Section of Supportive Hospice and Palliative Medicine

Department of Family and Community Medicine

University of the Philippines – Philippine General Hospital
Manila

SHPM PROGRAM DOCUMENT (CFAT 012011-3)

COMPENDIUM OF FILIPINO ASSESSMENT TOOLS FOR CLINICAL PRACTICE & RESEARCH

SCREEM FAMILY RESOURCES SURVEY (SCREEM-RES)

AUTHOR/S: Manuel Medina Jr. and the Section of Supportive Hospice and Palliative Medicine (SHPM)

FILIPINO VERSION: The Filipino and English Versions were developed simultaneously.

PURPOSE: To assess general family resources.

DESCRIPTION: The SCREEM-RES was developed by M. Medina, Jr. M.D. and the Section of Supportive Hospice and Palliative Medicine,
University of the Philippines – Philippine General Hospital (SHPM, UP-PGH). The goal was to develop a valid and reliable Filipino measure
of family resources. It is primarily intended for family medicine and palliative medicine physicians. The items used in the construction of the
MAPGAR were directly based on a review of relevant international tools and research, and the opinion and experience of the Section of
SHPM in the assessment of family function. In particular, the review and evaluation of available materials focused on materials related to the
SCREEM Method of Analysis of the family’s resources originally developed by Smilkstein (1978) and adapted by the Philippine Academy
of Family Physicians, and materials related to family resources in times of crisis. The brief 15 item SCREEM-RES provides a measure of
general family resources. It also includes 6 two-item subscales, representing the 6 domains of the original SCREEM Method of Analysis:
Social, Cultural, Religious, Economic, Educational and Medical.

SCORING: Each item is scored on a 0 to 3 basis using the following key: strongly agree = 3, agree = 2, disagree = 1, strongly disagree = 0.
The scores for the all the items in the SCREEM-RES and its subscales are summed resulting in scores for the SCREEM-RES subscales
(Social, Cultural, Religious, Economic, Educational and Medical) and a total score for the entire SCREEM-RES. Higher scores reflect more
adequate family resources – in general or based on the 6 dimensions measured by the subscales, and better family resource adequacy to adapt
in times of crisis; while lower scores reflect more inadequate family resources and poorer family resource adequacy to adapt in times of
crisis. The scores range from 0 to 36 for the entire SCREEM-RES (general family resources) and from 0 to 6 for the Social, Cultural,
Religious, Economic, Educational and Medical subscales.

Simplified Classification System: Many family medicine and palliative medicine clinicians are used to using simplified classification systems
such as those used in the familiar Family APGAR. To address the requests for a simplified classification system for the SCREEM-RES, the
following system is proposed. This proposed scoring system is developed in the same manner as the scoring system of original Family
APGAR as proposed by Smilkstein- the scale is divided evenly into classes and the classification system is based solely on what appears to
be most appropriate and conceptually correct; as opposed to an empirically based division of the scale. The author/s recommends that for
intensive clinical assessment and/or research, the actual scale should be used instead of the classification system.

The total SCREEM-RES scores are grouped using the following key: Severely Inadequate Family Resources = 0 to 12, Moderately
Inadequate Family Resources = 13 to 24, Adequate Family Resources = 25 to 36. For each of the domain subscales, scores can be grouped
using the following key: Severely Inadequate Family Resources = 0 to 2, Moderately Inadequate Family Resources = 3 to 4, Adequate
Family Resources = 5 to 6.

RELIABILITY: The SCREEM-RES (Filipino Version) has excellent internal consistency. Cronbach alpha for the entire scale was 0.80.
Subscales for social and religious family resources had modest split half reliability and internal consistency (rs and α between .60 and .63).
Subscales for cultural, economic, and educational family resources had good split half reliability and internal consistency (rs and α between
.77 and .92). The subscale for medical resources had a lower split half reliability and internal consistency (rs and α between .40 and .42).
These initial findings, led to a re-evaluation of the items in the Medical subscale and a minor modification of one of its items (see notes
below). Further reliability studies are ongoing and/or planned by the author/s.

VALIDITY: Preliminary evaluation of the SCREEM-RES (Filipino Version) in families of children with cancer shows that it has good
correlation with general family function and satisfaction with family function as measured by the Filipino version of the original 5 item
Family APGAR. In another study involving the same sample population of families of children with cancer, the SCREEM-RES also
correlated well with the quality of life of the patient, the well-being of the caregiver as measured by the WHO Index of Well Being, and the

Page 1 of 4
psychological reaction to illness of both the patient and the family caregiver. Construct validity was also achieved through the process of tool
development and item selection based on expert opinion and the review of relevant international recognized tools and research. Further
validation studies are ongoing and planned by the author/s.

ADDITIONAL NOTES

January 2011a: Initial studies using a sample of families of children with cancer who are being seen at the UP-PGH showed relatively lower
reliability in the Medical Resources Subscale. Revaluation of the subscale led the author/s and study investigators to conclude that this
problem may be due to some confusion regarding the 2 items of the subscale. It is likely that the first item was viewed referring to the
availability and access to medical resources in the community, while the second item was viewed as referring to the help being received from
physicians and health care providers in general – including help being received in PGH. Based on this, the following modification was made:
the second item of the Medical Resources Subscale will clearly indicate that the item refers to resources in the family’s own hometown or
community. “Natutulungan kami ng mga doctor, nars, at health workers” (“We are helped by doctors, nurses and health workers”) was
modified to “Natutulungan kami ng mga doctor, nars, at health workers sa aming komunidad” (“We are helped by doctors, nurses and health
workers in our community”).

January 2011b: Initial studies using a sample of families of children with cancer using the introductory phrase “Simula ng nagkasakit ang isa
sa amin sa pamilya” (“Ever since a member of our family became sick”). The author/s of the tool have suggested that this phrase, or the
phrase ”Simula ng nagkasakit si ___” (“Ever since ___ became sick”) for similar populations of patients and families. However, the author/s
also recommend a more generic phrase “Kapag may nagkakasakit sa aming pamilya” (“When someone in our family gets sick”), for a more
general population of families.

ADMINISTRATION: The tool can be answered by adults and older children (preadolescents and adolescents); patients and/or family
caregivers. It can be administered in a number of formats, including traditional “paper and pencil” format (either self-administration or
research-staff interview – face to face, telephone, or internet based interview) and electronic formats and Web-based applications.

PRIMARY REFERENCES: 1) M Medina and the Section of Supportive Hospice and Palliative Medicine (SHPM). SCREEM Family
Resources Survey (SCREEM-RES). SHPM, DFCM, UP-PGH. 2010. 2) M. Medina, A Panganiban-Corales, L Nicodemus, and A Ang.
Family Resources Study: Part 2: Development and Evaluation of the SCREEM Family Resources Survey (SCREEM-RES). SHPM Research
Document (FAM 012010-2). Section of Supportive Hospice and Palliative Medicine (SHPM), DFCM, UP-PGH. 2010.

In addition to the primary reference, this document can be cited as follows: M. Medina and the Section of Supportive Hospice and Palliative
Medicine (SHPM). The SCREEM Family Resopurces Survey. SHPM Program Document. Compendium of Filipino Assessment Tools for
Clinical Practice & Research (CFAT 012011-3). SHPM, DFCM, UP-PGH. 2011.

AVAILABILITY: Permission to use the SCREEM-RES should be obtained from the author/s. The SCREEM-RES is in an early stage of
development. In order to maintain an organized program for further development and ensure appropriate use, use of the SCREEM-RES is
mainly restricted to programmed studies within the SHPM. However, the authors also recognize the severe lack of easily available Filipino
measures to assess family resources. Therefore, the author/s are amenable to the use of the SCREEM-RES in studies outside of SHPM as
long as permission is obtained. Requirements include: submission of program / project / research plan or proposal to the author/s, changes or
modifications to the plan or proposal as required by the author/s; regular updates; citation of the role of the author/s in the program / project /
research, and as co-author; and submission of the final draft of report or paper for suggestions prior to final approval. No fees apply to non-
funded clinical and research programs. No changes or modifications to the content, format, scoring and interpretation of scores of this
assessment tool are allowed by the author/s.

Page 2 of 4
 SCREEM FAMILY RESOURCES SURVEY (SCREEM-RES) – FILIPINO

Matinding
Matinding Hindi
Kapag may nagkakasakit sa aming pamilya Sumasang- Hindi
Sumasang- Sumasang-
… ayon Sumasang-
ayon ayon
ayon
Kami ay nagtutulungan sa isa’t isa sa
S1
aming pamilya.
Natutulungan kami ng aming mga
S2
kaibigan at kasamahan sa komunidad
Ang aming kultura ay nagpapatatag ng
C1
loob ng aming pamilya
Ang kultura ng pagtutulungan at
C2 pagmamalasakit sa aming komunidad ay
nakatutulong sa aming pamilya
Ang aming pananampalataya at relihiyon
R1
ay nakatutulong sa aming pamilya
Natutulungan kami ng aming mga
R2 kasamahan sa simbahan o mga grupong
relihiyoso
Sapat ang naipong pera ng aming
E1 pamilya para sa aming mga
pangangailangan
Sapat ang kinikita ng aming pamilya
E2
para sa aming mga pangangailangan
Sapat ang aming kaalaman upang
E’1 maintindihan ang mga impormasyon
tungkol sa sakit.
Sapat ang aming kaalaman upang
E’2
maalagaan ang may sakit.
Madaling makakuha ng tulong medikal
M1
sa aming komunidad.
Natutulungan kami ng mga doktor, nars,
M2
at “health workers” sa aming komunidad.

PARA SA DOKTOR
S E’
C M
R
E TOTAL

Manuel Medina Jr. MD and the Section of Supportive Hospice & Palliative Medicine, University of the Philippines-Philippine General Hospital, Manila. 2010.

Page 3 of 4
 SCREEM FAMILY RESOURCES SURVEY (SCREEM-RES) – ENGLISH

Strongly Strongly
When someone in our family gets sick … Agree Disagree
Agree Disagree

S1 We help each other in our family

Our friends and people in our community
S2
are helpful to our family
Our culture gives our family strength and
C1
courage
Our culture of helpfulness, caring and
C2 concern in our community is helpful to
our family.
Our faith and religion are helpful to our
R1
family
Members of our church and/or religious
R2
groups are helpful to our family
Our family’s savings are sufficient for our
E1
needs
Our family’s income is sufficient for our
E2
needs
Our knowledge and education is
E’1 sufficient for us to understand the
information about the illness
Our knowledge and education is
E’2 sufficient for us to take care of our sick
family member
Medical help is readily available in our
M1
community.
Doctors, nurses and/or health workers in
M2
our community are helpful to our family

FOR THE DOCTOR

S E’
C M
R
E TOTAL

Manuel Medina Jr. MD and the Section of Supportive Hospice & Palliative Medicine, University of the Philippines-Philippine General Hospital, Manila. 2010.

Page 4 of 4