Content » Vol 51, Issue 9

Original report

The World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the WHO Minimal Generic Set of Domains of Functioning and Health versus Conventional Instruments in subacute stroke

Sinikka Tarvonen-Schröder, Saija Hurme, Katri Laimi
Department of Rehabilitation and Brain Trauma, Turku University Hospital, PO Box 52, FI-20521 Turku, Finland. E-mail: sinikka.tarvonen-schroder@tyks.fi
DOI: 10.2340/16501977-2583

Abstract

Objective: To compare short generic International Classification of Functioning, Disability and Health (ICF)-based measures of functioning with traditional measures of stroke severity and dependence in subacute stroke.
Methods: In this cross-sectional study patients with stroke (n = 195) and their significant others completed the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0) at discharge from rehabilitation. A neurologist assessed functioning with the 7-item World Health Organization (WHO) Minimal Generic Set of domains of functioning and health. These scores were compared with assessments of severity of stroke (National Institutes of Health Stroke Scale; NIHSS) and dependence (modified Rankin Scale; mRS; and Functional Independence Measure; FIM).
Results: From mild to severe stroke, increasing disability was found in single items and sum scores of WHODAS and the WHO Minimal Generic Set. Al-though proxies rated 6 out of the 12 separate WHODAS functions more impaired than did the patients, correlations between the different measures (proxy- and patient-WHODAS, the WHO Minimal Generic Set, mRS, NIHSS and FIM total and sub-scores) were strong to very strong, except for moderate correlations between patient-WHODAS, and NIHSS or FIM cognitive sub-score.
Conclusion: Despite their brevity, both generic ICF-based tools were useful in finding disabilities for patient- and family-centred goal-setting and service-planning after subacute rehabilitation.

Lay Abstract

This study compared short generic International Classification of Functioning, Disability and Health (ICF)-based measures of functioning, the patient- and proxy-reported 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the 7-item WHO Minimal Generic Set of domains of functioning and health assessed by a neurologist, with traditionally used measures of stroke in the subacute phase. Although proxies rated 6 out of 12 separate WHODAS functions more impaired than did the patients, the scores of patient- and proxy-reported WHODAS 2.0 and the WHO Minimal Generic Set correlated well with each other and with older measures of stroke severity (National Institutes of Health Stroke Scale) and dependence (modified Rankin Scale and Functional Independence Measure). Both ICF-based tools, despite their brevity, were useful in finding disabilities for patient- and family-centred goal-setting and service-planning after subacute stroke rehabilitation.

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