Khalaf Mohammad K, Rosen Heather E, Paichadze Nino, Siddiqi Samid, Neki Kazuyuki, Seager Jennifer, Mitra Sudeshna, Wang Yan, Rahman A K M Fazlur, Hyder Adnan A
Department of Global Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia, USA.
Centre for Injury Prevention and Research - Bangladesh, Dhaka, Bangladesh.
Disabil Rehabil. 2025 Jun;47(13):3421-3435. doi: 10.1080/09638288.2024.2425755. Epub 2024 Nov 18.
Road traffic injuries (RTIs) are a leading cause of disability in low- and middle-income countries. This study assesses the psychometric properties of 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 among patients with orthopedic injuries from road traffic crashes in Bangladesh across two timepoints after hospital discharge.
Confirmatory factor analysis (CFA) assessed WHODAS 2.0 construct validity and investigated measurement invariance among a sample of RTI patients at an orthopedic hospital one month and three months post-discharge. Cronbach's alpha measured reliability.
A single-factor structure was identified in CFA for the one-month sample (χ2(53)=894.337, < 0.001; CFI = 0.989, TLI = 0.986; SRMR = 0.052, RMSEA = 0.151) and the three-month sample (χ2(53)=630.119, < 0.001; CFI = 1.000, TLI = 1.000; SRMR = 0.022, RMSEA = 0.130). Measurement invariance was supported, and internal consistency was excellent (α > 0.9) at each timepoint. Mean disability score decreased from 37.89 (out of 48, SD = 10.44) one-month post-discharge to 27.19 (SD = 18.10, < 0.001) three months post-discharge indicating improvement in functional status over time.
WHODAS 2.0 is valid and reliable for measuring disability among patients with RTIs in Bangladesh and has validity for making meaningful comparisons in disability level over time. Future research should include samples with different types of RTIs to strengthen the evidence supporting the use of the instrument.
道路交通伤害（RTIs）是低收入和中等收入国家残疾的主要原因。本研究评估了世界卫生组织残疾评定量表2.0（WHODAS 2.0）12项版本在孟加拉国因道路交通事故导致骨科损伤的患者出院后两个时间点的心理测量特性。
验证性因素分析（CFA）评估WHODAS 2.0的结构效度，并调查了一家骨科医院的道路交通伤害患者样本在出院后1个月和3个月时的测量不变性。Cronbach's α系数用于测量信度。
CFA在1个月样本中确定了单因素结构（χ2(53)=894.337，p<0.001；CFI = 0.989，TLI = 0.986；SRMR = 0.052，RMSEA = 0.151），在3个月样本中也确定了单因素结构（χ2(53)=630.119，p<0.001；CFI = 1.000，TLI = 1.000；SRMR = 0.022，RMSEA = 0.130）。支持测量不变性，且每个时间点的内部一致性都非常好（α>0.9）。平均残疾评分从出院后1个月的37.89（满分48分，标准差 = 10.44）降至出院后3个月的27.19（标准差 = 18.10，p<0.001），表明功能状态随时间有所改善。
WHODAS 2.0在测量孟加拉国道路交通伤害患者的残疾情况时是有效且可靠的，并且在随时间进行有意义的残疾水平比较方面具有效度。未来的研究应纳入不同类型道路交通伤害的样本，以加强支持该工具使用的证据。
