Measuring coping in parents of children with disabilities: a rasch model approach.

BACKGROUND

Parents of a child with disability must cope with greater demands than those living with a healthy child. Coping refers to a person's cognitive or behavioral efforts to manage the demands of a stressful situation. The Coping Health Inventory for Parents (CHIP) is a well-recognized measure of coping among parents of chronically ill children and assesses different coping patterns using its three subscales. The purpose of this study was to provide further insights into the psychometric properties of the CHIP subscales in a sample of parents of children with disabilities.

METHODS

In this cross-sectional study, 220 parents (mean age, 33.4 years; 85% mothers) caring for a child with disability enrolled in special schools as well as in mainstream schools completed the 45-item CHIP. Rasch analysis was applied to the CHIP data and the psychometric performance of each of the three subscales was tested. Subscale revision was performed in the context of Rasch analysis statistics.

RESULTS

Response categories were not used as intended, necessitating combining categories, thereby reducing the number from 4 to 3. The subscale - 'maintaining social support' satisfied all the Rasch model expectations. Four item misfit the Rasch model in the subscale -maintaining family integration', but their deletion resulted in a 15-item scale with items that fit the Rasch model well. The remaining subscale - 'understanding the healthcare situation' lacked adequate measurement precision (<2.0 logits).

CONCLUSIONS

The current Rasch analyses add to the evidence of measurement properties of the CHIP and show that the two of its subscales (one original and the other revised) have good psychometric properties and work well to measure coping patterns in parents of children with disabilities. However the third subscale is limited by its inadequate measurement precision and requires more items.