Unit:
Department of Physical Education & Sport ScienceLibrary of the School of Physical Education and Sport Science
Author:
Theotokatos Georgios
Dissertation committee:
-Εμμανουήλ Σκορδίλης, Καθηγητής Προσαρμοσμένης Κινητικής Αγωγής, ΤΕΦΑΑ-Σχολή Επιστήμης Φυσικής Αγωγής και Αθλητισμού, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών, Επιβλέπων Καθηγητής
-Κωνσταντίνος Καρτερολιώτης, Καθηγητής Μεθοδολογίας Έρευνας στη Φυσική Αγωγή και Αθλητισμό, ΤΕΦΑΑ-Σχολή Επιστήμης Φυσικής Αγωγής και Αθλητισμού
Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών, Μέλος τριμελούς συμβουλευτικής επιτροπής
-Ειρήνη Γραμματοπούλου, Καθηγήτρια Φυσικοθεραπευτικών Τεχνικών και Μεθόδων Αξιολόγησης στις Αναπνευστικές Παθήσεις, Τμήμα Φυσικοθεραπείας- Σχολή Επιστημών Υγείας & Πρόνοιας, Πανεπιστήμιο Δυτικής Αττικής, Μέλος τριμελούς συμβουλευτικής επιτροπής
-Ιωάννης Γκιόσος, Αναπληρωτής Καθηγητής Φιλοσοφίας του Αθλητισμού, ΤΕΦΑΑ-Σχολή Επιστήμης Φυσικής Αγωγής και Αθλητισμού, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών, Μέλος εξεταστικής επιτροπής
-Δημήτριος Κοκαρίδας, Αναπληρωτής Καθηγητής Άσκησης σε Άτομα με Αναπηρίες
ΤΕΦΑΑ-Σχολή Επιστήμης Φυσικής Αγωγής και Αθλητισμού, Πανεπιστήμιο Θεσσαλίας
Μέλος εξεταστικής επιτροπής
-Νικόλαος Χρυσάγης, Επίκουρος Καθηγητής Κλινικής Νευρολογικής Φυσικοθεραπείας
Τμήμα Φυσικοθεραπείας-Σχολή Επιστημών Υγείας & Πρόνοιας, Πανεπιστήμιο Δυτικής Αττικής, Μέλος εξεταστικής επιτροπής
-Εμμανουήλ Αδαμάκης, Επίκουρος Καθηγητής Μεθοδολογίας Έρευνας στη Φυσική Αγωγή, ΤΕΦΑΑ-Σχολή Επιστήμης Φυσικής Αγωγής και Αθλητισμού, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών, Μέλος εξεταστικής επιτροπής
Original Title:
Ψυχομετρικές ιδιότητες της κλίμακας αξιολόγησης λειτουργικότητας: WHODAS 2.0. Αξιολόγηση της αναπηρίας, εφαρμογή σε άτομα με μυοσκελετικές κακώσεις.
Translated title:
Psychometric properties of the functioning assessment tool: WHODAS 2.0. Disability assessment, application to patients with musculoskeletal injuries.
Summary:
Introduction: The overall disability burden is affecting daily lives of the patients and necessitates the need of enhancing health services. Based on the biopsychosocial model of the World Health Organization, developed in 2001, known as the International Classification of Functioning, Disability and Health (ICF), disability depends on the interaction of body function and structures, environmental and personal factors, affecting participation and activities involved. The WHO developed a functioning assessment tool based on the ICF framework: WHODAS 2.0 (World Health Organization Disability Schedule 2.0). In Greece, the WHODAS 2.0 has been used in a limited number of studies and utilized upon specific health conditions. Researchers suggested further examination of the tool’s psychometric properties in Greek. In addition, there are no recent epidemiologic studies considering Greece. Finally, it is important to examine the sensitivity of change (or the responsiveness) of the WHODAS 2.0 in a group of patients undergoing rehabilitation services.
Aim: The study consisted of three major steps: 1. Examination of the psychometric properties of the short form of the WHODAS 2.0 (interview-administered), in a sample of patients that had applied for welfare benefits (validation study). 2. Examination of the disability prevalence among the welfare benefits applicants, based on WHODAS 2.0 scores and the respective medical decision (disability prevalence study). 3. Examination of the responsiveness of the WHODAS 2.0 (clinical change) in musculoskeletal patients who participated in a rehabilitation program (intervention study).
Methods: Every part of the study consisted of the respective methodology: 1. Examination of the psychometric properties of the WHODAS 2.0 12-item version, in a sample who had apply for welfare benefits (validation study): The analyses were tested in a Databank of the Ministry of Labor and Social Solidarity (Ν=10.163). The study population was consisted of adult applicants from three main regions of Greece (Attica, Thessaloniki and Achaia-Patras). The participants who were not adults, did not fully comprehend the Greek language or were not able to respond to the questionnaire due to cognitive/sensory impairments were excluded from the study (when a proxy was not available) 2. Epidemiologic study and examination of the different disability scores (WHODAS 2.0 and the medical committee-Barema score). Similarly to the 1st step, the population were the applicants of welfare benefits (Databank, Ν=10.163). 3. Finally, the responsiveness of the WHODAS 2.0, was tested on musculoskeletal adult patients who participated in a rehabilitation program (intervention study) (Ν=37). Along with WHODAS 2.0, other clinical functioning tests were implemented (handgrip strength, 5 times sit to stand test), while more clinical characteristics were recorded (e.g.: Maximum and average Numerical Pain Rating Scale, severity etc.).
Statistical Analyses: The Statistical Package for Social Sciences (SPSS) (Windows, version 26) was used. The data were examined for outliers, while the skeweness and kyrtosis were tested. Confirmatory and Exploratory factor analysis examined the construcst validity. The Cronbach’s Alpha coefficient examined the internal consistency of the 12-item version and the data were also tested for floor or ceiling effects. Pearson’s r examined the correlation between the Barema and WHODAS 2.0 scores. Multiple regression analysis was used to test which of the demographics could predict the WHODAS 2.0 score. In addition, mixed ANOVA tested the interaction effect between the different health condition categories and gender (2 Χ 8, men/women and the eight different health condition categories) with respect to the WHODAS 2.0 scores. The responsiveness was tested with the standardized response mean (SRM) and the effect size (ES). The level of significance was p< 0.05.
Results: The Cronbach alpha examining the internal consistency of the 12-items was 0.918. Significant correlation was found between Barema and WHODAS 2.0 scores. Factor analysis showed two factors. No floor or ceiling effects were found. The WHODAS 2.0 showed high responsiveness after the intervention program (SRM was 1.69 and ES was 1.27). Certain health conditions such as mental health disorders and neoplasms, showed higher disability scores based on WHODAS 2.0, while demographics were significant predictors of the WHODAS scores.
Discussion: The 12-item WHODAS 2.0 Greek version was found to be valid, reliable in a wide sample of applicants for welfare benefits and showed high responsiveness to rehabilitation in patients with musculoskeletal health conditions. The results confirmed that disability is affected from several factors and certain diseases led to more restrictions of daily activities and higher disability scores. The utilization of an ICF-based tool can contribute to an enhanced needs assessment and WHODAS 2.0 is recommended as a quick and feasible option. An assessment that combines biomedical and biopsychosocial approaches can help the State to develop disability assessment policies for efficient health services and the support of people with disabilities.
Main subject category:
Health Sciences
Keywords:
Psychometric properties, disability assessment, functioning assessment, epidemiologic study, musculoskeletal patients, welfare benefits, ICF.
Number of references:
149
