Article

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 (L.I.F.E.).
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 L.I.F.E., based on
solid empirical evidence and design principles, may be a practical solution to
assessment of function in the global culture.

Langue : ANGLAIS