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Graduate Student Paper:  Reviewing the Life Satisfaction in the Elderly Scale (LSES)

 

Abstract

This study reviewed the Life Satisfaction in the Elderly Scale (LSES) that was developed by Salamon and Conte in 1984. The LSES was designed in order to produce an assessment tool with improved psychometric properties that could be useful in measuring an elderly (55 and older) individual's self-reported perception of life satisfaction. The findings of this review indicate that the LSES has stronger reliability and validity levels than previously developed scales, and measures the domains of Pleasure in daily activity, Meaningfulness of life, Goodness of fit between desired and achieved goals, Mood tone, Self-concept, Social contact, Perceived health, and Financial security. All are considered important characteristics of the abstract construct of life satisfaction. The LSES has been used in numerous research studies and is considered useful in clinical assessments of depression, and as a rapport building tool during the counseling session.

  Beginning with Erik Erikson's developmental theory and the concept of "ego integrity versus despair in late adulthood," more than 50 years of research and assessment attempts have been introduced in an effort to appraise the elderly's satisfaction with life and their sense of well-being (Barrow, 1996; Phillips, 1986; Rathus, 1993). Erikson purported that the aging person is faced with the challenge of retaining their individual belief that life remains meaningful in view of approaching death (Euler, 1992; Rathus, 1993). It is this underlying theoretical concept and the hope that once satisfaction in life is defined, advances could be made to assist the aging populace to further achieve a comfortable level of contentment in the final years (Conte & Salamon, 1982; Phillips, 1986; Ryff, 1995; Schultz & Heckhausen, 1996). This perspective has repeatedly stirred the social and gerontological sciences to labor to quantify and qualify the constructs of satisfaction and subjective well-being (Barrow, 1996; Neugarten, Havighurst & Tobin, 1961; Phillips, 1986; Salamon, 1988; Conte & Salamon, 1982).
  Salamon and Conte (1982, 1988) have operationally defined life satisfaction as the perceived degree to which an individual has successfully cleared life's developmental circumstances. These developmental circumstances are things such as overcoming childhood illnesses, the process of education, to marry or to remain single, employment and/or job loss, and coping with the loss or death of loved ones (e.g., through divorce or runaway, etc.)(Conte & Salamon, 1982).
Excellent introduction: strong foundation and definition of construct Well-being is further defined as an individual's perceived state of health, prosperity, happiness, sense of accomplishment, and comfort in life (Ryff, 1995). In addition, elderly is defined as an individual aged 55 and older (Conte & Salamon, 1982).  This evaluation of life satisfaction is subjective in that it is one's personal opinion of their adaptation processes and their general well-being (Conte & Salamon, 1982).  Neugarten, Havinghurst and Tobin (1961) advocated that only through the use of a self-report instrument could the sciences appropriately measure a person's subjective well-being; after all, only the individual is the best judge of their own happiness and contentment with life (p. 134).
  Salamon and Conte authored the Salamon-Conte Life Satisfaction in the Elderly Scale (SCLSES) in 1984 (title later changed to LSES; Salamon, 1988), in order to develop an assessment instrument with sound psychometric properties that would improve on the then widely used Life Satisfaction Index (LSI) scale developed by Neugarten, et al. (1961) (Conoley, Kramer & Mitchell, 1988; Conte & Salamon,1982; Salamon, 1988). Aside from improving on the psychometric properties of the LSI, Salamon and Conte also expanded the coverage of areas on the instrument to include other facets that elderly individuals considered important at their particular stage of life. This additional information was obtained through extensive literary review and survey of the elderly (Brockett, 1987; Conoley, et al, 1988; Gould, 1992; Neri, Andermarcher, Pradelli & Salvioli, 1995; Salamon, 1988).
 

Test Description

The LSES, a multi-factor scale, is constructed of 40 multiple choice questions believed to measure the construct of well-being (Salamon, 1988; Conte, Salamon, 1982). Five of the eight subscale domains are taken from the LSI scale. Neugarten, et al. (1961), and later Salamon and Conte (1984) and others (Conoley et al, 1988; Conte & Salamon, 1982; Phillips, 1986) have hypothesized that these constructs are measures of psychological well-being, happiness, morale, and/or contentment in life (terms used interchangeably throughout the literary review).

  The five basic domains of satisfaction measurement incorporated in the LSES and borrowed from the LSI are: Pleasure in daily activities, Regarding life as meaningful, Desired versus achieved goals, Positive mood, and Positive self-concept (Conoley et al, 1988). The other three domains that were added later are: Perceived health, Perceived financial security and Satisfaction with social contacts (Conoley et al, 1988). The three that were later added by Salamon and Conte, were based on Spreitzer and Snyder's (1974) research that indicates that the perceptions of finances, health and social involvement were influential considerations to the elderly, and must be factored into the overall concept of life satisfaction (Conoley et al, 1988; Conte & Salamon, 1982; Salamon, 1985, 1988; Gould, 1992).
  Conte and Salamon (1982) advise that the different domains are generally written as open-ended sentences and are structured to measure different concepts of the theoretical description of life satisfaction. These domains, a brief description, an example of an item within that subscale, and the Likert choice of answers are as follows:

1. Pleasure in daily activity: measures the individual's degree of satisfaction with numerous, unspecified daily activities of the older person. (i.e., My daily routine is: very boring, boring, average, satisfying, very satisfying)

2. Meaningfulness of life: reflects the individual's positive attitude toward life as a result of a sense of usefulness and purpose in his or her life situation. (i.e., I am most satisfied with my life situation: never, almost never, sometimes, often, always)

3. Goodness of fit between desired and achieved goals: involves matching the individual's degree of satisfaction with his or her present stage of life relative to previous stages. (i.e., In my life I have achieved: nothing, very little, something, a lot, a great deal)

4. Mood tone: This subscale allows for a measure of general positive effect, happiness, or optimism, nonspecific with regard to one's environment or social situation. (i.e., I am ___ in a bad mood: always, often, sometimes, seldom, never)

5. Self-concept: Measures the degree of personal self-regard and favorable self- appraisal. (i.e., Compared to any other time in my life, I am now: very unsatisfied, unsatisfied, average, satisfied, very satisfied)

6. Perceived health: Measures the individual's self assessment of overall physical well-being. (i.e., Physically I am: unhealthy, somewhat unhealthy, average, healthy, very healthy)

7. Financial security: The individual evaluates their own present and recent financial situation. (i.e., I have enough money to enjoy myself: never, rarely, sometimes, often, always)

8. Social Contact: Measures one's perceived level of satisfaction with the number and quality of social contacts that are characteristic of the respondent's usual routine. (i.e., I try to spend time with people: never, rarely, sometimes, often, always) (p. 197)

 

 

 

Use 'e.g.,' instead of 'such as'

Each test kit, published by Psychological Assessment Resources, Inc., costs $43 and includes 50 scoring sheets, 50 test booklets and the 27 page test manual that was revised in 1992 (M. J. Salamon, personal communication, April 1999). Items are written at a sixth grade reading level and are addressed in the first-person (Conoley, Kramer & Mitchell, 1988; Phillips, 1986). The authors advise that this pencil and paper instrument is easy to administer and score, using simple addition. No special training is required to administer and/or score. The LSES takes approximately 20 minutes to complete, and is considered non-threatening by the test taker (Conte & Salamon, 1982). They further advise that in the event of physical or visual impairment (such as arthritis, poor eyesight and/or illiteracy), another person could read the items to the elderly individual and score their responses on the score sheet provided. Instructions are included in the test manual regarding scoring and possible interpretations (Conoley et al, 1988; Conte & Salamon, 1982).
Highest value?  indicate valance

Clarify that items are summed.

Test Scoring

The LSES is constructed as a self-report instrument in a five-point Likert scale format. The scores for each item vary from one to five, with five being the highest value possible (Conoley et al, 1988; Conte & Salamon, 1982; Phillips, 1988). The test-taker merely places an "X" on the line above one of the five responses provided for each item; each response yields a numerical score of 1 to 5. This instrument produces a total score of 40 to 200 points, and subscale scores range from 5 to 20. The analysis is that the higher the score, the higher the individual's assessment of their satisfaction with life (Conoley et al, 1988; Phillips, 1986; Salamon, 1987, 1988).

What other normative factors should be considered?

Is this sample large enough?

Normative Sample

The LSES was administered in three different studies to 649 individuals who lived in the New York Metropolitan area (Conoley et al, 1988; Salamon, 1984, 1988). Conte and Salamon (1982) report that subjects were randomly solicited from various health care facilities, nursing homes, assisted living quarters, and retirement communities in order to access a broad spectrum of the socioeconomic levels. The authors advise that the normative sample was based on data from the 1980 census and represents the various socio-economic levels (Conte & Salamon; 1982; Salamon, 1988). All participants were 55 to 90 years of age (Conoley et al, 1988; Conte & Salamon, 1982).

 

Reliability

Test-Retest
Reliability is the term used to define the dependability and/or consistency of a test when used under similar circumstances (Cohen, Swerdlik & Phillips, 1996). Information regarding the reliability estimate of the LSES is confusing. Dixon reports test-retest reliability coefficients estimates of .90 at one month time and .67 after a 6 month time lapse (Conoley et al., 1988). Dixon did not specify in his evaluation whether these coefficient estimates are for the total 649 individuals or only a subset of the sample. Neither did he indicate if the test-retest values were based on subscales or total scores, however, he did comment that "subscale reliabilities are adequate for most subscales; however, the Goals and Self-concept subscales are questionable due to the subjective dependence on present happiness (coefficient alpha reliabilities of .60, .50 and .61, .47 respectively for two different samples)" (Conoley et al, 1988, p.170).

 

 

Add spaces to (n=50) to read (n = 50)

Salamon (1988) indicated that at the 6 month test-retest interval, with 57of the original sample, a reliability coefficient of .67 was measured based on total scores. Busch-Rossnagel reported a test-retest reliability estimate on 120 of the original sample, of .67 for the total score; while at the one month test-retest interval, a total score estimate of .90 (n=50) and reliability coefficient estimate above .88 for all subscales was measured for fifty of the sample group (Conoley et al., 1988, p. 172).
  Salamon (1988) commented that these scores indicate a "high moderate range" for test-retest reliability (p. 48). This appears to be a liberal interpretation of conflicting data. However, assuming the test-retest reliability estimates of .90 and .67 are accurate figures for one month and 6 month intervals, one could surmise that the LSES reflects acceptable reliability and is sensitive to change over time within the elderly population (Conoley et al, 1988).
  Internal Consistency
Internal consistency computations, based on the total scale, produced high coefficient alphas of .93 and .92 on two sample groups (Conoley et al, 1988). Conte and Salamon (1982) report that after computing Spearman Brown coefficients for the individual scores of each of the initial five scales, the average coefficient was .95, which indicates highly significant reliability. Busch-Rossnagel reports that moderate subscale reliabilities range from .47 to .79 for two different sample groups; with the subscales of Desired versus achieved goals and Positive self-concept ranking the lowest with moderate reliability coefficient scores of .47 to .61 (Conoley et al, 1988).
Check spelling of 'Crombach'

Delete 'to item'

Add spaces to 'p<.05' to read 'p < .05'

Brockett (1987) used the LSES in his study of elderly people and their self-reported level of education. He reports a Crombach alpha score of .88, which he interpreted as a high degree of consistency (Brockett, 1987; Salamon, 1988). Brockett (1987) then conducted an item to item analysis of the scale and compared it to the total scale and found that 37 of the 40 items correlated strongly at 92.5%, p< .05, which adds additional support of internal consistency of this instrument; which simply means that the items in the scale are measuring the same thing (p. 232-233).
 

Validity

Construct Validity
Construct Validity has been defined as the overarching type of test validation, in that it is based on the definition of the construct being measured within context, time and place (M. McCarthy personal communication, September 2, 1999). As stated earlier, the authors define "life satisfaction . . . as the individual's assessment of their progress toward perceived life's goals" (Salamon, 1988; p. 48). Conte and Salamon hypothesized that the higher the total test score, the higher the measure of life satisfaction of the individual (Brockett, 1987; Conte & Salamon, 1982; Salamon, 1987).

  Factor analysis and cluster analysis were performed on the eight factors. Salamon (1987,1988) reports that the perceived level of health and financial security both correlated highly, while there was moderate correlation among the other six categories.
Interpret!
A summary statement needs to be here.
Further reports indicate that a sophisticated rotation analysis was performed on the eight subscales, and four of the five items from five subscales showed high homogeneity (Conoley et al., 1988). Salamon (1988) stated that these items correlated in the hypothesized positive manner; such as a high perception of mood and health would strongly correlate with a high measure of daily activities and/or social contact and thus, a perceived high level of life satisfaction (p. 48). The inverse would also correlate equally (Salamon, 1987, 1988).
  Content Validity
Busch-Rossnagel reported that information in the manual confirms the face validity of this instrument was based on the evaluation of four experts, but that no additional information was provided (Conoley et al., 1988, p. 171). A current examination of literary articles pertaining to the LSES, also yielded no information to confirm or discredit this statement; nor was there any recorded appraisal of face validity by the test takers.
  Criterion Validity
Dixon and Busch-Rossnagel stated that no criterion validity was reported in the 1984 manual (Conoley et al., 1988). Salamon (1988) later advised that scores from the second sample group, (n = 241) correlated at an above average range of r = .85 when compared to individual medical records from the local health care facility and social service intake reports (p. 49).
Interpret why this is criterion validity Salamon (1988) advised that a separate study involving 20 elderly living in a long term health care facility was conducted, using the LSES, the Beck Depression Inventory (BDI), and the Geriatric Depression Scale (GDS). These instruments were administered to this small sample group. Statistical analysis revealed that total LSES and BDI correlated at r = .48, and the GDS at r = .51. The mood subscale of the LSES correlated moderately with BDI at r = .73 and with the GDS at r = .78. Salamon (1988) considered these correlations to be significant, yet low to moderate (p. 49).
Interpret In another study, Salamon (1988) reported that there was a strong correlation between the LSES and other measures of health and well-being. He referred to a study of 75 applicants to a health care clinic for the elderly. These individuals completed the LSES, Health Background Questionnaire and were also extensively interviewed during intake procedures. Accordingly, Salamon (1988) stated that "highly significant correlations resulted p> .00l between the LSES and the additional data collected" (p. 49).
  Brockett (1987) also used the LSES in his study with 64 elderly in which he was striving to determine if the individuals self-directed learning experiences correlated with their perceived life satisfaction. The subjects in this study were asked to complete the LSES and the Self-Directed Learning Readiness Scale (SDLRS). The SDLRS is a 58-item Likert scale designed to measure an individual's perception of their skills and attitudes as self-directed learners (Brockett, 1987; p. 230). His study revealed that five of the eight subscales correlated at .21 to .24 using a Product Moment Correlation Coefficient with p< .05 with the SDLRS. These results were interpreted by Brockett as low, yet significant and indicate that the individuals that retain a strong sense of independence and control also self-report higher levels of satisfaction with life (p. 231-233).
How is this criterion validity? The LSES was also used in additional studies measuring such things as the individual's involvement in social groups and their level of life satisfaction (Salamon, 1985); the perception of life satisfaction while living in an long term care institution (nursing home) (Gould, 1992; Salamon, 1987); the level of androgyny exhibited in the elder as they progress through the aging process and their perceived level of life satisfaction (Dean-Church & Gilroy, 1993); and as a pre-test and post-test assessment tool used by clinical counselors after intervention and group therapy (Weiss, 1994).
  The LSES has been used in numerous unpublished master's theses as well as a study conducted by Jacobson (1993) (cited in: M.J. Salamon, personal communication, April, 1999). In Jacobson's study, Salamon noted that the LSES was used along with the State-Trait Anxiety Inventory with women of the baby-boomer age group to assess their level of depression and their perceived satisfaction in life (M.J. Salamon, personal communication, April, 1999). These various applications of the LSES instrument in research strengthen the validity of the LSES as an adequate research and assessment tool of individuals across the ages.
Good interpretation

Test Bias

Closer scrutiny of the normative sample group, by Busch-Rossnagel, raised questions as to the omission of data regarding gender breakdown, education level, and socioeconomic status (Conoley et al., 1988). An additional criticism mentioned by various authors is that the instrument appears to be normed on a small cross-section of a portion of the North Eastern US, which would indicate that this normative sample does not reflect the greater population (Conoley et al., 1988; Neri, Andermarcher, Pradelli & Salvioli, 1995; Phillips, 1986).

 

 

Add year after 'Dixon and Busch-Rossnagle'

Discussion

The LSES was developed by Salamon and Conte (1984) in order to provide the social and gerontological sciences with an improved instrument used to measure the abstract concept of life satisfaction. Dixon and Busch-Rossnagle state that the authors have adequately designed this instrument with internal consistency levels measuring stronger psychometric properties in the moderate to high range depending on the subscale. They also expanded the pre-existing life satisfaction measurement scales to include additional characteristics of concepts of satisfaction in life that the elderly individuals reported to be important at this stage in life.(Conoley et al., 1988). The LSES instrument appears easy to use, inexpensive, and is considered non threatening by the elderly, advised Salamon (1987).

  Both Dixon and Busch-Rossnagel caution that interpretation must be made with discretion since the instrument is tapping into one's subjective self-report assessment of mood and attitude in the moment (Conoley et al., 1988).
  Salamon (1988) reported two cases in which he used the LSES in the clinical setting; in each case, the tool was used for assessment prior to treatment for depression and post-treatment. In both instances, he noted marked improvement in subscale scores and recommends that this instrument could best be used as an assessment measure (p. 51-53). He and others have also argued that this instrument has shown relevance as a research tool and also has been used successfully as a springboard for dialog during the clinical intake procedure, focusing on areas of specific topics (i.e., low scores in subscales of Goodness of fit , Mood tone, Meaningfulness of life and etc.) and for strengthening rapport with the elderly client (e.g., Dean-Church & Gilroy, 1993; Gould, 1992; Neri et al., 1995; Phillips, 1986; Weiss, 1994)
  Realizing that the construct of life satisfaction is abstract and difficult to measure due to variables such as the individual's frame of reference, culture, ethnicity, values and spirituality, the LSES should never be used as an absolute measure of life satisfaction. It does, however, show remarkable value as a tool used in the assessment of depression and as a pre and post treatment assessment tool, however it is the opinion of this reviewer that the LSES should be administered to a larger, stratified sample group in order to further improve the psychometric properties.
 

Add a space between all the authors' initials, for example, 'Barrow, G. M.'

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References

Barrow, G.M., (1996). Special problems. Aging, the Individual and Society (6th ed.). Minneapolis/St. Paul: West Publishing Co.

Brockett, R.G., (1987). Life satisfaction and learner self-direction: enhancing quality of life during the later years. Educational Gerontology, 13, 225-237.

Cohen, R.J., Swerdilk, M.E., Phillips, S.M., (Eds.). (1996). Psychological Testing and Assessment: An introduction to tests and measurements (3rd ed.). Mountain View, CA: Mayfield Publishing Company.

Conoley, J.C., Kramer, J.J., & Mitchell, J.V. (Eds.). (1988). The Supplement to the Ninth Mental Measurements Yearbook. Lincoln, NE: University of Nebraska Press. (pp.170-172).

Conte, V.A., & Salamon, M.J., (1982). An objective approach to the measurement and use of life satisfaction with older persons. Measurement and Evaluation in Guidance, 15, (3): 194-200.

Dean-Church, L., & Girlie, F.D., (1993). Relation of sex-role orientation to life satisfaction in a healthy elderly sample. Journal of Social Behavior and Personality, 8, (1) 133-140.

Euler, B.L., (1992). A flaw in gerontological assessment: the weak relationship of elderly superficial life satisfaction to deep psychological well-being. The International Journal of Aging and Human Development, 34, (4) 299-310.

Gould, M.T., (1992). Nursing home elderly: social-environmental factors. Journal of Gerontological Nursing,18, (8)13-20.

Neri, M., Andermarcher, E., Pradelli, J.M., & Salvioli, G., (1995). Influence of a double blind pharmacological trial on two domains of well-being in subjects with age associated memory impairment. Archives of Gerontology and Geriatrics, 21, (3) 241-252.

Neugarten, B.L., Havighurst, R.J., & Tobin, S. S., (1961). The measurement of life satisfaction. The Journal of Gerontology, 16, 134-143.

Phillips, E.J., (1986). A review of the life satisfaction in the elderly scale. Journal of Counseling and Development, 64: 542-543.

Rathus, S.A., (1993). Psychology (5th ed.). Philadelphia, PA: Harcourt Brace College Publishers.

Ryff, C.D., (1995). Psychological well-being in adult life. Current Directions in Psychological Science, 4, (4) 99-104.

Salamon, M.J., (1985). Sociocultural role theories in the elderly: a replication and extension. Activities, Adaptation and Aging, 7, (2) 111-122.

Salamon, M.J., (1987). Health care environment and life satisfaction in the elderly. Journal of Aging Studies, 1, (3) 287-297.

Salamon, M.J., (1988). Clinical use of the life satisfaction in the elderly scale. Clinical Gerontologist, 8, (1) 45-54.

Schultz, R., Heckhausen, J., (1996). A life span model of successful aging. American Psychologist, 702-714.

Weiss, J.C., (1994). Group therapy with older adults in long-term care settings: research and clinical cautions and recommendations. The Journal for Specialists in Group Work, 19, (1) 22-29


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