Bourke-Taylor H, Law M, Howie L, Pallant J F
School of Occupational Therapy, La Trobe University, Bundoora, Vic., Australia.
Child Care Health Dev. 2010 Jul;36(4):491-8. doi: 10.1111/j.1365-2214.2009.01055.x. Epub 2009 Dec 29.
Caring for a child with a disability can be especially difficult when the child exhibits challenging behaviours. Childhood disability often calls for the mother to be conscientious, capable and organized to meet the child's health and developmental needs. Mothers are known to feel particularly stressed when their child also behaves in ways that are difficult to manage. In these circumstances maternal mental health may be compromised and mothers therefore need more support. The Child's Challenging Behaviour Scale (CCBS) is an 11-item scale that measures a mother's report of challenging behaviours exhibited by their child with disability, that are associated with compromised maternal mental health and caregiving difficulties. This paper describes the initial development and psychometric evaluation of the CCBS.
A mixed methodology instrument design model was used to develop the CCBS. A qualitative study generated items, and quantitative data were collected from 152 mothers of a child with a disability.
The CCBS showed excellent internal consistency (Cronbach's alpha = 0.89) and factor analysis supported its unidimensionality. Construct validity was supported by correlations with the PedsQL Psychosocial Health Summary Score (rho =-0.51) and cooperation taking medication (rho = 0.40). There were significant differences in CCBS scores between groups of children with and without either autism or psychiatric conditions. The CCBS showed moderate correlations with self-reported health status; the mother's sense of empowerment (rho =-0.44); and family cohesion (rho =-0.30). Mothers with a mental health condition recorded significantly higher CCBS scores.
The CCBS is a brief, psychometrically sound instrument that provides clinicians with a new tool that measures a mother's rating of their child's behaviours that are challenging and associated with reduced maternal well-being. The CCBS assists professionals to identify mothers and family situations who may be in need of more support and interventions.
当残疾儿童表现出具有挑战性的行为时，照顾他们会格外困难。儿童残疾往往要求母亲认真负责、有能力且有条理，以满足孩子的健康和发育需求。众所周知，当孩子的行为难以管理时，母亲会感到特别有压力。在这种情况下，母亲的心理健康可能会受到影响，因此母亲需要更多支持。儿童挑战性行为量表（CCBS）是一个包含11个条目的量表，用于测量母亲报告的残疾儿童所表现出的具有挑战性的行为，这些行为与母亲心理健康受损和照顾困难相关。本文描述了CCBS的初步开发和心理测量学评估。
采用混合方法工具设计模型来开发CCBS。通过定性研究生成条目，并从152名残疾儿童的母亲那里收集定量数据。
CCBS显示出出色的内部一致性（克朗巴哈系数=0.89），因子分析支持其单维度性。与儿童生活质量量表心理社会健康总结得分（rho=-0.51）和服药合作情况（rho=0.40）的相关性支持了结构效度。患有或未患有自闭症或精神疾病的儿童组之间，CCBS得分存在显著差异。CCBS与自我报告的健康状况、母亲的赋权感（rho=-0.44）和家庭凝聚力（rho=-0.30）呈中度相关。患有心理健康问题的母亲的CCBS得分显著更高。
CCBS是一种简短、心理测量学上可靠的工具，为临床医生提供了一种新的工具，用于测量母亲对其孩子具有挑战性且与母亲幸福感降低相关的行为的评分。CCBS有助于专业人员识别可能需要更多支持和干预的母亲及家庭情况。
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