Measuring Values in Everyday Life and Their Correlation to Activity Participation

SIGNIFICANCE: Client-centered care requires an understanding of both the person’s occupations and his or her perception of sense of self, relationships, cognitive appraisal, and perceived abilities. Currently, there are few tools to measure these constructs, which are central to understanding meaning. We are introducing a tool to address this gap.

INNOVATION: We propose to address this gap by using a modern test theory approach to develop a set of self-reported measures derived from an item bank developed by a prominent psychologist over a period of 40 yr of clinical practice. Research questions included the following: Can we measure values and life satisfaction? Is there a relationship between values and life satisfaction and activity participation?

Traditional practice focuses on the impact of an impairment or injury on activity and participation, often excluding the client’s subjective viewpoint. Understanding the client’s values may lead to a greater understanding of the client’s occupational performance and participation goals that can be addressed with interventions.

METHOD: We used a cross-sectional design in a community setting. Eighty-eight community-dwelling volunteers stratified by age were tested. The SPVLS and Activity Card Sort were administered. Data on demographic and other clinical variables were collected by face-to-face interviews. Rasch analysis of item responses, in which items were selected from the panel review, was used to assess the measurement properties of these instruments. Hierarchical regression analyses were used to investigate the unique contribution of each domain on activity participation, controlling for the demographic variables.

RESULTS: Four domains were developed: sense of self, relationships, cognitive appraisal, and perceived abilities. The resulting domains demonstrated the appropriateness of rating scale functioning as well as adequate internal validity measured by person separation and item separation indexes. Deleting a few misfit items enhanced the model fit with tolerant structural validity. Almost all domains predicted the participation of low-demand leisure activities (F[6, 79] = 3.50–4.49, R ² = 14.9%–19.6%), high-demand leisure activities (F[6, 79] = 4.64–6.24, R ² = 20.5%–26.8%), social activities (F[6, 79] = 1.78–3.61, R ² = 5.2%–15.4%), and total current activities (F[6, 79] = 2.77–3.94, R ² = 11.1%–17.0%).

CONCLUSION: The SPVLS domains are promising and valid methods for assessing values of everyday life. Coupling with a measure of activity participation will provide occupational therapists with essential information to enable clients to fully engage in what they need and want to do in their everyday lives.