Psychometric properties of self-reported instruments for occupational balance: A COSMIN-based systematic review

Abstract

Introduction Instruments being used currently to evaluate Occupational Balance (OB) are all self-report outcome measures which demand robust psychometric properties for precise assessment. This study aimed to systematically review the psychometric properties of the current OB instruments.

Methods For this systematic review, COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 were adopted. Peer-reviewed articles published between January 2010 and February 2021 were searched for in PubMed, Cochrane, Web of Science, and PsycINFO databases. Search terms were full names and abbreviations of the OB instruments: Life Balance Inventory (LBI), Meaningful Activity Wants and Needs Assessment (MAWNA), Occupational Balance Questionnaire (OBQ), and Occupational Balance-Questionnaire (OB-Quest).

Results Of the 400 articles identified in a systematic database search, 12 studies from 10 articles were analysed. Five instruments, including the revised version of the OBQ (i.e., OBQ11), were analysed within the COSMIN taxonomy. The LBI demonstrated ‘high’ evidence for insufficient structural validity. The others demonstrated ‘moderate’ or ‘high’ evidence for indeterminate structural validity. Less than sufficient structural validity led to indeterminate internal consistency across five instruments, and their quality of evidence varied from ‘very low’ to ‘high’. The MAWNA and OBQ demonstrated ‘very low’ evidence for sufficient reliability.

Conclusion OB instruments with psychometric properties of sufficient overall ratings supported by ‘high’ quality of evidence are unavailable. Further studies are required to clarify the concept of OB, to examine more diverse psychometrics of OB instruments, and to consolidate their robustness.