Measuring social participation: reliability of the LIFE-H in older adults with disabilities

Purpose: Much more attention should be paid to instruments documenting social participation as this area is increasingly considered a pivotal outcome of a successful rehabilitation. The purpose of this study was to document the reliability of a participation measure, the Assessment of Life Habits (LIFEH), in older adults with functional limitations. Methods: Eighty-four individuals with physical disabilities living in three different environments were assessed twice with the LIFE-H, an instrument that documents the quality of social participation by assessing a person's performance in daily activities and social roles ( life habits). Results: The intraclass correlation coefficients (ICC) computed for intrarater reliability exceeded 0.75 for seven out of the 10 life habits categories. For interrater reliability, the total score and daily activities subscore are highly reliable ( ICC less than or equal to0.89), and the social roles subscore is moderately reliable (ICC= 0.64). 'Personal care' is the category with the highest ICC, and for five other categories ICCs are moderate to high (<0.60). Conclusion: LIFE-H is a valuable addition to instruments that mostly emphasize the concepts of function or functional independence. It is particularly meaningful to evaluate the participation of older adults in significant social role domains such as recreation and community life. It may be considered among the instruments having the best fit with the ICF definition of participation ( the person's involvement in a life situation) and a majority of its related domains.