Purpose
A generic instrument that measures health and disability in six life domains across cultures using a standardized method.
Link to Instrument
Area of Assessment
CognitionBodily Functions
Activities & Participation
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A generic instrument that measures health and disability in six life domains across cultures using a standardized method.
36
20 minutes
5 to 20 minutes
Adolescent
13 - 17
yearsAdult
18 - 64
yearsInitially reviewed in 2018 by University of Illinois at Chicago Master of Science in Occupational Therapy students Michelle Dominguez, OTS; Claudia Sanchez-Ayala, OTS; Vivian Villegas, OTS.
Interviewer, proxy, and self-administered versions available.
WHODAS 2.0 does not assess environmental factors enabling/inhibiting activity and participation.
Rheumatoid Arthritis: (Meesters et al., 2009; n = 85; mean age = 61.0 years; mean duration of RA = 6.0 years; female = 77%; scores after inpatient and day-patient therapy by trained multidisciplinary team; Netherlands sample)
Median score at baseline: 40.5
Rheumatoid Arthritis: (Meesters et al., 2009)
Excellent internal consistency (Cronbach’s alpha = 0.91)
Convergent validity:
Rheumatoid Arthritis: (Meesters et al., 2009)
Adequate: HAQ, stair test, grip strength, D-AIMS2, DAS-28, VAS-Pain, and RAQoL (Pearson rank correlation coefficients = 0.50, 0.39, 0.29, 0.53, 0.28, 0.42, 0.52)
Poor: 50-feet walk test, timed-stands test, and Escola Paulista de Medicina Range of Motion scale (Pearson rank correlation coefficients = 0.22, 0.20, 0.19)
Rheumatoid Arthritis: (Meesters et al., 2009)
Adequate floor effect of 17% for subscale “understanding and communicating”
Adequate floor effect of 18% for subscale “getting along with people”
Adequate floor effect of 14% for subscale “self-care”
Rheumatoid Arthritis: (Meesters et al., 2009)
High: “getting around” and “participation in society” (RR = 0.84, 0.80)
Moderate: WHODAS 2.0 total score, “understanding and communicating”, “self-care”, “life activities” (RR = 0.58, 0.56, 0.58, 0.48)
Low: “getting along with people” (RR = 0.04)
Schizophrenia: (Guilera et al., 2012; n = 352; mean age = 36.7; mean average duration of illness = 140.65 months; diagnoses include schizophrenia, schizoaffective disorder and schizophreniform disorder; Spanish sample)
Excellent test-retest reliability: (ICC = 0.92). Subscale range = 0.63-0.88
Trauma: (Abedzadeh-kalahroudi, 2015; n = 220; mean age = 34.7; mean time post trauma = at least 24 hours; mean GCS score = 12.7; Persian)
Excellent interrater reliability: (ICC = 0.99)
Trauma: (Abedzadeh-kalahroudi, 2015)
Acceptable to Excellent: Cronbach’s alpha = 0.51-0.87 (only 3/12 items had an alpha value < 0.68)
Schizophrenia (Guilera et al., 2012)
Excellent: Cronbach’s alpha = 0.94)
Normative Sample: (Haley et al., 1992; n = 412)
Excellent: Cronbach's alpha range from 0.95-0.99
Schizophrenia (Guilera et al., 2012)
Low/Moderate to High correlation with the Positive and Negative Syndrome Scale (PANSS-G) and the Hamilton Depression Rating Scale (HAM-D)
Trauma: (Abedzadeh-kalahroudi et al., 2015)
Items representing the activity domain have a very strong mean Spearman’s rank coefficient (rho = .81). The range for these items is 0.67 - 0.93)
Items representing the participation domain have a strong mean Spearman’s rank coefficient (rho = .76). The range for these items is 0.50 - 0.92)
Schizophrenia (Guilera et al., 2012)
All indicators are relevant for defining the corresponding domains (cognition, mobility, self-care, getting along, life activities and participation).
Schizophrenia (Guilera et al., 2012).
Strong floor effects
Strong ceiling effects, with more than 60% of participants obtaining the best score on sub scales of “getting around” and “self-care”
Spinal Cord Injury: (De Wolf et al., 2012; n = 63; mean age = 34.7 years; studied at 2 years post discharge from inpatient unit; male = 81%; ASIA Impairment Scale: A = 59%, B = 6%, C = 6%, D = 29%; Australian sample)
Excellent internal consistency for WHODAS 2.0 Total Score (Cronbach’s alpha = 0.95)
Excellent internal consistency for following domains: “understanding and communicating”, “self-care”, “life activities”, and “participation” (Cronbach’s alpha = 0.93, 0.94, 0.96, 0.97)
Adequate internal consistency for “getting along with others” domain (Cronbach’s alpha = 0.73)
Poor internal consistency for “getting around” domain (Cronbach’s alpha = 0.61)
Discriminant validity:
Spinal Cord Injury: (De Wolf et al., 2012)
Excellent discriminant validity for WHODAS 2.0 Total Score (Mann-Whitney U = 2.02)
Excellent discriminant validity for following domains: “getting around”, “self-care”, and “life activities” (Mann-Whitney U = 2.79, 4.90, 1.89)
Spinal Cord Injury: (De Wolf et al., 2012)
Adequate ceiling effect of following domains: “getting along with others” and “life activities” (Ceiling Effects % = 19, 16)
Poor ceiling effect of following domains: “understanding and communicating” and “self-care” (Ceiling Effects % = 54, 29)
Stroke: (Schlote et al., 2008, n = 84; mean age = 56; diagnoses include: ischemic and hemorrhagic strokes)
Satisfactory to Excellent Interrater Reliability (ICC= 0.64*-0.94)
*Understanding and Communication and Total Score
Stroke: (Küçükdeveci et al., 2013; n = 188; mean age = 61; time since stroke: min = 3 months, median = 27 months, and max = 240 months)
Stroke: (Schlote et al., 2008)
Stroke: (Schlote et al., 2008)
Items representing the different domains of the assessment have varying Spearman’s Rank coefficients ranging from low to strong: (0.31-0.83)
Low to moderate correlation with ratings for understanding and communicating (rho = 0.44-0.56).
Moderate to strong correlation with rating for getting around (rho = 0.60-0.75).
Moderate to strong correlations with rating for self-care (rho = 0.62-0.83)
Moderate correlation with ratings for getting along with people (rho = 0.43-0.58).
Moderate to strong correlation with ratings for life activities (rho = 0.64-0.78).
Low to moderate correlation with ratings for participation in society (rho = 0.31-0.59).
Moderate correlation with ratings for single items (rho = 0.49-0.58)
Abedzadeh–kalahroudi, M., Razi, E., Sehat, M., & Asadi-Lari, M. (2016). Psychometric properties of the World Health Organization Disability Assessment Schedule II-12 Item (WHODAS II) in trauma patients. Injury, 47(5), 1104-1108. Find it on PubMed
De Wolf, A. C., Tate, R. L., Lannin, N. A., Middleton, J., Lane-Brown, A., & Cameron, I. D. (2012). The World Health Organization Disability Assessment Scale, WHODAS II: Reliability and validity in the measurement of activity and participation in a spinal cord injury population. Journal of Rehabilitation Medicine, 44(9), 747-755. Find it on PubMed
Guilera, G., Gómez-Benito, J., Pino, O., Rojo, J. E., Cuesta, M. J., Martínez-Arán, A., ... & Crespo-Facorro, B. (2012). Utility of the World Health Organization Disability Assessment Schedule II in schizophrenia. Schizophrenia Research, 138(2), 240-247. Find it on PubMed
Küçükdeveci, A. A., Kutlay, Ş., Yıldızlar, D., Öztuna, D., Elhan, A. H., & Tennant, A. (2013). The reliability and validity of the World Health Organization Disability Assessment Schedule (WHODAS-II) in stroke. Disability and Rehabilitation, 35(3), 214-220. Find it on PubMed
Meesters, J. J., Verhoef, J., Liem, I. S., Putter, H., & Vliet Vlieland, T. P. (2009). Validity and responsiveness of the World Health Organization Disability Assessment Schedule II to assess disability in rheumatoid arthritis patients. Rheumatology, 49(2), 326-333. Find it on PubMed
Schlote, A., Richter, M., Wunderlich, M. T., Poppendick, U., Möller, C., Schwelm, K., & Wallesch, C. W. (2009). WHODAS II with people after stroke and their relatives. Disability and Rehabilitation, 31(11), 855-864. Find it on PubMed
World Health Organization. (2017, September 4). WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Retrieved from http://www.who.int/classifications/icf/more_whodas/en/
World Health Organization. (2010). Measuring health and disability. Manual for WHO disability assessment scale. Whodas 2.0. [assessment manual]. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/43974/9789241547598_eng.pdf;jsessionid=73DE626D8D6E4E4B7577B086E3B29AC6?sequence=1
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.