Self-report family assessment instruments: an evaluative review [see comment].

Family medicine is challenged to document the impact of family systems on health and physiologic function. For this research investigators must measure family system variables with instruments that are both valid and reliable. In this context, eight self-report measures of total family functioning are reviewed and assessed according to a standardized approach to instrument design. The instruments evaluated include the Family Assessment Device, the Family Assessment Measure, the Family Adaptability and Cohesion Evaluation Scales, the Family Environment Scale, the Family Functioning Index, the Self-Report Family Inventory, the Family APGAR, and the Family Functioning Questionnaire. The analysis indicates two major problems with these instruments. First, there is disagreement on key concepts and definitions. Second, there is inconsistency in design and attention to detail in empirical analysis and psychometic evaluation. Family assessment techniques need further development and remain a fertile research field for family medicine investigation.