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

Abstract

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.

Disability and its prevalence and cause in northwestern Ethiopia: evidence from Dabat district of Amhara National Regional State: A community based cross-sectional study

“…Besides, inadequate health care services were also significant contributors to the disability problem on the continent [17]. Similarly, this study reported a very small proportion of PwDs employed in the government -both in urban and rural areas -and a significant majority of them were involved in small-scale farming with strained livelihoods.…”

“…The household survey questionnaire included items from The World Health Organization Disability Assessment Schedule (WHODAS 2.0), International Classification of Functioning, Health and Disability (ICF) and MedicalOutcomes Study-Short Form (SF-36) tools, which were adapted based on local context and translated into the local language -Amharic. WHODAS 2.0 is standardized and validated tool to assess health and disability status both at individual and population levels, and across cultures[17]. As a generic tool, it is effective to assess activity limitations and participation-restriction due to disability in daily lives of individuals both at population and clinical set-up.…”

“…As a generic tool, it is effective to assess activity limitations and participation-restriction due to disability in daily lives of individuals both at population and clinical set-up. It has also been used to measure the effectiveness of disability interventions[17]. The household survey included items from WHODAS 2.0 to assess mainly the six domains of disability: cognition, mobility, self-care, getting along, life activities and participation.…”

Disability and its prevalence and cause in northwestern Ethiopia: evidence from Dabat district of Amhara National Regional State: A community based cross-sectional study

“…Furthermore, it was pre-tested on a population with similar demographic and socioeconomic pro le as the study area, with its outcomes used to review and adapt its framework, organization as well as items sequencing and wording. WHODAS-2.0 is a standardized and validated tool to assess health and disability status both at individual and community levels, and across cultures [19]. As a generic tool, it effectively assesss disability induced limitations on activity and participation both in community and clinical set-up.…”

“…As a generic tool, it effectively assesss disability induced limitations on activity and participation both in community and clinical set-up. Furthermore, it has been fruitfully deployed to measure the effectiveness of disability interventions [19]. The survey questionnaire speci cally adapted items from WHODAS-2.0 that measure the six domains of disability: learning and intellectual, mobility, self-care, getting along, life activities and participation.…”