Exploring Factors Associated with Functional Change and Predictors of Participation Improvement—A Two Years Follow-Up on People with Depression

Abstract

The purpose of this study is to understand the functional status distribution and to explore the factors associated with changes in functional status and social participation in people with depression using two-year follow-up data. Subjects were selected from the Taiwan Databank of Persons with Disabilities (TDPD) if they had an evaluation date between July 2012 and 31 December 2017. We used data for 1138 individuals with multiple evaluation records and who were diagnosed with depression. The WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) was the primary functional status measure. Other factors selected from the TDPD included social demographic data, living situation, employment status, economic status, and educational level. The results show scores in all dimensions of the WHODAS 2.0 declined over two years, especially in the domains of cognition, household activities, social participation, and total WHODAS 2.0 score. Aging groups showed poor recovery in cognition, getting along with others, and household activities. People living in suburban areas showed poorer recovery than people living in rural and urban areas in cognition, self-care, and general function (total score of WHODAS 2.0). Employment was also strongly associated with functional recovery in household activities, social participation, and general function. The original scores for cognition and getting along with others showed a significant negative relationship with social participation improvement. Our results can be used by policy makers to provide resources and conduct investigations, and by clinicians when making rehabilitation plans.

A general framework for selecting work participation outcomes in intervention studies among persons with health problems: a concept paper

“…Different disease trajectories may predetermine which stages of work participation the outcome measurement should focus on, as illustrated in Fig. 2 which includes five common diseases [ 90 – 95 ]. Besides the disease status or its course of progression (chronic, progressive, intermittent, relapsing, resolving), the baseline status of the target group (employed-unemployed, seeking-maintaining-losing work) may determine the preferred outcome, and the specific intervention types or aims [ 11 ].…”

Factor Structure of an ICF-Based Measure of Activity and Participations for Adults in Taiwan's Disability Eligibility Determination System

“…For example, the WHODAS 2.0 shows as a valid instrument to assess functioning differences related to the clinical impact classification level in subjects with chronic obstructive pulmonary disease ( 36 ) and has the potential to become a patient-reported outcome measure ( 20 ). For persons with depression, most performance on the WHODAS 2.0 were improved after 2-year follow-up ( 40 ). We need to investigate the progress of other health conditions.…”

“…The WHODAS 2.0 has been translated into 47 languages and dialects and is suitable for assessing health status and disability in a variety of settings and populations (28). Psychometric properties of the WHODAS 2.0 and/or the FUNDES-Adult have been evaluated for a number of clinical conditions, including, but not limited to, the following health conditions: musculoskeletal diseases (29-32), chronic diseases (31,(33)(34)(35)(36), psychiatric conditions (29,31,33,(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47), cancer (33,48,49), hearing impairment (50-52), visual impairment (50), stroke (10,31,33,(53)(54)(55)(56)(57)(58)), Parkinson's disease (59)(60)(61)(62), spinal conditions (18,(63)(64)(65), traumatic brain injury (63,66,67), multiple sclerosis (68), persons with disabilities (22,23,…”