 1.4 billion people reside.
authors.affiliation: School of Public Health, The University of Hong Kong.
authors.forename: Sushma
authors.initials: S
authors.lastname: Kavikondala
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Centre at Dallas.
authors.forename: Sunita M
authors.initials: SM
authors.lastname: Stewart
authors.affiliation: School of Public Health, The University of Hong Kong.
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Ni
authors.affiliation: School of Public Health, The University of Hong Kong.
authors.forename: Brandford H Y
authors.initials: BH
authors.lastname: Chan
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Lee
authors.affiliation: Department of Applied Social Studies, College of Liberal Arts and Social Sciences, City University of Hong Kong.
authors.forename: Kin-Kit
authors.initials: KK
authors.lastname: Li
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa.
authors.forename: Ian
authors.initials: I
authors.lastname: McDowell
authors.affiliation: School of Public Health, The University of Hong Kong.
authors.forename: Janice M
authors.initials: JM
authors.lastname: Johnston
authors.affiliation: School of Nursing, The University of Hong Kong.
authors.forename: Sophia S
authors.initials: SS
authors.lastname: Chan
authors.affiliation: School of Public Health, The University of Hong Kong.
authors.forename: T H
authors.initials: TH
authors.lastname: Lam
authors.affiliation: School of Public Health, The University of Hong Kong.
authors.forename: Wendy W T
authors.initials: WW
authors.lastname: Lam
authors.affiliation: School of Public Health, The University of Hong Kong.
authors.forename: Richard
authors.initials: R
authors.lastname: Fielding
authors.affiliation: School of Public Health, The University of Hong Kong.
authors.forename: Gabriel M
authors.initials: GM
authors.lastname: Leung
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics / Q000295:instrumentation; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000175:diagnosis*