Ferro Mark A, Basque Dominique, Elgie Melissa, Dol Megan
School of Public Health Sciences, University of Waterloo, Waterloo, Canada.
Disabil Rehabil. 2023 Sep;45(19):3125-3134. doi: 10.1080/09638288.2022.2120095. Epub 2022 Sep 6.
This study modelled the factor structure and tested for measurement invariance between youth and parent reports on the 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0; estimated agreement between informants; and, examined moderators of youth-parent discrepancies.
Data come from the baseline wave of the Multimorbidity in Youth across the Life-course study ( = 117). Multiple-group confirmatory factor analysis was used to test for measurement invariance and Wilcoxon signed-rank tests compared informant scores. Intraclass correlation coefficient (ICC) and Bland-Altman limits of agreement plots were used to examine the youth-parent agreement.
The WHODAS 2.0 demonstrated measurement invariance [ = 221.8(136), < 0.01; RMSEA = 0.073 (0.055, 0.091); CFI = 0.962; and, SRMR = 0.078]. Youth typically reported more disability compared to parent proxies, with the exception of item Q5 (emotional). The agreement was low (ICC = 0.08-0.53). Youth sex moderated informant agreement such that more consistent agreement was seen for female youth ( = 0.54, < .01) compared to male youth ( = 0.11, = .29).
Youth and their parents interpret the construct of disability, as measured by the 12-item WHODAS 2.0, similarly. Thus, informant differences represent real differences that are not a consequence of error. Low parent-youth agreement reinforces the need for collecting multiple perspectives in the pediatric setting, especially for male youth.Implications for rehabilitationThe WHODAS 2.0 is one of the most widely used measures of disability and functioning.Measurement invariance of the WHODAS 2.0 suggests that youth and parents interpret the construct of disability similarly.Parent-youth agreement was low and youth typically report more disability compared to parent proxies.More consistent agreement with parents was found for female youth compared to male youth.
本研究构建了12项世界卫生组织残疾评定量表（WHODAS）2.0中青少年与家长报告之间的因子结构并测试了测量不变性；估计了报告者之间的一致性；并研究了青少年与家长差异的调节因素。
数据来自全生命周期青少年多重疾病研究的基线波次（n = 117）。采用多组验证性因子分析来测试测量不变性，并用Wilcoxon符号秩检验比较报告者得分。组内相关系数（ICC）和Bland-Altman一致性界限图用于检验青少年与家长的一致性。
WHODAS 2.0显示出测量不变性[χ² = 221.8(136)，p < 0.01；RMSEA = 0.073(0.055, 0.091)；CFI = 0.962；SRMR = 0.078]。除了条目Q5（情绪方面）外，青少年通常比家长代理报告的残疾情况更多。一致性较低（ICC = 0.08 - 0.53）。青少年性别调节了报告者之间的一致性，与男性青少年（ICC = 0.11，p = 0.29）相比，女性青少年的一致性更高（ICC = 0.54，p < 0.01）。
青少年及其家长对12项WHODAS 2.0所测量的残疾概念的理解相似。因此，报告者之间的差异代表的是真实差异，而非误差导致。青少年与家长之间较低的一致性强化了在儿科环境中收集多种观点的必要性，尤其是对于男性青少年。
对康复的启示
WHODAS 2.0是最广泛使用的残疾和功能测量工具之一。
WHODAS 2.0的测量不变性表明青少年和家长对残疾概念的理解相似。
青少年与家长的一致性较低，且青少年通常比家长代理报告的残疾情况更多。
与男性青少年相比，女性青少年与家长的一致性更高。
