Researchers developed a culturally grounded measure of family adaptation and caregiving role engagement in Thai first-episode psychosis. Focus groups with 17 caregivers, item development and piloting preceded validation in 343 caregivers from four psychiatric hospitals, split into EFA (171) and CFA (172) groups. The 23-item, four-dimension FACRI explained 68.71% of variance and had overall Cronbach's alpha of 0.94. This is preliminary validity evidence, not a diagnostic test or proof of patient benefit.
Key findings
- The final instrument contains 23 items across four dimensions spanning consequences, recognition and practical caregiving challenges.
- Qualitative development involved 17 caregivers, followed by 343 in the main study split into 171 for EFA and 172 for CFA; four factors explained 68.71% of variance.
- KMO was 0.91; the second-order model had CFI 0.918, TLI 0.907, SRMR 0.0629 and RMSEA 0.0864, with overall Cronbach's alpha of 0.94.
Why this matters globally
A culturally responsive tool could help mental-health teams identify family needs early and tailor support. It also extends measurement beyond Western settings, although broader validation is needed before wide implementation.
Thai researcher contribution
Wilai Napa, Nantiya Ekathikhomkit and Pennapa Unsanit of Ramathibodi School of Nursing, Mahidol University, together with Patraporn Bhatarasakoon of Chiang Mai University, built the instrument from Thai caregiver experience.
Limitations to consider
Purposive sampling covered four psychiatric hospitals in two regions, with one sample split for EFA and CFA and no external cohort. Test-retest, criterion, convergent validity and responsiveness were not reported. Correlated residuals were added and RMSEA near 0.086 indicates acceptable or marginal—not excellent—fit.