Psychometric Validation of a Family Adaptation Measure for First-Episode Psychosis

Background: Contemporary tools for assessing caregiver adaptation are often developed in Western contexts, limiting their applicability to capturing authentic caregiving experiences in diverse cultural settings such as Thailand. To address this gap, this study developed and validated a psychometric scale to assess family adaptation and caregiving role engagement among relatives of individuals with first-episode psychosis in Thailand. Method: Using a sequential mixed-methods design, focus group interviews were initially conducted with 17 caregivers to identify key experiential dimensions. The resulting instrument was subsequently administered to 171 caregivers evaluated using exploratory factor analysis and to 172 caregivers evaluated using confirmatory factor analysis. The final 23-item scale comprises four dimensions: Consequences at the illness onset, Caregiving consequences, Psychosis recognitions, and Transportation and uncontrolled behavior challenges. Result: All dimensions demonstrated strong psychometric properties, with factor loadings ranging from 0.83 to 0.95, Cronbach’s alpha coefficients exceeding 0.94, and satisfactory model fit indices. Conclusions: Ultimately, this 23-item scale provides mental health professionals with a practical and reliable instrument to systematically identify caregiver needs, enabling tailored interventions that can improve care outcomes for individuals experiencing psychosis and their families.