Activity Card Sort measurement properties – Brazil: the evaluation of elderly participation in activities

Bernardo, Lilian Dias; Deodoro, Tainá Maria Silva; Ferreira, Rafaela Guilherme; Pontes, Tatiana Barcelos; Almeida, Pedro Henrique Tavares Queiroz de

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Original Article • Cad. Bras. Ter. Ocup. 29 • 2021 • https://doi.org/10.1590/2526-8910.ctoAO2202 copy

Activity Card Sort measurement properties – Brazil: the evaluation of elderly participation in activities¹ 1 This article is the result of research “Translation, adaptation and validation of the Activity Card Sort”, developed and coordinated by Professor Dr. Lilian Dias Bernardo, from the Federal Institute of Rio de Janeiro. The research aimed to translate and adapt the Activity Card Sort instrument to the Brazilian context, as well as to validate it through its application in a sample of elderly brazilians. The cross-cultural adaptation process has been previously published in this journal. The research received funding from CNPq and IFRJ.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

The Activity Card Sort (ACS) is a standardized assessment tool, adapted to Brazilian culture, which evaluates the participation of older adults in instrumental, social, and leisure activities.

Objective

To evaluate the measurement properties of the Activity Card Sort-Brazil (ACS-Brazil) community-living version (form C).

Method

Internal consistency and concurrent, convergent and discriminative validity were evaluated. To determine internal consistency, Cronbach's Alpha coefficient was used. Concurrent validity was determined by comparing the ACS-Brazil scores with the LIFE-H 3.1 instrument. Convergent validity was compared with the SF-36 and MMSE-2 assessment instruments, using Spearman's Correlation. The discriminative validity of the ACS-Brazil was assessed using the Mann-Whitney U test, comparing different age groups and years of study.

Results

Evaluations for analysis of measurement properties were applied to 65 elderly people living in the community. The measure showed excellent internal consistency (α=0.91); strong and positive correlation between the total scores of ACS-Brazil and LIFE-H 3.1 (r=0.442, p < 0.01), and moderate to strong correlation between ACS-Brazil and SF-36, in the domain of physical aspects (r=0.509, p<0.01) and vitality (r=0.518, p<0.01) and pain (r=0.409, p=0.01), except for general health and emotional aspects. The results also show that the ACS-Brazil is valid for discriminating between age groups and education.

Conclusion

The ACS-Brazil, community-living version (form C), presented satisfactory psychometric properties, with values consistent with the original version and those from other countries. This indicates its clinical usefulness in application in elderly people to measure participation and engagement in daily activities.

Keywords:
Occupational Therapy; Aged; Social Participation; Validation Studies

Variables	Distribution
Variables	Mean	Standard deviation (SD); in years
Age	69,4	7,2
Years of study	9,96	4,1
Years of study	N	%
0-4 years	08	12,3
5-8 years	15	23,1
9-12 years	29	44,6
>12 years	13	20,0
Gender	N	%
Male	23	35,4
Female	42	64,6
Marital state	N	%
Single	09	13,8
Married	42	64,6
Divorced	06	9,2
Widow/Widower	08	12,3
Family composition	N	%
Spouse and/or children	41	63,1
Just children/parents	09	13,8
Alone	15	23,1

ACS-Brazil Assessment instrument	Cronbach’s α
General evaluation	0,91
Instrumental activities category	0,61
High demand leisure category	0,61
Low demand leisure category	0,84
Social activities category	0,78

Variables	ACS- Brazil	LIFE-H 3.1	MMSE-2	Physical aspects	Functional capability	Emotional aspects	Vitality	Mental health	Social aspects	Pain	General health
ACS- Brazil	1	.442^ The correlation is significant at the 0.01 level (p-value).	.439^ The correlation is significant at the 0.01 level (p-value).	.509^ The correlation is significant at the 0.01 level (p-value).	.399^ The correlation is significant at the 0.01 level (p-value).	.225	.518^ The correlation is significant at the 0.01 level (p-value).	.303^* * The correlation is significant at the 0.05 level (p-value).	.248^* * The correlation is significant at the 0.05 level (p-value).	.409^ The correlation is significant at the 0.01 level (p-value).	.184
ACS- Brazil		.000	.000	.000	.001	.072	.000	.014	.047	.001	.142
LIFE- H 3.1		1	.183	.635^ The correlation is significant at the 0.01 level (p-value).	.334^ The correlation is significant at the 0.01 level (p-value).	.229	.447^ The correlation is significant at the 0.01 level (p-value).	.347^ The correlation is significant at the 0.01 level (p-value).	.054	.216^* * The correlation is significant at the 0.05 level (p-value).	.248^* * The correlation is significant at the 0.05 level (p-value).
LIFE- H 3.1			.145	.000	.006	.067	.000	.005	.669	.083	.047
MMSE-2			1	.174	.209	.220	.154	.180	.117	-.157	.014
MMSE-2				.165	.095	.078	.220	.152	.353	.213	.910
Physical aspects				1	.481^ The correlation is significant at the 0.01 level (p-value).	.210	.578^ The correlation is significant at the 0.01 level (p-value).	.378^ The correlation is significant at the 0.01 level (p-value).	.352^ The correlation is significant at the 0.01 level (p-value).	.354^ The correlation is significant at the 0.01 level (p-value).	.255^* * The correlation is significant at the 0.05 level (p-value).
Physical aspects					.000	.092	.000	.002	.004	.004	.040
Functional capability					1	.491**	.551^ The correlation is significant at the 0.01 level (p-value).	.361^ The correlation is significant at the 0.01 level (p-value).	.383^ The correlation is significant at the 0.01 level (p-value).	.509^ The correlation is significant at the 0.01 level (p-value).	.159
Functional capability						.000	.000	.003	.002	.000	.206
Emotional aspects						1	.480^ The correlation is significant at the 0.01 level (p-value).	.430^ The correlation is significant at the 0.01 level (p-value).	.353^ The correlation is significant at the 0.01 level (p-value).	.191	.208
Emotional aspects							.000	.000	.004	.127	.096
Vitality							1	.628^ The correlation is significant at the 0.01 level (p-value).	.448^ The correlation is significant at the 0.01 level (p-value).	.551^ The correlation is significant at the 0.01 level (p-value).	.347^ The correlation is significant at the 0.01 level (p-value).
Vitality								.000	.000	.000	.005
Mental health								1	.339^ The correlation is significant at the 0.01 level (p-value).	.317^ The correlation is significant at the 0.01 level (p-value).	.244^* * The correlation is significant at the 0.05 level (p-value).
Mental health									.001	.010	.050
Social aspects									1	.338^ The correlation is significant at the 0.01 level (p-value).	.105
Social aspects										.006	.404
Pain										1	.079
Pain											.532
General health											1

Universidade Federal de São Carlos, Departamento de Terapia Ocupacional Rodovia Washington Luis, Km 235, Caixa Postal 676, CEP: , 13565-905, São Carlos, SP - Brasil, Tel.: 55-16-3361-8749 - São Carlos - SP - Brazil
E-mail: cadto@ufscar.br

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[1] Author’s Contributions

Lilian Dias Bernardo participated in all stages of writing the article: text design, organization of sources and/or analyses, text writing, review. Tatiana Barcelos Pontes and Pedro Henrique Tavares Queiroz de Almeida participated in the data analysis, manuscript writing and review. Rafaela Guilherme Ferreira and Tainá Maria Silva Deodoro participated in the data collection and writing of the manuscript. All authors approved the final version of the text.