Psychometric properties of the WHODAS 2.0 in patients with orthopedic injuries from road traffic crashes in Bangladesh

Abstract

Purpose Road traffic injuries (RTIs) are a leading cause of disability in low- and middle-income countries. This study assesses the psychometric properties of 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 among patients with orthopedic injuries from road traffic crashes in Bangladesh across two timepoints after hospital discharge. Materials and methods Confirmatory factor analysis (CFA) assessed WHODAS 2.0 construct validity and investigated measurement invariance among a sample of RTI patients at an orthopedic hospital one month and three months post-discharge. Cronbach’s alpha measured reliability. Results A single-factor structure was identified in CFA for the one-month sample (χ2(53)=894.337, p < 0.001; CFI = 0.989, TLI = 0.986; SRMR = 0.052, RMSEA = 0.151) and the three-month sample (χ2(53)=630.119, p < 0.001; CFI = 1.000, TLI = 1.000; SRMR = 0.022, RMSEA = 0.130). Measurement invariance was supported, and internal consistency was excellent (α > 0.9) at each timepoint. Mean disability score decreased from 37.89 (out of 48, SD = 10.44) one-month post-discharge to 27.19 (SD = 18.10, p < 0.001) three months post-discharge indicating improvement in functional status over time. Conclusions WHODAS 2.0 is valid and reliable for measuring disability among patients with RTIs in Bangladesh and has validity for making meaningful comparisons in disability level over time. Future research should include samples with different types of RTIs to strengthen the evidence supporting the use of the instrument.