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  • Title: The World Health Organization Disability Assessment Scale, WHODAS II: reliability and validity in the measurement of activity and participation in a spinal cord injury population.
    Author: Wolf AC, Tate RL, Lannin NA, Middleton J, Lane-Brown A, Cameron ID.
    Journal: J Rehabil Med; 2012 Sep; 44(9):747-55. PubMed ID: 22854805.
    Abstract:
    OBJECTIVE: To evaluate the reliability and validity of WHODAS II within the spinal cord injury population. SUBJECTS: Sixty-three people with traumatic spinal cord injury. METHODS: The World Health Organization Disability Assessment Scale II (WHODAS II), Craig Handicap Assessment and Reporting Technique, and Medical Outcomes Study 36-item Short-Form Health Survey (MOS SF-36) were administered at 2 years post discharge from rehabilitation. Distribution, reliability, discriminant validity, and convergent/divergent validity were evaluated using classical tests. Rasch analyses were applied to assess dimensionality, item spread, and person/item reliability. RESULTS: Cronbach's alpha coefficients ranged from 0.61 (getting around) to 0.97 (participation). Ceiling effects were present in 4 out of 6 domains. WHODAS II discriminated between levels of impairment and work force status on 'self-care', 'getting around', 'life activities', and total score. Correlations with MOS SF-36 supported convergent/divergent validity. Five items didn't fit the Rasch model. The item/person map reveald a shortage of items able to differentiate the more able person. WHODAS II demonstrated good person and item separation and reliability. CONCLUSION: This study provides preliminary support for reliability and validity of WHODAS II in a spinal cord injured population. Limitations were noted for dimensionality and item person distribution. Findings need to be confirmed in larger samples.
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