Abstract
ObjectiveTo validate the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) 12‐item tool against the 36‐item version for measuring functioning and disability associated with pregnancy and the occurrence of maternal morbidity.MethodsThis is a secondary analysis of the Brazilian retrospective cohort study on long‐term repercussions of severe maternal morbidity (SMM) among women who delivered at a tertiary facility (COMMAG study). We compared WHODAS‐12 and WHODAS‐36 scores of women with and without SMM using measures of central tendency and variability, tests for instruments’ agreement (Bland‐Altman plot), confirmatory factor analysis (CFA), and Cronbach alpha coefficient for internal consistency.ResultsThe COMMAG study enrolled 638 women up to 5 years postpartum. Although the median WHODAS‐36 and ‐12 scores for all women were statistically different (13.04 and 11.76, respectively; P<0.001), there was a strong linear correlation between them. Furthermore, the mean difference and the differences in variance analyses demonstrated agreement of total scores between the two versions. CFA demonstrated how the WHODAS‐12 questions are divided into six previously defined factors and Cronbach alpha showed good internal consistency.Conclusion WHODAS‐12 demonstrated agreement with WHODAS‐36 for total score and was a good instrument for screening functioning and disability among postpartum women, with and without SMM.
Highlights
According to the United Nations World Report on Disability, more than 1 billion people in the world live with some form of disability, of which nearly 200 million experience considerable difficulties in functioning
This is a secondary analysis of the Brazilian retrospective cohort study, known as COMMAG, on the long-term repercussions of severe maternal morbidity (SMM) on women who delivered at a tertiary maternity unit.[9]
Our validation study indicated that WHO Disability Assessment Schedule (WHODAS)-12 is a good substitute for WHODAS-36
Summary
According to the United Nations World Report on Disability, more than 1 billion people in the world live with some form of disability, of which nearly 200 million experience considerable difficulties in functioning. The use of a simple and effective tool to identify and measure disability in the postpartum period is key to improving maternal health worldwide.[2,3]. Its second version (WHODAS 2.0) was presented as a general measure of functioning impairment and disability in major life domains. For each domain of the original WHODAS-36, the 12-item version includes two sentinel items with good screening properties that identify over 90% of individuals with mild functioning impairment, based on all 36 items, in general populations.[5]. The objectives of the current analysis were to compare and validate the abbreviated WHODAS-12, using the complete WHODAS-36 as the reference, for assessing postpartum disability among women (both with and without maternal morbidity) who delivered up to 5 years before assessment
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