Turkish version of life balance inventory: Validity, reliability, and cultural adaptation study.

BACKGROUND: Life balance is an important concept in occupational therapy and is considered an essential component of the outcomes of life, such as happiness, and satisfaction of needs. AIMS: The aim of this study was to investigate the validity and reliability of the Turkish version of the Life Balance Inventory (LBI) in healthy individuals. MATERIALS AND METHODS: The study consisted of three stages: (1) translation and cultural adaptation, (2) testing internal consistency and reliability, and (3) checking construct validity of LBI. The LBI and the Juhnke-Balkin Life Balance Inventory were implemented. RESULTS: The study was completed with a total of 312 individuals. Cronbach's alpha for Turkish LBI (T-LBI) total score was 0.939. The test-retest ICC scores of T-LBI were found to be 0.986 for the 'health' subscale, 0.980 for the 'relationship' subscale, 0.974 for the 'identity' subscale, and 0.990 for the 'challenge/interest' subscale. The total ICC score of the inventory was 0.989. CONCLUSION AND SIGNIFICANCE: The T-LBI is a valid and reliable assessment tool for measuring life balance in healthy individuals. We believe that our results will anticipate to increase the number of studies on life balance in the field of occupational therapy in Turkey.

Assessing life balance of European people with multiple sclerosis: A multicenter clinimetric study within the RIMS network.

BACKGROUND: Life balance is defined as "a satisfying pattern of daily activity that is healthful, meaningful, and sustainable to an individual within the context of his or her current life circumstances". To assess life balance, the self-report instrument Life Balance Inventory (LBI) has been developed in the US. The aim of this study was to evaluate cross-cultural, construct validity and test-retest reliability of translated versions of the LBI in people with multiple sclerosis (MS) within different European cultures (Dutch, Flemish, Slovenian, and Spanish). METHOD: The LBI was translated according to the principles of forward/backward translation and the cultural adaption process of patient-reported outcomes and evaluated in people with MS in each country/language area. LBI (score range 1-3; higher scores refer to better balance) was registered twice with an interval of 7 days to evaluate test-retest reliability using Intraclass Correlation Coefficients (ICCs) and Bland Altman analyses. To evaluate construct validity, Pearson correlations of the LBI with quality of life, fatigue, depression and self-efficacy were explored. RESULTS: The total sample (n = 313, 50 ± 11 years of age, MS duration 13 ± 8 years) consisted of five subsamples: Dutch (n = 81, 74% women, 54 ± 9.6 years of age), Flemish 1 (n = 42, 57% women, 49 ± 12 years), Flemish 2 (n = 105, 63% women, 50 ± 10.6 years), Slovenian (n = 48, 79% women, 44 ± 11.2 years) and Spanish (n = 37, 62% women, 47 ± 9.0 years). Baseline total LBI scores differed between subsamples (F(4, 312)=7.19, p < 0.001). ICC [95% CI] of total LBI was 0.88 [0.83-0.92] (Flemish 2), 0.65 [0.39-0.82] (Flemish 1), 0.55 [0.37-0.69] (Dutch), 0.45 [0.15-0.67] (Spanish) and 0.35 [0.07-0.59] (Slovenian). Systematic error was present in one sample; no proportional bias occurred. Correlations ranged from 0.05 to 0.55 for quality of life and self-efficacy, from -0.50 to 0.05 for fatigue and from -0.44 to -0.28 for depression, not fully supporting the hypotheses. CONCLUSION: The study results provide limited support for test-retest reliability, cross-cultural and construct validity of the LBI in different European subsamples. Although LBI may serve as a supportive tool in goalsetting in rehabilitation, the current version of LBI is not recommended for (international) research purposes.

Life Balance and Stress in Adults With Medical Conditions or Obesity.

This cross-sectional research examined differences in life balance and perceived stress by body mass index (BMI) levels and self-reported medical conditions that limited physical activity. The sample consisted of 2,338 participants between the ages of 18 and 49 years who took the Life Balance Inventory, the Perceived Stress Scale, and provided demographic information including height and weight. Findings showed that individuals who were obese (BMI > 30.0) reported significantly lower life balance scores and higher stress scores than participants without obesity (p < .001). Also, individuals who had medical conditions that resulted in activity limitations reported significantly less life balance and more stress than individuals without medical conditions (p < .001). These findings highlight the importance of addressing activity participation as a means to promote health and wellness.

Life balance and perceived stress: predictors and demographic profile.

This article explored differences in life balance scores between demographic groups and whether life balance predicted perceived stress. This research used secondary analysis of 1,048 subjects from a database for the Life Balance Inventory (LBI). Analysis of variance showed that the profile of people with the highest total life balance scores was: white, 61 years or older, earned a master's degree, had incomes between $81,000 and $100,000, lived in the suburbs, had two children (but the children were not at home), were not working (if working, they were self-employed), owned a home, and lived in the United States. Other demographic groups differed in their LBI subscale scores. Regression analysis showed that life balance scores predicted lower perceived stress scores. This research provides additional construct validity evidence for the LBI and its associated Life Balance Model. [OTJR: Occupation, Participation & Health 2013;33(3):146-158.].

One-year follow-up to a randomized controlled trial of an energy conservation course for persons with multiple sclerosis.

In this randomized controlled trial, 169 persons with multiple sclerosis were randomly assigned to an immediate intervention group or a delayed control group using a crossover design. The outcome measures (Fatigue Impact Scale and SF-36 Health Survey) were measured four times before and after courses. This study investigated whether the immediate benefits of a 6-week, community-based, energy conservation course for persons with multiple sclerosis were maintained at 1-year follow-up. We performed intent-to-treat and compliers-only analyses using mixed effects analysis of variance models. Results showed that the beneficial effects were maintained 1-year postcourse compared with immediate postcourse. In addition, there were significant improvements in all three subscales of the Fatigue Impact Scale and in four subscales of SF-36 Health Survey 1-year postcourse compared with precourse. Together, these results provide strong evidence that the beneficial effects of the energy conservation course taught by occupational therapists were maintained up to 1-year postcourse.

Use and perceived effectiveness of energy conservation strategies for managing multiple sclerosis fatigue.

OBJECTIVE: This study describes the use and perceived effectiveness of energy conservation strategies by persons with multiple sclerosis after participation in an energy conservation course. METHOD: One hundred twenty-three participants completed a survey about their use of energy conservation strategies. RESULTS: All strategies were newly used by at least 50% of the participants and rated as effective. Strategies that involved rest and delegation were used most and rated most effective, followed by modifying priorities and standards. The most common reason for not implementing strategies was that participants were already using them. CONCLUSION: Persons with multiple sclerosis who participated in an energy conservation course implemented a number of new energy conservation strategies and reported them as effective.

Randomized controlled trial of an energy conservation course for persons with multiple sclerosis.

OBJECTIVE: To assess the short-term efficacy and effectiveness of a six-week energy conservation course on fatigue impact, quality of life and self-efficacy for persons with multiple sclerosis (MS). METHODS: In this randomized controlled trial, we randomly assigned 169 persons with MS to an immediate intervention group or a delayed control group using a crossover design. The outcome measures: Fatigue Impact Scale, SF-36 Health Survey and Self-Efficacy for Performing Energy Conservation Strategies were measured before and after courses and no intervention control periods. We performed intent-to-treat analysis and compliers-only analyses using mixed effects analysis of variance models. RESULTS: Taking the energy conservation course had significant effects on reducing the physical and social subscales of Fatigue Impact Scale and on increasing the Vitality subscale of the SF-36 scores compared with not taking the course. Additional subscales were significant depending on methods of analyses. Self-Efficacy for Performing Energy Conservation Strategies Assessment increased significantly (P <0.05) postcourse compared to precourse. CONCLUSIONS: Results support the efficacy and effectiveness of the energy conservation course to decrease fatigue impact, and to increase self-efficacy and some aspects of quality of life.

Outcomes of a pilot occupational therapy wellness program for older adults.

OBJECTIVE: The purpose of this study was to evaluate a pilot occupational therapy wellness program designed to teach elders the importance of participation in meaningful social and community occupations to their quality of life. METHOD: Sixty-five older adults participated in this pilot wellness program held at each of three senior apartment complexes. Measures of health-related quality of life using the SF-36 Health Survey and frequencies of social and community participation from a program-specific intake form were completed by 39 participants before and after the 6-month program. Participants also evaluated components of the program through a satisfaction survey. RESULTS: Scores on the SF-36 Health Survey were significantly higher in vitality, social functioning, and the mental health summary scores following participation in the program. Participants reported an increased frequency of socialization and community participation with an average of 55% participating in at least three or more activities per week before the program to an average of 66% participating after the program. Participants who benefited the most attended more classes, were older, and were nondrivers. Eighty percent of those polled rated the pilot program as good or excellent. CONCLUSION: This pilot study provides additional support for prevention efforts for elders in the community. Wellness programs for seniors may be most effective if targeted to those who are older and nondrivers.