Preliminary Validation of the World Health Organization Disability Assessment Schedule 2.0 for Mild Traumatic Brain Injury.

Abstract

The purpose of this study is to examine the reliability, factor structure, and validity of the World Health Organization Disability Assessment Schedule (WHODAS 2.0 12 item version) in a sample of patients who were slow to recover from a mild traumatic brain injury (mTBI). Participants were 79 adults with mTBI recruited from one of four specialty outpatient clinics in Vancouver, Canada. The WHODAS 2.0 12 item version is a disease-nonspecific measure of disability representing six International Classification of Disability, Functioning, and Health activity and participation domains including cognition, mobility, self-care, interpersonal functioning, life activities, and participation. Results of analyses showed that the WHODAS 2.0 had high internal consistency and adequate construct and concurrent validity. A three factor structure emerged in this sample. The scale differentiated between patients with good and those with poor outcomes based on post-concussion syndrome, psychiatric, and pain status. Participants with multiple comorbidities reported the most disability on the WHODAS. Concurrent validity was also supported by lower WHODAS scores in participants who had returned to work versus those who had not. To our knowledge, this is the first study to evaluate the psychometric properties of the WHODAS 2.0 in a sample of people with mTBI. In summary, the WHODAS was sensitive to post-concussion syndrome after mTBI, as well as to health conditions that commonly co-occur with mTBI (e.g., mental health problems and chronic pain).