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Plener J, Mior S, Atkinson-Graham M, Hogg-Johnson S, Côté P, Ammendolia C. Information is power: a qualitative study exploring the lived experiences of patients with degenerative cervical radiculopathy. Pain 2024; 165:347-356. [PMID: 37625188 PMCID: PMC10785052 DOI: 10.1097/j.pain.0000000000003019] [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: 01/17/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 08/27/2023]
Abstract
ABSTRACT Degenerative cervical radiculopathy (DCR) can lead to severe pain, paraesthesia, and/or motor weakness, resulting in significant morbidity, disability, and reduced quality of life. Typically, individuals suffer from prolonged symptoms, with time to complete recovery spanning months to years. Little is known about the impact DCR has on peoples' lives. Therefore, this study aimed to explore the everyday experiences of individuals living with DCR. A qualitative study was conducted through an interpretivist lens exploring the experiences of participants. Participants were purposefully recruited and interviewed with 2 research team members. Transcripts were independently analyzed by 2 reviewers and coding was finalized by consensus. Analysis was performed using an interpretative phenomenological approach, with emergent themes mapped onto the 5 domains of the International Classification of Functioning, Disability and Health framework. Eleven participants were interviewed between December 2021 and April 2022. Three themes emerged: the biopsychosocial impact of DCR, role of the health care provider, and uncertainty surrounding DCR. Pain and paraesthesia were the most common symptoms experienced by participants, leading to significant psychological distress and impact to daily activities, most notably driving, housecleaning, sleep, and ability to work. Participants described the uncertainty they experienced as a result of the unpredictable nature of DCR and the important role that health care providers play in their journey with DCR. Health care providers were seen acting as either a facilitator or a barrier to their recovery. The findings from this study can be used by clinicians providing patient-centered care to better understand the experiences of people with DCR.
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Affiliation(s)
- Joshua Plener
- Division of Graduate Education, Canadian Memorial Chiropractic College, Toronto, Canada
- Department of Medicine, Mount Sinai Hospital, Toronto, Canada
| | - Silvano Mior
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
- Institute for Disability and Rehabilitation Research, Oshawa, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Melissa Atkinson-Graham
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Sheilah Hogg-Johnson
- Department of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
- Institute for Disability and Rehabilitation Research, Oshawa, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Pierre Côté
- Institute for Disability and Rehabilitation Research, Oshawa, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Carlo Ammendolia
- Department of Medicine, Mount Sinai Hospital, Toronto, Canada
- Department of Surgery, University of Toronto, Toronto, Canada
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Ma BH, Chen G, Badji S, Petrie D. Mapping the 12-item World Health Organization disability assessment schedule 2.0 (WHODAS 2.0) onto the assessment of quality of life (AQoL)-4D utilities. Qual Life Res 2024; 33:411-422. [PMID: 37906346 PMCID: PMC10850031 DOI: 10.1007/s11136-023-03532-9] [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] [Accepted: 09/26/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a widely used disability-specific outcome measure. This study develops mapping algorithms to estimate Assessment of Quality of Life (AQoL)-4D utilities based on the WHODAS 2.0 responses to facilitate economic evaluation. METHODS The study sample comprises people with disability or long-term conditions (n = 3376) from the 2007 Australian National Survey of Mental Health and Wellbeing. Traditional regression techniques (i.e., Ordinary Least Square regression, Robust MM regression, Generalised Linear Model and Betamix Regression) and machine learning techniques (i.e., Lasso regression, Boosted regression, Supported vector regression) were used. Five-fold internal cross-validation was performed. Model performance was assessed using a series of goodness-of-fit measures. RESULTS The robust MM estimator produced the preferred mapping algorithm for the overall sample with the smallest mean absolute error in cross-validation (MAE = 0.1325). Different methods performed differently for different disability subgroups, with the subgroup with profound or severe restrictions having the highest MAE across all methods and models. CONCLUSION The developed mapping algorithm enables cost-utility analyses of interventions for people with disability where the WHODAS 2.0 has been collected. Mapping algorithms developed from different methods should be considered in sensitivity analyses in economic evaluations.
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Affiliation(s)
- Bernice Hua Ma
- Monash Business School Centre for Health Economics, Caulfield East, Australia.
- Centre of Research Excellence in Disability and Health, Parkville, Australia.
| | - Gang Chen
- Monash Business School Centre for Health Economics, Caulfield East, Australia
| | - Samia Badji
- Monash Business School Centre for Health Economics, Caulfield East, Australia
- Centre of Research Excellence in Disability and Health, Parkville, Australia
| | - Dennis Petrie
- Monash Business School Centre for Health Economics, Caulfield East, Australia
- Centre of Research Excellence in Disability and Health, Parkville, Australia
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Measurement Properties and Minimal Important Change of the World Health Organization Disability Assessment Schedule 2.0 in Persons With Low Back Pain: A Systematic Review. Arch Phys Med Rehabil 2023; 104:287-301. [PMID: 35798195 DOI: 10.1016/j.apmr.2022.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/19/2022] [Accepted: 06/07/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine the measurement properties and minimal important change (MIC) of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) short (12 questions) and full (36 questions) versions in persons with nonspecific low back pain (LBP). DATA SOURCES MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, APA PsycInfo, and Cochrane Central Register of Controlled Trials (inception to May 2021). STUDY SELECTION Eligible studies assessed measurement properties or MIC of WHODAS 2.0 in persons with LBP. DATA EXTRACTION Paired reviewers screened articles, extracted data, and assessed risk of bias using Consensus-Based Standards for Selection of Health Measurement Instruments (COSMIN) and COSMIN-Outcome Measures in Rheumatology checklists. DATA SYNTHESIS We descriptively synthesized results stratified by measurement property and LBP duration (subacute: 6 weeks to 3 months; chronic: ≥3 months). RESULTS We screened 297 citations and included 14 studies (reported in 15 articles). Methodological quality of studies was very good for internal consistency and varied between very good and doubtful for construct validity, doubtful for responsiveness, and adequate for all other properties assessed. Evidence suggests that WHODAS 2.0 full version has adequate content validity (2 studies); WHODAS 2.0 short and full versions have adequate structural validity (3 studies), but construct validity is indeterminate (9 studies). WHODAS 2.0 short and full versions have adequate internal consistency (10 studies), and the full version has adequate test-retest and interrater reliability (3 studies) in persons with LBP. Minimal detectable change (MDC) was 10.45-13.99 of 100 for the full version and 8.6 of 48 for the short version in persons with LBP (4 studies). WHODAS 2.0 full version has no floor or ceiling effects, but the short version has potential floor effects in persons with chronic LBP (3 studies). One study estimated MIC for the full version as 4.87 of 100 or 9.74 of 100 (corresponding to 1- and 2-point change on 0- to 10-cm visual analog scale for pain, respectively), and 1 study estimated 3.09-4.68 of 48 for the short version. CONCLUSIONS In persons with LBP, WHODAS 2.0 full version has adequate content validity, structural validity, internal consistency, and reliability. WHODAS 2.0 short version has adequate structural validity and internal consistency. Construct validity of the short and full versions is indeterminate. Since MDC is estimated to be larger than MIC, users may consider both MIC and MDC thresholds to measure change in functioning for LBP.
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Defar S, Abraham Y, Reta Y, Deribe B, Jisso M, Yeheyis T, Kebede KM, Beyene B, Ayalew M. Health related quality of life among people with mental illness: The role of socio-clinical characteristics and level of functional disability. Front Public Health 2023; 11:1134032. [PMID: 36875411 PMCID: PMC9978447 DOI: 10.3389/fpubh.2023.1134032] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Background People with mental illness (PWMI) have declining health related quality of life (HRQoL), which is frequently equivalent to or greater than that of medical disorders. Although, HRQoL is rapidly being recognized as an essential treatment outcome indicator in modern psychiatry, research on the identification and significance of factors impacting QoL in PWMI is still in its early stages. Objective The aim of this study was to identify predictors of HRQoL among people with mental illness who underwent outpatient follow-up in Sidama region, southern Ethiopia. Methods We conducted a multicenter, cross-sectional study from April-1, to May-30, 2022. A total of 412 participants took part in the study, using an interviewer-administered structured questionnaire. The HRQoL was measured using the 12-item Short-Form Health Survey-Version 2 (SF-12v2) scale. To describe different variables, descriptive statistics were employed. To find independent HRQoL predictors, we used multivariable linear regression analysis. P-value of <0.05 were declared statistically significant at 95% confidence interval (CI). Result Out of 412 participants, nearly two-third 261 (63.3%) were male and nearly half 203 (49.3%) were diagnosed as schizophrenia. HRQoL was positively associated with social support (β = 0.321) and being single (β = 2.680). Conversely, functional disability (β = -0.545), being a student (β = -4.645) and jobless (β = -3.279) by occupation, and being diagnosed with depression (β = -2.839) were negatively impacted HRQoL among PWMI. Conclusion HRQoL of people with mental disorders in this study was significantly associated to social support, marital status, occupation, diagnosis and level of functional disability. Therefore, the mental health care system should develop HRQoL promoting measures that enhance PWMI functioning, social support and employment.
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Affiliation(s)
- Semira Defar
- Department of Midwifery, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Yacob Abraham
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Yared Reta
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Bedilu Deribe
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Meskerem Jisso
- School of Public Health, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Tomas Yeheyis
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Kurabachew Mengistu Kebede
- Department of Anesthesia, Faculty of Medicine, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Bereket Beyene
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Mohammed Ayalew
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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Shahedifar N, Sadeghi-Bazargani H, Asghari-Jafarabadi M, Farahbakhsh M, Bazargan-Hejazi S. Psychometric properties of the 12-item WHODAS applied through phone survey: an experience in PERSIAN Traffic Cohort. Health Qual Life Outcomes 2022; 20:106. [PMID: 35810300 PMCID: PMC9270832 DOI: 10.1186/s12955-022-02013-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/29/2022] [Indexed: 11/30/2022] Open
Abstract
Background Due to limited capability to function in post-injury daily life injury, survivors need to be reliably assessed without need to commute more than necessary. The key action is to determine the level of functioning difficulties. Having the opportunity of conducting a national post-crash traffic safety and health cohort study, we aimed to translate into Persian and assess the psychometric properties of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) through phone surveys six month post injury. Methods First, having World Health Organization permission, we tested the translation validity by forward translation, expert panel evaluation, back-translation, pre-testing and cognitive interviewing, and finalizing the Persian WHODAS. Then, through a psychometric study within a national cohort platform, the validity, reliability and applicability of the 12-item WHODAS was assessed through phone surveys. We included data of 255 road traffic injury patients enrolled from the cohort at six-month follow-up. The psychometric assessment (internal consistency reliability and stability reliability) was conducted on test–retest data of 50 patients with an average 7-day time span. An exploratory factor analysis tested the construct validity using extraction method of principal component factor and oblique rotation on data from 255 patients. Regarding the multiple criteria including an eigenvalue > 0.9, Cattell’s scree test, cumulative variance, and the theoretical basis, the minimum number of factors were retained. Data were analyzed using STATA statistical software package. Results The respondents were mostly male (81%), employed (71%), educated (87%), and with a mean age of 37.7(14.9). The Persian version had high internal consistency reliability (Cronbach’s α = 0.93) and excellent stability reliability (ICC = 0.97, 95% CI: 0.92–0.98). An exploratory factor analysis retained four factors defining 86% of all the variance. Factors of Self-care, Mobility, and Cognition were completely retained. Conclusions The brief Pesrian WHODAS 2.0 was highly reliable and valid to be applied through phone interviews post injury.
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Affiliation(s)
- Nasrin Shahedifar
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, 5167846311, East Azerbaijan, Islamic Republic of Iran.,Injury Epidemiology and Prevention Research Group, Turku Brain Injury Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Homayoun Sadeghi-Bazargani
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, 5167846311, East Azerbaijan, Islamic Republic of Iran.
| | - Mohammad Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, VIC, 3144, Australia.,Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, 5167846311, East Azerbaijan, Islamic Republic of Iran.,School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, VIC, 3800, Australia
| | - Mostafa Farahbakhsh
- Research Center of Psychiatry and Behavioural Sciences, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
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Correlation between Oswestry disability index and 12-item self-administered version of World Health Organization Disability Assessment Schedule (WHODAS 2.0) in patients with chronic low back pain. Int J Rehabil Res 2021; 44:170-172. [PMID: 33724972 DOI: 10.1097/mrr.0000000000000465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of the study was to investigate the correlation between the 12-item WHO Disability Assessment Schedule (WHODAS 2.0) and the Oswestry disability index (ODI). Prospective cross-sectional study of 1379 patients (age 48 years) with chronic low back pain. The Spearman's rank correlation test was employed. Of all the possible 143 correlations, 46 (32%) were strong and nine (6%) were very strong. The strongest correlations ≥0.6 were seen for 'personal care' (ODI) vs. 'washing whole body' (WHODAS 2.0), 'personal care' (ODI) vs. 'getting dressed' (WHODAS 2.0), 'walking' (ODI) vs. 'walking long distances' (WHODAS 2.0) and 'social life' (ODI) vs. the WHODAS 2.0 total score. In conclusion, while items defining physical functioning were mostly strongly correlated, items defining social or psychological functioning were less associated. Both scales could be used together providing valuable information regarding the functioning of people with chronic low back pain.
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Yuliana S, Muslih M, Sim J, Vidyanti AN, Brahmadhi A, Tsai HT. Development and validation of the World Health Organization disability Assessment Schedule 2.0 (WHODAS 2.0) Indonesian version in stroke survivors. Disabil Rehabil 2021; 44:4459-4466. [PMID: 33745407 DOI: 10.1080/09638288.2021.1900413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Stroke is the third most common cause of disability worldwide. In order to effectively study the disability status experienced by stroke survivors, it is important to identify reliable and valid tools to measure disability that can be administered to this population. No previous study had been conducted on the Indonesian version of the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). The aim of this study was to develop and validate the Indonesian version of the WHODAS 2.0 for stroke survivors in Indonesia. METHODS Following translation and back-translation, the Indonesian version of the WHODAS 2.0 was administered to 183 stroke survivors. We used all six domains of the WHODAS 2.0, with the exception of four items of "work or school activities" in domain 5. Internal consistency was measured by Cronbach's alpha, the inter-rater reliability was measured by interclass correlations (ICCs), and the construct validity was tested with an exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). RESULTS The range of Cronbach's alpha was 0.86-0.92, which indicated excellent reliability, and ICC was very good at 0.87-0.99. The EFA and CFA for the main 32-item questionnaire exhibited a total variance of 95% (KMO) and a p value of <0.05. The factor loadings per items were >0.4, and all the model fit indices were acceptable. CONCLUSIONS The WHODAS 2.0 was adapted for use in Indonesia and showed good results for all six domains. Therefore, the Indonesian version of the WHODAS 2.0 can be applied to assess disability in Indonesian stroke survivors.Implications for rehabilitationThe WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) was developed as a single, generic instrument for assessing the health status and disability in different cultures and settings.In this study, we adapted and validated an Indonesian version of the WHODAS 2.0 for stroke survivors in Indonesia.The WHODAS 2.0 was adapted for use in Indonesia and showed good results for all six domains.The Indonesian version of the WHODAS 2.0 can be applied to assess disability in Indonesian stroke survivors.
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Affiliation(s)
- Sri Yuliana
- Department of Nursing, Yahya Health Science Institute of Bima, Bima, Indonesia
| | - Muhammad Muslih
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC.,School of Nursing, Faculty of Health Science, Universitas Muhammadiyah Malang, Malang, Indonesia
| | - Jenny Sim
- School of Nursing, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Amelia Nur Vidyanti
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ageng Brahmadhi
- International PhD Program for Cell Therapy and Regeneration Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC.,Faculty of Medicine, University of Muhammadiyah, Purwokerto, Indonesia
| | - 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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Psychometric properties of the Polish version of the 36-item WHODAS 2.0 in patients with hip and knee osteoarthritis. Qual Life Res 2021; 30:2415-2427. [PMID: 33719013 PMCID: PMC8298349 DOI: 10.1007/s11136-021-02806-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 01/25/2023]
Abstract
Purpose To examine psychometric properties of the Polish version of the 36-item WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) in the population with hip and knee osteoarthritis (OA). Methods This was a longitudinal study with repeated measures during retest examinations. Subjects from a Polish Specialist Hospital (age = 68.3 ± 9.2years, 71% female, 44.2% knee OA, 55.8% hip OA) were tested three times. They completed the Polish version of the 36-item WHODAS 2.0, the SF-36 Health Survey 2.0, the Western Ontario and Macmaster Universities Osteoarthritis Index 3.1, the Hospital Anxiety and Depression Scale, and the Numerical Rating Scale. Results The 36-item WHODAS 2.0—Polish version demonstrated high internal consistency (Cronbach’s alpha for total = 0.94), and test–retest reliability (Total ICC2,1 = 0.98). High construct validity was found as 12 out of 15 a priori hypotheses (80%) were confirmed. Most domains and Total Scores in the 36-item WHODAS 2.0 (Total ES = − 0.62, SMR = − 1.09) showed a moderate degree of responsiveness. Minimal clinically important difference (MCID) for the Total WHODAS 2.0 was 3.29 in patients undergoing rehabilitation for knee or hip OA. Conclusions The Polish version of the 36-item WHODAS 2.0 assesses disability according to ICF in a reliable, valid and responsive way. Therefore, it provides considerable support in clinical practice and national and international scientific research of patients with hip or knee OA.
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Greenberg J, Mace RA, Bannon SM, Kulich RJ, Vranceanu AM. Mind-Body Activity Program for Chronic Pain: Exploring Mechanisms of Improvement in Patient-Reported, Performance-Based and Ambulatory Physical Function. J Pain Res 2021; 14:359-368. [PMID: 33574699 PMCID: PMC7872894 DOI: 10.2147/jpr.s298212] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/20/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Improving physical function among patients with chronic pain is critical for reducing disability and healthcare costs. However, mechanisms underlying improvement in patient-reported, performance-based, and ambulatory physical function in chronic pain remain poorly understood. PURPOSE To explore psychosocial mediators of improvement in patient-reported, performance-based, and objective/accelerometer-measured physical function among participants in a mind-body activity program. METHODS Individuals with chronic pain were randomized to one of two identical 10-week mind-body activity interventions aimed at improving physical function with (GetActive-Fitbit; N=41) or without (GetActive; N=41) a Fitbit device. They completed self-reported (WHODAS 2.0), performance-based (6-minute walk test), and objective (accelerometer-measured step-count) measures of physical function, as well as measures of kinesiophobia (Tampa Kinesiophobia Scale), mindfulness (CAMS-R), and pain resilience (Pain Resilience Scale) before and after the intervention. We conducted secondary data analyses to test mediation via mixed-effects modeline. RESULTS Improvements in patient-reported physical function were fully and uniquely mediated by kinesiophobia (Completely Standardized Indirect Effect (CSIE)=.18; CI=0.08, 0.30; medium-large effect size), mindfulness (CSIE=-.14; CI=-25, -.05; medium effect size) and pain resilience (CSIE=-.07; CI=-.16, -.005; small-medium effect size). Improvements in performance-based physical function were mediated only by kinesiophobia (CSIE=-.11; CI=-23, -.008; medium effect size). No measures mediated improvements in objective (accelerometer measured) physical function. CONCLUSION Interventions aiming to improve patient-reported physical function in patients with chronic pain may benefit from skills that target kinesiophobia, mindfulness, and pain resilience, while those focused on improving performance-based physical function should target primarily kinesiophobia. More research is needed to understand mechanisms of improvement in objective, accelerometer-measured physical function. TRIAL REGISTRATION ClinicalTrials.gov NCT03412916.
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Affiliation(s)
- Jonathan Greenberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ryan A Mace
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sarah M Bannon
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ronald J Kulich
- Harvard Medical School, Boston, MA, USA
- Center for Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
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Denu ZA, Yassin MO, Bisetegn TA, Biks GA, Gelaye KA. The 12 items Amharic version WHODAS-2 showed cultural adaptation and used to measure disability among road traffic trauma victims in Ethiopia. BMC Psychol 2021; 9:1. [PMID: 33388086 PMCID: PMC7777354 DOI: 10.1186/s40359-020-00492-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 11/24/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Adapting and translating already developed tools to different cultures is a complex process, but once done, it increases the validity of the construct to be measured. This study aimed to assess the 12 items WHODAS-2 and test its psychometric properties among road traffic injury victims in Ethiopia. This study aimed to translate the 12 items WHODAS- 2 interview-based tools into Amharic and examine the psychometric properties of the new version among road traffic injury victims. METHODS The 12 items WHODAS 2 was first translated into Amharic by two experts. Back translation was done by two English experts. A group of experts reviewed the forward and backward translation. A total of 240 patients with road traffic injury completed the questionnaires at three selected Hospitals in Amhara Regional State. Internal consistency was; assessed using Chronbach's alpha, convergent, and divergent validity, which were; tested via factor analysis. Confirmatory factor analysis (CFA); was computed, and the model fit; was examined. RESULTS The translated Amharic version 12 -items WHODAS-2 showed that good cross-cultural adaptation and internal consistency (Chronbach's α =0.88). The six factor structure best fits data (model fitness indices; CFI = 0.962, RMSEA = 0.042, RMR = 0.072, GFI = 0.961, chi-square value/degree of freedom = 1.42, TLI = 0.935 and PCLOSE = 0.68). Our analysis showed that from the six domains, mobility is the dominant factor explaining 95% of variability in disability. CONCLUSION The 12 items interview-based Amharic version WHODAS-2; showed good cultural adaptation at three different settings of Amhara Regional State and can be used to measure dis-ability following a road traffic injury.
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Affiliation(s)
- Zewditu Abdissa Denu
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Mensur Osman Yassin
- Department of Surgery, School of Medicine College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale Bisetegn
- Department of Health Communication and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Andargie Biks
- Department of Health Policy and Management, Institute of Public health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Ćwirlej-Sozańska A, Bejer A, Wiśniowska-Szurlej A, Wilmowska-Pietruszyńska A, de Sire A, Spalek R, Sozański B. Psychometric Properties of the Polish Version of the 36-Item WHODAS 2.0 in Patients with Low Back Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7284. [PMID: 33036141 PMCID: PMC7579066 DOI: 10.3390/ijerph17197284] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 09/26/2020] [Accepted: 09/30/2020] [Indexed: 12/15/2022]
Abstract
The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is considered by the World Health Organization (WHO) to be a useful tool for assessing the functioning and disability of the general population as well as the effectiveness of the applied interventions. Until this study, no data regarding the validity of the 36-item WHODAS 2.0 in chronic low back pain (LBP) in Poland have been explored. This study was conducted on 92 patients suffering from chronic LBP admitted to the rehabilitation ward. The Polish version of the 36-item WHODAS 2.0, the Sf-36 Health Survey (SF-36), the Oswestry Disability Index (ODI), the Hospital Anxiety and Depression Scale (HADS) and the Visual Analogue Scale (VAS) questionnaires were applied to assess patients. The scale score reliability of the entire tool for the study population was very high. The Cronbach's alpha test result for the entire scale was 0.92. For the overall result of the WHODAS 2.0, the Intraclass Correlation Coefficient (ICC1,2) was 0.928, which confirmed that the scale was consistent over time. The total result and the vast majority of domains of the 36-item WHODAS 2.0 correlated negatively with domains of the SF-36 questionnaire; thus, a higher WHODAS 2.0 score was associated with a lower score on the SF-36 questionnaire. We found that the minimal clinically important difference (MCID) for the total WHODAS 2.0 score in patients after rehabilitation for LBP was 4.87. Overall, the results indicated that the Polish version of the 36-item WHODAS is suitable for assessing health and disability status in patients with LBP.
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Affiliation(s)
- Agnieszka Ćwirlej-Sozańska
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana16C, 35-959 Rzeszow, Poland; (A.B.); (A.W.-S.); (B.S.)
| | - Agnieszka Bejer
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana16C, 35-959 Rzeszow, Poland; (A.B.); (A.W.-S.); (B.S.)
| | - Agnieszka Wiśniowska-Szurlej
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana16C, 35-959 Rzeszow, Poland; (A.B.); (A.W.-S.); (B.S.)
| | | | - Alessandro de Sire
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Viale Piazza D’Armi 1, 28100 Novara, Italy;
- Department of Geriatrics, Neurosciences, Orthopedics, Center for Geriatric Medicine (CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, L.go F.Vito 8, 00168 Rome, Italy; or
| | - Renata Spalek
- Department of Geriatrics, Neurosciences, Orthopedics, Center for Geriatric Medicine (CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, L.go F.Vito 8, 00168 Rome, Italy; or
- Rehabilitation Unit, ‘Mons. L. Novarese’ Hospital, Str. Sotto Cerca, 13040 Vercelli, Italy
| | - Bernard Sozański
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, University of Rzeszow, Rejtana16C, 35-959 Rzeszow, Poland; (A.B.); (A.W.-S.); (B.S.)
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Greenberg J, Mace RA, Popok PJ, Kulich RJ, Patel KV, Burns JW, Somers TJ, Keefe FJ, Schatman ME, Vranceanu AM. Psychosocial Correlates of Objective, Performance-Based, and Patient-Reported Physical Function Among Patients with Heterogeneous Chronic Pain. J Pain Res 2020; 13:2255-2265. [PMID: 32982388 PMCID: PMC7498493 DOI: 10.2147/jpr.s266455] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/13/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Improving all aspects of physical function is an important goal of chronic pain management. Few studies follow recent guidelines to comprehensively assess physical function via patient-reported, performance-based, and objective/ambulatory measures. PURPOSE To test 1) the interrelation between the 3 types of physical function measurement and 2) the association between psychosocial factors and each type of physical function measurement. METHODS Patients with chronic pain (N=79) completed measures of: 1) physical function (patient-reported disability; performance-based 6-minute walk-test; objective accelerometer step count); 2) pain and non-adaptive coping (pain during rest and activity, pain-catastrophizing, kinesiophobia); 3) adaptive coping (mindfulness, general coping, pain-resilience); and 4) social-emotional dysfunction (anxiety, depression, social isolation and emotional support). First, we tested the interrelation among the 3 aspects of physical function. Second, we used structural equation modeling to test associations between psychosocial factors (pain and non-adaptive coping, adaptive coping, and social-emotional dysfunction) and each measurement of physical function. RESULTS Performance-based and objective physical function were significantly interrelated (r=0.48, p<0.001) but did not correlate with patient-reported disability. Pain and non-adaptive coping (β=0.68, p<0.001), adaptive coping (β=-0.65, p<0.001) and social-emotional dysfunction (β=0.65, p<0.001) were associated with patient-reported disability but not to performance-based or objective physical function (ps>0.1). CONCLUSION Results suggest that patient-reported physical function may provide limited information about patients' physical capacity or ambulatory activity. While pain and non-adaptive reactions to it, adaptive coping, and social-emotional dysfunction may potentially improve patient-reported physical function, additional targets may be needed to improve functional capacity and ambulatory activity. TRIAL REGISTRATION ClinicalTrials.gov NCT03412916.
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Affiliation(s)
- Jonathan Greenberg
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ryan A Mace
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Paula J Popok
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Ronald J Kulich
- Harvard Medical School, Boston, MA, USA
- Center for Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Kushang V Patel
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA
| | - John W Burns
- Division of Behavioral Sciences, Rush Medical College, Chicago, IL, USA
| | - Tamara J Somers
- Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Francis J Keefe
- Department of Medicine, Duke University School of Medicine, Durham, NC, US
| | - Michael E Schatman
- Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, MA, USA
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Salehi R, Negahban H, Khiavi FF, Saboor S, Majdinasab N, Shakhi K. Validity and Reliability of the World Health Organization Disability Assessment Schedule 2.0 36-Item Persian Version for Persons with Multiple Sclerosis. Korean J Fam Med 2020; 41:195-201. [PMID: 32252498 PMCID: PMC7272363 DOI: 10.4082/kjfm.18.0155] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/05/2018] [Indexed: 11/09/2022] Open
Abstract
Background No previous studies have assessed the psychometric properties of the 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in the Persian language of Iran. This study was designed and conducted to evaluate the validity and reliability of the Persian version using a sample of persons with multiple sclerosis in Ahvaz, Iran. Methods The methodological study was conducted in two stages: First, the 36 items of the original WHODAS 2.0 were translated to create a Persian version, after which the translation validity and psychometric properties were tested. The factor structure of the instrument was also tested using exploratory and confirmatory factor analyses. Results The intraclass correlation coefficients were very good to excellent, varying between 0.82 and 0.99 for the six domains, and all domains had Cronbach’s α reliability values of above 0.70. For construct validity, results showed negative and strong correlation between the total score of WHODAS 2.0 and the Multiple Sclerosis Quality of Life-54. Exploratory factor analysis divided the Persian version of WHODAS 2.0 into seven factors for multiple sclerosis patients. Conclusion The results of this study indicate that the Persian version of WHODAS 2.0 is a valid and reliable instrument to study the disabilities of people with multiple sclerosis.
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Affiliation(s)
- Reza Salehi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzad Faraji Khiavi
- Department of Healthcare Administration, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shiva Saboor
- Clinical Psychology Department, Azad University of Sari, Khouzestan Association for Autism, Ahvaz, Iran
| | - Nastaran Majdinasab
- Neurology Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kamal Shakhi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Park SH, Kang BH, Kim MJ, Kim B, Lee GY, Seo YM, Yoo JI, Park KS. Validation of the Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF) and Its Relevance to Disability and Frailty. Yonsei Med J 2020; 61:251-256. [PMID: 32102126 PMCID: PMC7044687 DOI: 10.3349/ymj.2020.61.3.251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/07/2020] [Accepted: 02/10/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to evaluate the validity of the Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF) for the assessment of musculoskeletal disorders. We evaluated whether WOMAC-SF correlated with the World Health Organization Disability Assessment Schedule 12 (WHODAS-12) and Kaigo-Yobo questionnaires for assessing health-outcomes in Korea. MATERIALS AND METHODS This cross-sectional study used data from the Namgaram-2 cohort. WOMAC, WOMAC-SF, WHODAS-12, and Kaigo-Yobo questionnaires were administered to patients with musculoskeletal disorders, including radiology-confirmed knee osteoarthritis (RKOA), sarcopenia, and osteoporosis. The relationships among WOMAC-SF, WHODAS-12, and Kaigo-Yobo scores were analyzed by stepwise multiple regression analysis. RESULTS WOMAC-SF was associated with the WOMAC questionnaire. The results of confirmatory factor analysis for the hypothesized model with two latent factors, pain and function, provided satisfactory fit indices. WOMAC-SF pain and function were associated with RKOA. Kaigo-Yobo was associated with WOMAC-SF pain (B=0.140, p=0.001) and WOMAC-SF function (B=0.042, p=0.004). WHODAS-12 was associated with WOMAC-SF pain (B=0.679, p=0.003) and WOMAC-SF function (B=0.804, p<0.001). CONCLUSION WOMAC-SF was validated for the evaluation of low extremity musculoskeletal disorders and health-related quality of life in a community-based population. Furthermore, we confirmed that WOMAC-SF were reflective of disability and frailty, which affect health outcomes.
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Affiliation(s)
- Soo Hyun Park
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
| | - Byeong Hun Kang
- Department of Orthopedic Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Mi Ji Kim
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Bokyoung Kim
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Gyeong Ye Lee
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Young Mi Seo
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea
| | - Jun Il Yoo
- Department of Orthopedic Surgery, Gyeongsang National University Hospital, Jinju, Korea.
| | - Ki Soo Park
- Department of Preventive Medicine, College of Medicine and Institute of Health Science, Gyeongsang National University, Jinju, Korea
- Center for Farmer's Safety and Health, Gyeongsang National University Hospital, Jinju, Korea.
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Horta-Baas G, Romero-Figueroa MDS. Self-reported disability in women with fibromyalgia from a tertiary care center. Adv Rheumatol 2019; 59:45. [DOI: 10.1186/s42358-019-0086-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/10/2019] [Indexed: 01/17/2023] Open
Abstract
Abstract
Background
The World Health Organization Disability Assessment Schedule (WHODAS) 2.0 is a generic instrument to assess disability. Pain and psychological factors seem to play a pronounced disabling role in fibromyalgia (FM). There are few studies that investigate the factors associated with disability in patients with fibromyalgia from the patient’s perspective. Information about FM disability using self-reported questionnaires is limited. This study aimed to assess the relationship between the ordinal response variable (degree of disability), and four explanatory variables: pain intensity, depression, anxiety, and alexithymia.
Methods
One hundred fifteen women with FM were enrolled in the cross-sectional study. For the assessment of disability the WHODAS 2.0 (36-item version) was used. Univariate and multivariate (ordinal logistic regression) analyses were performed to assess the relationship between pain (Visual Analogue Scale), depression and anxiety (Hospital Anxiety and Depression Scale), alexithymia (Modified Toronto Alexithymia Scale) and disability.
Results
Disability was detected by global WHODAS score in 114 patients (99%), with the corresponding percentages for mild, moderate and severe disability being 11.3, 46.96 and 40.87%, respectively. Global WHODAS score was more severe among subjects with depression (50 vs 36.4, p < 0.001, effect size = 0.33) and alexithymia (50 vs 33.6, p < 0.001, effect size = 0.38). Pain intensity mean scores for mild, moderate and severe disability were 5.0, 6.1 and 7.3, respectively (p < 0.001, omega-squared = 0.12). Pain intensity explained the global disability degree and its domains except for the cognitive one. Whereas, depression explained cognitive and personal relation domains. On the other hand, alexithymia explained global disability degree and all domains of WHODAS 2.0 questionnaire.
Conclusions
Most of the patients with fibromyalgia perceived themselves with moderate to severe disability. The main explanatory variables of the perceived disability were the pain intensity and psychological factors (alexithymia and depression).
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Gender-related differences in psychometric properties of WHO Disability Assessment Schedule 2.0. Int J Rehabil Res 2019; 42:316-321. [PMID: 31425347 DOI: 10.1097/mrr.0000000000000365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objective of this study was to investigate the gender-related differential item function of 12-item WHODAS 2.0 amongst patients with chronic musculoskeletal pain. This was a cross-sectional survey study among 1,988 patients at a university Physical and Rehabilitation Medicine outpatient clinic. To assess DIF, WHODAS 2.0 items were dichotomized as `none' rated by respondents as `0' versus `any limitation' rated as `1,2,3 or 4'. The item response theory analysis was used to define discrimination and difficulty parameters of a questionnaire. The probit logistic regression was used to test uniformity of DIF between gender groups. The results of DIF analysis were presented and evaluated graphically as item characteristic curves based on 2-parameter IRT analysis of dichotomized responses. High to perfect discrimination ability was observed for all the items except one. Difficulty levels of eight items were shifted towards the elevated disability level, four items demonstrated a perfect difficulty property. Significant DIF between genders was observed in seven of 12 items. The detected DIFs were uniform. For item `household', `emotional affection' and `work', men had to experience slightly worse disability than women to achieve the same score. A reverse effect was observed for items `concentration', `washing', `dressing' and dealing with strangers. In this study, significant DIF between genders was found in seven of twelve items of 12-item WHODAS 2.0. amongst 1988 patients with chronic musculoskeletal pain. All the detected DIFs were uniform. Regardless gender-related DIF shown in seven out of 12 items, we recommend using and studying 12-item WHODAS 2.0 in different populations.
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Habtamu K, Medhin G, Selamu M, Tirfessa K, Hanlon C, Fekadu A. Functional impairment among people diagnosed with depression in primary healthcare in rural Ethiopia: a comparative cross-sectional study. Int J Ment Health Syst 2019; 13:50. [PMID: 31346349 PMCID: PMC6635998 DOI: 10.1186/s13033-019-0305-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 07/10/2019] [Indexed: 12/24/2022] Open
Abstract
Background There have been few studies examining the functioning of clinically-diagnosed people with depression in primary healthcare (PHC) in low- and middle-income countries (LMICs). The aim of this study was to identify factors associated with functional impairment among people diagnosed with depression in PHC in Ethiopia as part of implementation of a task-shared model of mental healthcare. Methods A comparative cross-sectional study was conducted. As part of the Programme for Improving Mental health carE (PRIME), PHC clinicians were trained to diagnose depression using an adapted version of the World Health Organization (WHO) mental health Gap Action Programme (mhGAP). A total of 2038 adult consecutive PHC attendees were screened for depressive symptoms using the 9-item Patient Health Questionnaire (PHQ-9). Those who scored five or above on the PHQ-9 (n = 131) were assessed by PHC workers. Of these, 92 were diagnosed to have depression (“PHC diagnosed cases”) and the remaining 39 people were PHQ positive but considered not to have depression (“non-diagnosed controls”). PHC diagnosed cases were also compared to a community representative sample of adult healthy controls (n = 197; “community controls”). The 12-item version of the WHO Disability Assessment Schedule (WHODAS-2.0) was used to assess functional impairment. Multivariable negative binomial regression models were fitted to examine the association of demographic, social, economic and clinical characteristics with functional impairment. Results No significant difference in functional impairment was found between diagnosed cases and non-diagnosed controls. PHC diagnosed cases were found to have higher depressive symptom severity and suicidality, but lower social support compared to non-diagnosed controls (P < 0.05). In the multivariable model, greater functional impairment was associated with higher depressive symptoms (RR = 1.04; 95% CI 1.02, 1.05) and lower social support (RR = 0.96; 95% CI 0.95, 0.98). Diagnosed cases were found to have higher functional impairment compared to community controls (RR = 1.91; 95% CI 1.74, 2.09). Conclusion In this study, PHC clinicians identified cases of depression with high symptom burden, suicidality and functional impairment. These findings support current initiatives to scale-up mental health services at the PHC level; and indicate that social support is an important target for intervention.
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Affiliation(s)
- Kassahun Habtamu
- 1School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O.BOX: 1176, Addis Ababa, Ethiopia
| | - Girmay Medhin
- 2Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Medhin Selamu
- 3Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kebede Tirfessa
- 3Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- 3Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,4Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, Kings College London, London, UK
| | - Abebaw Fekadu
- 3Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,5Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, King's College London, London, UK.,6Global health & Infection, Brighton and Sussex Medical School, Brighton, UK
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Habtamu K, Alem A, Medhin G, Fekadu A, Hanlon C. Functional impairment among people with severe and enduring mental disorder in rural Ethiopia: a cross-sectional study. Soc Psychiatry Psychiatr Epidemiol 2018; 53:803-814. [PMID: 29947862 DOI: 10.1007/s00127-018-1546-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 06/06/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE Evidence regarding functional impairment in people with severe mental disorders (SMD) is sparse in low- and middle-income countries. The aim of this study was to identify factors associated with functional impairment in people with enduring SMD in a rural African setting. METHODS A cross-sectional study was conducted at the baseline of a health service intervention trial. A total of 324 participants were recruited from an existing community-ascertained cohort of people with SMD (n = 218), and attendees at the Butajira General Hospital psychiatric clinic (n = 106). Inclusion criteria defined people with SMD who had ongoing need for care: those who were on psychotropic medication, currently symptomatic or had a relapse in the preceding 2 years. The World Health Organization Disability Assessment schedule (WHODAS-2.0) and the Butajira Functioning Scale (BFS) were used to assess functional impairment. Multivariable negative binomial regression models were fitted to investigate the association between demographic, socio-economic and clinical characteristics, and functional impairment. RESULTS Increasing age, being unmarried, rural residence, poorer socio-economic status, symptom severity, continuous course of illness, medication side effects, and internalized stigma were associated with functional impairment across self-reported and caregiver responses for both the WHODAS and the BFS. Diagnosis per se was not associated consistently with functional impairment. CONCLUSION To optimize functioning in people with chronic SMD in this setting, services need to target residual symptoms, poverty, medication side effects, and internalized stigma. Testing the impact of community interventions to promote recovery will be useful. Advocacy for more tolerable treatment options is warranted.
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Affiliation(s)
- Kassahun Habtamu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O.BOX: 1176, Addis Ababa, Ethiopia. .,Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Atalay Alem
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Psychological Medicine, Centre for Affective Disorders, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Charlotte Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Health Services and Population Research Department, Centre for Global Mental Health, Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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WHO disability assessment schedule 2.0 is related to upper and lower extremity disease-specific quality of life. Qual Life Res 2018; 27:2243-2250. [DOI: 10.1007/s11136-018-1869-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2018] [Indexed: 11/26/2022]
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Correlation between the pain numeric rating scale and the 12-item WHO Disability Assessment Schedule 2.0 in patients with musculoskeletal pain. Int J Rehabil Res 2018; 41:87-91. [DOI: 10.1097/mrr.0000000000000262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Walters JL, Baxter K, Chapman H, Jackson T, Sethuramachandran A, Couldridge M, Joshi HR, Kundra P, Liu X, Nair D, Sullivan B, Shotwell MS, Jense RJ, Kassebaum NJ, McQueen KAK. Chronic Pain and Associated Factors in India and Nepal: A Pilot Study of the Vanderbilt Global Pain Survey. Anesth Analg 2017; 125:1616-1626. [PMID: 28806206 DOI: 10.1213/ane.0000000000002360] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Evaluation and treatment of chronic pain worldwide are limited by the lack of standardized assessment tools incorporating consistent definitions of pain chronicity and specific queries of known social and psychological risk factors for chronic pain. The Vanderbilt Global Pain Survey (VGPS) was developed as a tool to address these concerns, specifically in the low- and middle-income countries where global burden is highest. METHODS The VGPS was developed using standardized and cross-culturally validated metrics, including the Brief Pain Inventory and World Health Organization Disability Assessment Scale, as well as the Pain Catastrophizing Scale, the Fibromyalgia Survey Questionnaire along with queries about pain attitudes to assess the prevalence of chronic pain and disability along with its psychosocial and emotional associations. The VGPS was piloted in both Nepal and India over a 1-month period in 2014, allowing for evaluation of this tool in 2 distinctly diverse cultures. RESULTS Prevalence of chronic pain in Nepal and India was consistent with published data. The Nepali cohort displayed a pain point prevalence of 48%-50% along with some form of disability present in approximately one third of the past 30 days. Additionally, 11% of Nepalis recorded pain in 2 somatic sites and 39% of those surveyed documented a history of a traumatic event. In the Indian cohort, pain point prevalence was approximately 24% to 41% based on the question phrasing, and any form of disability was present in 6 of the last 30 days. Of the Indians surveyed, 11% reported pain in 2 somatic sites, with only 4% reporting a previous traumatic event. Overall, Nepal had significantly higher chronic pain prevalence, symptom severity, widespread pain, and self-reported previous traumatic events, yet lower reported pain severity. CONCLUSIONS Our findings confirm prevalent chronic pain, while revealing pertinent cultural differences and survey limitations that will inform future assessment strategies. Specific areas for improvement identified in this VGPS pilot study included survey translation methodology, redundancy of embedded metrics and cultural limitations in representative sampling and in detecting the prevalence of mental health illness, catastrophizing behavior, and previous traumatic events. International expert consensus is needed.
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Affiliation(s)
- Jenna L Walters
- From the *Department of Anesthesiology and Pain Medicine, Vanderbilt University, Nashville, Tennessee; †University of Washington School of Medicine, Seattle, Washington; ‡Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Institute of National Importance, Pondicherry, India; §Casper, Wyoming; ∥Nepal Medical College, Kathmandu, Nepal; ¶Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee; #Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Institute of National Importance, Pondicherry, India; **Behavioral Neuroscience Program, Western Washington University, Bellingham, Washington; ††Department of Anesthesiology and Pain Medicine and Global Health Adjunct, University of Washington, Seattle, Washington; ‡‡Department of Pediatric Anesthesiology and Pain Medicine, Seattle Children's Hospital, Seattle, Washington; §§Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington; and ∥∥Department of Anesthesiology, Director of Vanderbilt Anesthesia Global Health and Development Affiliate Faculty, Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee
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Ćwirlej-Sozańska A, Wilmowska-Pietruszyńska A, Sozański B. Validation of the Polish version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) in an elderly population (60-70 years old). INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2017; 24:386-394. [PMID: 28391768 DOI: 10.1080/10803548.2017.1316596] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess the reliability and validity of the Polish version of the 36-point World Health Organization Disability Assessment Schedule (WHODAS 2.0) in an elderly population. METHOD One thousand randomly selected individuals, aged 60-70 years, living in south-eastern Poland were assessed using the Polish version of the WHODAS 2.0. RESULTS The analysis confirmed the high reliability and validity of the tool. Cronbach's α index was 0.89. The tool had high stability, and the correlation between test and retest results was high. The relevance of the domain selection was high or very high. A factor analysis confirmed the relevance of assigning questions to domains. High theoretical relevance was also demonstrated. Statistically significant differences between those who were and were not suffering from health problems were observed. An analysis of the internal structure of the WHODAS 2.0 revealed strong correlations between the components of each domain and the final result. CONCLUSION The Polish version of the WHODAS 2.0 showed high reliability and validity; thus, it can be used to assess health, functioning and disability in the elderly population of Poland.
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Affiliation(s)
| | | | - Bernard Sozański
- b Centre for Innovative Research in Medical and Natural Sciences, University of Rzeszow , Poland
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Habtamu K, Alem A, Medhin G, Fekadu A, Dewey M, Prince M, Hanlon C. Validation of the World Health Organization Disability Assessment Schedule in people with severe mental disorders in rural Ethiopia. Health Qual Life Outcomes 2017; 15:64. [PMID: 28381230 PMCID: PMC5382515 DOI: 10.1186/s12955-017-0647-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 03/31/2017] [Indexed: 11/26/2022] Open
Abstract
Background The World Health Organization Disability Assessment Schedule (WHODAS-2.0) has been adapted and validated in several cultures, but data on performance in the African context are lacking. The aim of the study was to evaluate the validity and psychometric properties of the WHODAS-2.0 among people with severe mental disorders (SMD) and their caregivers in a rural African setting. Methods The content validity of the 36 item WHODAS was assessed using free listing and pile sorting in 36 community members. Cognitive interviewing was conducted with 20 people with SMD and 20 caregivers to assess comprehensibility. Convergent validity and sensitivity to change were evaluated in a facility-based cohort study of new or acutely relapsed cases of people with SMD (n = 150) and their caregivers (n = 150) consecutively recruited from a psychiatric clinic. A repeat assessment was conducted in a sub-sample (n = 84) after 6 weeks. Confirmatory factor analysis was used to evaluate construct validity in people with SMD (n = 250) and their caregivers (n = 250). Results Internal consistency of the items of the overall scale and each domain ranged from very good (alpha = 0.82) to excellent (alpha = 0.98). Scores on the WHODAS-2.0 correlated highly with a locally developed measure of functioning (r = 0.88) and moderately with clinical symptom severity (r = 0.52). The WHODAS- 2.0 was sensitive to treatment changes (effect size = 0.50). As hypothesized, the six sub-scales loaded highly onto the general disability factor and each item loaded significantly onto their respective domains. The factor loadings of each item in the one factor model of the brief version of WHODAS (12 item) were also high. For both 12- and 36-item scales the goodness of fit indices, were close to, but outside of, recommended ranges. The caregiver data of both the 36 and 12 item versions had similar psychometric properties, but higher mean values and better responsiveness to change. Conclusions Our study showed that both the 12 and 36 item versions of the WHODAS 2.0 have acceptable validity and psychometric properties and can be used as a cross-cultural measure; however, careful and rigorous adaptation is required for rural African settings. Electronic supplementary material The online version of this article (doi:10.1186/s12955-017-0647-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kassahun Habtamu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia. .,School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, P.O.BOX: 1176, Addis Ababa, Ethiopia.
| | - Atalay Alem
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, London, UK
| | - Michael Dewey
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Martin Prince
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Charlotte Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
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Moen VP, Drageset J, Eide GE, Klokkerud M, Gjesdal S. Validation of World Health Organization Assessment Schedule 2.0 in specialized somatic rehabilitation services in Norway. Qual Life Res 2017; 26:505-514. [PMID: 27506525 PMCID: PMC5288428 DOI: 10.1007/s11136-016-1384-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2016] [Indexed: 01/30/2023]
Abstract
PURPOSE The World Health Organization Disability Assessment Schedule (WHODAS) 2.0 is a generic instrument to assess disability covering six domains. The purpose of this study was to investigate the potential of the instrument for monitoring disability in specialized somatic rehabilitation by testing reliability, construct validity and responsiveness of WHODAS 2.0, Norwegian version, among patients with various health conditions. METHODS For taxonomy, terminology and definitions, the Consensus-based Standards for the Selection of Health Measurement Instruments were followed. Reproducibility was investigated by the intra-class correlation coefficient (ICC) in a randomly selected sample. Internal consistency was assessed by Cronbach's alpha. Construct validity was evaluated by correlations between WHODAS 2.0 and the Medical Outcomes Study 36-item Short Form, and fit of the hypothesized structure using confirmatory factor analysis (CFA). Responsiveness was evaluated in another randomly selected sample by testing a priori formulated hypotheses. RESULTS Nine hundred seventy patients were included in the study. Reproducibility and responsiveness were evaluated in 53 and 104 patients, respectively. The ICC for the WHODAS 2.0 domains ranged from 0.63 to 0.84 and was 0.87 for total score. Cronbach's alpha for domains ranged from 0.75 to 0.94 and was 0.93 for total score. For construct validity, 6 of 12 expected correlations were confirmed and CFA did not achieve satisfactory fit indices. For responsiveness, 3 of 8 hypotheses were confirmed. CONCLUSION The Norwegian version of WHODAS 2.0 showed moderate to satisfactory reliability and moderate validity in rehabilitation patients. However, the present study indicated possible limitations in terms of responsiveness.
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Affiliation(s)
- Vegard Pihl Moen
- Centre for Habilitation and Rehabilitation, Haukeland University Hospital, Østre Nesttunveg 2, 5221, Bergen, Norway.
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Jorunn Drageset
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Geir Egil Eide
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Mari Klokkerud
- National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Sturla Gjesdal
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Federici S, Bracalenti M, Meloni F, Luciano JV. World Health Organization disability assessment schedule 2.0: An international systematic review. Disabil Rehabil 2016; 39:2347-2380. [PMID: 27820966 DOI: 10.1080/09638288.2016.1223177] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE This systematic review examines research and practical applications of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) as a basis for establishing specific criteria for evaluating relevant international scientific literature. The aims were to establish the extent of international dissemination and use of WHODAS 2.0 and analyze psychometric research on its various translations and adaptations. In particular, we wanted to highlight which psychometric features have been investigated, focusing on the factor structure, reliability, and validity of this instrument. METHOD Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology, we conducted a search for publications focused on "whodas" using the ProQuest, PubMed, and Google Scholar electronic databases. RESULTS We identified 810 studies from 94 countries published between 1999 and 2015. WHODAS 2.0 has been translated into 47 languages and dialects and used in 27 areas of research (40% in psychiatry). CONCLUSIONS The growing number of studies indicates increasing interest in the WHODAS 2.0 for assessing individual functioning and disability in different settings and individual health conditions. The WHODAS 2.0 shows strong correlations with several other measures of activity limitations; probably due to the fact that it shares the same disability latent variable with them. Implications for Rehabilitation WHODAS 2.0 seems to be a valid, reliable self-report instrument for the assessment of disability. The increasing interest in use of the WHODAS 2.0 extends to rehabilitation and life sciences rather than being limited to psychiatry. WHODAS 2.0 is suitable for assessing health status and disability in a variety of settings and populations. A critical issue for rehabilitation is that a single "minimal clinically important .difference" score for the WHODAS 2.0 has not yet been established.
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Affiliation(s)
- Stefano Federici
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Marco Bracalenti
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Fabio Meloni
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Juan V Luciano
- b Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu , St. Boi De Llobregat , Spain.,c Primary Care Prevention and Health Promotion Research Network (RedIAPP) , Madrid , Spain
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Habtamu K, Alem A, Medhin G, Fekadu A, Prince M, Hanlon C. Development and validation of a contextual measure of functioning for people living with severe mental disorders in rural Africa. BMC Psychiatry 2016; 16:311. [PMID: 27604273 PMCID: PMC5015207 DOI: 10.1186/s12888-016-1022-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 08/29/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Most measures of functioning in people with severe mental disorders (SMD) have been developed in Western societies. Many of the questions in these scales are culture-bound, fail to capture differentiation of tasks by gender and are difficult to adapt to other contexts. The aim of this study was to develop a measure of functioning for people with SMD which is contextually appropriate for a rural African setting. METHODS A review of existing scales, a qualitative study, free listing and pile sorting exercises, and expert consensus were used to establish a pool of items. Cognitive interviewing guided initial item reduction and refinement. The resulting scale was pilot-tested in people with SMD (n = 200) and their caregivers (n = 200) to inform further item reduction based on psychometric properties. The final Butajira Functioning Scale (BFS) comprised 33 items that were common to both men and women, and an additional eight items for women only, covering the following domains: self-care, work, and family and community participation. Psychometric properties of the finalized BFS were examined in a facility-based sample of 150 people with SMD and their caregivers (n = 150), with longitudinal follow-up of n = 84. RESULTS The BFS in people with SMD had excellent internal consistency (Cronbach's α = 0.99), acceptable convergent validity (r = 0.88 with the World Health Organization Disability Assessment Schedule [WHODAS-2.0] and r = 0.32 with the Brief Psychiatric Rating Scale [BPRS-E]) and was sensitive to change following treatment (effect size =0.50). Addition of the items specific to women did not improve the psychometric properties. The caregiver version had similar psychometric properties but higher mean values for each item and better responsiveness to change. Exploratory factor analysis of the BFS provided evidence of construct validity, with four underlying dimensions. CONCLUSIONS We have developed a measure of functioning for people with SMD in a rural, low income country setting with acceptable psychometric properties. The BFS is easy to administer, sensitive to changes following treatment and has content, construct and convergent validity. The BFS includes domains from existing measures, but has more emphasis on social and occupational domains, which reflects priorities in the setting.
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Affiliation(s)
- Kassahun Habtamu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, P.O.BOX: 1176, Ethiopia. .,School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Atalay Alem
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, P.O.BOX: 1176 Ethiopia
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaw Fekadu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, P.O.BOX: 1176 Ethiopia ,Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Martin Prince
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Charlotte Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, P.O.BOX: 1176 Ethiopia ,Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
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Salehi R, Shakhi K, Khiavi FF. ASSOCIATION BETWEEN DISABILITY AND QUALITY OF LIFE IN MULTIPLE SCLEROSIS PATIENTS IN AHVAZ, IRAN. Mater Sociomed 2016; 28:215-9. [PMID: 27482165 PMCID: PMC4949033 DOI: 10.5455/msm.2016.28.215-219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 05/19/2016] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Multiple Sclerosis (MS) is a neurodegenerative and chronic disease of central nervous system which affected the middle aged people. The disabling nature of this disease can limit the daily activities, restrict the society roles, unemployment and finally lead to decline the quality of life (QoL) in MS patients. So, the main purpose of this study was to determine association between disability and quality of life among MS patients in Ahvaz, Iran. MATERIALS AND METHODS One hundred and one MS patients who living in Khouzestan participated in the cross-sectional study. Two questionnaires include the MSQoL-54 and World Health Organization disability assessment schedule 2.0 (WHODAS2.0) were used in order to measure the QoL and disability severity. Descriptive statistics as well as Pearson correlation coefficient and simple linear regression were used to analysis the data. RESULTS The respondent rate was 100 percent. The disability showed a large and negative association with QoL (p<0.001) but QoL was not significantly associated with EDSS score. Social participation and cognition subscales recognized as QoL predictors according to simple regression results. CONCLUSION The cognition and participation, disability subscales, were the most important predicators for QoL. Therefore, increasing employment opportunities, changing society's attitude and using the psychotherapy programs might improve the MS patient's QoL.
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Affiliation(s)
- Reza Salehi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khozestan, Iran
| | - Kamal Shakhi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khozestan, Iran
| | - Farzad Faraji Khiavi
- Department of Healthcare Administration, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khozestan, Iran
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Hergenrather KC, Zeglin RJ, Conyers L, Misrok M, Rhodes SD. Persons Living With HIV/AIDS: Employment as a Social Determinant of Health. REHABILITATION RESEARCH POLICY AND EDUCATION 2016. [DOI: 10.1891/2168-6653.30.1.4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose: For persons living with HIV/AIDS (PLWHA), the advent of highly active antiretroviral therapy has increased their longevity and quality of life. As HIV progresses, many PLWHA present declined domains of functioning that impede their ability to work. The authors explore employment as a social determinant of health to identify issues impacting employment outcomes for PLWHA.Methods: The authors reviewed the literature addressing HIV across the domains of mental health functioning, neurocognitive functioning, and physical function and employment.Results: When providing employment services to PLWHA, considerations for rehabilitation practitioners and educators include HIV/AIDS education, functional assessment, social support, considerations for women with HIV, highly active antiretroviral therapy (HAART), HIV/AIDS stigma, and employment resources for PLWHA.Conclusion: With more than 1.2 million PLWHA in the United States, and most of new infections among persons 25–44 years of age, the prevalence of PLWHA seeking employment and inclusive of the U.S. workforce will continue to increase. Proving employment services for PLWHA is a complex process that is best served by an integrative service approach.
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Measurement Invariance of the WHODAS 2.0 in a Population-Based Sample of Youth. PLoS One 2015; 10:e0142385. [PMID: 26565410 PMCID: PMC4643914 DOI: 10.1371/journal.pone.0142385] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 10/21/2015] [Indexed: 11/19/2022] Open
Abstract
The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a brief measure of global disability originally developed for adults, which has since been implemented among samples of children and youth. However, evidence of its validity for use among youth, particularly measurement invariance, is lacking. Investigations of measurement invariance assess the extent to which the psychometric properties of observed items in a measure are generalizable across samples. Satisfying the assumption of measurement invariance is critical for any inferences about between-group differences. The objective of this paper was to empirically assess the measurement invariance of the 12-item interview version of the WHODAS 2.0 measure in an epidemiological sample of youth (15 to 17 years) and adults (≥ 18 years) in Canada. Multiple-group confirmatory factor analysis using a categorical variable framework allowed for the sequential testing of increasingly restrictive models to evaluate measurement invariance of the WHODAS 2.0 between adults and youth. Findings provided evidence for full measurement invariance of the WHODAS 2.0 in youth aged 15 to 17 years. The final model fit the data well: χ2(159) = 769.04, p < .001; CFI = 0.950, TLI = 0.958, RMSEA (90% CI) = 0.055 [0.051, 0.059]. Results from this study build on previous work supporting the validity of the WHODAS 2.0. Findings indicate that the WHODAS 2.0 is valid for making substantive comparisons of disability among youth as young as 15 years of age.
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Moreira A, Alvarelhão J, Silva AG, Costa R, Queirós A. Tradução e validação para português do WHODAS 2.0 ‐ 12 itens em pessoas com 55 ou mais anos. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.rpsp.2015.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hergenrather KC, Zeglin RJ, McGuire-Kuletz M, Rhodes SD. Employment as a Social Determinant of Health: A Systematic Review of Longitudinal Studies Exploring the Relationship Between Employment Status and Physical Health. REHABILITATION RESEARCH POLICY AND EDUCATION 2015. [DOI: 10.1891/2168-6653.29.1.2] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose:To explore employment as a social determinant of health through examining the relationship between employment status and physical health.Method:The authors explored the causal relationship between employment status and physical health through conducting a systematic review of 22 longitudinal studies conducted in Finland, France, the Netherlands, Nigeria, Sweden, United Kingdom, and the United States.Results:Five common trajectories were identified as employment, unemployment, job loss, reemployment, and retired. Unemployment and job loss were associated with poorer physical health. Employment and reemployment were associated with better physical health.Conclusion:To enhance employment outcomes, it is important for service providers to acknowledge the interaction between the client’s physical health and employment status, and assess client physical functioning. Additional research is necessary to further elucidate this interaction.
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Hergenrather KC, Zeglin RJ, McGuire-Kuletz M, Rhodes SD. Employment as a Social Determinant of Health: A Review of Longitudinal Studies Exploring the Relationship Between Employment Status and Mental Health. REHABILITATION RESEARCH POLICY AND EDUCATION 2015. [DOI: 10.1891/2168-6653.29.3.261] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose: To explore employment as a social determinant of health through examining the relationship between employment status and mental health.Method: The authors conducted a systematic review of 48 longitudinal studies conducted in Australia, Canada, Croatia, Germany, Ireland, Israel, the Netherlands, Norway, United Kingdom, and United States to explore the causal relationship between employment status and mental health.Results: Five common trajectories were identified as employment, unemployment, job loss, reemployment, and retired. Employment and reemployment were associated with better mental health (e.g., lower psychological distress, lower depression, lower anxiety), whereas unemployment and job loss were correlated with poorer mental health (e.g., higher depression, higher psychological distress).Conclusion: To enhance employment outcomes, service providers must acknowledge the relationship between employment status and mental health. The trajectories of employment and reemployment should be further explored by category (e.g., temporary, adequacy, income, skill level, hours, status). Additional research is needed to further elucidate the relationship between employment status and mental health.
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