Assessment of Life Habits (LIFE-H)

Evidence Reviewed as of before: 26-01-2008

Author(s)*: Sabrina Figueiredo, BSc

Editor(s): Johanne Desrosiers, PhD OT; Annie Rochette, PhD OT; Nicol Korner-Bitensky, PhD OT; Elissa Sitcoff, BA BSc

Purpose

The Assessment of Life Habits (LIFE-H) was developed to assess the quality of social participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. of people with disabilities by estimating how a client accomplishes activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
of daily living and social roles (Fougeyrollas, Noreau, Bergeron, Cloutier, Dion & St-Michel, 1998).

In-Depth Review

Purpose of the measure

The Assessment of Life Habits (LIFE-H) was developed to assess the quality of social participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual's involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. of people with disabilities by estimating how a client accomplishes activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
of daily living and social roles (Fougeyrollas, Noreau, Bergeron, Cloutier, Dion & St-Michel, 1998).

Available versions

The LIFE-H, with 298 items, was developed by Fougeyrollas, Noreau, Bergeron, Cloutier, Dion and St-Michel, in 1997. In 1998, the number of items was cut down to 240 LIFE-H 3.0 (Fougeyrollas and Noreau, 1998).

The LIFE-H is also available in three shortened versions, the latest one being version 3.1. The LIFE-H 2.1 was developed by Fougeyrollas, Noreau, Bergeron, Cloutier, Dion and St-Michel, in 1997, and contains 58 items. The LIFE-H 3.0, developed by Fougeyrollas and Noreau in 1998 contains 69 items on its short form. The LIFE-H 3.1, developed by Fougeyrollas, Noreau and St-Michel in 2001, contains 77 items.

The International Network of Disability Creation Process (INDCP) encourages use of versions 3.0 and 3.1.

Features of the measure

Items:
The LIFE-H is a self-administered questionnaire. If the client has a low cognitive level the questionnaire can be answered by a proxy respondent (Poulin & Desrosiers, 2008). It evaluates the level of participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. in daily activitiesAs defined by the International Classification of Functioning, Disability and Health, activity is the performance of a task or action by an individual. Activity limitations are difficulties in performance of activities. These are also referred to as function.
and social roles by considering the degree of difficulty in carrying out life habits and the type of assistance required (Desrosiers, Noreau, Robichaud, Fougeyrollas, Rochette & Viscogliosi, 2004).

The LIFE-H assesses accomplishment of life habits and satisfaction with how they are accomplished. The accomplishment scale of the LIFE-H covers all 12 domains of life habits proposed by the Disability Creation Process (DCP) model. These 12 domains are similar to 7 of the 9 domains proposed by the International Classification of Functioning and Disabilities (ICF) of the World Health Organization (WHO, 1998). The first 6 domains are related to activities of daily living (ADL)Basic tasks that involve bodily issues (bathing, dressing, toileting, transferring, continence, eating and walking) that are done on a daily basis. including: nutrition, fitness, personal care, communication, housing, mobility. The remaining are related to social roles: responsibilities, interpersonal relationships, community life, education, employment and leisure (Fougeyrollas et al., 1998).

The versions of the LIFE-H cover all 12 domains with varying number of items under each domain as seen in Table 1.

Domains	LIFE-H 3.0		LIFE-H 3.1
Domains	Short Version	Long Version	LIFE-H 3.1
Nutrition	3	17	4
Fitness	3	9	4
Personal Care	7	33	8
Communication	7	14	8
Housing	8	40	8
Mobility	5	18	5
Responsibilities	6	25	8
Family relations	N/A – included in interpersonal relationship	N/A	N/A – included in interpersonal relationship
Interpersonal Relationships	7	14	7
Community Life	7	18	8
Education	3	13	3
Employment	7	12	7
Recreation/Leisure	6	27	7
Number of total items	69	240	77

For each item in the accomplishment scale the client is asked about perceived difficulty in performing a life habit and the type of assistance used to perform it. When a life habit is not realized because it is not part of the person’s daily life, it is considered as a non-applicable item. (Desrosiers et al., 2004; Desrosiers, Boubonnais, Noreau, Rochette, Bravo, & Bourget, 2005; Fougeyrollas et al., 1998; Poulin & Desrosiers, 2008).

The definitions of the difficulty level and the types of assistance are provided within the questionnaire and are as follows (Fougeyrollas et al., 1998):

Level of difficulty	Definition
No difficulty	The person perceives he/she can easily perform a life habit even if this requires a technical aid, adaptation or human assistance, as needed.
With difficulty	The person perceives that he/she performs a life habit with some difficulty even if this requires a technical aid, adaptation or human assistance, as needed.
Performed by substitution	The person does not actively participate in the performance of a life habit. It is entirely done by another person (human assistance).
Not performed	The person does not perform a life habit because the barriers are too great or lack of assistance.
Not applicable	The life habit has no part in the person’s daily life.

Types of aides	Definition
Technical aids	Any (non-human) support to assist in the accomplishment of a life habit, such as wheelchair, visual aid, hearing aid, medication, other items.
Adaptation	Any modification to the person’s environment to facilitate the accomplishment of life habits, such as access ramp, wider door, modification of a life habit or time to carry out (e.g. allow more time to perform it).
Human Assistance	Any person assisting in the accomplishment of a life habit such as relatives, friends, orderlies (this covers both physical assistance and supervision)

In the satisfaction scale the client is asked to indicate the degree of satisfaction (on a five point scale from very satisfied to very dissatisfied) in accomplishing each item (Desrosiers et al., 2004; Desrosiers et al, 2005; Fougeyrollas et al., 1998; Poulin & Desrosiers, 2008).

Subscales:
Two sub-scales exist. The ADL sub-scale contains the following categories: nutrition, fitness, personal care, communication, housing, mobility. The Social Role sub-scale is represented by responsibilities, interpersonal relationships, community life, education, employment and leisure (Desrosiers et al., 2004; Desrosiers et al., 2005).

Scoring:
The LIFE-H has a continuous score ranging from 0 to 9. In the original version, a score of 0 implies an optimal level of participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. and 9 indicates total handicap or total disruption in participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations.. However, in the three shortened versions (LIFE-H 2.1, 3.0, and 3.1) the scale was inverted and a score of 0 indicates total handicap or total disruption in participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. and a score of 9 means an optimal level of participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. (Fougeyrollas et al., 1998).

To calculate a single item score the answers related to the difficulty level and assistance are combined based on the grid below (Desrosiers et al., 2004; Desrosiers et al, 2005; Fougeyrollas et al., 1998; Poulin & Desrosiers, 2008):

Original version	Versions 2.1; 3.0; 3.1	Definition
0	9	Performed with no difficulty
1	8	Performed with no difficulty with technical aid (or adaptation)
2	7	Performed with difficulty with no assistance
3	6	Performed with difficulty and technical aid (or adaptation)
4	5	Performed with no difficulty with human assistance
5	4	Performed with no difficulty with technical aid (or adaptation) and human assistance
6	3	Performed with difficulty and human assistance
7	2	Performed with difficulty and technical aid (or adaptation) and human assistance
8	1	Performed by a substitute
9	0	Not performed
N/A	N/A	Not applicable

The LIFE-H total score is obtained by summing the scores on each item and then dividing by the number of items (means). It is also possible to calculate the categories, ADL and Social Roles sub-scores by calculating the means of the sub-score of interest. (Desrosiers, Rochette, Noreau, Bravo, Hebert & Boutin, 2003; Fougeyrollas et al., 1998).

As the LIFE-H has a different number of items under each category, a normalized score can be calculated. The normalized score takes into account the number of items in each category and the number of non-applicable items, allowing a similar weight to each category sub-score (Noreau, Fougeyrollas & Vincent, 2002).

Normalized score = {SUM (Raw scores) x 10} / (Number of applicable items x 9)

The non-applicable items are not counted into the raw score. The satisfaction level on accomplishing an item is not considered in the scoring process. Rather, the answers related to satisfaction are used to document the quality of social participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. (Fougeyrollas et al., 1998).

Time:
The LIFE-H 3.0 (short form) takes approximately 20 to 40 minutes to complete. The administration time for the long form can vary from 20 to 120 minutes, according to the number of categories administered (Noreau et al., 2002). The time required to complete the other versions of the LIFE has not been reported.

Equipment:
Only a pencil and the test are needed.

Training:
None typically reported.

Alternative forms of the LIFE-H

LIFE-H 2.1, LIFE-H 3.0 (short and long version), and LIFE-H 3.1.

Client suitability

Can be used with:

Clients with any type of disabilities, including children.
Clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.

Should not be used in:

When administering the LIFE-H to clients with severe cognitive impairments the answers should be given by a proxy who knows the individual well.

In what languages is the measure available?

French, English, and Dutch (version 3.0).

Summary

What does the tool measure?	The LIFE-H assesses the quality of social participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. of people with disabilities.
What types of clients can the tool be used for?	Clients with any type of disabilities, including children.
Is this a screeningTesting for disease in people without symptoms. or assessment tool?	Assessment.
Time to administer	The LIFE-H 3.0 (short version) takes approximately 30 to 60 minutes and the long version can takes from 20 to 120 minutes.
Versions	LIFE-H 2.0; LIFE-H 2.1., LIFE-H 3.0., and LIFE-H 3.1 (short and long version)
Other Languages	French, English and Dutch.
Measurement Properties
ReliabilityReliability can be defined in a variety of ways. It is generally understood to be the extent to which a measure is stable or consistent and produces similar results when administered repeatedly. A more technical definition of reliability is that it is the proportion of “true” variation in scores derived from a particular measure. The total variation in any given score may be thought of as consisting of true variation (the variation of interest) and error variation (which includes random error as well as systematic error). True variation is that variation which actually reflects differences in the construct under study, e.g., the actual severity of neurological impairment. Random error refers to “noise” in the scores due to chance factors, e.g., a loud noise distracts a patient thus affecting his performance, which, in turn, affects the score. Systematic error refers to bias that influences scores in a specific direction in a fairly consistent way, e.g., one neurologist in a group tends to rate all patients as being more disabled than do other neurologists in the group. There are many variations on the measurement of reliability including alternate-forms, internal consistency , inter-rater agreement , intra-rater agreement , and test-retest .	Internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency.: Two studies examined the internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency. of the LIFE-H. One reported excellent consistency between two repeated measures of the LIFE-H total score and sub-scores and the other reported adequate to excellent consistency between clients and proxies. Test-retest: Two studies have examined the test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society). of the LIFE-H and reported excellent test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society). using ICC. Inter-rater: One study examined the inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept. of the LIFE-H and reported adequate to excellent inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept. using ICC.
ValidityThe degree to which an assessment measures what it is supposed to measure.	Content: One study examined the content validityRefers to the extent to which a measure represents all aspects of a given social concept. Example: A depression scale may lack content validity if it only assesses the affective dimension of depression but fails to take into account the behavioral dimension. of the LIFE-H and reported that after a consultation with 12 rehabilitation experts, few LIFE-H items were either modified or removed from the original version. After this procedure the experts recognized the LIFE-H as being able to measure participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. and handicap situations. Criterion: Predictive: Six studies examined the predictive validityA form of criterion validity that examines a measure’s ability to predict some subsequent event. Example: can the Berg Balance Scale predict falls over the following 6 weeks? The criterion standard in this example would be whether the patient fell over the next 6 weeks. of the LIFE-H. Five studies reported that age, environmental barriers, impairments and disability level, lower extremity coordination, leg and arm function, walking endurance and speed, length of stay, the Berg Balance Scale, the Beck DepressionIllness involving the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood or a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression. Inventory, the Comorbidity Index and the Stress Appraisal Measure measured at 2 weeks after strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. or at discharge from a rehabilitation program were able to predict LIFE-H scores at 6 months, 2 and 4 years post-stroke. One study reported that severity of lower extremity impairments was the best predictor of disagreement on clients and proxies’ responses. Construct: Convergent: Four studies examined convergent validityA type of validity that is determined by hypothesizing and examining the overlap between two or more tests that presumably measure the same construct. In other words, convergent validity is used to evaluate the degree to which two or more measures that theoretically should be related to each other are, in fact, observed to be related to each other. of the LIFE-H. One study with clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. reported adequate to excellent correlations between the LIFE-H, the SMAF, and the FIM. The three other studies, using different populations, reported poor to excellent correlations between the LIFE-H and the Caregiver Strain Index, the London Handicap Scale and the Impact on ParticipationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. and Autonomy Questionnaire using Pearson CorrelationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation. Coefficient. No correlations were found between the LIFE-H and the Beck DepressionIllness involving the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood or a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression. Inventory. Known Groups: One study examined known groups’ validityThe degree to which an assessment measures what it is supposed to measure. and reported that the LIFE-H is able to discriminate healthy individuals from clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..
Floor/Ceiling Effects	One study verified floor effects in few categories of the LIFE-H, when measuring participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. at 2 weeks post-stroke. At 6 months all categories of the LIFE-H showed ceiling effects. The proportion of patients reaching ceiling and floor effects were not reported.
Does the tool detect change in patients?	Two studies examined the responsivenessThe ability of an instrument to detect clinically important change over time. of the LIFE-H and reported greater changes at 2 weeks post strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. (large effects sizes) when compared with changes at 6 months post-stroke (moderate effects sizes). Additionally, changes in participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. were more significant on personal relationships, employment and recreation with moderate to large effect sizes.
Acceptability	When administered to clients with severe cognitive impairments the scores should be obtained from proxies.
Feasibility	The administration of the LIFE-H is simple since it’s a self-administered questionnaire.
How to obtain the tool?	Information on the LIFE-H can be obtained by emailing the International Network of Disability Creation Process (INDCP), at ripph@irdpq.qc.ca

Psychometric Properties

Overview

We conducted a literature search to identify all relevant publications on the psychometric properties of the LIFE-H. We identified sixteen studies in total, eleven included participants with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain..

Floor/Ceiling Effects

Rochette, Desrosiers, Bravo, St-Cyr/Tribble & Bourget (2007b) observed, in 35 clients with mild strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain., floor effects in the Nutrition, Mobility, Community Life, Education/Employment and Recreation categories of the LIFE-H when measuring participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual's involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. at 2 weeks post-stroke. At 6 months post-stroke, ceiling effects could be observed in all categories of the LIFE-H. The proportion of participants scoring the minimum and maximum scores was not reported.

Reliability

Internal consistencyA method of measuring reliability . Internal consistency reflects the extent to which items of a test measure various aspects of the same characteristic and nothing else. Internal consistency coefficients can take on values from 0 to 1. Higher values represent higher levels of internal consistency.:
Lemmens, van Engelen, Post, de Witte, Beurskens, and Wolters (2007) administered the LIFE-H, Dutch version 3.0 (short form), to 35 older adults with functional limitations due to strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. The consistency of the LIFE-H total score between two repeated measures showed an excellent Intraclass Correlation Coefficient (ICC)Intraclass correlation (ICC) is used to measure inter-rater reliability for two or more raters. It may also be used to assess test-retest reliability. ICC may be conceptualized as the ratio of between-groups variance to total variance. of 0.78. Consistency for the two subscales was also excellent (ICC = 0.80).

Poulin and Desrosiers, (2008) evaluated the consistency of the LIFE-H version 3.1, when completed by proxy versus patient respondents by comparing responses from 40 clients and their proxies. Clients and proxies were assessed separately by the same rater. Proxy interviews were conducted one week apart of the client’s assessment. Consistency between clients and proxies was excellent for the total score (ICC = 0.82) and the ADL sub-score (ICC = 0.87). Consistency for the Social Roles sub-score was adequate (ICC = 0.73).

Test-retest:
Noreau, Desrosiers, Robichaud, Fougeyrollas, Rochette, and Viscogliosi (2004) examined the test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
of the LIFE-H, version 3.0 (short form), in 40 clients with functional limitations caused by many conditions, including strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. Participants were re-assessed within 5 to 10 days by the same rater and under the same conditions. Test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
assessed using an Intraclass Correlation Coefficient (ICC)Intraclass correlation (ICC) is used to measure inter-rater reliability for two or more raters. It may also be used to assess test-retest reliability. ICC may be conceptualized as the ratio of between-groups variance to total variance., was found to be excellent for the LIFE-H total score (ICC = 0.95), for the ADL sub-score (ICC = 0.96) and for the Social Roles sub-score (ICC = 0.76).

Lemmens et al., (2007) assessed the test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
of the LIFE-H, Dutch version 3.0 (short form), in 35 older adults with functional limitations due to strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. Participants completed the LIFE-H questionnaire twice, the second time after a 2-week interval. Test-retest reliabilityA way of estimating the reliability of a scale in which individuals are administered the same scale on two different occasions and then the two scores are assessed for consistency. This method of evaluating reliability is appropriate only if the phenomenon that the scale measures is known to be stable over the interval between assessments. If the phenomenon being measured fluctuates substantially over time, then the test-retest paradigm may significantly underestimate reliability. In using test-retest reliability, the investigator needs to take into account the possibility of practice effects, which can artificially inflate the estimate of reliability (National Multiple Sclerosis Society).
, as calculated using Intraclass CorrelationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
Coefficient, was excellent for the total score (ICC = 0.80), for the ADL sub-score (ICC = 0.78) and for the Social Roles sub-score (ICC = 0.78).

Inter-rater:
Noreau et al., (2004) evaluated the inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
of the LIFE-H, version 3.0 (short form), in 44 older adults with functional limitations caused in part by strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain.. The LIFE-H was administered by 2 examiners within 3 to 5 days of each other. Inter-rater reliabilityA method of measuring reliability . Inter-rater reliability determines the extent to which two or more raters obtain the same result when using the same instrument to measure a concept.
, as calculated using ICC, was excellent for the total score (ICC = 0.89) and ADL sub-score (ICC = 0.91) and adequate for the Social Roles sub-score (ICC = 0.64).

Validity

Content:
Fougeyrollas, Noreau, Bergeron, Cloutier, Dion and St-Michel (1998) sent the original copy of the LIFE-H to 12 experts including researchers, service providers and consumer representatives having occupational therapy, nursing, social work, psychology as a professional background. Following consultation, modifications related to clearness of items, definitions of the terms, and the rank of the accomplishment level were made and some items were eliminated. After this procedure the experts recognized the LIFE-H as being able to measure participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. and handicap situations.

Criterion:
Concurrent:
No gold standardA measurement that is widely accepted as being the best available to measure a construct.
exists against which to compare the LIFE-H.

Predictive:
Rochette, Desrosiers, and Noreau (2001) examined the ability of age, gender, impairments and disabilities level (comprised of cognition, perception, depressionIllness involving the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood or a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.
, communication, sensorimotor and comorbidity) and environmental factorsAs defined by the International Classification of Functioning, Disability and Health, environmental factors make up the physical, social and attitudinal environment in which people live and conduct their lives. (comprised of perceived environmental barriers and facilitators), measured at discharge from a rehabilitation program, to predict handicap situations at 6 months post-stroke in 51 clients. Handicap situations were measured with the LIFE-H, version 2.1. Logistic regression revealed the best predictor of handicap situations at 6 months to be impairment and disabilities level (R2 = 38.3%) followed by age (R2 = 14.4%) and environmental barriers (R2 = 6.2%), respectively.

Desrosiers, Noreau, Rochette, Bravo and Boutin (2002) assessed, in 102 clients, whether age, length of stay in a rehabilitation program, motivation, communication problems, urinary and fecal incontinence, upper and lower extremity coordination, motor function impairment, lower and upper extremity disabilities, affect, visual perceptual performance, cognition, comorbidity and perceived social support, measured at discharge from a rehabilitation program, were able to predict handicap situations at 6 months after a strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. Handicap situations were measured with the LIFE-H, version 2.1., motor function impairment with the Fugl-Meyer Assessment (Fugl-Meyer, Jääskö, Leyman, Olsson, & Steglind, 1975); lower extremity disabilities with walking speed, the Berg Balance Scale (Berg, Wood-Dauphinee, Williams & Maki, 1989) and the 2-Minute Walk Test (Kosak & Smith, 2005); upper extremity disabilities with the Upper Extremity Performance Evaluation Test for the Elderly (Test d’evaluation des membres superieurs des personnes agees – TEMPA) (Desrosiers, Hébert, Dutil, & Bravo, 1994); affect with the (Beck, Ward, Mendelson, Mock, & Erbraugh, 1961); visual perceptual performance with the Motor-Free Visual Perceptual test (Colarusso & Hammill, 1972); cognition with the Modified Mini-Mental State (Teng & Chui, 1987); comorbidity with the Comorbidity Index (Charlson, Pompei, Ales, Mock, & Erbraugh, 1987) and perceived social support with the Social Provisions Scale (Cutrona, 1986). Multiple regression analysis indicated that the Beck DepressionIllness involving the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood or a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.
Inventory (R2 = 23.0%), lower extremity coordination (R2 = 31.0%), length of stay (R2 = 3.0%), the Berg Balance Scale (R2 = 9.0%), age (R2 = 1.0 %) and the Comorbidity Index (R2 = 1.0%) were the best predictors of handicap situations 6 months post-stroke.

Desrosiers, Malouin, Bourbonnais, Richards, Rochette & Bravo (2003) analyzed, in 102 clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain., the ability of arm and leg impairments and disabilities, measured at discharge of a rehabilitation program, to predict participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. 6 months later. ParticipationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. was measured with the LIFE-H, version 2.1., motor function and sensation with the Fugl-Meyer Assessment (Fugl-Meyer et al., 1975), arm coordination with the Finger to Nose test and leg coordination with a specific test developed by the same researcher team (Desrosiers, Hébert, Bravo, Dutil, 1995), arm disabilities with the Upper Extremity Performance Evaluation Test for the Elderly (Test d’evaluation des membres superieurs des personnes agees – TEMPA) (Desrosiers et al., 1994) and leg disabilities with the Berg Balance Scale (Berg et al., 1989), the 2-Minute Walk Test (Kosak & Smith, 2005) and walking speed. Balance (r = 0.67), walking endurance (r = 0.63), walking speed (r = 0.62), and leg coordination (r = 0.62) were found to be excellent predictors of the LIFE-H. Leg function (r = 0.58), arm disabilities (r = 0.48), arm coordination (r = 0.47), arm function (r = 0.43), and leg sensation (r = 0.31) were considered adequate predictors of the LIFE-H. Finally, arm sensation and the LIFE-H were poorly correlated, suggesting this variable is not able to predict the LIFE-H.

Desrosiers, Noreau, Rochette, Bourbonnais, Bravo and Bourget (2006) verified, in 66 clients, whether age, length of stay in a rehabilitation program, motivation, communication problems, urinary and fecal incontinence, upper and lower extremity coordination, motor function impairment, lower extremity disabilities, upper extremity disabilities, affect, visual perceptual performance, cognition, comorbidity, and perceived social support, measured at discharge from a rehabilitation program, were able to predict participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. at 2 and 4 years after a strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. ParticipationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. was measured by the LIFE-H, version 2.1., motor function impairment with the Fugl-Meyer Assessment (Fugl-Meyer et al., 1975); lower extremity disabilities with walking speed, the Berg Balance Scale (Berg et al., 1989) and the 2-Minute Walk Test (Kosak & Smith, 2005); upper extremity disabilities with the Upper Extremity Performance Evaluation Test for the Elderly (Test d’evaluation des membres superieurs des personnes agees – TEMPA) (Desrosiers et al., 1994); affect with the Beck DepressionIllness involving the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood or a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.
Inventory (Beck et al., 1961); visual perceptual performance with the Motor-Free Visual Perceptual test (Colarusso & Hammill, 1972); cognition with the Modified Mini-Mental State (Teng & Chui, 1987); comorbidity with the Comorbidity Index (Charlson et al., 1961) and perceived social support with the Social Provisions Scale (Cutrona, 1986). From a multiple regression analysis the best predictors for participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. at 2 and 4 years post-stroke are age (R2 = 11.0%), comorbidity (R2 = 18.0%), motor coordination (R2 = 15.0%), upper extremity disability (R2 = 6.0%) and affect (R2 = 3.0%).

Rochette, Bravo, Desrosiers, St-Cyr/Tribble and Bourget (2007a) estimated, in 88 clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. the ability of the Stress Appraisal Measure (Peacock & Wong, 1990) and the Revised Ways of Coping Questionnaire (Folkman & Lazarus, 1988) measured in the first 2 weeks post-stroke to predict the LIFE-H, version 3.0 (short form) 6 months post-stroke. Multiple linear regression analysis suggested that the Threat, Challenge, Centrality and Stressfulness’ subscales of the Stress Appraisal Measure were more likely to predict the LIFE-H scores. These four variables together were able to explain 25 % of variance on the LIFE-H scores provided by clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Poulin and Desrosiers (2008) examined, in 40 clients with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. and 40 proxies, whether age, gender, schooling, living environment, relationship of proxy, strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. type, side of motor impairmentLoss of strength and coordination, decrease in arm or leg movement
, previous strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain., number of months since strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain., self-perceived health, the Mini-Mental State Examination (Folstein, Folstein, & McHugh, 1975), the Chedoke McMaster StrokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. Assessment (Gowland, Van Hullenar, Moreland, Vanspall, Barreca, Ward et al., 1995) and the Geriatric DepressionIllness involving the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood or a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.
Scale (Jongenelis, Pot, Eisses, Gerritsen, Derksen, Beekman et al., 2005) were able to predict disagreement on responses provided by clients and their proxies on the LIFE-H, version 3.1. All the variables were measured at one point in time among community-dwelling individuals who had been hospitalized due to strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. and their proxies. Severe lower extremity impairment and poorer cognitive performance were found to be the best predictors of disagreement on the LIFE-H total score (R2 = 40%). For the ADL sub-score, the variables able to predict disagreement on the LIFE-H were severity of lower extremity impairment, living environment and gender (R2 = 44%). For the Social Role sub-scores the best predictors of disagreement were severity of lower extremity impairment, cognitive functions and number of months since strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain., explaining 32% of the variance.
Note: Although disagreement levels between clients’ responses and their proxies do not appear to be clinically significant, the predictors of disagreement should be considered when interpreting proxy responses.

Construct:
Desrosiers, Rochette, Noreau, Bravo, Hébert and Boutin (2003) evaluated the construct validityReflects the ability of an instrument to measure an abstract concept, or construct. For some attributes, no gold standard exists. In the absence of a gold standard , construct validation occurs, where theories about the attribute of interest are formed, and then the extent to which the measure under investigation provides results that are consistent with these theories are assessed.
of the LIFE-H, version 2.1, by comparing it to the Functional Autonomy Measurement System (Systeme de mésure de l’autonomie fonctionelle – SMAF) (Hébert, Carries, & Bilodeau, 1988) and the Functional Independence Measure (FIM) (Keith, Granger, Hamilton, & Sherwin, 1987) at 2 weeks and at 6 months after discharge from a strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. rehabilitation program. At the first point in time, 118 participants were available and at the second point in time 102. Correlations, as calculated using Pearson correlationThe extent to which two or more variables are associated with one another. A correlation can be positive (as one variable increases, the other also increases – for example height and weight typically represent a positive correlation) or negative (as one variable increases, the other decreases – for example as the cost of gasoline goes higher, the number of miles driven decreases. There are a wide variety of methods for measuring correlation including: intraclass correlation coefficients (ICC), the Pearson product-moment correlation coefficient, and the Spearman rank-order correlation.
coefficients, were found to be excellent between the SMAF and the LIFE-H total score (r1 = 0.85; r2 = 0.89), the LIFE-H ADL sub-score (r1 = 0.89; r2 = 0.91), and the LIFE-H Social Roles sub-score (r1 = 0.66; r2 = 0.77) and between the FIM and the LIFE-H total score (r1 = 0.79; r2 = 0.85), the LIFE-H ADL sub-score (r1 = 0.85; r2 = 0.88), and the LIFE-H Social Roles sub-score (r2 = 0.71). Correlations between the LIFE-H and the FIM at 2 weeks after discharge were adequate (r1 = 0.57).

Convergent:
Three studies have investigated the convergent validityA type of validity that is determined by hypothesizing and examining the overlap between two or more tests that presumably measure the same construct. In other words, convergent validity is used to evaluate the degree to which two or more measures that theoretically should be related to each other are, in fact, observed to be related to each other.
of the LIFE-H in older individuals with functional limitations but not necessarily individuals with strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain..

Desrosiers, Noreau, Robichaud, Fougeyrollas, Rochette and Viscogliosi (2004) measured the convergent validityA type of validity that is determined by hypothesizing and examining the overlap between two or more tests that presumably measure the same construct. In other words, convergent validity is used to evaluate the degree to which two or more measures that theoretically should be related to each other are, in fact, observed to be related to each other.
of the LIFE-H, version 3.0 (short form), by comparing it to the Functional Autonomy Measurement System (Système de mesure de l’autonomie fonctionelle – SMAF) (Hébert et al., 1988) in 87 elderly adults with functional limitations. Correlations were excellent between the SMAF and LIFE-H total score (r = 0.70) and the ADL sub-score (r = 0.76) and adequate between the SMAF and the LIFE-H Social Roles sub-score (r = 0.43).

Rochette, Desrosiers, Bravo, St-Cyr/Tribble and Bourget (2007c) analyzed the convergent validityA type of validity that is determined by hypothesizing and examining the overlap between two or more tests that presumably measure the same construct. In other words, convergent validity is used to evaluate the degree to which two or more measures that theoretically should be related to each other are, in fact, observed to be related to each other.
by comparing changes of participation’s level on the LIFE-H version 3.0 (short form) to the Caregiver Strain Index (Robinson, 1983) and the Beck DepressionIllness involving the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood or a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.
Inventory (Beck et al., 1961) in 54 spouses of individuals with a first ever strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. Correlations between the Caregiver Strain Index and the LIFE-H total score (r = 0.32) and the Social Roles sub-score (r = 0.39) were adequate. The Caregiver Strain Index and the LIFE-H ADL sub-score were poorly correlated (0.02). No correlations were found between the LIFE-H and the Beck DepressionIllness involving the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood or a sign of personal weakness or a condition that can be wished away. People with a depressive disease cannot merely “pull themselves together” and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people with depression.
Inventory.

Lemmens et al., (2007) examined the convergent validityA type of validity that is determined by hypothesizing and examining the overlap between two or more tests that presumably measure the same construct. In other words, convergent validity is used to evaluate the degree to which two or more measures that theoretically should be related to each other are, in fact, observed to be related to each other.
of the LIFE-H, Dutch version 3.0 (short form), with the Impact on ParticipationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. and Autonomy Questionnaire (IPA) (Cardol, Haan, Van den Bos, De Jong, & De Groot, 1999) and the London Handicap Scale (LHS) (Hardwood, Roger, Dickinson, & Ebrahim, 1994) in 63 older adults with functional limitations. Excellent correlations were found between the total score and the IPA (rho = 0.82) and the LHS (rho = 0.90).

Known groups:
Desrosiers, Bourbonnais, Noreau, Rochette, Bravo, and Bourget (2005) verified the ability of the LIFE-H, version 2.1, to discriminate between older individuals who had experienced a strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain. (n = 46) and healthy older individuals (n = 46). Known group validityThe degree to which an assessment measures what it is supposed to measure.
, as calculated using Student’s t-test, showed that scores of healthy subjects were significantly higher than the scores of the participants with strokeAlso called a "brain attack" and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a "schemic stroke", or the formation of a blood clot in a vessel supplying blood to the brain..

Responsiveness

Rochette et al., (2007b) examined the responsivenessThe ability of an instrument to detect clinically important change over time.
of the LIFE-H, version 3.0 (short form) in 35 clients with mild strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. ParticipationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. level was measured before strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. (T0), in a retrospective way, at 2 weeks (T1), 3 months (T2) and 6 months post (T3). At T1, effects sizes were large for the LIFE-H total score (1.21) as well as for the ADL and Social Roles sub-scores (1.15; 1.24). For the timeline T3-T1 and T3-T0, effects sizes were all moderate : LIFE-H total score (0.60; 0.62), ADL sub-score (0.64; 0.58), and the Social Roles sub-score (0.56; 0.70).

Rochette et al., (2007c) analyzed the responsivenessThe ability of an instrument to detect clinically important change over time.
of the LIFE-H, version 3.0 (short form) in 54 spouses of individuals with a first ever strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain.. ParticipationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. level was measured before strokeAlso called a “brain attack” and happens when brain cells die because of inadequate blood flow. 20% of cases are a hemorrhage in the brain caused by a rupture or leakage from a blood vessel. 80% of cases are also know as a “schemic stroke”, or the formation of a blood clot in a vessel supplying blood to the brain. (T0), in a retrospective way, and at 2 weeks (T1) and 6 months (T2) post-stroke. At T1, effects sizes were moderate for the LIFE-H total score (0.53), small for the ADL sub-scores (0.0), and large for the Social Roles sub-score (0.90). At T2, the LIFE-H total score (0.38) and the ADL sub-score (0.13) demonstrated a small effect sizeEffect size (ES) is a name given to a family of indices that measure the magnitude of a treatment effect. Unlike significance tests, these indices are independent of sample size. The ES is generally measured in two ways: as the standardized difference between two means, or as the correlation between the independent variable classification and the individual scores on the dependent variable. This correlation is called the “effect size correlation”.
and the Social Roles sub-scores a moderate one (0.76). Changes in participationAs defined by the International Classification of Functioning, Disability and Health, participation is an individual’s involvement in life situations in relation to health conditions, body functions or structures, activities, and contextual factors. Participation restrictions are problems an individual may have in the manner or extent of involvement in life situations. were larger for personal relationships (T1 = 0.67; T2 = 0.83), employment (T1 = 0.68; T2 = 0.63) and recreation (T1 = 1.16; T2 = 0.93) showing moderate to large effect sizes.

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See the measure

How to obtain the LIFE-H

A copy of the LIFE-H can be ordered from the International Network on the Disability Creation Process (INDCP). The initial user’s rights fee is CAN$ 288.00 and enhances using the LIFE-H for a 3-year period. One assessment tool can be obtained for CAN$ 23.00 and additional information records forms for CAN$ 3.00 each. INDCP detains all rights on the reproduction and distribution on all the versions of the LIFE-H.

Students are not charged the initial user’s rights fee (CAN$ 288.00) and are allowed to reproduce the LIFE-H for their ongoing research project. However, to do so, students have to buy one copy of the assessment tool (CAN$ 23.00) and commit in not using it for purposes other than their current research project. At the end of the project, a copy of their master’s or doctorate thesis should be sent to the INDCP.

Further information on the LIFE-H can be obtained by emailing the International Network of Disability Creation Process (INDCP), at ripph@irdpq.qc.ca.

The following links allow you to download sample versions of both the General Short Form (LIFE- H 3.1), and General Long Form (LIFE- H 3.0). They are for viewing purposes only and may not be reproduced.

LIFE-H short version (LIFE- H 3.1):
http://www.ripph.qc.ca/documents/MHAVIE_ADULTE_ABREGE_AN_no-reproduction.pdf
LIFE-H long version (LIFE- H 3.0):
http://www.ripph.qc.ca/documents/MHAVIE_ADULTE_DETAILLE_AN_no-reproduction.pdf