Comparing disability between traumatic brain injury and spinal cord injury using the 12-item WHODAS 2.0 and the WHO minimal generic data set covering functioning and health

Tarvonen-Schröder, Sinikka; Tenovuo, Olli; Kaljonen, Anne; Laimi, Katri

doi:10.1177/0269215518785945

Cited by 16 publications

(15 citation statements)

References 30 publications

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“…Previous studies of WHODAS 2.0 in stroke patients have usually been based on a longer version of this scale (36). The aim of the current study was to identify as simple validated functioning scales as possible, and the 12-item WHODAS 2.0 was found suitable, especially as, in previous studies among patients with amyotrophic lateral sclerosis, traumatic brain injury, spinal cord injury and spinal pain (20)(21)(22)(23)(24), this measure was easy to apply for both patients and significant others. As WHODAS includes not only activities, but also items of participation, it provides a wider perspective for goal-setting and service-planning than the conventional instruments.…”

Section: Discussionmentioning

confidence: 96%

“…To unify the assessment of functioning globally, regardless of health condition, the World Health Organization (WHO) has developed a generic patient-and proxy-reported instrument to measure both activities and participation, the WHO Disability Assessment Schedule (WHODAS 2.0), which has been validated in various conditions, including stroke (18). The short 12-item form of WHODAS 2.0 has been found to be practical for use in various clinical settings (19)(20)(21)(22)(23)(24). Another short ICF-based instrument, the 7-item WHO Minimal Generic Set of domains of functioning and health, has been suggested for use as a starting point to address comparability of data across studies (25).…”

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confidence: 99%

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The World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the WHO Minimal Generic Set of Domains of Functioning and Health versus Conventional Instruments in subacute stroke

Tarvonen-Schröder

Hurme²,

Laimi³

2019

J Rehabil Med

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LAY ABSTRACTThis study compared short generic International Classification of Functioning, Disability and Health (ICF)based measures of functioning, the patient-and proxyreported 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the 7-item WHO Minimal Generic Set of domains of functioning and health assessed by a neurologist, with traditionally used measures of stroke in the subacute phase. Although proxies rated 6 out of 12 separate WHODAS functions more impaired than did the patients, the scores of patient-and proxy-reported WHODAS 2.0 and the WHO Minimal Generic Set correlated well with each other and with older measures of stroke severity (National Institutes of Health Stroke Scale) and dependence (modified Rankin Scale and Functional Independence Measure). Both ICF-based tools, despite their brevity, were useful in finding disabilities for patient-and family-centred goal-setting and service-planning after subacute stroke rehabilitation. Objective: To compare short generic International Classification of Functioning, Disability and Health (ICF)-based measures of functioning with traditional measures of stroke severity and dependence in subacute stroke. Methods: In this cross-sectional study patients with stroke (n = 195) and their significant others completed the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0) at discharge from rehabilitation. A neurologist assessed functioning with the 7-item World Health Organization (WHO) Minimal Generic Set of domains of functioning and health. These scores were compared with assessments of severity of stroke (National Institutes of Health Stroke Scale; NIHSS) and dependence (modified Rankin Scale; mRS; and Functional Independence Measure; FIM).Results: From mild to severe stroke, increasing disability was found in single items and sum scores of WHODAS and the WHO Minimal Generic Set. Although proxies rated 6 out of the 12 separate WHO-DAS functions more impaired than did the patients, correlations between the different measures (proxyand patient-WHODAS, the WHO Minimal Generic Set, mRS, NIHSS and FIM total and sub-scores) were strong to very strong, except for moderate correlations between patient-WHODAS, and NIHSS or FIM cognitive sub-score. Conclusion: Despite their brevity, both generic ICFbased tools were useful in finding disabilities for patient-and family-centred goal-setting and serviceplanning after subacute rehabilitation.

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Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 99%

The World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the WHO Minimal Generic Set of Domains of Functioning and Health versus Conventional Instruments in subacute stroke

Tarvonen-Schröder

Hurme²,

Laimi³

2019

J Rehabil Med

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“…Many previous studies focused on the medical problems and treatment of CNS injuries [14,15], while measures of activity and participation for community-dwelling people with chronic CNS injuries remain relatively underdeveloped. Several studies evaluated the activity and participation of people with CNS injuries, and compared the pattern of disability between different disease groups [16][17][18][19][20]. Some previous studies employed WHODAS 2.0 to study various health conditions, including stroke, TBI, SCI, and aging.…”

Section: Introductionmentioning

confidence: 99%

“…Some previous studies employed WHODAS 2.0 to study various health conditions, including stroke, TBI, SCI, and aging. Two studies compared functioning and disability between TBI and SCI groups [16,17], and another compared the disability level between amyotrophic-lateral-sclerosis and TBI groups [18]. Studies with institutionalized individuals suggested that institution-dwelling is related to poor functioning [16,18].…”

Section: Introductionmentioning

confidence: 99%

Comparing Activity and Participation between Acquired Brain Injury and Spinal-Cord Injury in Community-Dwelling People with Severe Disability Using WHODAS 2.0

Yoon

Leigh

Lee

et al. 2020

IJERPH

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Central-nervous-system (CNS) injuries constitute a significant cause of morbidity (often resulting in long-term disability) and mortality. This cross-sectional study compared the activity and participation of community-dwelling people with severe disability from acquired brain injuries (ABI) (n = 322) and spinal-cord injuries (SCI) (n = 183) to identify risk factors related to disability. Data were collected through a questionnaire survey of community-dwelling people with severe disability attending 65 healthcare centers. The survey included the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and sociodemographic factors. We categorized a registered grade of disability of 1 or 2 as severe disability. WHODAS 2.0 domain and summary scores were compared between the ABI and SCI groups, and risk factors associated with disability were identified through regression analysis. ABI participants had significantly higher disability in cognition and relationships, whereas patients with SCI had higher disability in mobility (p < 0.05). Onset duration was negatively correlated with cognition, relationships, participation, and summary scores in ABI participants (p < 0.05). Neither group’s socioeconomic factors were associated with WHODA 2.0 scores. Understanding the different patterns of disability between SCI and ABI in community-dwelling people with severe disability helps establish future plans for the management of health resources.

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“…Priorities in developing appropriate functioning instruments for patients with SCI include understanding the dimensions of participation, and the importance of both objective and subjective measures (10). Only a few studies, however, have tested participation instruments, such as WHODAS 2.0, in individuals with SCI, and there is still a lack of studies comparing self-rated functioning with more objectively defined parameters (14)(15)(16)(17)(18)(19). Other difficulties in measuring functioning lie in a redundancy of instruments for different health conditions and tools that are too time-consuming for clinical settings.…”

mentioning

confidence: 99%

Utility of the World Health Organization Disability Assessment Schedule and the World Health Organization minimal generic set of domains of functioning and health in spinal cord injury

Tarvonen-Schröder¹,

Kaljonen²,

Laimi³

2019

J Rehabil Med

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Two easy-to-use validated International Classification of Functioning, Disability and Health (ICF)-based tools, the 12-item patient and proxy World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the 7-item World Health Organization minimal generic set used by a physician, were found to be reliable and useful in assessing functioning in patients with spinal cord injury. These tools can, with little effort, be used to detect activity limitations and participation restrictions, and differentiate various severities and levels of spinal cord injury. As the minimal generic set is brief and limited, we recommend using the 12-item WHODAS 2.0 when planning individualized services for patients with spinal cord injury. Objective: To compare easy-to-use International Classification of Functioning, Disability and Health (ICF)-based measures of functioning with the level and severity of spinal cord injury. Methods: Cross-sectional study. Patients (n = 142) and their significant others completed the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0) questionnaire. A physician at the university hospital outpatient clinic assessed functioning with the 7-item World Health Organization (WHO) minimal generic set. Results: The patient and proxy WHODAS sum score was rated severe with decreasing severity in groups with complete and partial tetraplegia and paraplegia, respectively. Working ability was rated most severely impaired in the tetraplegic groups. Between-group differences were also found in mobility, household tasks, and self-care. Mobility was found to be associated with lesion severity; life activities, participation and friendships with lesion level; and self-care and WHODAS sum score with both lesion severity and level. Depending on the level and severity of spinal cord injury, a moderate to strong correlation was found between the sum scores of the 2 tools, and mostly very strong correlations between patient and proxy assessments of functioning. Conclusion: Both generic ICF-based tools, despite their briefness, seemed to be useful as they were able to differentiate various levels and severities of spinal cord injury. We recommend using the 12-item WHODAS 2.0 when planning individualized services for patients with spinal cord injury.

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Comparing disability between traumatic brain injury and spinal cord injury using the 12-item WHODAS 2.0 and the WHO minimal generic data set covering functioning and health

Abstract: Both generic measures were able to detect severe disability but also to detect differences between two patient populations with different underlying diagnoses.

Cited by 16 publications

References 30 publications

The World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the WHO Minimal Generic Set of Domains of Functioning and Health versus Conventional Instruments in subacute stroke

The World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the WHO Minimal Generic Set of Domains of Functioning and Health versus Conventional Instruments in subacute stroke

Comparing Activity and Participation between Acquired Brain Injury and Spinal-Cord Injury in Community-Dwelling People with Severe Disability Using WHODAS 2.0

Utility of the World Health Organization Disability Assessment Schedule and the World Health Organization minimal generic set of domains of functioning and health in spinal cord injury

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