A new questionnaire could give primary care doctors and community mental health workers a structured way to assess the resources available to families supporting someone with schizophrenia.
The multidimensional family resource assessment tool, known as the M-FRAT, was evaluated with 304 family caregivers recruited from seven community health centers in Beijing. The caregivers completed the survey between November 2021 and February 2022.
The study, published in Frontiers in Psychiatry in 2026, found that the final questionnaire had 37 questions covering seven types of family resources. Researchers describe the tool as an assessment aid rather than evidence that measuring resources changes health outcomes.
What the questionnaire measures
Caregivers rate each statement from 1, meaning strongly disagree, to 5, meaning strongly agree. Higher total scores indicate that caregivers report more available resources.
The seven resource types include three categories within the family and four external categories. The questionnaire was shortened from 46 to 37 items after nine items were removed during exploratory factor analysis.
Economic resources were combined with environmental resources. Information and education support were combined with medical treatment support. A structural support category was removed because its internal consistency was low, with a Cronbach’s alpha of 0.117.
The final 37-item structure accounted for 70.245% of the variation in caregiver responses. Its overall internal consistency was high, with a Cronbach’s alpha of 0.927. Eight experts also rated the relevance of the items: item-level content validity scores ranged from 0.88 to 1.00, and the average score across the scale was 0.97.
Where caregivers reported gaps
Caregivers reported the fewest resources in economic and environmental areas, including subsidies, welfare support and rehabilitation services.
On the original 46-item questionnaire, the highest-rated individual item concerned access to a free yearly physical examination in the community. Overall, 60.5% of caregivers strongly agreed that this service was available.
Total M-FRAT scores did not differ significantly between rural and urban families. The reported average scores were 131.4 for rural families and 127.0 for urban families, with a p value of 0.089. Cultural-resource scores did differ: 7.16 for rural families compared with 6.59 for urban families, with a p value of 0.030.
Connection with caregiver quality of life
In regression models, higher M-FRAT scores were associated with better scores in seven of eight SF-36 quality-of-life domains. However, the questionnaire explained only 1.7% to 5.3% of the differences in caregiver quality-of-life scores.
Simple correlations were statistically significant only for the four physical-health domains of the SF-36, with correlation values ranging from 0.124 to 0.187. Because the study collected information at one point in time, these findings show an association, not proof that greater family resources improve caregiver health.
The researchers also noted that both the resource assessment and quality-of-life measures were self-reported by caregivers. Using the same reporting source for both measures may inflate the observed association.
Why the findings are preliminary
The 304 participants represented 94.4% of the 322 caregivers invited. Caregivers averaged 59 years of age; 44.7% were spouses and 31.6% were parents. About 71.0% had provided care for more than 10 years, and most patients were described as being in a stable phase of illness.
The questionnaire’s seven-group structure was developed through exploratory factor analysis in the same sample used to reduce the number of questions. It was not confirmed in an independent sample. The study also did not test whether scores remain stable over time or change when family resources change.
The researchers propose that community-based professionals could use the M-FRAT to identify gaps and connect families with services. But the tool has not been tested in an intervention study, so there is no evidence from this work that using it reduces caregiver burden or changes patient recovery or relapse.
The study took place in one city, with purposive recruitment from seven Beijing community health centers. The source also notes a discrepancy in how the recruitment setting was described: the discussion referred to urban Beijing, while 55.9% of caregivers reported rural residence.
Further testing is needed in other regions and health systems. Because most patients were in a stable phase, resources that may become important during relapse, such as home-safety arrangements, may have been underrepresented. Religious resources were also excluded during development and may require study in other cultural settings.
AI tools were used to assist with the preparation of this article under our editorial standards.
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