Harvard School of Public Health, Boston, Massachusetts, United States of America.
PLoS One. 2013;8(3):e57725. doi: 10.1371/journal.pone.0057725. Epub 2013 Mar 7.
The World Health Organization Disability Assessment Schedule for children (WHODAS-Child) is a disability assessment instrument based on the WHO's International Classification of Functioning, Disability and Health for children and youth. It is modified from the original adult version specifically for use with children. The aim of this study was to assess the WHODAS-Child structure and metric properties in a community sample of children with and without reported psychosocial problems in rural Rwanda.
The WHODAS-Child was first translated into Kinyarwanda through a detailed committee translation process and back-translation. Cognitive interviewing was used to assess the comprehension of the translated items. Test-retest reliability was assessed in a group of 64 children. The translated WHODAS-Child was then administered to a final sample of 367 children in southern Kayonza district in rural southeastern Rwanda within a larger psychosocial assessment battery. The latent structure was assessed through confirmatory factor analysis. Reliability was evaluated in terms of internal consistency (Cronbach's alpha) and test-retest reliability (Pearson's correlation coefficient). Construct validity was explored by examining convergence between WHODAS-Child scores and mental disorder status, and divergence of WHODAS-Child scores with protective factors and prosocial behaviors. Concordance between parent and child scores was also assessed.
The six-factor structure of the WHODAS-Child was confirmed in a population sample of Rwandan children. Test-retest and inter-rater reliability were high (r = .83 and ICC = .88). WHODAS-Child scores were moderately positively correlated with presence of depression (r = .42, p<.001) and post-traumatic stress disorder (r = .31, p<.001) and moderately negatively correlated with prosocial behaviors (r = .47, p<.001). The Kinyarwanda version of the WHODAS-Child was found to be a reliable and acceptable self-report tool for assessment of functional impairment among children largely referred for psychosocial problems in the study district in rural Rwanda. Further research in low-resource settings and with more general populations is recommended.
世界卫生组织残疾评定量表儿童版（WHODAS-Child）是一种残疾评定工具，基于世界卫生组织针对儿童和青少年的《国际功能、残疾和健康分类》。它是从原始的成人版专门为儿童使用而修改的。本研究的目的是评估 WHODAS-Child 在卢旺达农村一个有和没有报告心理社会问题的社区样本儿童中的结构和度量属性。
首先通过详细的委员会翻译过程和回译将 WHODAS-Child 翻译成基尼亚卢旺达语。认知访谈用于评估翻译项目的理解情况。在 64 名儿童中评估了测试-重测信度。在卢旺达东南部农村卡永扎区南部的最后一个 367 名儿童样本中，对翻译后的 WHODAS-Child 进行了测试。通过验证性因素分析评估潜在结构。通过内部一致性（克朗巴赫α）和测试-重测信度（皮尔逊相关系数）评估信度。通过检查 WHODAS-Child 分数与精神障碍状况的收敛性以及 WHODAS-Child 分数与保护因素和亲社会行为的发散性来探索结构效度。还评估了父母和孩子分数之间的一致性。
WHODAS-Child 的六因素结构在卢旺达儿童的人群样本中得到了确认。测试-重测和评分者间信度都很高（r=0.83，ICC=0.88）。WHODAS-Child 分数与抑郁（r=0.42，p<.001）和创伤后应激障碍（r=0.31，p<.001）的存在呈中度正相关，与亲社会行为（r=0.47，p<.001）呈中度负相关。在卢旺达农村研究地区，基尼亚卢旺达语版 WHODAS-Child 被认为是一种可靠且可接受的自我报告工具，用于评估儿童的功能障碍，这些儿童主要是因心理社会问题而接受评估。建议在资源较少的环境中和更广泛的人群中进一步开展研究。
