title: Assessment of family functioning: evaluation of the General Functioning Scale in a Swedish Bariatric Sample.
abstract: BACKGROUND
  The 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.
  
  
  OBJECTIVE
  To evaluate aspects of reliability and validity in GFS in a Swedish bariatric sample, focusing on factor structure.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  Data were positively skewed. The S-GFS showed good internal consistency (ordinal α = 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.|Department of Surgical Science, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden.|Department of Surgery, Ersta Hospital, Stockholm, Sweden.
authors.forename: Ami
authors.identifier: http://orcid.org/0000-0001-7118-4933
authors.initials: A
authors.lastname: Bylund
authors.affiliation: Center for Collaborative Palliative Care, School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.|Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Kristofer
authors.initials: K
authors.lastname: Årestedt
authors.affiliation: School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.|Center for Collaborative Palliative Care, School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Benzein
authors.affiliation: Department of Surgical Science, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden.|Department of Surgery, Ersta Hospital, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Thorell
authors.affiliation: School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.|Center for Collaborative Palliative Care, School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Persson
mesh_terms: D049088:Bariatrics; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D013548:Sweden
keywords: family assessment device; family functioning; gastric bypass; psychometric evaluation