Rocha Lia Rodrigues, Ximenes Thalia Oliveira, da Silva Elidia Nascimento, Araújo Ana Karoline da Silva de, Pereira Jennifer Rego, Nascimento Simony Lira
Master Program in Physiotherapy and Functioning (PPGFisio), Physiotherapy Department, Federal University of Ceará (UFC), Fortaleza, Brazil.
Physiotherapy Department, Federal University of Ceará (UFC), Fortaleza, Brazil.
Physiother Res Int. 2025 Oct;30(4):e70106. doi: 10.1002/pri.70106.
The World Health Organization Disability Assessment Schedule (WHODAS 2.0) is a generic instrument created by the World Health Organization (WHO) for measuring functioning and disability. Although this instrument has been extensively studied in different populations, its validity concerning breast cancer patients who have undergone surgery remains uncharted. This study aims to analyze the measurement properties of the Brazilian version of WHODAS 2.0 to validate it as a tool for assessing the functioning/disability of postoperative breast cancer surgery patients.
This is a validation study conducted at three centers in the northeast of Brazil, involving women between 3 and 12 months after mastectomy or quadrantectomy, interviewed with the Brazilian version of the 36-item WHODAS 2.0. Participants also completed the Functional Assessment of Cancer Therapy (FACT-B+4) questionnaire. Internal consistency was assessed using Cronbach's alpha. Intraclass correlation coefficients (ICC), standard error of measurement (SEM) and smallest detectable change (SDC) were used to measure test-retest reliability. Both construct and convergent validity were analyzed using Spearman correlation.
Ninety-five women with a mean age of 53.12 (± 11.10) answered the WHODAS. The responses revealed satisfactory internal consistency for all domains (α ≥ 0.7) and the total score (α = 0.93). Excellent test-retest reliability was observed (ICC = 0.87). Regarding the construct validity, a strong negative correlation was found between FACT-B+ 4 and WHODAS (ρ = -0.75). Moreover, the convergent validity analysis depicted correlations (between WHODAS and FACT-B+ 4 domains) ranging from weak to moderate, except for the "mobility" subscale of WHODAS, which showed a strong correlation with the "physical well-being" subscale of FACT-B+ 4.
The results provide evidence that the WHODAS 2.0 is a valid and reliable instrument for assessing the functioning/disability of the target population, which allows its use as outcome measure based on the biopsychosocial model.
世界卫生组织残疾评定量表（WHODAS 2.0）是世界卫生组织（WHO）制定的一种通用工具，用于衡量功能和残疾情况。尽管该工具已在不同人群中进行了广泛研究，但其在接受手术的乳腺癌患者中的有效性仍不明确。本研究旨在分析巴西版WHODAS 2.0的测量特性，以验证其作为评估乳腺癌手术后患者功能/残疾情况的工具的有效性。
这是一项在巴西东北部三个中心进行的验证研究，纳入了乳房切除术或象限切除术后3至12个月的女性，采用巴西版36项WHODAS 2.0进行访谈。参与者还完成了癌症治疗功能评估（FACT-B+4）问卷。使用Cronbach's alpha评估内部一致性。使用组内相关系数（ICC）、测量标准误差（SEM）和最小可检测变化（SDC）来测量重测信度。使用Spearman相关性分析结构效度和收敛效度。
95名平均年龄为53.12（±11.10）岁的女性回答了WHODAS问卷。结果显示所有领域（α≥0.7）和总分（α=0.93）的内部一致性令人满意。观察到极好的重测信度（ICC=0.87）。关于结构效度，FACT-B+4与WHODAS之间存在强烈的负相关（ρ=-0.75）。此外，收敛效度分析显示WHODAS与FACT-B+4各领域之间的相关性从弱到中等不等，除了WHODAS的“活动能力”子量表与FACT-B+4的“身体健康”子量表显示出强烈相关性。
结果提供了证据表明WHODAS 2.0是评估目标人群功能/残疾情况的有效且可靠的工具，这使得它能够作为基于生物心理社会模型的结局指标使用。
