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 participation of people with disabilities by estimating how a client accomplishes activities 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 participation of people with disabilities by estimating how a client accomplishes activities 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 participation in daily activities 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) 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
Short Version Long Version
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 participation and 9 indicates total handicap or total disruption in participation. 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 participation and a score of 9 means an optimal level of participation (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 participation (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 stroke

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 participation 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 screening 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
Reliability
  • Two studies examined the consistency of the LIFE-H. 1 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.
  • Two studies have examined the test-retest reliability of the LIFE-H and reported excellent test-retest reliability using ICC.
  • One study examined the inter-rater reliability of the LIFE-H and reported adequate to excellent inter-rater reliability using ICC.
Validity

Content

One study examined the content validity 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 participation and handicap situations.

Criterion

Predictive Validity:

Six studies examined the predictive validity 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 Depression Inventory, the Comorbidity Index and the Stress Appraisal Measure measured at 2 weeks after stroke 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 validity:

Four studies examined convergent validity of the LIFE-H. One study with clients with stroke 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 Participation and Autonomy Questionnaire using Pearson Correlation Coefficient. No correlations were found between the LIFE-H and the Beck Depression Inventory.

Known Groups:

One study examined known groups’ validity and reported that the LIFE-H is able to discriminate healthy individuals from clients with stroke.

Floor/Ceiling Effects One study verified floor effects in few categories of the LIFE-H, when measuring participation 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 responsiveness of the LIFE-H and reported greater changes at 2 weeks post stroke (large effects sizes) when compared with changes at 6 months post-stroke (moderate effects sizes). Additionally, changes in participation 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 stroke.

Floor/Ceiling Effects

Rochette, Desrosiers, Bravo, St-Cyr/Tribble & Bourget (2007b) observed, in 35 clients with mild stroke, floor effects in the Nutrition, Mobility, Community Life, Education/Employment and Recreation categories of the LIFE-H when measuring participation 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

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 stroke. The consistency of the LIFE-H total score between two repeated measures showed an excellent Intraclass Correlation Coefficient (ICC) 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 reliability of the LIFE-H, version 3.0 (short form), in 40 clients with functional limitations caused by many conditions, including stroke. Participants were re-assessed within 5 to 10 days by the same rater and under the same conditions. Test-retest reliability assessed using an Intraclass Correlation Coefficient (ICC), 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 reliability of the LIFE-H, Dutch version 3.0 (short form), in 35 older adults with functional limitations due to stroke. Participants completed the LIFE-H questionnaire twice, the second time after a 2-week interval. Test-retest reliability, as calculated using Intraclass 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 reliability of the LIFE-H, version 3.0 (short form), in 44 older adults with functional limitations caused in part by stroke. The LIFE-H was administered by 2 examiners within 3 to 5 days of each other. Inter-rater reliability, 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 participation and handicap situations.

Criterion

Concurrent:

No gold standard 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, depression, communication, sensorimotor and comorbidity) and environmental factors (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 stroke. 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 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 stroke, the ability of arm and leg impairments and disabilities, measured at discharge of a rehabilitation program, to predict participation 6 months later. Participation 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 participation at 2 and 4 years after a stroke. Participation 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 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 participation 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 stroke 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 stroke.

Poulin and Desrosiers (2008) examined, in 40 clients with stroke and 40 proxies, whether age, gender, schooling, living environment, relationship of proxy, stroke type, side of motor impairment, previous stroke, number of months since stroke, self-perceived health, the Mini-Mental State Examination (Folstein, Folstein, & McHugh, 1975), the Chedoke McMaster Stroke Assessment (Gowland, Van Hullenar, Moreland, Vanspall, Barreca, Ward et al., 1995) and the Geriatric 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 stroke 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 stroke, 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 validity 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 stroke 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 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 validity of the LIFE-H in older individuals with functional limitations but not necessarily individuals with stroke.

Desrosiers, Noreau, Robichaud, Fougeyrollas, Rochette and Viscogliosi (2004) measured the convergent validity 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 validity 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 Depression Inventory (Beck et al., 1961) in 54 spouses of individuals with a first ever stroke. 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 Depression Inventory.

Lemmens et al., (2007) examined the convergent validity of the LIFE-H, Dutch version 3.0 (short form), with the Impact on Participation 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 stroke (n = 46) and healthy older individuals (n = 46). Known group validity, as calculated using Student’s t-test, showed that scores of healthy subjects were significantly higher than the scores of the participants with stroke.

Responsiveness

Rochette et al., (2007b) examined the responsiveness of the LIFE-H, version 3.0 (short form) in 35 clients with mild stroke. Participation level was measured before stroke (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 responsiveness of the LIFE-H, version 3.0 (short form) in 54 spouses of individuals with a first ever stroke. Participation level was measured before stroke (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 size and the Social Roles sub-scores a moderate one (0.76). Changes in participation 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.

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