Evidence for validity of the Swedish self-rated 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in patients with mental disorders: a multi-centre cross-sectional study using Rasch analysis

Abstract

Background The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a generic instrument for the assessment of functioning in six domains, resulting in a total health-related disability score. The aim of this study was to investigate the psychometric properties of the Swedish-language version of the self-rated 36-item version in psychiatric outpatients with various common psychiatric diagnoses using Rasch analysis. A secondary aim was to explore the correlation between two methods of calculating overall scores to guide clinical practice: the WHODAS simple (summative) model and the WHODAS complex (weighted) model. Methods Cross-sectional data from 780 Swedish patients with various mental disorders were evaluated by Rasch analysis according to the partial credit model. Bivariate Pearson correlations between the two methods of calculating overall scores were explored. Results Of the 36 items, 97% (35 items) were within the recommended range of infit mean square; only item D4.5 (Sexual activities) indicated misfit (infit mean square 1.54 logits). Rating scale analysis showed a short distance between severity levels and disordered thresholds. The two methods of calculating overall scores were highly correlated (0.89–0.99). Conclusions The self-administered WHODAS 2.0 fulfilled several aspects of validity according to Rasch analysis and has the potential to be a useful tool for the assessment of functioning in psychiatric outpatients. The internal structure of the instrument was satisfactorily valid and reliable at the level of the total score but demonstrated problems at the domain level. We suggest rephrasing the item Sexual activities and revising the rating scale categories. The WHODAS simple model is easier to use in clinical practice and our results indicate that it can differentiate function among patients with moderate psychiatric disability, whereas Rasch scaled scores are psychometrically more precise even at low disability levels. Further investigations of different scoring models are warranted.

Prevalence and levels of disability post road traffic orthopaedic injuries in Rwanda

“…The WHODAS 2.0 is a standard multidimensional questionnaire applicable to measure the level of disability across many conditions and has been validated in several languages. Therefore, this schedule has been translated into 16 languages in 14 countries, and has been reported to have adequate internal consistency, construct and discriminate validity (Svanborg et al 2022 ). The patient’s overall disability was evaluated using WHODAS 2.0, an assessment tool developed by the WHO to measure disability and functional impairment under the International Classification of Functioning, Disability and Health (ICF) (Svanborg et al 2022 ).…”

“…Therefore, this schedule has been translated into 16 languages in 14 countries, and has been reported to have adequate internal consistency, construct and discriminate validity (Svanborg et al 2022 ). The patient’s overall disability was evaluated using WHODAS 2.0, an assessment tool developed by the WHO to measure disability and functional impairment under the International Classification of Functioning, Disability and Health (ICF) (Svanborg et al 2022 ). The WHODAS 2.0 is a self-reported tool, administered to participants aged 18 years and above.…”

“…The International Classification of Functioning, Disability and Health (ICF) Framework defines disability as ‘difficulty in functioning at the body, person, or societal levels, in one or more life domains, as experienced by an individual with a health condition in interaction with contextual factors’ (Perenboom & Chorus 2003 ). The World Health Organization Disability and Health Assessment Schedule (WHODHAS 2.0) is the most widely accepted tool designed to evaluate disability from the ICF and comprises 12 or 36 items scored over 100 Svanborg et al 2022 ).…”

Psychometric evaluation of the WHODAS 2.0 and prevalence of disability in a Swedish general population

“…Although WHODAS 2.0 has undergone several psychometric evaluations, it is necessary to perform further evaluations when a new language version has been developed [16]. The Swedish 36-item version of WHODAS 2.0 has been psychometrically evaluated in mixed psychiatric populations [17][18][19]. However, no studies have been conducted to determine the extent to which the Swedish 36-item version is valid for the wide range of its intended users in Sweden, and reference data from the Swedish general population are not available.…”

Validation of the Alcohol-Related Sexual Consequences Scale in Swedish University Students

“…The Rutgers Alcohol Problem Index (RAPI) [11] does not include any items on alcohol-related sexual consequences, the Young Adult Alcohol Problems Screening Test (YAAPST) [12] includes one item, and the Young Adult Alcohol Consequences Questionnaire (YAACQ) [13] includes two items. Limited items on alcohol-related sexual consequences are also included in other measures, such as the WHO (World Health Organization) Disability Assessment Schedule (WHODAS 2.0) [14], the WHO Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) [15], and the CORE Alcohol and Drug Survey [16].…”