Reliability and validity of a Japanese version of life-space assessment in institutionalized settings

Tomoyuki Shinohara PhD , Shota Saito MS , Ayumi Maruyama , Yuta Yabana , Yosuke Tomita PhD , Klaus Hauer PhD
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Abstract

Purpose

A reduction in life space (LS) is associated with a negative impact on medical and functional status during hospitalization, with potential consequences after discharge. A validated version of an evaluation tool for assessing LS in Japanese individuals in an institutionalized setting is lacking. This study developed and validated a Japanese version of the Life-Space Assessment in Institutionalized Settings (LSA-IS-J).

Material and methods

The LSA-IS-J was developed using a specified process. This study included 30 inpatients admitted to the rehabilitation ward. The Timed Up and Go Test, Berg Balance Scale scores, 10-meter walking time, Functional Independence Measure, and Falls Efficacy Scale-International were used to assess construct validity. For test-retest reliability, the same assessor evaluated the LSA-IS-J within two days. Correlation coefficients were calculated to determine the construct validity.

Results

The mean LSA-IS-J total score mean was 37.7 (standard deviation: 7.4), with skewness of -0.17 and kurtosis of -1.39. No ceiling or floor effects are observed. The test-retest reliability was excellent for the total and subtests, with intraclass correlations ranging from 0.78 to 0.99. The LSA-IS-J showed significant correlations with almost all variables related to motor status and concerns about falling, indicating high construct validity. In contrast, more generic variables were not significantly associated.

Conclusions

The LSA-IS-J demonstrated broad feasibility for assessing LS without ceiling or floor effects among patients undergoing ward-based rehabilitation. The LSA-IS-J also demonstrated excellent test-retest reliability and adequate construct validity for constructs with a high impact on LS.

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日语版养老院生活空间评估的可靠性和有效性
目的 生命空间(LS)的减少会对住院期间的医疗和功能状况产生负面影响,并可能在出院后产生后果。目前还缺乏一种经过验证的评估工具,用于评估日本人在住院环境中的生活空间。本研究开发并验证了日语版的《住院环境中的生命空间评估》(LSA-IS-J)。本研究包括 30 名入住康复病房的住院患者。研究采用了定时起立行走测试、Berg 平衡量表评分、10 米步行时间、功能独立性测量和国际跌倒效能量表来评估建构效度。在测试-重测可靠性方面,由同一评估者在两天内对 LSA-IS-J 进行评估。结果LSA-IS-J总分的平均值为37.7(标准差:7.4),偏度为-0.17,峰度为-1.39。没有观察到上限或下限效应。总分和分项测验的重测信度极佳,类内相关系数在 0.78 至 0.99 之间。LSA-IS-J与几乎所有与运动状态和对跌倒的担忧有关的变量都有显著的相关性,表明其具有很高的建构效度。结论LSA-IS-J在评估病房康复患者的LS方面具有广泛的可行性,没有上限或下限效应。LSA-IS-J还显示出极佳的测试再测可靠性,以及对LS影响较大的构念具有充分的构念效度。
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