Emotional Experiences in Activities of Daily Living Scale (EEADLs)

Abstract

The Emotional Experiences in Activities of Daily Living Scale (EEADLs) is a specialized 125-item psychometric instrument developed by Dr. Karen R. Hebert and Dr. Timothy J. Ricker in 2023 at the University of South Dakota. Designed to bridge the empirical divide between functional occupational performance and affective experience, the scale systematically evaluates the emotional valence experienced by individuals while carrying out everyday occupations. Grounded theoretically in flow theory, mindfulness, and transactional frameworks of daily psychological distress, the instrument assesses emotional states across three discrete occupational dimensions: personal care activities of daily living (PADL), simple instrumental activities of daily living (Simple IADL), and complex instrumental activities of daily living (Complex IADL). The scale utilizes a modular, two-stage evaluation format comprising 25 distinct occupations crossed with five distinct affective items, yielding 125 potential item responses rated on a 5-point Likert scale ranging from 1 (“almost never”) to 5 (“almost always”). Following rigorous content validation by an expert panel of occupational therapists, structural validation with 328 adult participants utilizing exploratory principal components analysis and confirmatory factor analysis (CFA) supported a two-factor emotional structure (positive emotion and negative emotion) and a three-factor occupational structure. Internal consistency estimates demonstrate robust reliability, with Cronbach’s alpha values ranging from .81 to .82 for emotional dimensions, and between .635 and .723 across occupational clusters. By capturing the subjective emotional valence associated with routine tasks, the EEADLs offers clinicians, occupational therapists, and behavioral health researchers a standardized mechanism for profiling affective barriers to functional independence and well-being.

Keywords

Activities of Daily Living, Affective Valence, Complex Instrumental Activities of Daily Living, Daily Occupations, Emotional Experiences, Functional Status, Negative Affect, Occupational Engagement, Occupational Therapy, Personal Care, Positive Affect, Psychometrics, Simple Instrumental Activities of Daily Living.

Authors

The Emotional Experiences in Activities of Daily Living Scale was developed and validated by:

• Karen R. Hebert, Ph.D., OTR/L
  Affiliation: Department of Occupational Therapy, School of Health Sciences, University of South Dakota, Vermillion, South Dakota, United States.
  ORCID: 0000-0003-3233-7671
  Email: [email protected]
  Correspondence Address: University of South Dakota, Department of Occupational Therapy, 414 East Clark Street, Vermillion, SD 57069, USA.
• Timothy J. Ricker, Ph.D.
  Affiliation: Department of Psychology, University of South Dakota, Vermillion, South Dakota, United States.

Purpose

Traditional functional status evaluations in occupational therapy, rehabilitation medicine, and clinical neuropsychology have historically prioritized motoric, cognitive, and sensory-perceptual competencies. Standardized assessment tools routinely measure whether a client possesses the physical capability or cognitive executive functioning to complete basic activities of daily living (e.g., dressing, bathing, toileting) or instrumental activities of daily living (e.g., meal preparation, financial management, medication administration). However, such functional assessments predominantly treat human occupational performance as a purely mechanistic endeavor, frequently overlooking the subjective, phenomenological, and affective components that accompany task execution. The Emotional Experiences in Activities of Daily Living Scale (EEADLs) was explicitly engineered to address this critical diagnostic and evaluative void.

The primary clinical and empirical objective of the EEADLs is to quantify the frequency and valence of emotional states elicited during everyday occupations. Daily activities are neither emotionally neutral nor universally pleasant; instead, they evoke a dynamic continuum of affective responses spanning fulfillment, contentment, mastery, frustration, dread, anxiety, or apathy. Understanding these emotional dynamics is crucial because psychological distress, depressive symptomatology, chronic pain, and cognitive fatigue fundamentally alter how individuals perceive and experience necessary routines. When mundane activities persistently trigger negative emotional reactions (e.g., severe anxiety during grocery shopping or distress during self-care), individuals frequently engage in behavioral avoidance, leading to occupational deprivation, diminished quality of life, and secondary disability.

Clinically, the EEADLs serves as a diagnostic profiling instrument that enables practitioners to identify target activities requiring therapeutic intervention, environmental modification, or psychological scaffolding. In occupational therapy and mental health contexts, the tool assists clinicians in pinpointing whether occupational dysfunction is primarily motoric, environmental, or emotionally driven. In behavioral medicine and rehabilitation research, the scale allows investigators to measure changes in affective responses over time, systematically evaluating the efficacy of mindfulness-based occupational interventions, energy conservation programs, cognitive behavioral therapy adaptations, and flow-promoting restorative activities.

Psychological Construct

The central psychological constructs measured by the EEADLs are emotional valence and affective frequency contextualized within discrete domains of human occupational performance. Valence refers to the intrinsic pleasantness (positive affect) or unpleasantness (negative affect) of an emotional experience, as conceptualized in circumplex and dimensional models of emotion. Rather than viewing affect as a static, trait-level phenomenon, the EEADLs assesses task-embedded, state-related emotional experiences accumulated over a standard recall interval (the previous month). The instrument delineates this construct across two overarching emotional domains and three distinct occupational categories:

1. Emotional Valence Dimensions

• Positive Emotion: Represents the regular emergence of constructive, pleasant, and motivating psychological states during task engagement. Rooted in psychological theories of positive affectivity, mindfulness, and optimal experience (flow), positive emotion in this context reflects senses of satisfaction, enjoyment, calm, or focused absorption experienced while executing daily tasks.
• Negative Emotion: Represents the frequency of distressing, adverse, or aversive psychological states during task execution. This dimension captures manifestations of subjective distress, such as anxiety, irritation, tension, or feelings of defeat that arise when interacting with demanding, taxing, or tedious occupational environments.

2. Occupational Dimensions

• Personal Care (Basic ADLs): Fundamental self-maintenance tasks essential for survival, bodily hygiene, and functional independence within private domains. These tasks encompass basic, habitual behaviors such as bathing, grooming, dressing, and personal hygiene routines. These activities carry significant intimate, bodily, and psychological meaning, often evoking distinct feelings of dignity, bodily vulnerability, comfort, or exhaustion.
• Simple Instrumental Activities of Daily Living (Simple IADL): Routine domestic and maintenance tasks that require minimal environmental interaction, moderate cognitive processing, and standardized motor routines. Examples include basic housekeeping tasks, preparing simple foods, or light organization within familiar domestic confines.
• Complex Instrumental Activities of Daily Living (Complex IADL): Multifaceted, cognitively demanding occupations necessary for independent living within the broader socio-cultural community. These tasks demand higher-order executive functioning, external socialization, financial problem-solving, navigation, and time management (e.g., managing complex financial budgets, shopping in crowded environments, arranging transportation, or coordinating healthcare appointments). Because these tasks introduce greater environmental unpredictability, they typically present a wider variation in affective valence.

Theoretical Framework

The construction of the EEADLs synthesizes three influential theoretical frameworks within psychology and occupational science: Flow Theory, the Transactional Model of Daily Hassles and Uplifts, and contemporary Mindfulness and Affective Well-Being Theories.

Flow Theory and Optimal Experience

Developed by Mihaly Csikszentmihalyi, flow theory posits that optimal human experience occurs when there is an equilibrium between perceived occupational challenges and personal competencies. In flow, individuals experience heightened concentration, intrinsic reward, loss of self-consciousness, and deep engagement. The positive emotion items of the EEADLs were conceptually guided by flow principles to identify occupations that foster subjective well-being, intrinsic motivation, and meaningful absorption. Conversely, when task challenges drastically outstrip perceived skills, anxiety and distress manifest; when skills substantially exceed challenge, emotional detachment occurs.

The Transactional Model: Daily Hassles and Uplifts

Grounded in the stress and coping paradigms formalized by Richard Lazarus and operationalized in the Daily Hassles and Uplifts framework (Kanner et al., 1981), daily well-being is largely determined not by rare, catastrophic life events, but by the cumulative wear-and-tear and micro-satisfactions of routine living. Daily hassles represent irritating, frustrating, or distressing demands (e.g., misplacing items, cleaning stubborn messes, standing in long lines), while uplifts are positive, joyful encounters that buffer against chronic stress. The EEADLs adapts this perspective by anchoring affective appraisals directly to habitual occupational requirements, recognizing that repetitive negative affective states during personal maintenance can erode mental health over time.

Mindfulness and Occupational Adaptation

Mindfulness frameworks emphasize non-judgmental present-moment awareness during routine activities. Within occupational therapy, theories such as the Model of Human Occupation (MOHO) and the Occupational Adaptation framework assert that human beings possess an innate occupational drive, and that emotional satisfaction is an indispensable feedback mechanism signaling successful occupational adaptation. The EEADLs grounds this affective feedback loop into an empirical measurement system, identifying whether everyday performance nurtures psychological restoration or exacerbates distress.

Validity

The EEADLs underwent rigorous stages of content and structural construct validation during its development:

Content and Face Validity

The scale development began with an expansive pool of candidate items: seven emotional descriptors derived from psychological literature on flow, mindfulness, and subjective distress, combined with 35 occupational activities identified through systematic analysis of established IADL inventories, occupational engagement indices, and the Daily Hassles and Uplifts Scales. To ensure ecological and clinical relevance, this initial inventory was submitted to a panel of expert occupational therapists. The panel evaluated items for clarity, distinctiveness, representativeness across functional spectrums, and administrative feasibility. Through this expert panel review, items were refined, condensed, and aligned with standard occupational therapy terminology, reducing the occupational set to 25 items and the emotional descriptors to five validated affect terms.

Construct and Factorial Validity

Structural construct validity was evaluated using both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) across a normative cohort of 328 university students in the United States. Following exploratory procedures that removed psychometrically redundant or cross-loading items, structural equation modeling evaluated the fit of the two-factor emotional structure and the three-factor occupational structure:

• Emotional Subscales CFA Fit: The two-factor model distinguishing positive from negative emotional affect exhibited an acceptable model fit: $\chi^2(4, N = 328) = 21, p = .01$, Comparative Fit Index (CFI) = 0.972, Root Mean Square Error of Approximation (RMSEA) = 0.072. These fit indices confirmed that positive and negative emotional experiences operate as distinct, partially orthogonal dimensions rather than polar ends of a single continuum.
• Positive Emotion Subscale across Occupations: Evaluating the three occupational factors (Personal Care, Simple IADL, Complex IADL) under positive valence revealed an acceptable fit: $\chi^2(4, N = 328) = 538, p = .03$, CFI = 0.953, RMSEA = 0.055.
• Negative Emotion Subscale across Occupations: The three occupational factors under negative valence similarly produced acceptable fit: $\chi^2(4, N = 328) = 591, p = .02$, CFI = 0.956, RMSEA = 0.060.

Reliability

The EEADLs demonstrates adequate to strong internal consistency across its factor-analytically confirmed subscales:

• Emotional Dimensions: The internal consistency for the primary emotional subscales is high, demonstrating Cronbach’s alpha coefficients ranging from $\alpha = .81$ to $\alpha = .82$. This confirms strong inter-item covariance among the emotional descriptors selected to represent positive and negative affective states.
• Occupational Categories: Internal consistency estimates across occupational categories, calculated using coefficient alpha, range from moderate to acceptable. For the positive affect ratings within complex IADLs, alpha was estimated at $\alpha = .635$, reflecting the broad behavioral diversity inherent in complex activities (e.g., banking vs. driving). For personal care activities under positive affect, alpha reached $\alpha = .723$. Across negative emotion subscales, occupational alphas demonstrated comparable stability.

These psychometric properties indicate that while behavioral heterogeneity naturally dampens alpha coefficients within broad functional activity clusters, the scale maintains sufficient measurement precision for group-level comparative analyses and structured individual clinical screening.

Factor Analysis

The factorial structure of the EEADLs was determined through a sequential two-phase psychometric investigation comprising exploratory principal components analysis followed by confirmatory factor analysis.

Exploratory Factor Analysis (EFA)

An initial EFA was conducted on the original pool of seven emotional descriptors. The analysis revealed two robust latent factors explaining 68% of the total cumulative variance:

• Factor 1 (Positive Emotion) and Factor 2 (Negative Emotion) accounted for the vast majority of shared variance.
• Two candidate items—”relaxation” and “boredom”—failed to demonstrate clear, unidimensional factor loadings, exhibiting cross-loadings or insufficient communalities. Consequently, both descriptors were dropped, retaining a clean five-item emotional factor structure.

For the occupational item pool, EFA conducted across affective ratings revealed three distinct latent factors:

• For the negative emotions occupational ratings, the three factors accounted for 40% of the total variance.
• For the positive emotions occupational ratings, the three factors explained 35% of the total variance.
• The resulting retained factors were categorized as: Personal Care, Simple Instrumental Activities of Daily Living, and Complex Instrumental Activities of Daily Living.

Confirmatory Factor Analysis (CFA)

CFA with maximum likelihood estimation was conducted on data from 328 respondents to verify the empirical tenability of the hypothesized structure:

• Two-Factor Emotion Model: $\chi^2(4) = 21, p = .01$; $\text{CFI} = 0.972$; $\text{RMSEA} = 0.072$.
• Three-Factor Occupational Model (Positive Affect): $\chi^2(4) = 538, p = .03$; $\text{CFI} = 0.953$; $\text{RMSEA} = 0.055$.
• Three-Factor Occupational Model (Negative Affect): $\chi^2(4) = 591, p = .02$; $\text{CFI} = 0.956$; $\text{RMSEA} = 0.060$.

All factor loadings were statistically significant ($p < .001$), supporting the conceptual partition between basic self-care, simple home management, and complex community-living occupations.

Instrument / Measurement Tool

The technical administration characteristics of the EEADLs are structured as follows:

• Test Type: Standardized self-report inventory / paper-and-pencil questionnaire.
• Total Item Count: 125 total assessment points (configured as a 25 × 5 item matrix: 25 distinct daily occupations evaluated across 5 emotional descriptors).
• Administration Format:
  • Step 1 (Frequency Screening): For each of the 25 listed occupations, the respondent first indicates whether they perform the activity at least once per week by circling either “Yes” or “No”.
  • Step 2 (Affective Rating): If the respondent answers “Yes”, they proceed to evaluate the frequency with which they have experienced each of the 5 emotional descriptors while executing that specific activity over the preceding one month.
• Response Scale: Ratings are captured on a 5-point Likert scale:
  • 1 = Almost never
  • 2 = Seldom / Rarely
  • 3 = Sometimes
  • 4 = Frequently / Often
  • 5 = Almost always
• Scoring Structure:
  • Subscale Scores: Computed by summing or averaging the Likert ratings across specific occupational categories (Personal Care, Simple IADL, Complex IADL) separated by emotional valence (Positive Emotion subscale vs. Negative Emotion subscale).
  • Missing / Inapplicable Activities: Activities answered with “No” (performed less than once per week) are excluded from the denominator when deriving mean domain scores, or handled via standardized imputation/mean-averaging protocols to avoid skewing affective profiles due to occupational non-participation.
• Target Population: Adults aged 18 years and older (including young adults, middle-aged adults, and clinical rehabilitation populations).
• Estimated Completion Time: Approximately 15 to 25 minutes.

Permissions & Fee and Test Year

• Test Publication Year: 2023.
• Commercial Availability: Non-commercial instrument.
• Usage Fee: Free for non-commercial educational, clinical, and scientific research purposes.
• Copyright & Permissions: The scale is copyrighted by the authors and the journal publisher (SAGE Publications / American Occupational Therapy Foundation). To obtain the full questionnaire, administration manual, or authorization for clinical and academic use, interested researchers and clinicians should directly contact the corresponding author, Dr. Karen R. Hebert.

References

• Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience. Harper & Row.
• Hebert, K. R., & Ricker, T. J. (2023). Reliability of the emotional experiences in activities of Daily Living Scale. OTJR: Occupation, Participation and Health, 43(2), 271–279. https://doi.org/10.1177/15394492221085288
• Kanner, A. D., Coyne, J. C., Schaefer, C., & Lazarus, R. S. (1981). Comparison of two modes of stress measurement: Daily hassles and uplifts versus major life events. Journal of Behavioral Medicine, 4(1), 1–39. https://doi.org/10.1007/BF00844265
• Law, M., Baum, C., & Baptiste, S. (2002). Occupational performance coaching: A practice guide for occupational therapists. SLACK Incorporated.
• Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. https://doi.org/10.1037/0022-3514.54.6.1063

Items of the Scale