Background & Aims
An illness experience can be very stressful for young children. The evidence highlights childhood coping processes as a determining factor of effective adaptation to disease processes, and to prevent long-term negative consequences. However, in young children, coping is significantly modulated by caregivers’ scaffolding strategies. In this context, the Maternal Scaffolding Questionnaire (MSQ) has been a promising scale developed for the evaluation of parental strategies against childhood stress. MSQ allows you to identify which types of strategies may be effective or ineffective in everyday problems. But to date it has not been adapted to stressful health situations, where, according to evidence, scaffolding strategies focused on the regulation of fear, discomfort and pain are necessary. In relation to what has been described, the general objective is to culturally adapt and preliminarily validate the scaffolding questionnaire for caregivers in situations of childhood stress in health.
Methods
A comprehensive theoretical and empirical literature review was conducted about MSC. A translation of the instrument from English to Spanish was carried out independently by 2 bilingual experts, and a back-translator by a third professional. The translated version was reviewed by a committee of experts to evaluate linguistic and conceptual equivalence. In this process, 2 daily child stress and 2 health-related stress situations were established; High control (Do something he/she dislike and coping with pain of a fall injury) and low control (Say goodbye to a caregiver and coping painful medical procedure). A multicenter pilot test was carried out in 4 Chilean PEDs, with a sample of 100 caregivers. Cognitive interviews were conducted with 50% of sample. Questions of comprehension, interpretation, evocation, opinion and evaluation allowed iterative cultural adjustments.Exploratory factor analyzes were performed to examine the factor structure of the MSC.
Results
Statistical analyzes of the original scale in everyday stress situations showed a significant lack of variability in response rates. This phenomenon was reflected in the factorial results in both situation 1 (CFI = 0.82, TLI = 0.76, RMSEA = 0.12, SRMR = 0.22), and situation 2 (CFI = 0.64, TLI = 0.50, RMSEA = 0.16, SRMR = 0.26) From a qualitative and quantitative analysis, 6 MSQ items were identified that work in everyday situations but not in health events. Additionally, 10 items were added according to theory and evidence of health coping strategies. The adaptation of these items showed favorable results for situation 3 (CFI=0.96, TLI=0.95, RMSEA= 0.04, SRMR =0.10) and situation 4 (CFI=0.97, TLI =0.96, RMSEA =0.03, SRMR=0.10) suggesting a preliminary structure of 3 factors (2 with negative scaffolding, and 1 with positive scaffolding). Based on the interviews with caregivers, 10 new items were added, making a total of 36 items on children’s coping with stressful health events.
Conclusions
The version of the adapted caregiver scaffolding scale showed promising results for its use in relation to stressful health events. Based on theory and evidence, significant context-specific coping strategies of parental scaffolding in painful processes, whether due to illness or medical procedures, were identified. Active participation of caregivers in cognitive interviews contributed to iterative cultural adjustments. The results of the preliminary latent structure suggest the presence of 3 factors focused on negative invalidating strategies, positive responsiveness, and negative responsiveness, which should be corroborated in future studies considering the new items added and significant sample size.
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Presenting Author
Gabriela Ruiz Valenzuela
Poster Authors
Gabriela Ruiz Valenzuela
BNSc
Universidad de Chile. Medical Student, Universidad de Chile
Lead Author
Mariela Bustamante
PhD
Universidad de Chile. Master in Health Psychology and Doctoral Candidate in Psychology Pontificia Universidad Católica de Chile
Lead Author
Valeska Tapia
MD
Universidad de Chile
Lead Author
Sofía Hidalgo
BS
Universidad de Chile. Psychology Student, Universidad de Chile
Lead Author
Scarlett Caroca
BNSc
Universidad de Chile. Bachelor in Medicine, Universidad de Chile
Lead Author
Topics
- Assessment and Diagnosis