In the present study, 149 women (63.7%) and 86 men (36.3%) participated. Of these, 143 participants (61.3%) lived with their families and 92 (38.7%) lived alone at home but received support from families.
The demographic characteristics of the participants (
| Gender | Male | 86 | 37 |
| Female | 149 | 63 | |
| Education level | Illiterate | 108 | 46 |
| Under diploma | 57 | 24 | |
| Diploma | 35 | 15 | |
| Academic | 35 | 15 | |
| Marital status | Divorced | 3 | 1.3 |
| Widow | 88 | 37.4 | |
| Married | 144 | 61.3 | |
| Economic condition (self-report) | Excellent | 3 | 1.3 |
| Good | 76 | 32.3 | |
| Moderate | 132 | 56.2 | |
| Poor | 24 | 10.2 | |
| Medication use | No | 37 | 15.8 |
| Yes | 198 | 84.2 | |
| History of diseases | No | 44 | 18.7 |
| Yes | 191 | 81.3 |
“Unable to read or write” means Illiterate; “higher than diploma” means Academic.
The item pool consisted of 62 items. During the qualitative face validity, six items were revised due to the perspective of the participants in terms of clarity. Also, the impact score of the items was reported as >1.5.
The CVR was reported as 0.94. Also, ICVI and SCVI were reported ≥ 0.80 and > 0.94, respectively. The CVI score of item 7 was 0.4. The item, stating “Without my children and other family members' help, it is not possible for me to clean the house,” had a CVR = 0.2 and overlapped with other items. Therefore, it was deleted. Items 10, 14, 15, and 52 had borderline CVR scores in comparison to the numerical value of the Lawche table. However, considering that they had acceptable CVI scores, they were kept in the questionnaire. Item 51 (“My children and other family members teach me how to use a bank card”), item 47 (“My children and other family members accompany me when using my bank card”), item 52 (“My children and other family members patiently repeat to me how to work with electrical devices and technological tools such as mobile phones, bank cards, computers, and the internet”), and item 53 (“My children and other family members explain to me the use of internet”) were all merged into item 58 (“My children and other family members help me patiently to use tools such as a mobile, computer, and the internet”).
The clarity and adequacy of the items were approved by the expert panel. Required corrections were made during qualitative and quantitative content validities. A 58-item questionnaire with a Likert scale of “always,” “often,” “sometimes,” “never,” and “rarely” was developed.
The questionnaire was first distributed to older people
The research team evaluated the items based on the results of item analysis and made decisions regarding the need to maintain necessary items and improve the structure of the whole questionnaire. Accordingly, eight items were deleted. The coefficient after the deletion of items was 0.935 (
Item analysis of the questionnaire.
| 2 | 149.80 | 1,282.303 | 0.232 | 0.935 | |
| 4 | 151.83 | 1,292.420 | 0.070 | 0.937 | |
| 13 | 150.27 | 1,285.857 | 0.123 | 0.936 | |
| 14 | 149.80 | 1,274.717 | 0.273 | 0.935 | |
| 21 | 149.47 | 1,288.326 | 0.297 | 0.935 | |
| 23 | 150.13 | 1,302.326 | −0.002 | 0.936 | |
| 27 | 149.70 | 1,289.252 | 0.260 | 0.935 | |
| 48 | 151.67 | 1,335.471 | −0.339 | 0.939 |
Family support for older people questionnaire.
| 1. My children or other family members help me clean the house regularly | □Never | □Some times | □Often | □Always | □I don't need |
| 2. My children or other family members help me with personal hygiene such as bathing | □Never | □Some times | □Often | □Always | □I don't need |
| 3. My children or other family members help me with home appliances | □Never | □Some times | □Often | □Always | □I don't need |
| 4. The health of home appliances is monitored by my children or other family members | □Never | □Some times | □Often | □Always | □I don't need |
| 5. Unsafe home appliances are controlled and replaced by my children or other family members | □Never | □Some times | □Often | □Always | □I don't need |
| 6. Inevitably, I am responsible for the maintenance of the house | □Never | □Some times | □Often | □Always | □I don't need |
| 7. I get help from others to maintain my home appliances due to the lack of attention from my children or other family members | □Never | □Some times | □Often | □Always | □I don't need |
| 8. My children or other family members provide facilities such as a toilet, installation of handles in the bathroom, installation of fences, non-slip surface at my home to prevent falling | □Never | □Some times | □Often | □Always | □I don't need |
| 9. My children or other family members pay attention to the physical security of my home in terms of installing guards, secure doors, and alarm systems | □Never | □Some times | □Often | □Always | □I don't need |
| 10. I depend on my children or other family members to prepare and cook food | □Never | □Some times | □Often | □Always | □I don't need |
| 11. It is difficult to meet the current needs of my life without the help of my children or other family members | □Never | □Some times | □Often | □Always | □I don't need |
| 12. My children or other family members regularly meet the current needs of my life | □Never | □Some times | □Often | □Always | □I don't need |
| 13. My children or other family members support me financially in special situations and circumstances | □Never | □Some times | □Often | □Always | □I don't need |
| 14. My children or other family members help me pay my current bills | □Never | □Some times | □Often | □Always | □I don't need |
| 15. My children or other family members help me get my pension and salary | □Never | □Some times | □Often | □Always | □I don't need |
| 16. My children or other family members help me with administrative and banking matters | □Neve | □Some times | □Often | □Always | □I don't need |
| 17. My children or other family members respect me and do not blame me | □Never | □Some times | □Often | □Always | □I don't need |
| 18. My children or other family members appreciate the hard work I put into them | □Never | □Some times | □Often | □Always | □I don't need |
| 19. My children or other family members listen to my past memories and conversations | □Never | □Some times | □Often | □Always | □I don't need |
| 20. I feel that my children and other family members care about me not being alone, especially at night | □Never | □Some times | □Often | □Always | □I don't need |
| 21. My children or other family members understand my physical and mental condition | □Never | □Some times | □Often | □Always | □I don't need |
| 22. My children or other family members try to cheer me up because my comfort is important to them | □Never | □Some times | □Often | □Always | □I don't need |
| 23. My children or other family members are regularly greeted by telephone | □Never | □Some times | □Often | □Always | □I don't need |
| 24. My children or other family members visit me regularly and ask for my help | □Never | □Some times | □Often | □Always | □I don't need |
| 25. Damage to home appliances is remedied with compassion and urgency by children or other family members | □Never | □Some times | □Often | □Always | □I don't need |
| 26. Children or other family members pay attention to my choices and interests (birthday, mother or father's day, holidays, and customs). | □Never | □Some times | □Often | □Always | □I don't need |
| 27. My children or other family members pay attention to my rest and sleep | □Never | □Some times | □Often | □Always | □I don't need |
| 28. My children or other family members teach me how to take care of my own health | □Never | □Some times | □Often | □Always | □I don't need |
| 29. My children or other family members take me to the doctor for time-to-time check-ups and examinations | □Never | □Some times | □Often | □Always | □I don't need |
| 30. My children or other family members pay attention and control my diet | □Never | □Sometimes | □Often | □Always | □I don't need |
| 31. My children or other family members control my blood pressure | □Never | □Some times | □Often | □Always | □I don't need |
| 32. My children or other family members provide first aid supplies to me | □Never | □Some times | □Often | □Always | □I don't need |
| 33. My children or other family members teach me how to exercise at home | □Never | □Some times | □Often | □Always | □I don't need |
| 34. My children or other family members prepare my medications and give them to me | □Never | □Some times | □Often | □Always | □I don't need |
| 35. My children or other family members take care of me when I am hospitalized or am at home | □Never | □Some times | □Often | □Always | □I don't need |
| 36. My children or other family members help me when I am sick or in need of immediate medical attention | □Never | □Some times | □Often | □Always | □I don't need |
| 37. My children or other family members teach me how to take and store mediations | □Never | □Some times | □Often | □Always | □I don't need |
| 38. When I have a disability or illness, my children or other family members take care of me | □Never | □Some times | □Often | □Always | □I don't need |
| 39. My children or other family members help me to keep up to date with the latest news and communication tools | □Never | □Some times | □Often | □Always | □I don't need |
| 40. My children or other family members accompany me when I use my bank card to allay my fear of making a mistake | □Never | □Some times | □Often | □Always | □I don't need |
| 41. My children or other family members try to teach me how to use a landline phone and mobile phone | □Never | □Some times | □Often | □Always | □I don't need |
| 42. My children or other family members teach me how to use electrical appliances, such as a washing machine, TV, etc. | □Never | □Some times | □Often | □Always | □I don't need |
| 43. My children or other family members make it easy for me to work with electrical appliances by using labels and signs | □Never | □Some times | □Often | □Always | □I don't need |
| 44. My children or other family members inform me about community issues and the prevention of dangers such as abuse and scams | □Never | □Some times | □Often | □Always | □I don't need |
| 45. My children or other family members help me go on pilgrimages and to religious ceremonies | □Never | □Some times | □Often | □Always | □I don't need |
| 46. My children and family members provide me with entertainment at home | □Never | □Some times | □Often | □Always | □I don't need |
| 47. My children or other family members help me with my favorite pastimes | □Never | □Some times | □Often | □Always | □I don't need |
| 48. My children or other family members help me with city and suburban travel | □Never | □Some times | □Often | □Always | □I don't need |
| 49. My children or other family members pay attention to me at family meetings and sessions | □Never | □Some times | □Often | □Always | □I don't need |
| 50. My children or other family members encourage me to connect with relatives and participate in the community | □Never | □Some times | □Often | □Always | □I don't need |
The appropriateness of CFA was confirmed using goodness-of-fit indicators (
All indexes of
Confirmatory factor analysis model of the instrumental dimension of the family support for older people questionnaire. All items in the questionnaire showed a factor load >0.3, indicating appropriate metrics for the tool factor.
Confirmatory factor analysis model of the financial dimension of the family support for older people questionnaire. All items in the questionnaire showed a factor load >0.3, indicating appropriate metrics for the tool factor.
Confirmatory factor analysis model of the affective dimension of the family support for older people questionnaire. All items in the questionnaire showed a factor load >0.3, indicating appropriate metrics for the tool factor.
Confirmatory factor analysis model of the therapeutic dimension of the family support for older people questionnaire. All items in the questionnaire showed a factor load >0.3, indicating appropriate metrics for the tool factor.
Confirmatory factor analysis model of the questionnaire on the technology dimension of the family support for older people questionnaire. All items in the questionnaire showed a factor load >0.3, indicating appropriate metrics for the tool factor.
Confirmatory factor analysis model of the social dimension of the family support for older people questionnaire. All items in the questionnaire showed a factor load >0.3, indicating appropriate metrics for the tool factor.
Cronbach's alpha coefficient for the whole questionnaire was 0.94. The coefficients for the domains were as follows: IN = 0.87, FI = 0.82, AF = 0.86, TH = 0.87, TH = 0.76, and SO = 0.79. With regard to stability, ICC scores, with a 95% confidence interval for the whole questionnaire and for each domain, were reported in
The intraclass correlation coefficient (ICC) of the domains and the whole questionnaire.
| Instrumental (IN) | 0.96 | 0.90–0.98 | < 0.001 |
| Financial (FI) | 0.96 | 0.92–0.98 | < 0.001 |
| Affective (AF) | 0.89 | 0.74–0.95 | < 0.001 |
| Therapeutic (TH) | 0.95 | 0.89–0.98 | < 0.001 |
| Technological (TE) | 0.81 | 0.54–0.92 | < 0.001 |
| Social (SO) | 0.89 | 0.75–0.95 | < 0.001 |
| Total | 0.98 | 0.95–0.99 | < 0.001 |
The results of the independent t-test (
Examination of the total score of the FSOP questionnaire in relation to the participants' age.
| ≤ 75 years | 175 | 135.87 | 33.65 | 0.032 |
| >75 years | 60 | 146.61 | 32.33 |
The percentages of MDC in all domains except TH was close to or <30%, which were acceptable. Also, the MDC percentage of the whole questionnaire was 7.92 (
The absolute stability of the questionnaire in the six domains.
| Instrumental (IN) | 37.27 (11.37) | 0.96 | 2.28 | 5.29 | 14.20 | Acceptable |
| Financial (FI) | 10.40 (5.46) | 0.96 | 1.09 | 2.54 | 24.43 | |
| Affective (AF) | 33.04 (4.14) | 0.89 | 1.38 | 3.20 | 9.68 | |
| Therapeutic (TH) | 34.90 (9.53) | 0.95 | 2.13 | 4.96 | 14.20 | |
| Technological (TE) | 12.72 (6.21) | 0.81 | 2.71 | 6.30 | 49.49 | |
| Social (SO) | 14.40 (5.43) | 0.89 | 1.80 | 4.19 | 29.08 | |
| Total | 142.77 (34.37) | 0.98 | 4.86 | 11.31 | 7.92 |
The values for all domains reported were under 20%, indicating no ceiling and floor effects (
The ceiling and floor effects in the domains.
| Instrumental (IN) | 1 | 4.0 | 3 | 3.1 |
| Financial (FI) | 10 | 3.4 | 43 | 3.18 |
| Affective (AF) | 0 | 0 | 30 | 8.12 |
| Therapeutic (TH) | 1 | 4.0 | 12 | 1,5 |
| Technological (TE) | 2 | 9.0 | 11 | 7.4 |
| Social (SO) | 0 | 0 | 24 | 2.10 |
| Total | 0 | 0 | 0 | 0 |
The approximate duration of completing the questionnaire was between 15 and 20 mins. Also, the option “I don't need support” provided more choice to the participants and reduced the number of unanswered items.
The FSOP questionnaire had a five-point Likert scale. For the scoring of positive items, a score of 1 was given to the option “never,” 2 to “sometimes,” 3 to “often,” and 4 to “always.” For negative items, scoring was in reverse so that a score of 1 was given to the option “always,” 2 to “often,” 3 to “sometimes,” and 4 to “never.” Items 6, 7, and 11 had reverse scoring. In both positive and inverse cases, a score of 0 was given to the option “I do not need support.”
The score for each domain was determined through calculating the scores of related items of the domain. The total score of the FSOP questionnaire was determined through the summation of the scores for each domain according to a formula. The total score of the questionnaire varied from 50 to 200 and the level of family support was interpreted according to the qualitative quarters.
The following formula is based on the total raw score of each person divided by the minimum score that the same person achieved. For example, if for ten items the participant selected the option of “I do not need support,” he/she answered 40 questions with a minimum of 40 and a maximum of 160. If the total score of the tool was 100, this should be divided by 40 (the participant's minimum score), which achieves a score of 2.5, indicating a poor qualitative range of family support for the participant. If the participant selected “I do not need support” for eight items, their score ranged from 42 to 168. If he/she achieved a score of 110, divided by 42, the calculated score was 2.61, indicating the desired or good family support. According to qualitative quarters, a score of 1–1.75 denotes adverse family support, 1.76–2.5 is poor family support, 2.26–3.25 is favorable or good family support, and 3.26–4 is excellent family support. To facilitate the use of this questionnaire, the calculation of questionnaire scores can be easily performed using Excel.