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Psychometric evaluation of the WHODAS 2.0 and prevalence of disability in a Swedish general population
Örebro University, School of Health Sciences. University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center.ORCID iD: 0000-0002-2559-5456
Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.ORCID iD: 0000-0002-4475-0650
Örebro University, School of Health Sciences. University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID iD: 0000-0003-2411-1795
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2023 (English)In: Journal of patient-reported outcomes, E-ISSN 2509-8020, Vol. 7, no 1, article id 36Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The World Health Organization Disability Assessment Schedule (WHODAS 2.0) is a generic questionnaire that captures health and disability-related functioning information corresponding to six major life domains: Cognition, Mobility, Self-care, Getting along, Life activities, and Participation. The WHODAS 2.0 is used in a wide range of international clinical and research settings. A psychometric evaluation of WHODAS 2.0, Swedish version, in the general population is lacking, together with national reference data to enable interpretation and comparison. This study aims to evaluate the psychometric properties of the Swedish 36-item version of WHODAS 2.0 and describe the prevalence of disability in a Swedish general population.

METHODS: A cross-sectional survey was performed. Internal consistency reliability was assessed with Cronbach's alpha. The construct validity was evaluated with item-total correlation, Pearson's correlation between the WHODAS 2.0 domains and the RAND-36 subscales, analysis of known groups by one-way ANOVA, and analysis of the factor structure by confirmatory factor analysis.

RESULTS: Three thousand four hundred and eighty two adults aged 19-103 years (response rate 43%) participated. Significantly higher degrees of disability were reported by the oldest age group (≥ 80 years), adults with a low level of education, and those on sick leave. Cronbach's alpha was from 0.84 to 0.95 for the domain scores and 0.97 for the total score. The item-scale convergent validity was satisfactory, and the item-scale discriminant validity was acceptable except for the item about sexual activity. The data partially supported the factor structure, with borderline fit indices.

CONCLUSION: The psychometric properties of the self-administered Swedish 36-item version of the WHODAS 2.0 are comparable to those of other language versions of the instrument. Data of the prevalence of disability in Swedish general population enables normative comparisons of WHODAS 2.0 scores of individuals and groups within clinical practice. The instrument has certain limitations that could be improved on in a future revision. The test-retest reliability and responsiveness of the Swedish version of WHODAS 2.0 for different somatic patient populations remain to be evaluated.

Place, publisher, year, edition, pages
Springer, 2023. Vol. 7, no 1, article id 36
Keywords [en]
Disability evaluation, Health surveys, Patient-reported outcome measures, RAND-36, Reference values, Validity and reliability
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:oru:diva-105444DOI: 10.1186/s41687-023-00580-0ISI: 000963677200001PubMedID: 37020121Scopus ID: 2-s2.0-85152640756OAI: oai:DiVA.org:oru-105444DiVA, id: diva2:1750854
Funder
Örebro UniversityRegion Örebro County, OLL-506801Available from: 2023-04-14 Created: 2023-04-14 Last updated: 2024-01-02Bibliographically approved
In thesis
1. Measurement properties of the Swedish self-administered version of the World Health Organization Disability Assessment Schedule 2.0
Open this publication in new window or tab >>Measurement properties of the Swedish self-administered version of the World Health Organization Disability Assessment Schedule 2.0
2023 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a leading patient-reported outcome measure of disability. However, patients' perspective of the WHODAS 2.0 self-administered Swedish version have not been sufficiently described. Similarly, knowledge of its construct validity in the general population is missing. This creates a gap because updated norm data to use as reference is also missing. The overall aim of this study was to establish evidence of the measurement properties of the self-administered Swedish version of the WHODAS 2.0.

Both qualitative and quantitative methods were adopted. In Study I, interviews with patients (n = 12) with orthopaedic or psychiatric conditions were performed and data were analysed by deductive content analysis. In Study II, a cross-sectional general population survey (n = 3 482) was conducted, and statistical methods based on classical test theory were used in the data analysis.

The results show that the items were well understood, acceptable and easy to answer by outpatients, with the exception of six items (Study I).The internal consistency reliability was good or excellent and the construct validity was overall acceptable, with partial support for the factor structure in the general populations (Study II).

The self-administered Swedish 36-item version of the WHODAS 2.0 is comparable to other language versions of the instrument. Some of the previous known weaknesses of its construct validity in relation to the item content and insufficient instructions were confirmed. The evidence of overall good content and construct validity together with available norm data supports its use in clinical settings and research.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2023. p. 77
Series
Örebro Studies in Medical Science
Keywords
Cognitive interviewing, Disability evaluations, International Classification of Functioning, Disability and health, Patient-reported outcome measures
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-110554 (URN)978-91-7529-510-7 (ISBN)978-91-7529-511-4 (ISBN)
Supervisors
Available from: 2023-12-29 Created: 2023-12-29 Last updated: 2024-01-12Bibliographically approved

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Norén, PaulinaKarlsson, JanOhlsson-Nevo, EmmaMöller, MargaretaHermansson, Liselotte

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Occupational Therapy

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