School of Public Health Sciences, University of Waterloo, Waterloo, Canada.
Disabil Rehabil. 2023 Sep;45(19):3135-3142. doi: 10.1080/09638288.2022.2118868. Epub 2022 Sep 10.
This study investigated the psychometric properties of the 12-item proxy-administered World Health Organization Disability Assessment Schedule (WHODAS) 2.0 in young children with chronic physical illness in Canada.
Data come from the Multimorbidity in Youth across the Life-course, a longitudinal study of Canadian youth with physical illnesses ( = 263). Baseline parent-reported data from children (2-9 years, = 143) and adolescents (10-16 years, = 117) were analyzed. Wilcoxon's tests examined differences in WHODAS 2.0 scores between subgroups. Internal consistency was estimated, and confirmatory factor analysis modeled the WHODAS 2.0 factor structure. Regression modeling examined if the WHODAS 2.0 could discriminate between children with vs. without mental comorbidity.
Differences were found between children and adolescents regarding self-care and getting along, and for the item on emotional affect. Inter-item correlations were similar between subgroups and internal consistency was strong for children ( = 0.90) and adolescents ( = 0.93). The factor structure of the WHODAS 2.0 was confirmed; parameter estimates were similar between subgroups. The association between mental comorbidity and disability did not differ by age - comorbidity was associated with greater disability ( = 5.87, < 0.01).
The 12-item proxy-administered WHODAS 2.0 appears valid and reliable in young children with physical illness and can be used in this population.Implications for rehabilitationThe 12-item proxy-administered WHODAS 2.0 has acceptable inter-item correlations and internal consistency in young Canadian children with chronic physical illness, and its factor structure is consistent with previous reportsExpansion of its use in measuring disability in young children provides the opportunity to use the WHODAS 2.0 across the life-course, facilitating the interpretation of changes in disability over time or in response to treatmentAdditional research is needed to determine responsiveness to change and the minimal clinically important difference of the WHODAS 2.0 in this population.
本研究旨在考察加拿大慢性病儿童使用代理版 12 项世界卫生组织残疾评定量表（WHODAS）2.0 的心理测量特性。
数据来自多系统疾病青少年纵向研究，这是一项对加拿大患有躯体疾病的青少年（ = 263）的纵向研究。对儿童（2-9 岁， = 143）和青少年（10-16 岁， = 117）的基线家长报告数据进行了分析。采用 Wilcoxon 检验比较了 WHODAS 2.0 评分在亚组之间的差异。估计了内部一致性，并采用验证性因子分析对 WHODAS 2.0 的因子结构进行建模。回归模型检验了 WHODAS 2.0 是否能区分有或无精神共病的儿童。
儿童和青少年在自我护理和相处以及情绪情感项目上存在差异。亚组之间的项目间相关性相似，儿童的内部一致性较强（ = 0.90），青少年的内部一致性较强（ = 0.93）。WHODAS 2.0 的因子结构得到了验证；亚组之间的参数估计值相似。精神共病与残疾之间的关联不因年龄而异-共病与更大的残疾相关（ = 5.87， < 0.01）。
在患有躯体疾病的加拿大年轻儿童中，代理版 12 项 WHODAS 2.0 具有良好的有效性和可靠性，可在该人群中使用。
12 项代理版 WHODAS 2.0 在患有慢性躯体疾病的加拿大年轻儿童中具有可接受的项目间相关性和内部一致性，其因子结构与以往报告一致。将其用于测量年轻儿童的残疾程度，为在整个生命周期中使用 WHODAS 2.0 提供了机会，便于解释随着时间的推移或对治疗的反应残疾的变化。需要进一步的研究来确定该人群中 WHODAS 2.0 的反应性和最小临床重要差异。
