School of Nursing, China Medical University, Shenyang, Liaoning, China.
Qual Life Res. 2013 May;22(4):897-906. doi: 10.1007/s11136-012-0212-9. Epub 2012 Jun 9.
This study sought to determine the psychometric properties of the Chinese version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in a sample of 402 primary breast cancer patients receiving chemotherapy after surgery.
Four-hundred and two subjects were interviewed with the Chinese version of the WHODAS 2.0. Patients also completed the Functional Assessment of Cancer Therapy-Breast (FACT-B). Internal consistency reliability was measured by Cronbach's α. Spearman correlation coefficients between total scores and subscales of FACT-B and WHODAS 2.0 were examined to get the convergent validity. Independent sample t test was applied to test discriminant validity by comparing the difference of disability scores for different degree of relevant symptoms. The factor structure of the WHODAS 2.0 was examined by exploratory factor analysis (EFA) and confirmatory factor analysis.
The Chinese version of the WHODAS 2.0 showed satisfactory internal consistency (r, 0.72-0.92), convergent validity and discriminant validity. After 4 items(item D2.2: standing up; D3.3: eating; D4.5: sexual activities; and D6.3: living with dignity) were excluded, EFA identified seven separate factors for 'Self-care and Household activities,' 'Getting along with people,' 'Getting around,' 'Understanding,' 'Communicating,' 'Participation in society' and 'Family burden'(explained variance 72.13 %). The reduced model also presented the best fit [confirmatory fit index = 0.914, Tucker-Lewis index = 0.900, root mean square error of approximation = 0.069] compared with the model suggested by EFA and hypothesized a prior.
Overall, the Chinese version of the WHODAS 2.0 is a reliable and valid instrument for measuring activity limitation and participation restrictions in Chinese breast cancer patients receiving chemotherapy.
本研究旨在探讨中文版世界卫生组织残疾评定量表 2.0（WHODAS 2.0）在 402 例接受手术后化疗的原发性乳腺癌患者中的心理测量特性。
402 名患者接受中文版 WHODAS 2.0 访谈。患者还完成了功能性评估癌症治疗-乳房（FACT-B）。采用 Cronbach's α 评估内部一致性信度。WHODAS 2.0 总分与 FACT-B 各分量表之间的 Spearman 相关系数用于获得聚合效度。通过比较不同相关症状程度的残疾评分差异，应用独立样本 t 检验检验区分效度。通过探索性因子分析（EFA）和验证性因子分析检验 WHODAS 2.0 的因子结构。
中文版 WHODAS 2.0 显示出满意的内部一致性（r，0.72-0.92）、聚合效度和区分效度。剔除 4 项后（项目 D2.2：站立；D3.3：进食；D4.5：性活动；D6.3：有尊严地生活），EFA 确定了“自我护理和家务活动”、“与人相处”、“走动”、“理解”、“沟通”、“参与社会”和“家庭负担”7 个独立因子（解释方差 72.13%）。简化模型也呈现了最佳拟合[验证性拟合指数=0.914，Tucker-Lewis 指数=0.900，均方根误差近似值=0.069]，优于 EFA 建议模型和假设模型。
总体而言，中文版 WHODAS 2.0 是一种可靠且有效的工具，可用于测量接受化疗的中国乳腺癌患者的活动受限和参与受限。
