Validation of the Brazilian version of the World Health Organization Disability Assessment Schedule 2.0 for institutionalized older adults

Grou, Thais Cristina; Castro, Shamyr Sulyvan de; Leite, Camila Ferreira; Carvalho, Mariana Thays; Patrizzi, Lislei Jorge

doi:10.1590/1809-2950/20024628012021

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ORIGINAL RESEARCH • Fisioter. Pesqui. 28 (1) • Jan-Mar 2021 • https://doi.org/10.1590/1809-2950/20024628012021 copy

Validation of the Brazilian version of the World Health Organization Disability Assessment Schedule 2.0 for institutionalized older adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Factors associated with the institutionalization of older adults may interfere with the Functioning of this population. There are few instruments that evaluate this component according to the biopsychosocial model. The World Health Organization Disability Assessment Schedule (WHODAS 2.0) is an instrument developed by WHO (World Health Organization) to measure functioning and disability supported by the theoretical-conceptual model of the International Classification of Functioning, Disability and Health (ICF). This study aims to verify the reliability, internal consistency (IC) and criterion validity of the Brazilian version of the WHODAS 2.0 when applied to institutionalized older adults with different health conditions. In total, 100 older adults participated in the study. IC was assessed by Cronbach’s alpha. Spearman’s coefficient was used to analyze test-retest reliability, with the WHODAS questionnaire being reapplied seven days after the first interview. Criterion validity (convergent and divergent) was also analyzed by Spearman’s coefficient by the correlation analysis with the WHOQOL-BREF and the WHOQOL-OLD. As a result, we obtained an IC that was adequate for all domains (Cronbach’s alpha ≥0.75), with strong test-retest reliability (r> 0.85). In the criterion validity, we obtained only moderate correlations of the WHODAS 2.0 domains with the WHOQOL-BREF and WHOQOL-OLD domains (r=−0.62; r=−0.61 respectively). The psychometric properties tested indicated reliability - good internal consistency and strong test-retest reliability - and qualifications correlations in the criterion value. These results demonstrated that WHODAS 2.0 is a valid and reliable instrument, thus providing an assessment tool for institutionalized older adults following the concepts and principles proposed by WHO for assessing functioning.

Keywords |
Validation Study; Disability Evaluation; Health of Institutionalized Older Adults; International Classification of Functioning, Disability and Health; Surveys and Questionnaires

WHODAS 2.0	WHOQoL-BREF	WHOQoL-OLD	Expected relationship
Cognition	Psychological	Autonomy	Convergent
Cognition	Social relations	Past, Present and Future Activities	Divergent
Mobility	Physical	Sensory abilities	Convergent
Mobility	Social relations	Death and dying	Divergent
Self-care	Physical	Autonomy	Convergent
Self-care	Environment	Intimacy	Divergent
Getting along	Social relations	Social participation	Convergent
Getting along	Psychological	Sensory abilities	Divergent
Life activities	Physical	Autonomy	Convergent
Life activities	Social relations	Intimacy	Divergent
Participation	Environment	Social participation	Convergent
Participation	Intimacy	Death and dying	Divergent

Characteristic		n (100)
Gender
	Male	54
	Female	46
Marital Status
	Never married	32
	Currently married	6
	Separated	7
	Divorced	23
	Widower	32
Work activity
	Retired	98
	Others	2
		Mean	Standard Deviation
Age group		74.77	9.77
Years of schooling		3.72	2.96
WHODAS 2.0 (36-item version)
	Cognition	24.2	22.45
	Mobility	42.06	32.56
	Self-care	22	25.89
	Getting Along	24.83	24.38
	Life activities (domestic)	16.20	15.40
	Participation	30.41	21.87
	TOTAL	30.36	19.71
WHOQoL-bref
	Physical	59.16	18.77
	Psychological	60.20	18.87
	Social relations	55.33	19.45
	Environment	54.30	17.58
	TOTAL	57.25	14.09
WHOQoL-old
	Sensory abilities	66	25.25
	Autonomy	47.53	21.11
	Past, present and future activities	58.68	20.56
	Social participation	57	18.59
	Death and dying	73.37	24.30
	Intimacy	40.24	28.14
	TOTAL	57.13	15.19

WHODAS 2.0 (domain)*	Internal Consistency (Cronbach’s alpha)	Test-retest Reliability (r)
Cognition	0.83	0.86
Mobility	0.89	0.90
Self-care	0.76	0.91
Getting Along	0.75	0.81
Life activities (domestic)	0.94	0.89
Participation	0.81	0.85
TOTAL	0.93	0.95

Instrument/ domain		WHODAS 2.0 / domains
Instrument/ domain		Cognition	Mobility	Self-care	Getting Along	Life activities	Participation	Total
WHOQoL-BREF
	Physical	−0.45*	−0.52*	−0.57*	−0.48*	−0.46*	−0.64*	−0.69*
	Psychological	−0.49*	−0.19	−0.33*	−0.32*	−0.31*	−0.51*	−0.46*
	Social relations	−0.25*	−0.22*	−0.14	−0.34*	−0.38*	−0.37*	−0.39*
	Environment	−0.28*	−0.11	−0.17	−0.27*	−0.10	−0.49*	−0.34*
	Total	−0.48*	−0.33*	−0.40*	−0.46*	−0.40*	−0.66*	−0.62*
WHOQoL-OLD
	Sensory abilities	−0.46*	−0.41*	−0.30*	−0.38*	−0.27*	−0.43*	−0.50*
	Autonomy	−0.40*	−0.20*	−0.16	−0.33*	−0.21*	−0.45*	−0.40*
	Past, present and future activities	−0.24*	−0.20*	−0.12	−0.37*	−0.27*	−0.43*	−0.35*
	Social participation	−0.27*	−0.51*	−0.25*	−0.44*	−0.31*	−0.58*	−0.57*
	Death and dying	−0.19*	−0.11	−0.22*	−0.24*	−0.26*	−0.37*	−0.30*
	Intimacy	−0.21*	−0.26*	−0.12	−0.22*	−0.36*	−0.23*	−0.33*
	Total	−0.44*	−0.42*	−0.28*	−0.48*	−0.42*	−0.61*	−0.61*

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[1] Corresponding address: Thais Cristina Grou-Rua Antonio Benedito Borelli, 313 - Porto Ferreira (SP), Brazil - ZIP Code: 13661-084 - E-mail: thaais_pf@hotmail.com