Beier, Klaus P.,Boggess, Tony,Chan, Lilliene,Haig, Andrew J.,Jayarajan, Senthil,Juang, Derek,Kalpakjian, Claire,Loar, Jesse,Maslowski, Eric,Owusu-Ansah, Bertha,Tinney, Melissa,Yamakawa, Karen S.
Pennsylvania Commonwealth System of Higher Education (PCSHE), Temple University, University of Ghana, University of Michigan, University of Michigan System, Vet Hosp Huntington
"Beier, Klaus P.: University of Michigan","Beier, Klaus P.: University of Michigan System","Chan, Lilliene: University of Michigan","Chan, Lilliene: University of Michigan System","Haig, Andrew J.: University of Michigan","Haig, Andrew J.: University of Michigan System","Jayarajan, Senthil: Pennsylvania Commonwealth System of Higher Education (PCSHE)","Jayarajan, Senthil: Temple University","Juang, Derek: University of Michigan","Juang, Derek: University of Michigan System","Loar, Jesse: University of Michigan","Loar, Jesse: University of Michigan System","Maslowski, Eric: University of Michigan","Maslowski, Eric: University of Michigan System","Owusu-Ansah, Bertha: University of Ghana",
Haig AJ, Jayarajan S, Maslowski E, Yamakawa KS, Tinney M, Beier KP, Juang D, Chan L, Boggess T, Loar J, Owusu-Ansah B, Kalpakjian C. Development of a language-independent functional evaluation. Arch Phys Med Rehabil 2009;90:2074-80.
Objective: To design, validate, and critique a tool for self-report of physical functioning that is independent of language and literacy.
Design: Software design and 2 prospective trials followed by redesign.
Setting: United States and African university hospitals.
Participants: Outpatient and inpatient competent adults with diverse physical impairments.
Interventions: (1) Software design process leading to a Preliminary Language-Independent Functional Evaluation (Pre-L.I.F.E.); (2) patient surveys using a printed Pre-L.I.F.E. and a computer-animated Pre-L.I.F.E. tested in random order, followed by a questionnaire version of the standard Barthel Index; and (3) software redesign based on objective and qualitative experiences with Pre-L.I.F.E.
Main Outcome Measures: Validation of the general concept that written and spoken language can be eliminated in assessment of function. Development of a refined Language-Independent Functional Evaluation (LIFE.).
Results: A viable Pre-L.I.F.E. software was built based on design parameters of the clinical team. Fifty Americans and 51 Africans demonstrated excellent (Cronbach alpha>0.8 Americans) and good (alpha>.425 Africans) reliability. In general, the relations between Pre-L.I.F.E. and Barthel scores were excellent in the United States (interclass correlation coefficient for stair climbing, .959) but somewhat less good in Africa, with elimination functions very poorly related. The computer-animated Pre-L.I.F.E. was faster and trended to be more reliable than the printed Pre-L.I.F.E. in both the United States and Africa. Redesign meetings corrected statistical and qualitative challenges, resulting in a new tool, the L.I.F.E.
Conclusions: Literacy and language translation can be eliminated from some aspects of functional assessment. The new LIFE., based on solid empirical evidence and design principles, may be a practical solution to assessment of function in the global culture.
Africa,"DISABILITY EVALUATION","EDUCATIONAL STATUS",EPIDEMIOLOGY,LANGUAGE,"Outcome assessment (health care) Rehabilitation","STROKE REHABILITATION"