Impact on Family Scale

Construct: Parental perceptions of the impact of a child’s medical condition on the family

Description of Measure:

  • Developed in 1980 (copyright 1978)
  • Designed for use with parents or caregivers of children with medical conditions. Parents or caregivers complete the measure.
  • 27 item scale
  • Time frame to complete is 10 minutes
  • Purpose: to assess impact of pediatric illness on the family. Notable in that it looks at financial burdens on families with children as well as emotional concerns and positive outcomes.
  • Response format: 4 point Likert-type scale (strongly agree – strongly disagree). Can be used as questionnaire or read to subject. Can be administered by phone.
  • Item example: Fatigue is a problem, No time for other family members, Traveling to hospital is a strain (rate 1-4, strongly agree to strongly disagree).
  • Subscales: Financial Impact; Familial-Social Impact, Personal Strain, Mastery
  • Factors: one factor representing general negative impace on the social and familial system (15 items). Weaker factors in some samples of financial impact and coping
  • Languages: English and Spanish
  • Reliability and validity: Cronbach alphas (internal consistency) are high (total impact – in the high .80s, financial-..68-.79), coping (.46-.52).
  • Construct validity: well established. High Total Scores on Impact on Family correlate with maternal psychiatric symptoms, poor child health, poor child adjustment, and increased child hospitalizations. Also correlated with poor maternal education and mothers on public assistance.
  • Important normative samples: PACTS (Pediatric Ambulatory Care Treatment Study) and other pediatric care cohorts, including rural, poor subjects, middle-class parents of children with diabetes. STEP (Sharing the Experience of Parenting) longitudinal study of support intervention for children with chronic health conditions, FACE (Family Advocacy and Coordination Effort) advocacy program for children with chronic health problems.

To obtain the instrument: Ruth E. K. Stein, MD, Department of Pediatrics, Albert Einstein College of Medicine/Montefiore Medical Center, Centennial 1, 111 E. 210th Street, Bronx, NY 10467, e-mail.


Stein, R.E.K. & Riessman, C.K. (1980). The development of the Impact on Family Scale: Preliminary findings. Medical Care, 18, 465-472.

Stein, R.E.K. & Jessop, D.J. (1985). Documentation of the psychometric properties of a measure of impact of chronic illness on the family. New York: Albert Einstein College of Medicine.

Stein R.E.K. & Jessop D.J. (2003). The impact on family scale revisited: further psychometric data. Developmental and Behavioral Pediatrics, 24, 9-16