Validation of the Persian Version of the Engagement in Meaningful Activities Survey (EMAS) in an Iranian Stroke Population: Predictors of Participation in Meaningful Activities

Abstract

Abstract Importance: The inability to participate in meaningful activities is one of stroke survivors’ main difficulties and has a negative effect on their satisfaction and quality of life. Objective: To assess the reliability and validity of the Persian version of the Engagement in Meaningful Activities Survey (EMAS–P) and predictors of participation in meaningful activity among chronic stroke survivors. Design: Cross-sectional. Setting: Medical and rehabilitation centers. Participants: One hundred twenty-three people (75 men, 48 women) with chronic stroke. Outcomes and Measures: Participants were evaluated with the EMAS–P, Satisfaction With Life Scale (SWLS), Center for Epidemiologic Studies Depression Scale, Purpose in Life Test–Short Form (PIL–SF), 36-Item Short Form Health Survey (SF–36), and Life Satisfaction Index–Z (LSI–Z). Results: The EMAS–P showed good internal consistency (Cronbach’s α = .95) and test–retest reliability (intraclass correlation coefficient = .87 for EMAS–P total score). Test–retest reliability for each EMAS–P item was moderate (κ = .40–.65). A significant correlation between the EMAS–P and PIL–SF (r = .86), SWLS (r = .83), LSI–Z (r = .75), and SF–36 subscales (rs = .52–.83) indicated the appropriate convergent validity. The EMAS–P’s discriminative validity was also confirmed for age, depression level, and disability level among people with chronic stroke. Depression, disability level, gender, and fatigue were significant predictors of EMAS–P score. Conclusions and Relevance: The results indicate that the EMAS–P has acceptable reliability and validity among Iranian people with chronic stroke. Moreover, the EMAS–P showed good discriminant validity for age, depression, and disability level among them. What This Article Adds: The EMAS–P is a reliable and valid scale for assessing the engagement of Iranian chronic stroke survivors in meaningful activities and thus should be helpful in both clinical research and practice.