Abstract
The World Health Organization's (WHO) Disability Assessment Scale II (WHO-DAS II) is a generic health-status instrument firmly grounded in the WHO's International Classification of Functioning, Disability and Health (WHO-ICF). As such, it assesses functioning for six domains: communication, mobility, self-care, interpersonal, life activities, and participation. Domain scores aggregate to a total score. Because the WHO-DAS II contains questions relevant to hearing and communication, it has good face validity for use as an outcome measure for audiologic intervention. The purpose of the present study was to determine the psychometric properties of the WHO-DAS II on a sample of individuals with adult-onset hearing loss, including convergent validity, internal consistency, and test-retest stability. Convergent validity was established by examining correlations between the WHO-DAS II (domain and total scores) and the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the Hearing Aid Handicap for the Elderly (HHIE), two disease-specific measures, as well as with the Short Form-36 for veterans (SF-36V), a second generic measure. Data on all four measures were collected from 380 older individuals with adult-onset hearing loss who were not hearing aid users. The results of the convergent validity analysis revealed that the WHODAS II communication domain score was moderately and significantly correlated with scores on the APHAB and the HHIE. WHO-DAS II interpersonal and participation domain scores and the total scores were also moderately and significantly correlated with HHIE scores. These findings support the validity of using the WHO-DAS II for assessing activity limitations and participation restrictions of adult-onset hearing loss. Several WHO-DAS II domain scores and the total score were also significantly and moderately-markedly correlated with scores from the SF-36V. These findings support the validity of the WHO-DAS II as a generic health-status instrument. Internal consistency reliability for all the domain scores was adequate for all but the interpersonal domain. Test-retest stability for all the domain scores was adequate. Critical difference values were calculated for use in clinical application of the WHO-DAS II. From these findings, we concluded that the WHO-DAS II communication, participation, and total scores can be used to examine the effects of adult-onset hearing loss on functional health status. Further work examining the utility of the WHO-DAS II as an outcome measure for hearing aid intervention is warranted.
Highlights
The term outcome measure refers to those methods and tools that can be used to evaluate the results of audiologic intervention (Abrams and Hnath Chisolm, 2000)
In terms of the World Health Organization (WHO)-DAS II data, it can be seen that the greatest perceived problems occurred in the communica
This domain included items such as, “How much of a problem did you have joining in community activities?” and “How much of a problem did you have because of barriers or hindrances in the world around you?” The domain exhibiting the lowest average score was self-care
Summary
The term outcome measure refers to those methods and tools that can be used to evaluate the results of audiologic intervention (Abrams and Hnath Chisolm, 2000). The importance of determining the effectiveness of audiologic intervention has received considerable attention in recent years (e.g., Abrams and Hnath Chisolm, 2000; Johnson and Danhauer, 2002). The practicing audiologist currently has available a variety of widely used self-report outcome measures to determine the effectiveness of hearing aid intervention (see Abrams and Hnath Chisolm, 2000; Johnson and Danhauer, 2000; for reviews). Share one limiting characteristic: they are disease specific. That is, they measure the effectiveness of hearing aid intervention in terms of the impact on consequences of the hearing loss alone. Disease-specific instruments tend to be sensitive to the effects of treatments that are directed toward alleviating specific problems associated with hearing loss
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