Psychometric evaluation of the stress scale for parents with cleft lip and/or palate children - A preliminary study

Objective: To develop the Stress Scale for Parents With Cleft Lip and/or Palate Children in Taiwan and to evaluate the psychometric properties of the scale with a group of parents who have children with cleft lip and/or palate. Design: In phase 1, qualitative procedures were conducted in constructing the item pool for the Stress Scale for Parents With Cleft Lip and/or Palate Children. Psychometric properties of the scale were assessed in phase 2. Setting: Outpatient department of a children's hospital in northern Taiwan. Participants: Phase 1 included 21 parents of children with cleft lip and/or palate. Phase 2 included 184 parents of children with cleft lip and/or palate. Interventions: The item pool was developed by interview, content analysis, and literature review. Problematic items were identified by item analysis. Main Outcome Measures: Exploratory factor analysis was used to examine the construct validity. Reliabilities were evaluated by Cronbach alpha and intraclass correlation coefficients. Results: Thirty-three items with a content validity index greater than .80 were recognized. They were grouped into four categories by exploratory factor analysis and accounted for 42.34% of the total variance. Internal consistency reliability was high for the total scale (Cronbach α = .90) and ranged from .71 to .84 on the subscales. Test-retest reliability with intraclass correlation coefficient was .94 on the total scale (p < .0001, 95% confidence interval) and from .90 to .96 for the subscales. Conclusions: The Stress Scale for Parents With Cleft Lip and/or Palate Children appears to be a reliable tool with strong evidence of content and construct validity that may be useful in assessing parental stress in the caretakers of children with cleft lip and/or palate.