Psychometric Validation of the World Health Organization Disability Assessment Schedule 2.0—Twelve-Item Version in Persons With Spinal Cord Injuries

Abstract

Purpose: To evaluate the factorial and concurrent validity and internal consistency reliability of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 12-item version in persons with spinal cord injuries.Method: Two hundred forty-seven adults with spinal cord injuries completed an online survey consisting of the WHODAS 2.0 12-item version and measures of various psychosocial variables.Results: The initial confirmatory factor analysis (CFA) revealed that both the theoretical hierarchical model and the 1-factor model of the WHODAS 2.0 12-item version exhibited a poor fit with the data. Subsequent exploratory factor analysis (EFA) revealed a 3-factor solution consisting of the factors Activities/Participation, Self-Care, and Mobility. Each factor demonstrated adequate internal consistency. These results were confirmed by a secondary CFA. In the concurrent validity analysis, the Activities/Participation factor had the strongest relationships with the psychosocial variables under study (life satisfaction, core self-evaluations, community participation, and health-related quality of life).Conclusion: The WHODAS 2.0 12-item version is not unidimensional in persons with spinal cord injuries as predicted but instead yields a three-factor solution. However, the Activities/Participation factor appears to be the most valid measure of disability impact in persons with spinal cord injuries. Other implications of the use of the WHODAS 2.0 12-item version are discussed.