Physical housing environment: development of a self-assessment instrument.

The aims of this study were to construct and develop a self-administered assessment instrument, useful for studying clients' own perception of accessibility and usability in their housing environment, and to test the instrument for reliability. It was developed for use in combination with an objective, norm-based assessment of the physical housing environment, the Enabler instrument. The instrument developed in this study contains 31 questions about different aspects of the physical housing environment. Answers are given on a 7-point rating scale. Content validity was established by the use of an expert panel and pilot testing, followed by a test-retest study. Internal consistency of the instrument was good (Cronbach's alpha 0.96), and very good to moderate agreement between the two ratings was found on all items (mean weighted kappa, Kw 0.71) indicating good reliability. However, the removal of three items from the standardized part of the instrument is suggested. The instrument has a client-centred approach and is a valid and reliable tool, useful for occupational therapy practice and research.