Tohoku J. Exp. Med., 2005, 206(1)

Validity and Utility of the Craig Hospital Inventory of Environmental Factors for Korean Community-Dwelling Elderly with or without Stroke

CHANG-WAN HAN,^1,2 YUKI YAJIMA,³ EUN-JOO LEE,⁴ KAZUO NAKAJIMA,⁵ MAKIKO MEGURO⁶ and MASAHIRO KOHZUKI¹

¹Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan, ²School of Health and Welfare, Woosong University, Deajoen, Korea, ³Social and Environmental Sciences, Graduate School of Medicine and Dentistry, Okayama University, Okayama, Japan, ⁴Division of Neuropsychology, Department of Disability Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan, ⁵Department of Welfare System and Health Science (Health and Welfare Science), Okayama Prefectural University, Okayama, Japan and ⁶Division of Physiological Medicine, St. George's Hospital Medical School, Cranmer Terrance, London, UK

The social environmental barriers are considered to be important because the “social participation” of people with impairments would be facilitated by the prevention and reduction of environmental barriers. The Craig Hospital Inventory of Environmental Factors (CHIEF) is one of the few scales to assess the environmental barriers. In this study, we developed the Korean version of CHIEF and evaluated its construct validity and utility in a sample of Korean community-dwelling elderly with or without stroke. We evaluated the construct validity of the CHIEF by testing the original five-factor structure using a confirmatory factor analysis in 400 elderly in Seoul, Korea. The utility of the CHIEF was then assessed by examining the relationships between individual characteristics, Barthel Index and perceived environmental barriers, measured by the CHIEF, using a structural equation modeling approach. The confirmatory factor analysis result demonstrated the validity of a second-order factor model of the CHIEF comprising the five factors as first-order factors. The perceived environmental barrier was a second-order factor when provided acceptable fit indices after two modifications. The structural equation modeling indicates that perceived environmental barriers are significantly related to activities of daily life but not age, gender, and the episode of stroke. The CHIEF is useful in measuring environmental factors for Korean older adults with or without stroke.

keywords —— CHIEF; community-dwelling elderly; environment barrier; Korea

© 2005 Tohoku University Medical Press

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Correspondence: Masahiro Kohzuki, M.D., Ph.D., Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai 980-8574, Japan.

e-mail : kohzuki@mail.tains.tohoku.ac.jp