PURPOSE: The purpose of this study was to examine validity and reliability of the Korean version of the Assessment of Life Habits (K–LIFE–H).

RATIONALE: Participation in the occupations of daily life is an essential part of human development and lived experience. Hence, occupational therapy focuses on enhancing participation. The World Health Organization has addressed participation in the International Classification of Functioning, Disability and Health (ICF). According to the ICF model, participation is defined as involvement in a life situation. The American Occupational Therapy Association (AOTA) also stressed the importance of participation by including participation in the domain of occupational therapy in the Occupational Therapy Practice Framework (2nd ed.; AOTA, 2008). Despite the importance of participation, consensus on a criterion standard for defining and measuring participation is still lacking. The objective and subjective aspects of participation should also be measured independently.

The Assessment of Life Habits (LIFE–H) is the most complete instrument to evaluate participation. LIFE-H was developed to assess the quality of social participation from the Disability Creation Process. LIFE–H captures most of the items in the ICF participation dimension and also measures both objective and subjective participation.

DESIGN: Cross-sectional design

PARTICIPANTS: A total of 159 university students were recruited for this study. Ninety-five questionnaires were included in the final analysis, excluding 64 questionnaires of insufficient responses.

METHOD: We translated English version of LIFE-H 3.1 into Korean in a valid way. The questionnaires contain the K–LIFE–H, the Korean version of the Utrecht Scale for Evaluation of Rehabilitation Participation (K–USER–P), and the Korean version of the World Health Organization Quality of Life–BREF (K–WHOQOL–BREF). K–LIFE–H and K–USER–P were applied to examine participation, and K–WHOQOL–BREF evaluates health-related quality of life (HRQOL).

ANALYSIS: We investigated concurrent validity, construct validity for validity and internal consistency for reliability. In concurrent validity, K–LIFE–H and K–USER–P were compared by using spearman correlations. Spearman correlations was also conducted between and K–LIFE–H and K–WHOQOL–BRFE in construct validity. Cronbach’s α was applied for internal consistency of K–LIFE–H.

RESULTS: For internal consistency, the accomplishment scale and the satisfaction scale of the K–LIFE–H were high (Cronbach’s αs were .89 and .95, respectively). Concurrent validity was shown by fair correlations between the accomplishment scale of the K–LIFE–H and the restriction scale of the K–USER–P (r = .29, p < .01). Both the accomplishment scale of the K–LIFE–H and the restriction scale of the K–USER–P indicate objective participation. The correlation between the satisfaction scale of the K–LIFE–H and the satisfaction scale of the K–USER–P was moderate to good in concurrent validity (r = .60, p < .01). Both the satisfaction scale of the K–LIFE–H and the satisfaction scale of the K–USER–P mean subjective participation.

In construct validity, a correlation was shown between the satisfaction scale of K–LIFE–H, the satisfaction scale and the frequency of the K–USER–P and the total for the K–WHOQOL–BREF (rs = .27–73, p < .01). It indicates that HRQOL only includes the satisfaction of participation, which refers to subjective participation.

DISCUSSION: The K–LIFE–H appears to be a valid and reliable measure to rate objective and subjective participation. HRQOL only correlated with the subjective participation rather than with the objective participation. Consequently, participation needs to be considered as a distinct domain with HRQOL.

IMPACT STATEMENT: Because participation is the ultimate goal in occupational therapy, it is important to measure participation precisely. However, the instrument of participation is still lacking because of the ambiguity of concept of participation. LIFE–H is one of the most frequently used and systematic instrument to measure participation. Thus, we translated LIFE–H from English to Korean and investigated validity and reliability in university students. This will enhance the value of measuring participation in community-based occupational therapy.

American Occupational Therapy Association. (2008). Occupational therapy practice framework: Domain and Process (2nd ed.). American Journal of Occupational Therapy, 62, 625–683. http://dx.doi.org/10.5014/ajot.62.6.625