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Table 3 Changes to the Danish Life Space Assessment (LSA-DK) following cognitive interviews

From: A Danish version of the life-space assessment (LSA-DK) – translation, content validity and cultural adaptation using cognitive interviewing in older mobility limited adults

IPM StagesChallenges discovered in cognitive interviews and actions takenChanges made to the LSA-DK or to the Danish LSA manual
ComprehensionProblems understanding the word “activities”.
To avoid misunderstandings regarding the focus of the LSA, an introductory sentence was added to the Danish manual.
Added to manual
“The questions I am about to ask you, cover how far, how often and how you have gotten around during the last four weeks”
Problems understanding the phrase “been to”.
A probe was added to the Danish manual.
Added to manual
“It doesn’t matter for how long you’ve been in a room/an area. I just need to know if you’ve been in the room/the area or if you’ve passed through the area”
In LS1, “other rooms of your home…” was often not comprehended by respondents living in one-bedroom apartments.
Changes were made in both the LSA-DK and the Danish manual.
Added to questionnaire
A parenthesis with examples was added to the LS1 question.
“Other rooms of your home besides the room where you sleep (e.g. the kitchen or the bathroom)”
Added to manual
An explanatory text was added to the manual:
The example in the parenthesis can be used to clarify ambiguities to the respondent. For example it would be appropriate to sayfor example your kitchen or your bathroom” in Level 1 for respondents living in one-bedroom apartments”
The frequency item was understood and answered by some respondents as describing the preceding month and not being a weekly average.
An explanatory note was added to the Danish manual.
Added to manual
“For frequency, it is important to verify the respondent’s answer to ensure that the frequency noted is an average over the last 4 weeks, representing frequency per week and not per month”
In connection with items on equipment, the respondents did not consider furniture used for balance or a walking stick used as a safety precaution as being equipment.
The LSA manual already describes equipment used for safety.
A probe was added to the Danish manual regarding furniture support.
Added to manual
“Do you support yourself using for example furniture, when walking around inside or outside?”
At LS3 and LS4, the spatial definitions of neighborhood and town caused misunderstandings among some respondents.
No changes were made since no other Danish words are more suitable.
The LSA manual’s definitions of neighborhood and town are recommended to be used to clarify the questions.
Retrieval from memoryIn LS2, problems remembering the content due to the length of the question were identified.
Some of the examples (patio and garage), representing synonyms, were extracted from the LSA-DK after permission from the developers.
New wording in questionnaire:
“An area outside your home such as your porch, deck, yard, hallway (of an apartment building) or your driveway?”
Decision processes and Response processSome respondents calculated the frequency to include both the trip to and the return trip from e.g. the supermarket.
An explanatory text was added to the Danish manual.
Some respondents were challenged when answering the frequency questions since they forgot which time frame they had to consider (4 weeks).
A note was added to the manual.
Added to manual
“The interviewer must be aware, that some respondents will consider a trip to the supermarket to be a frequency of 2, thus counting both ways. This, however, should only be counted as 1, that is 1 time back and forth”.
Added to manual
“The interviewer must be aware of the necessity of using probes to elucidate responses regarding aids, personal assistance and frequency”.
  1. IPM: The Information Processing Model