title: Measuring family functioning in families with parental cancer: Reliability and validity of the German adaptation of the Family Assessment Device (FAD).
abstract: The concept of family functioning is gaining importance in psycho-oncology research and health care services. The Family Assessment Device (FAD) is a well-established measure of family functioning. Psychometric properties inherent in the German 51-item adaptation of the FAD are examined in different samples of families with parental cancer.
  
  
  
  Acceptance, reliability, and validity of FAD scales are analysed in samples from different study settings (N=1701 cancer patients, N=261 partners, N=158 dependent adolescent children 11 to 18years old).
  
  
  
  Missing items in the FAD scales (acceptance) are rare for adults (<1.1%) and adolescent children (<4.4%). In samples of adults and older adolescents (15 to 18years), all FAD scales except for the Roles scale are significantly reliable (0.75≤Cronbach's α≤0.88). The scales correlate highly (0.46≤Pearson's r≤0.59) with the criterion satisfaction with family life (convergent validity), and have smaller correlations (0.16≤r≤0.49) with measures of emotional distress and subjective well-being (divergent validity). In most FAD scales, adults seeking family counselling report worse family functioning (0.24≤Cohen's d≤0.59) than adults in other samples with parental cancer (discriminative validity).
  
  
  
  Overall, the German 51-item adaptation of the FAD reveals good acceptance, reliability, and validity for cancer patients and their relatives. Particularly the scale General Functioning shows excellent psychometric properties. The FAD is suitable in the assessment of families with parental cancer for adults and adolescents older than 11years.
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: v.beierlein@uke.de.
authors.forename: Volker
authors.initials: V
authors.lastname: Beierlein
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: johanna.bultmann@web.de.
authors.forename: Johanna Christine
authors.initials: JC
authors.lastname: Bultmann
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Muenster, Germany. Electronic address: birgit.moeller@ukmuenster.de.
authors.forename: Birgit
authors.initials: B
authors.lastname: Möller
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Leipzig University Hospital, Germany. Electronic address: Kai.vonKlitzing@medizin.uni-leipzig.de.
authors.forename: Kai
authors.initials: K
authors.lastname: von Klitzing
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, Otto-von-Guericke-University, Magdeburg, Germany. Electronic address: hans-henning.flechtner@med.ovgu.de.
authors.forename: Hans-Henning
authors.initials: HH
authors.lastname: Flechtner
authors.affiliation: Department of Child and Adolescent Psychiatry; Heidelberg University Hospital, Germany. Electronic address: Franz.Resch@med.uni-heidelberg.de.
authors.forename: Franz
authors.initials: F
authors.lastname: Resch
authors.affiliation: Department of General Internal Medicine and Psychosomatics, Heidelberg University, Germany. Electronic address: wolfgang.herzog@med.uni-heidelberg.de.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Herzog
authors.affiliation: Department of Medical Psychology and Medical Sociology, Leipzig University Hospital, Germany; Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Germany. Electronic address: elmar.braehler@medizin.uni-leipzig.de.
authors.forename: Elmar
authors.initials: E
authors.lastname: Brähler
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatic s and Psychotherapy, Charité University Medicine Berlin, Germany. Electronic address: Daniel.Fuehrer@charite.de.
authors.forename: Daniel
authors.initials: D
authors.lastname: Führer
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Muenster, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: Georg.Romer@ukmuenster.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Romer
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: koch@uke.de.
authors.forename: Uwe
authors.initials: U
authors.lastname: Koch
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany. Electronic address: bergelt@uke.de.
authors.forename: Corinna
authors.initials: C
authors.lastname: Bergelt
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003431:Cross-Cultural Comparison; D005195:Family Relations / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D011594:Psychometrics / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D013223:Statistics as Topic; D011795:Surveys and Questionnaires
keywords: Adolescents; Cancer; Family Assessment Device; Family functioning; Parents; Psychometric properties