Article

Activity limitation and participation restrictions of breast cancer patients receiving chemotherapy: Psychometric properties and validation of the Chinese version of the WHODAS 2.0

School of Nursing, China Medical University, Shenyang, Liaoning, China.
Quality of Life Research (Impact Factor: 2.49). 06/2012; 22(4). DOI: 10.1007/s11136-012-0212-9
Source: PubMed

ABSTRACT

Purpose:
This study sought to determine the psychometric properties of the Chinese version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in a sample of 402 primary breast cancer patients receiving chemotherapy after surgery.

Methods:
Four-hundred and two subjects were interviewed with the Chinese version of the WHODAS 2.0. Patients also completed the Functional Assessment of Cancer Therapy-Breast (FACT-B). Internal consistency reliability was measured by Cronbach's α. Spearman correlation coefficients between total scores and subscales of FACT-B and WHODAS 2.0 were examined to get the convergent validity. Independent sample t test was applied to test discriminant validity by comparing the difference of disability scores for different degree of relevant symptoms. The factor structure of the WHODAS 2.0 was examined by exploratory factor analysis (EFA) and confirmatory factor analysis.

Results:
The Chinese version of the WHODAS 2.0 showed satisfactory internal consistency (r, 0.72-0.92), convergent validity and discriminant validity. After 4 items(item D2.2: standing up; D3.3: eating; D4.5: sexual activities; and D6.3: living with dignity) were excluded, EFA identified seven separate factors for 'Self-care and Household activities,' 'Getting along with people,' 'Getting around,' 'Understanding,' 'Communicating,' 'Participation in society' and 'Family burden'(explained variance 72.13 %). The reduced model also presented the best fit [confirmatory fit index = 0.914, Tucker-Lewis index = 0.900, root mean square error of approximation = 0.069] compared with the model suggested by EFA and hypothesized a prior.

Conclusions:
Overall, the Chinese version of the WHODAS 2.0 is a reliable and valid instrument for measuring activity limitation and participation restrictions in Chinese breast cancer patients receiving chemotherapy.

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    • "As the ICF system is difficult and complex to use in daily clinical practice, the WHO developed the ICF Checklist and Disability Assessment Schedule 2.0 (WHODAS 2.0; Üstün et al., 2010; World Health Organization, 2000). The WHODAS 2.0 has been received with great success; it is now available in more than 10 different languages and the psychometric properties of its different versions have been studied in community population (Kim et al., 2005; Sousa et al., 2010; Von Korff et al., 2008) as well as in various conditions such as depression and back pain (Chwastiak and Von Korff, 2003), depression (Luciano et al., 2010a, 2010b, 2010c), schizophrenia (Chopra et al., 2004; Guilera et al., 2012; McKibbin et al., 2004; Pyne et al., 2003) schizophrenia and multiple sclerosis (Chopra et al., 2008), inflammatory arthritis (Baron et al., 2008), patients with systemic sclerosis (Hudson et al., 2008), spinal cord injury (De Wolf et al., 2012), adults with motor, mental or sensory disability (Federici et al., 2009), anxiety disorders (Perini et al., 2006), breast cancer (Zhao et al., 2013), rehabilitation patients (Pösl et al., 2007), adults with acquired hearing loss (Chisolm et al., 2005), and 13 physical and mental chronic conditions including 114 patients diagnosed with bipolar disorder (Garin et al., 2010). In general, these studies coincide in concluding that the WHODAS 2.0 is an easy-to-apply instrument for validly and reliably assessing individuals' functionality and disability, and have been proposed as the standard tool for measuring functioning by the DSM-5 and the forthcoming ICD-11. "
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    ABSTRACT: The WHODAS 2.0 is an ICF-based multidimensional instrument developed for measuring disability. The present study analyzes the utility of the 36-item interviewer-administered version in a sample of patients with bipolar disorder. There is no study to date that analyses how the scale works in a sample that only comprises such patients. A total of 291 patients with bipolar disorder (42.6% males) according to DSM-IV-TR criteria from a cross-sectional study conducted in outpatient psychiatric clinics were enrolled. In addition to the WHODAS 2.0, patients completed a comprehensive assessment battery including measures on psychopathology, functionality and quality of life. Analyses were centered on providing evidence on the validity and utility of the Spanish version of the WHODAS 2.0 in bipolar patients. Participation domain had the highest percentage of missing data (2.7%). Confirmatory factorial analysis was used to test three models formulated in the literature: six primary correlated factors, six primary factors with a single second-order factor, and six primary factors with two second-order factors. The three models were plausible, although the one formed by six correlated factors produced the best fit. Cronbach's alpha values ranged between .73 for the Self-care domain and .92 for Life activities, and the internal consistency of the total score was .96. Relationships between the WHODAS 2.0 and measures of psychopathology, functionality and quality of life were in the expected direction, and the scale was found to be able to differentiate among patients with different intensity of clinical symptoms and work situation. The percentage of euthymic patients was considerable. However, the assessment of euthymic patients is less influenced by mood. Some psychometric properties have not been studied, such as score stability and sensitivity to change. The Spanish version of the 36-item WHODAS 2.0 has suitable psychometric properties in terms of reliability and validity when applied to patients with bipolar disorder. Disability in bipolar patients is especially prominent in Cognition, Getting along, Life activities, and Participation domains, so functional remediation interventions should emphasize these areas in order to improve the daily living activities of these patients. Copyright © 2014 Elsevier B.V. All rights reserved.
    Full-text · Article · Dec 2014 · Journal of Affective Disorders
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    • "The highest proportion of missing domain was in Domain 4, getting along of our study. Many studies illustrated that the proportion of missing domains was varied and the most of them showed that the trait of highest missing proportion was item 4.5, sexual activity (Federici et al., 2009; Garin et al., 2010; Guilera et al., 2012; Schlote et al., 2009; Zhao et al., 2012). The possible causes were the sexual activity was lacking because of living type and the issue of sex is private for Asia culture. "
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    ABSTRACT: Background World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) provided a standardized method for measuring the health and disability and the traditional Chinese version has not been developed. Aims To describe the process of developing the traditional Chinese version of the WHODAS 2.0 36-item version and to evaluate the concurrent validity and test–retest reliability of this instrument. Methods The study was conducted in two phases. Phase I was the process of translation of WHODAS 2.0 36-item version. Phase II was a cross-sectional study. The participants were 307 adults who were tested the validity and reliability of draft traditional Chinese version. Results The reliability of Cronbach's α and ICC in the WHODAS 2.0 traditional Chinese version were 0.73–0.99 and 0.8–089, respectively. The content validity was good (r = 0.7–0.76), and the concurrent validity was excellent in comparison with the WHOQOL-BREF (p < 0.5). The construct validity, the model was explained total variance was 67.26% by the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) illustrated the traditional Chinese version was good to assess disability. There was a valid and reliable measurement scales for evaluating functioning and disability status. Conclusion For disability eligibility system of Taiwan government to measure the disability, the traditional Chinese version of the WHODAS 2.0 provided valuable evidence to design the assessment instrument.
    Full-text · Article · Nov 2014
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    • "The highest proportion of missing domain was in Domain 4, getting along of our study. Many studies illustrated that the proportion of missing domains was varied and the most of them showed that the trait of highest missing proportion was item 4.5, sexual activity (Federici et al., 2009; Garin et al., 2010; Guilera et al., 2012; Schlote et al., 2009; Zhao et al., 2012). The possible causes were the sexual activity was lacking because of living type and the issue of sex is private for Asia culture. "
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    ABSTRACT: Background: World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) provided a standardized method for measuring the health and disability and the traditional Chinese version has not been developed. Aims: To describe the process of developing the traditional Chinese version of the WHODAS 2.0 36-item version and to evaluate the concurrent validity and test-retest reliability of this instrument. Methods: The study was conducted in two phases. Phase I was the process of translation of WHODAS 2.0 36-item version. Phase II was a cross-sectional study. The participants were 307 adults who were tested the validity and reliability of draft traditional Chinese version. Results: The reliability of Cronbach's α and ICC in the WHODAS 2.0 traditional Chinese version were 0.73-0.99 and 0.8-089, respectively. The content validity was good (r= 0.7-0.76), and the concurrent validity was excellent in comparison with the WHOQOL-BREF (p<. 0.5). The construct validity, the model was explained total variance was 67.26% by the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) illustrated the traditional Chinese version was good to assess disability. There was a valid and reliable measurement scales for evaluating functioning and disability status. Conclusion: For disability eligibility system of Taiwan government to measure the disability, the traditional Chinese version of the WHODAS 2.0 provided valuable evidence to design the assessment instrument.
    Full-text · Article · Aug 2014 · Research in Developmental Disabilities
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