Purpose: The purpose of this research study was to determine the relationship between resilience levels and family function perceived by adolescents residing in a shelter in the community of Ventanilla, Peru. This is the first study reported in the literature specific to adolescents without parents, or living without parents, in a shelter type environment.
Methods: This is a cross-sectional correlation study with a three-instrument design to measure demographic variables, resilience, and family function. Three instruments included: 1) Adolescent and Family Profile (44-items); Connor-Davidson Resilience Scale (25-items); and the 3) Family APGAR (5-items). A non-probability convenience sample of 452 adolescent residents of a shelter participated in the study. The shelter is a place where adolescents live when they are without parents or their parents are unable to care for them. When the adolescents live in the shelter, they also attend school in the same location. This study was approved by the ethics committee of the institutional review board at the participating university. For each participant, an informed consent was completed by the parent or guardian and the assent of the adolescent was obtained.
The first instrument, Adolescent and Family Profile (AFP), was developed by the researchers from the literature to measure variables important for research specific to adolescents and families. The variables included age, sex, level of education, type of family (nuclear or extended), members of the family (father, mother, grandparent, grandmother, among others) and if they were with the internal (spend the most of the time in the shelter) or external (visited their family on the weekends) modality, and family characteristics.
The second instrument, Connor-Davidson Resilience Scale (CD-RISC), measured resilience with 25-items producing five factors: 1) personal competence, high standards, and tenacity; 2) trust in one’s instincts, tolerance of negative affect, and strengthening effects of stress; 3) positive acceptance of change and secure relationships; 4) control; and 5) spiritual. Each item is rated on a 5-point scale (0 ‘not true at all’ to 4 ‘true nearly all of the time’), yielding a total score which can range from 0 to 100, with higher scores reflecting a higher level of resilience (Connor & Davidson, 2003; Palomar-Lever & Gómez-Valdez, 2010). For this study population, the instrument has high face validity (89% approval of experts) with high reliability (Cronbach alpha =0.89).
The third instrument, Family APGAR, measures family function with 5-items that target the perception of a family member about the level of satisfaction with the characteristics of their family. The possible responses are "never” (0 points), “almost never” (1 point), “sometimes” (2 points), “almost always” (3 points) and “always” (4 points). The delineation is between 0 and 20 points with 4 categories: “severe family dysfunction” (0-9 points), “moderated family dysfunction” (10-13 points), “slight family dysfunction” (14-17 points) and “good family function” (18-20 points). The instrument was recently validated for use with Peruvian adolescents (Cabello, Rodríguez, León, Barboza, & Valles, 2015). The scale has a uni-factor behavior with an acceptable Cronbach alpha of 0.729.
The data collection process was completed from March to May 2017 in the classrooms of the shelter, requiring 45-minutes for each participant. The collected data was organized into a database with Excel for analysis in STATA 12.0. Descriptive statistics and analysis of the study variables was completed. In the case of resilience, a graphical analysis and prove normality with Shapiro-Wilk test was also performed. To determine the association between the levels of resilience and family functionality, an analysis of variance (ANOVA) with an α=0.05, and Bonferroni test to identify differential groups were performed.
Results: The study included 452 participants between 11 and 18 years of age (mean=13.7 years, SD=1.7), the majority of the participants were female (51.3%), high school students (86.3%), community residents in Ventanilla (87.8%), nuclear family (67.0%) and an external modality (64.6%). For the level of resilience, the mean score was 62.1 points (SD=15.9 points). In the case of family function, 15.5% of the participants considered their family severely dysfunctional, 29.4% moderately dysfunctional, 32.1% slightly dysfunctional, and 23.0% with good family function. For the relation between resilience and family function, there was a positive association as the participants perceiving better family function reported higher levels of resilience (severe family dysfunction=51.8 points, SD 16.3; moderated family dysfunction=58.3, SD 14.6; slight family dysfunction=64.1, SD 13.7; good family function=71.1, SD 14.7), this finding was statistically significant (p<0,0001), with significant differences between all the groups.
Discussion and Conclusions: Resilience levels for the adolescents were moderate, with lower scores than similar populations reported in the literature (Rodríguez-Fernández et al., 2015). In general, high levels of family dysfunction were observed with only 23.0% of young people reported having functional families. The positive association between family function and the level of resilience developed by the participants was consistent with other research related to adolescents (Leiva et al., 2013; Rodríguez-Fernández et al., 2015). In general, other researchers reported family relations have the greatest impact on the levels of resilience (Rodríguez-Fernández et al., 2016). However, the findings from this study with the unique circumstance of adolescents living in a shelter, without their parents, extends the literature to a segment of vulnerable adolescents. There seems to be nontraditional family support helping the adolescences strengthen their level of resilience. In this regard, nurses need to be aware of the unique circumstances adolescents confront when their parents are missing or not actively involved in their lives. As the adolescent replaces the traditional family structure with a new structure, perhaps substituting parents, the nurses needs to promote the positive attitudes and behaviors essential for normal adolescent development (Esquivel et al., 2013). By supporting the transition of the adolescent into a new family structure, the nurse will help the adolescents strengthen their level of resilience as a psychological protector (Rodríguez-Fernández et al., 2016).