Validation of the interview-based life-space assessment in institutionalized settings (LSA-IS) for older persons with and without cognitive impairment

Abstract

Background Self-reported life-space assessment methods so far focus on community-dwelling persons, with a lack of validated assessment methods for institutionalized settings. This study evaluated construct validity, test-retest reliability, sensitivity to change, and feasibility of a new Life-Space Assessment for Institutionalized Settings (LSA-IS) in geriatric patients. Methods Psychometric properties of the LSA-IS in 119 hospitalized geriatric patients (83.0 ± 6.2 years) with and without cognitive impairment (CI) [Mini-Mental State Examination: 22.4 ± 4.9 scores] were evaluated within a comprehensive validation design. For the total group and subgroups according to cognitive status, construct validity was assessed by calculating Spearman’s rank correlation coefficients (rho) with established construct variables, test–retest reliability by intra-class correlation coefficients (ICCs), sensitivity to change by standardized response means (SRMs) calculated for effects of early ward-based rehabilitation during hospital stay. Results The LSA-IS (total score) demonstrated good test–retest reliability (ICC = .704), and large sensitivity to change (SRM = .806), while construct validity was small to high indicated by significant correlations of the LSA-IS to construct variables (rho = .208–716), depending on relative construct association. On average results of LSA-IS sub-scores confirmed results of the total score. Subgroups according to cognitive status did not differ for most analyzed variables. A completion rate of 100% and a completion time of 3.2 ± 1.2 min documented excellent feasibility. Conclusions The interview-based LSA-IS has proven to be valid, reliable, sensitive, and feasible in hospitalized, multi-morbid, geriatric patients with and without CI documenting good psychometric properties for institutionalized settings. Trial registration DRKS00016028

Psychometric Properties of the Proxy-Reported Life-Space Assessment in Institutionalized Settings (LSA-IS-Proxy) for Older Persons with and without Cognitive Impairment

“…The LSA-IS-proxy is based on an external (proxy) report and represents a newly designed LSM assessment instrument adjusted for the institutionalized environment (hospital setting) and is consistent in content and documentation with the self-report, LSA-IS version [ 21 ]. The main difference is the type of assessment (self vs. proxy report).…”

“…Concurrent validity was determined using the proxy-based and the self-report version of the LSA-IS [ 21 ], which was assessed simultaneously at hospital admission by different assessors.…”

“…Currently, with the self-report Life-Space Assessment in Institutionalized Settings (LSA-IS) [ 21 ] and the Nursing Home Life-Space Diameter (NHLSD) [ 22 ], there are only two LSM surveys published and validated in institutionalized persons. The LSA-IS as an interview-based, self-report version was developed and comprehensively validated for use in hospitalized or institutionalized persons with and without CI [ 21 ]. Despite the excellent psychometric properties of the LSA-IS, the success of the assessment substantially depends on the ability of a person to be interviewed and the competence of the interviewer using the advanced interview support of the measure, which may not be provided in all settings.…”

Validation of the German version of the Life-Space Assessment LSA-D

“…8 Several instruments for measuring life-space mobility in specific populations and settings exist, including assessments of life-space within one’s own residence for home-bound individuals 9 or residents in nursing homes and other institutions. 10 11…”

“…27 To date, two modified German versions for assessment of life-space mobility in specific populations of older adults exist: One for those with mild cognitive impairment (LSA-CI) 23 that captures life-space of the past week and one for those in institutionalized settings where life-spaces are adapted to the living environment of care facilities (LSA-IS). 11 However, a validated and intercultural adapted version of the original LSA that can be administered in the context of a more general geriatric setting in the overall population of community-dwelling older adults is still missing. Therefore, we conducted a validation study of a German version of the original LSA the (LSA-D) in urban and rural areas.…”