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Ovando AC, Dall'Agnol C, Merlyn Luiz J, Andrade Momo R, De Castro SS. The Brazilian version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) is reliable and valid for chronic stroke survivors. Top Stroke Rehabil 2024; 31:211-220. [PMID: 37120851 DOI: 10.1080/10749357.2023.2207293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/22/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Stroke is the leading cause of disability worldwide. Assessing stroke's impact on patients' daily activities and social participation can provide important complementary information to their rehabilitation process. However, no previous study had been conducted on the psychometric properties of the Brazilian version of the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) in the stroke population. OBJECTIVES This study aimed to examine the internal consistency, test-retest and inter-rater reliability, convergent validity and floor/ceiling effect of the Brazilian version of the WHODAS 2.0 in individuals after chronic stroke. METHODS Two examiners interviewed 53 chronic stroke individuals who responded to the Brazilian 36-item version of the WHODAS 2.0 three times to analyze test-retest and inter-rater reliabilities. Floor/ceiling effects were calculated as relative frequencies of the lowest or the highest possible WHODAS 2.0 scores. Participants also responded to the Stroke Impact Scale 3.0 (SIS 3.0) and the Functional Independence Measure (FIM) to analyze convergent validity. RESULTS The internal consistency analyses for domains of WHODAS showed a strong correlation among the items of each domain (0.76-0.91) except for the "getting along" domain, which presented a moderate correlation (ρ = 0,62). Total scores of WHODAS 2.0 showed satisfactory internal consistency (α = 0.93), good inter-rater reliability (ICC = 0.85), excellent test-retest reliability (ICC = 0.92) and no significant floor/ceiling effect. Convergent validity indicated moderate to strong correlations (ρ=-0.51 to ρ=-0.88; p < 0.001), with the highest values associated with the correlation with the SIS scale. CONCLUSIONS The Brazilian version of the WHODAS 2.0 instrument presented evidence of reliability and validity for chronic post-stroke individuals.
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Affiliation(s)
- Angélica Cristiane Ovando
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina (UFSC), Araranguá, Brazil
- Department for Health Sciences, Federal University of Santa Catarina (UFSC), Araranguá, Brazil
| | - Catiane Dall'Agnol
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina (UFSC), Araranguá, Brazil
| | - Jhoanne Merlyn Luiz
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina (UFSC), Araranguá, Brazil
| | - Renata Andrade Momo
- Department for Health Sciences, Federal University of Santa Catarina (UFSC), Araranguá, Brazil
| | - Shamyr Sulyvan De Castro
- Master Program in Physiotherapy and Functioning (PPGFisio), Federal University of Ceará (UFC), Fortaleza, Brazil
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Karazi W, Scalco RS, Stemmerik MG, Løkken N, Lucia A, Santalla A, Martinuzzi A, Vavla M, Reni G, Toscano A, Musumeci O, Kouwenberg CV, Laforêt P, Millán BS, Vieitez I, Siciliano G, Kühnle E, Trost R, Sacconi S, Durmus H, Kierdaszuk B, Wakelin A, Andreu AL, Pinós T, Marti R, Quinlivan R, Vissing J, Voermans NC. Data from the European registry for patients with McArdle disease (EUROMAC): functional status and social participation. Orphanet J Rare Dis 2023; 18:210. [PMID: 37488619 PMCID: PMC10367320 DOI: 10.1186/s13023-023-02825-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND The European registry for individuals with GSD5 and other muscle glycogenosis (EUROMAC) was launched to register rare muscle glycogenosis in Europe, to facilitate recruitment for research trials and to learn about the phenotypes and disseminate knowledge about the diseases. A network of twenty collaborating partners from eight European countries and the US contributed data on rare muscle glycogenosis in the EUROMAC registry. METHODS Following the initial report on demographics, neuromuscular features and comorbidity (2020), we here present the data on social participation, previous and current treatments (medication, supplements, diet and rehabilitation) and limitations. Furthermore, the following questionnaires were used: Fatigue severity scale (FSS), WHO Disability Assessment Scale (DAS 2.0), health related quality of life (SF36) and International Physical Activity Questionnaire (IPAQ). RESULTS Of 282 participants with confirmed diagnoses of muscle glycogenosis, 269 had GSD5. Of them 196 (73%) completed all questionnaires; for the others, the data were incomplete. The majority, 180 (67%) were currently working. Previous medical treatments included pain medication (23%) and rehabilitation treatment (60%). The carbohydrate-rich diet was reported to be beneficial for 68%, the low sucrose diet for 76% and the ketogenic diet for 88%. Almost all participants (93%) reported difficulties climbing stairs. The median FSS score was 5.22, indicating severe fatigue. The data from the WHODAS and IPAQ was not of sufficient quality to be interpreted. CONCLUSIONS The EUROMAC registry have provided insight into the functional and social status of participants with GSD5: most participants are socially active despite limitations in physical and daily life activities. Regular physical activity and different dietary approaches may alleviate fatigue and pain.
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Affiliation(s)
- Walaa Karazi
- Neuromuscular Center Nijmegen, Department of Neurology, 910, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Renata S Scalco
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, National Hospital, London, UK
| | - Mads G Stemmerik
- Copenhagen Neuromuscular Center, Section 8077, , Rigshospitalet, University of Copenhagen, 2100, Copenhagen, Denmark
| | - Nicoline Løkken
- Copenhagen Neuromuscular Center, Section 8077, , Rigshospitalet, University of Copenhagen, 2100, Copenhagen, Denmark
| | - Alejandro Lucia
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- Instituto de Investigación Hospital, 12 de Octubre (imas12), Madrid, Spain
| | - Alfredo Santalla
- Instituto de Investigación Hospital, 12 de Octubre (imas12), Madrid, Spain
- Universidad Pablo de Olavide, Seville, Spain
| | - Andrea Martinuzzi
- Departments of Neurorehabilitation, IRCCS Medea Scientifc Insitute, Conegliano-Pieve Di Soligo, Italy
| | - Marinela Vavla
- Departments of Neurorehabilitation, IRCCS Medea Scientifc Insitute, Conegliano-Pieve Di Soligo, Italy
| | - Gianluigi Reni
- Department of Information Technology, Autonomous Province of Bolzano, Bolzano, Italy
| | - Antonio Toscano
- Neurology and Neuromuscular Diseases Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Olimpia Musumeci
- Neurology and Neuromuscular Diseases Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Carlyn V Kouwenberg
- Neuromuscular Center Nijmegen, Department of Neurology, 910, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Pascal Laforêt
- Neurology Department, Raymond Poincaré University Hospital, APHP, Garches, France
| | - Beatriz San Millán
- Pathology Department, Alvaro Cunqueiro Hospital, Vigo, Spain
- Rare Diseases and Pediatric Medicine Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGASUVIGO, Vigo, Spain
| | - Irene Vieitez
- Rare Diseases and Pediatric Medicine Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGASUVIGO, Vigo, Spain
| | - Gabriele Siciliano
- Neurology and Neuromuscular Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Enrico Kühnle
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bochum, Bochum, Germany
| | - Rebecca Trost
- Department of Neurology, Heimer Institute for Muscle Research, University Hospital Bochum, Bochum, Germany
| | - Sabrina Sacconi
- Peripheral Nervous System and Muscle Department, CHU Nice, Université Côte D'Azur, Institute for Research On Cancer and Aging of Nice (IRCAN), INSERM U1081, CNRS UMR 7284, Faculty of Medicine, Université Côte D'Azur (UCA), Nice, France
| | - Hacer Durmus
- Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Biruta Kierdaszuk
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Andrew Wakelin
- Association for Glycogen Storage Disease (UK), Bristol, UK
| | - Antoni L Andreu
- EATRIS, European Infrastructure for Translational Medicine, 1081 HZ, Amsterdam, The Netherlands
| | - Tomàs Pinós
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, and Research Group on Neuromuscular and Mitochondrial Diseases, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Ramon Marti
- Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, and Research Group on Neuromuscular and Mitochondrial Diseases, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Ros Quinlivan
- MRC Centre for Neuromuscular Diseases, UCL Institute of Neurology, National Hospital, London, UK
| | - John Vissing
- Copenhagen Neuromuscular Center, Section 8077, , Rigshospitalet, University of Copenhagen, 2100, Copenhagen, Denmark
| | - Nicol C Voermans
- Neuromuscular Center Nijmegen, Department of Neurology, 910, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Young CA, Ealing J, McDermott CJ, Williams TL, Al-Chalabi A, Majeed T, Talbot K, Harrower T, Faull C, Malaspina A, Annadale J, Mills RJ, Tennant A. Measuring disability in amyotrophic lateral sclerosis/motor neuron disease: the WHODAS 2.0-36, WHODAS 2.0-32, and WHODAS 2.0-12. Amyotroph Lateral Scler Frontotemporal Degener 2023; 24:63-70. [PMID: 35876069 DOI: 10.1080/21678421.2022.2102926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/05/2022] [Accepted: 07/12/2022] [Indexed: 01/26/2023]
Abstract
Aim: To investigate whether the World Health Organization Disability Assessment Schedule 2.0 (WHODAS) can provide interval level measurement of disability in Amyotrophic Lateral Sclerosis (ALS), allowing parametric analyses. Methods: Data on the WHODAS 12, 32, and 36-item versions, from 1120 patients studied at one or more time points, were fit to the Rasch model and comparisons made against ALSFRS-R, King's staging, and mortality. Trajectory modeling was undertaken for a newly diagnosed (≤6 months) cohort of 454 individuals. Results: Total scores for WHODAS 32 and 36-item versions can be converted to interval level measurement suitable for individual clinical use, and the 12-item WHODAS total for group use. The 36-item version is shown to be equivalent to the 32-item version. Expected correlations were seen with King's staging, ALSFRS-R, and EQ-5D-5L. Trajectory analysis of disability (WHODAS 2.0) showed three clearly demarcated groups with differences in King's staging, depressive symptomatology and mortality, but not age. Conclusions: The WHODAS 2.0 is a brief patient reported outcome measure which can be used to measure disability in ALS. Provided the patient answers all 36 (32 if not working) items, the conversion table produces an interval level estimate for parametric analyses. The different trajectories demonstrated from diagnosis support the concept of a prodromal period, and suggest the WHODAS 2.0 could be used for surveillance of at risk populations, such as those with genetic predisposition.
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Affiliation(s)
- Carolyn A Young
- Walton Centre NHS Foundation Trust, Lower Lane, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - John Ealing
- Department of Neurology, Greater Manchester Centre for Clinical Neurosciences, Salford, UK
| | | | - Tim L Williams
- Department of Neurology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Ammar Al-Chalabi
- Department of Basic and Clinical Neuroscience, King's College London, Maurice Wohl Clinical Neuroscience Institute, London, UK
- Department of Neurology, King's College Hospital, London, UK
| | - Tahir Majeed
- Department of Neurology, Lancashire Teaching Hospital, Preston, UK
| | - Kevin Talbot
- Department of Neurology, University of Oxford, Oxford, UK
| | | | | | | | - Joe Annadale
- Hywel Dda University Health Board, Wales, UK, and
| | - Roger J Mills
- Walton Centre NHS Foundation Trust, Lower Lane, Liverpool, UK
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Alan Tennant
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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Liu Y, Tian H, Chen X, Jia F, Li R, Sun Y, Chen L, Zhu J, Jiang D, Zhuo C. Validity and reliability of a Chinese version of the Bergen Work Addiction Scale. Front Psychol 2023; 14:1029846. [PMID: 37205064 PMCID: PMC10185827 DOI: 10.3389/fpsyg.2023.1029846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/06/2023] [Indexed: 05/21/2023] Open
Abstract
Background Work addiction (WA), which can impair personal relationships, engagement in recreational activities, and/or health, is a behavioral addiction. A tool for the early detection of WA in China is needed. Objective The aim of this study was to develop and determine the validity and reliability of a Chinese version of the Bergen Work Addiction Scale (C-BWAS). Methods Two hundred social workers who provided post-discharge services for adolescents with non-suicidal self-injury (NSSI) were enrolled in this study. The construct validity of the C-BWAS was assessed by confirmatory factor analysis (CFA). Criterion validity was assessed by conducting Pearson correlation analyses of C-CWAS scores with Hamilton Depression Scale (HAM-D) and Hamilton Anxiety Scale (HAM-A) scores. Cronbach's α and the intra-class correlation coefficient (ICC) were used to evaluate the reliability of the C-BWAS. Results CFA confirmed a one-dimensional structure of the C-BWAS with good construct validity indices [comparative fit index (CFI) = 0.964, Tucker-Lewis index (TLI) = 0.951, root-mean-square error of approximation (RMSEA) = 0.079, and minimum discrepancy Ĉ/degrees of freedom (Cmin/DF) = 0.362]. The standardized regression weights ranged from 0.523 to 0.753. All C-BWAS items loaded on one major factor (loading weights, 0.646-0.943). Coefficients of correlation between C-BWAS scores and HAM-D and HAM-A scores were 0.889 and 0.933, respectively. The Cronbach's α coefficient and ICC for the instrument was 0.837 and 0.905, respectively. Conclusion The presently developed C-BWAS showed very good reliability and acceptably validity. It can be employed as a useful tool for assessing WA severity in social workers who provide post-discharge services for adolescents with NSSI.
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Affiliation(s)
- Yuanyuan Liu
- Department of Psychosomatic Medicine, Tianjin Chest Hospital, Tianjin, China
- Yuanyuan Liu,
| | - Hongjun Tian
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
- Hongjun Tian,
| | - Xinying Chen
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin, China
| | - Feng Jia
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin, China
| | - Ranli Li
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin, China
| | - Yun Sun
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin, China
| | - Langlang Chen
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou, China
| | - Jingjing Zhu
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou, China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou, China
- *Correspondence: Deguo Jiang,
| | - Chuanjun Zhuo
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin, China
- Department of Psychiatry, Wenzhou Seventh People’s Hospital, Wenzhou, China
- Chuanjun Zhuo,
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Yuliana S, Yu E, Rias YA, Atikah N, Chang HJ, Tsai HT. Associations among disability, depression, anxiety, stress, and quality of life between stroke survivors and their family caregivers: An Actor-Partner Interdependence Model. J Adv Nurs 2023; 79:135-148. [PMID: 36257927 DOI: 10.1111/jan.15465] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/28/2022] [Accepted: 09/21/2022] [Indexed: 12/15/2022]
Abstract
AIM To explore the effects of disability, depressive, anxiety and stress symptoms on patients' and their partners' quality of life (QoL) using the actor-partner interdependence model (APIM). DESIGN A cross-sectional study using actor-partner interdependence model. METHODS We recruited 183 dyads of stroke survivors and their family caregivers in Indonesia. The World Health Organization Disability Assessment (WHODAS 2.0), Depression, Anxiety and Stress (DASS-42) and Rand Short Form Health Survey (SF-36) were used to measure disability, depressive, anxiety and stress symptoms and QoL of stroke survivors and family caregivers. The actor-partner interdependence model was tested using multilevel modelling. The actor-partner interdependence mediation model (APIMeM) was applied to estimate the direct and indirect effect. RESULTS Disability had actor effects on stroke survivor's overall QoL and partner effect on family caregiver's overall QoL. More severe disability of stroke survivors was associated with a lower overall QoL of their own and that of family caregiver's overall QoL. Depressive symptoms of stroke survivors had actor effects on stroke survivors' overall QoL and partner effects on family caregivers' overall QoL. Actor and partner effects also exist on family caregiver's depression symptoms to their own overall QoL and stroke survivor's overall QoL. Moreover, higher anxiety symptoms were associated with lower levels of their own and partner's overall QoL in both stroke survivors and family caregivers. Stroke survivor's stress symptoms also negatively associated with their own and family caregiver's overall QoL. However, a family caregiver's stress without a partner effects on stroke survivor's overall QoL. The APIMeM analysis showed that disability of stroke survivors directly decreased their own overall, physical (PCS) and mental QoL (MCS). Also, disability mediated by stroke survivor's depression, anxiety and stress symptoms decreased both stroke survivor's and family caregiver's physical (PCS) and mental QoL (MCS). CONCLUSION The findings suggest that stroke survivors and family caregivers may influence each other during the caregiving process and social life. The disability of stroke survivors, and the depression, anxiety and stress symptoms of stroke survivors and family caregivers affect their own QoL and their partners' QoL. Disability of stroke survivors directly decreased their own overall, physical (PCS) and mental QoL (MCS). Also, it indirectly via stroke survivor's depression, anxiety and stress symptoms decreased both stroke survivor's and family caregiver's physical (PCS) and mental QoL (MCS). IMPACT Dyadic actor-partner interdependence models have shown promising potential to predict the QoL among patients and family caregivers. The dyadic effects of disability, depression, anxiety and stress symptoms on the QoL of stroke survivors and family caregivers can be applied to guide the future development of nursing intervention addressed decreasing depression, anxiety and stress symptoms to optimize health outcomes among stroke survivors and their family caregivers.
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Affiliation(s)
- Sri Yuliana
- Department of Nursing, Sekolah Tinggi Ilmu Kesehatan Yahya Bima, West Nusa Tenggara, Indonesia.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
| | - Erica Yu
- Cizik School of Nursing, The University of Texas Health Science Center, Houston, Texas, USA
| | - Yohanes Andy Rias
- College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
| | - Nur Atikah
- Department of Pharmacy, Poltekkes Kemenkes Surakarta, Middle of Java, Indonesia
| | - Hsiu Ju Chang
- School of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Hsiu Ting Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC.,Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC
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Apriliyasari RW, Budi IS, Tan MP, Tsai PS. Physical activity and depression in Indonesian adults with stroke: A nationwide survey. J Nurs Scholarsh 2023; 55:356-364. [PMID: 36262085 DOI: 10.1111/jnu.12823] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/22/2022] [Accepted: 09/12/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE To examine the associations between physical activity and depressive symptoms in adults with stroke. DESIGN We conducted a cross-sectional study involving the data of 3234 adults with stroke obtained from the 2018 Basic Health Research (Riset Kesehatan Dasar, RISKESDAS). METHODS Physical activity level in metabolic equivalents-minutes per week were determined using the Global Physical Activity Questionnaire according to the World Health Organization (WHO) guidelines on physical activity and sedentary behavior recommendations. Depression was assessed using the Mini-International Neuropsychiatric Interview. Multivariate binomial logistic regression analysis was performed to examine the predictive role of physical activity for depression after adjusting for confounders. RESULTS Adults with stroke who met the WHO recommendation of physical activity were independently and significantly associated with lower odds of depression after adjustment for confounders (adjusted OR = 0.757, p = 0.017). CONCLUSIONS Performing physical activity according to the WHO recommendation is associated with a lower likelihood of depression among Indonesian adults with stroke. CLINICAL RELEVANCE Clinicians should be informed by the findings of this study and prescribe exercise interventions or plan physical activities to optimize recovery and prevent poststroke depression.
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Affiliation(s)
- Renny Wulan Apriliyasari
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Institut Teknologi Kesehatan (ITEKES) Cendekia Utama Kudus, Kudus, Indonesia
| | - Ilham Setyo Budi
- Department of Nursing, Institut Teknologi Kesehatan (ITEKES) Cendekia Utama Kudus, Kudus, Indonesia
| | - Maw Pin Tan
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Center for Nursing and Healthcare Research in Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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Liao HF, Yen CF, Chiu TY, Chi WC, Liou TH, Chang BS, Wu TF, Lu SJ. Factor Structure of an ICF-Based Measure of Activity and Participations for Adults in Taiwan's Disability Eligibility Determination System. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:879898. [PMID: 36188921 PMCID: PMC9397969 DOI: 10.3389/fresc.2022.879898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/11/2022] [Indexed: 11/24/2022]
Abstract
To assess activity and participation for adults in Taiwan's Disability Eligibility Determination System (DEDS), we developed a measure, the Functioning Disability Evaluation Scale—Adult version (FUNDES-Adult), based on the 36-item interviewer-administered version of the WHO Disability Assessment Schedule 2.0. The purpose of this study was to examine the factor structures of performance and capability dimensions of the FUNDES-Adult. This study followed a methodology research design to investigate the construct validity of the two dimensions of the FUNDES-Adult. Two samples were randomly stratified from the databank of adults with disabilities to examine structural validity by the exploratory factor analysis (EFA) (n = 8,730, mean age of 52.9 ± 16.81) and the confirmatory factor analysis (CFA) (n = 500, mean age of 54.3 ± 16.81). The results demonstrated that the EFA yielded 5-factor structures for both performance dimension (73.5% variance explained) and capability dimension (75.9% variance explained). The CFA indicated that the second-order factor structures of both dimensions were more parsimonious with adequate fit indices (GFI, NFI, CFI, and TLI ≥ 0.95, RMSEA < 0.09). The results of this study provide evidence that the FUNDES-Adult has acceptable structural validity for use in Taiwan's DEDS. Utility of the FUNDES-Adult in rehabilitation, employment, welfare, and long-term care services needs further study.
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Affiliation(s)
- Hua-Fang Liao
- School and Graduate Institute of Physical Therapy, National Taiwan University, Taipei, Taiwan
- Taiwan Society of ICF, Taipei, Taiwan
- *Correspondence: Hua-Fang Liao
| | - Chia-Feng Yen
- Department of Public Health, Tzu Chi University, Hualien, Taiwan
- Chia-Feng Yen
| | - Tzu-Ying Chiu
- Department of Health and Welfare, College of City Management, University of Taipei, Taipei, Taiwan
| | - Wen-Chou Chi
- Department of Occupational Therapy, Chungshan Medical University, Taichung, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ben-Sheng Chang
- Department of Psychology, Soochow University, Taipei, Taiwan
| | - Ting-Fang Wu
- Graduate Institute of Rehabilitation Counseling, National Taiwan Normal University, Taipei, Taiwan
| | - Shu-Jen Lu
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
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Nielsen LM, Oestergaard LG, Kirkegaard H, Maribo T. Construct Validity and Clinical Utility of World Health Organization Disability Assessment Schedule 2.0 in Older Patients Discharged From Emergency Departments. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:710137. [PMID: 36188825 PMCID: PMC9397984 DOI: 10.3389/fresc.2021.710137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022]
Abstract
Introduction: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is designed to measure functioning and disability in six domains. It is included in the International Classification of Diseases 11th revision (ICD-11). The objective of the study was to examine the construct validity of WHODAS 2.0 and describe its clinical utility for the assessment of functioning and disability among older patients discharged from emergency departments (EDs). Material and Methods: This cross-sectional study is based on data from 129 older patients. Patients completed the 36-item version of WHODAS 2.0 together with the Barthel-20, the Assessment of Motor and Process Skills (AMPS), Timed Up and Go (TUG), and the 30-Second Chair Stand Test (30 s-CST). Construct validity was examined through hypothesis testing by correlating the WHODAS with the other instruments and specifically the mobility domain in WHODAS 2.0 with the TUG and 30 s-CST tests. The clinical utility of WHODAS 2.0 was explored through floor/ceiling effect and missing item responses. Results: WHODAS 2.0 correlated fair with Barthel-20 (r = -0.49), AMPS process skills (r = -0.26) and TUG (r=0.30) and correlated moderate with AMPS motor skills (r = -0.58) and 30s-CST (r = -0.52). The WHODAS 2.0 mobility domain correlated fair with TUG (r = 0.33) and moderate with 30s-CST (r = -0.60). Four domains demonstrated floor effect: D1 "Cognition," D3 "Self-care," D4 "Getting along," and D5 "Household." Ceiling effect was not identified. The highest proportion of missing item responses were present for Item 3.4 (Staying by yourself for a few days), Item 4.4 (Making new friends), and Item 4.5 (Sexual activities). Conclusion: WHODAS 2.0 had fair-to-moderate correlations with Barthel-20, AMPS, TUG, and 30s-CST and provides additional aspects of disability compared with commonly used instruments. However, the clinical utility of WHODAS 2.0 applied to older patients discharged from EDs poses some challenges due to floor effect and missing item responses. Accordingly, patient and health professional perspectives need further investigation.
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Affiliation(s)
- Louise Moeldrup Nielsen
- Department of Occupational Therapy, Research Centre for Health and Welfare Technology, VIA University College, Aarhus, Denmark
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Lisa Gregersen Oestergaard
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM Central Denmark Region, Aarhus, Denmark
| | - Hans Kirkegaard
- Research Centre for Emergency Medicine, Emergency Department, Department of Clinical Medicine, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM Central Denmark Region, Aarhus, Denmark
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