CONCEPTUALIZATIONS OF HEALTH AMONG ADULTS WITH INTELLECTUAL IMPAIRMENTS (FORCED CHOICE, RETARDATION).
Contributors: University Of Illinois At Chicago, Health Sciences Center.
Published: 1996
Number of pages: 170
Subjects: Health Sciences, Public Health.; Health Sciences, Nursing.
Description: Adults with developmental disabilities often have little input into the way their health and health problems are perceived and defined. However, their health is greatly affected by definitions and perceptions of their health and health status. Conceptualizations of health by adults with intellectual impairments may differ from their adult counterparts without intellectual impairments by virtue of variations in stages of social, cognitive, and emotional development. In response to the many societal changes which have altered the needs and expectations for adults with developmental disabilities, the concept of health must be examined within the context of their own lives.

Currently, literature on health conceptualization among adults with intellectual impairments does not exist, therefore, a two phase study was conducted. The first phase focused on developing a forced-choice instrument that could be used as a second measure of health conception. Phase Two focused on assessing the reliability and the construct validity of the two health conception measures and describing the participants' health definitions from the closed-ended and forced-choice formats.

The findings from this study indicate that definitions of health can be measured validly and reliably with semi-structured open-ended questions and a forced-choice questionnaire among adults with intellectual impairments. The data in this study support the existence of an acceptable internal consistency for the 13-item Health Definitions Scale (HDS) ($\alpha$ =.787) for use in research studies. Internal consistency for the subscales in the Health Definitions Scale was not as well supported. Cronbach's alpha coefficient of reliability ranged from.24 to.61 within the subscales, reflecting a low to moderate degree of internal consistency. Preliminary construct validity for the HDS was demonstrated through principle components factor analysis with orthogonal varimax rotation on the 13-item HDS. Eleven items clustered into the theoretically proposed subscales, suggesting that the subconcepts may theoretically reflect the concept of health.

The Kappa statistic was computed for each of the health conceptions questions on the Definitions of Health Semi-Structured Format Instrument to assess interrater and intrarater reliability. The results demonstrated moderate to high levels of interrater agreement among the four content specialists. The average Kappa values, which ranged from 74.9% to 91.7%, provides evidence that the open-ended questions could generate reproducible and stable responses. Thus, preliminary support was shown that conceptualization of health can be measured by open-ended questions regarding the meaning of the word among adults with intellectual impairments.

The results also demonstrated that adults with intellectual impairments have an understanding of health that parallels the general population's multidimensional conception of health, and, incorporates their life experiences as individuals with disabling conditions.
Notes: Source: Dissertation Abstracts International, Volume: 57-11, Section: B, page: 6877.

Thesis (PH.D.)--UNIVERSITY OF ILLINOIS AT CHICAGO, HEALTH SCIENCES CENTER, 1996.

School code: 0806.