Validity and reliability of the Brazilian version of the World Health Organization Disability Assessment Schedule in blind people

Silveira, Laís Sampaio; Castro, Shamyr Sulyvan; Leite, Camila Ferreira; Oliveira, Nuno Miguel Lopes; Salomão, Angélica Emboaba; Pereira, Karina

doi:10.1590/1809-2950/17013126012019

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ORIGINAL RESEARCH • Fisioter. Pesqui. 26 (1) • Jan-Mar 2019 • https://doi.org/10.1590/1809-2950/17013126012019 copy

Validity and reliability of the Brazilian version of the World Health Organization Disability Assessment Schedule in blind people

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The World Health Organization Disability Assessment Schedule (WHODAS 2.0) is a tool developed by the World Health Organization (WHO) to measure functioning and disability, supporting the ICF model. The Brazilian version of WHODAS 2.0 was translated and made available for use by WHO in 2015. Thus, this study aims to validate the Brazilian version of WHODAS 2.0 for use in blind people. Participants were 56 blind people (mean age: 48.4 ± 13.6) years. Two assessment tools were used, the 36-item version of WHODAS 2.0 and the World Health Organization Quality of Life-BREF (WHOQOL-bref). The psychometric properties tested were internal consistency, test-retest and criterion validity. There was good test-retest reliability (ICC≥0.63). Cronbach’s alpha values showed good internal consistency in most areas, except in the subdomain of school or work activities (α = 0.55). The validity criterion was adequate, with moderate correlations between WHODAS 2.0 domains and WHOQOL-bref areas. The results indicated the validity of the WHODAS 2.0 for assessing the functionality of blind people.

Keywords
Disability Evaluation; Validation Studies; Psychometry; Blindness

Psychometric property	Objective	Tests	Reference Values
Internal consistency	Verify if the various items proposed to measure the same general construct produce similar results.	Cronbach’s Alpha	α between: 0.70 and 0.90 adequate internal consistency; >0.95 redundant items¹⁴14. Fleck MPA, Louzada S, Xavier M, Vieira G, Chachamovich E, Santos L, et al. Aplicação da versão em português do instrumento abreviado de avaliação da qualidade de vida "WHOQOL-bref.". Rev Saúde Pública. 2000;34(2):178-83. doi:10.1590/S0034-89102000000200012 https://doi.org/10.1590/S0034-8910200000...
Test-retest reliability	Verify the stability of the instrument in two measurements carried out at different periods.	Intraclass correlation coefficient and Spearman correlation test	Coefficient between: 1.0 and 0.81 excellent; 0.80 and 0.61 very good; 0.60 and 0.41 good; 0.40 and 0.21 reasonable; 0.20 and 0.00 poor reliability¹⁵15. Bland JM, Altman DG. Statistics notes: Cronbach's alpha. BMJ. 1997;314(7080):572. doi:10.1136/bmj.314.7080.572 https://doi.org/10.1136/bmj.314.7080.572...
Inter-rater reliability	Verify if the measurements or observations made by different raters are concordant under the same conditions.
Convergence criterion validity	Verify the relationship that the instrument to be validated has with another instrument.	Correlation coefficient	Coefficient:
Convergence criterion validity			above 0.70 strong/high;
Validity of discriminant criteria	Verify the non-correlation of the instrument content to be validated with domains or non-correlated fields of other instruments.		0.40 to 0.69 moderate;
Validity of discriminant criteria			0.39 to 0.10 weak/low association¹⁶16. Andrade AL, Wachelke JFR. Estatística para quem não gosta de números. Estud Psicol. 2009;26(1):109-10. doi:10.1590/S0103-166X2009000100012 https://doi.org/10.1590/S0103-166X200900...

Etiology	n (%)	Congenital	Acquired
Retinitis Pigmentosa	13 (23%)	0	13
Glaucoma	10 (18%)	2	8
Retinal Detachment	5 (9%)	0	5
Optic Nerve Atrophy	4 (7%)	1	3
Congenital Malformation	4 (7%)	4	0
Unable to inform	4 (7%)	1	3
Injury/trauma	3 (5%)	0	3
Cancer	3 (5%)	0	3
Diabetic Retinopathy	3 (5%)	0	3
Toxoplasmosis	2 (4%)	0	2
Iatrogeny	2 (4%)	1	1
Retinopathy of Prematurity	2 (4%)	2	0
Keratoconus	1 (2%)	0	1
Total	56 (100%)	11 (20%)	45 (80%)

		IC	Test-Retest
WHODAS 2.0	n	Cronbach’s α	ICC (CI 95%)	R
Cognition	56	0.78	0.59 (0.32-0.87)	0.75*
Mobility	55	0.73	0.78 (0.58-0.99)	0.90*
Self-care	51	0.79	0.85 (0.65-0.99)	0.79*
Interpersonal Relationships	52	0.65	0.73 (0.47-0.98)	0.76*
Domestic Activities	55	0.87	0.63 (0.31-0.95)	0.73*
School or Work Activities	18	0.22	0.50 (0.02-0.98)	0.93*
Participation	55	0.74	0.63 (0.40-0.86)	0.85*
Total	16	0.88	0.73 (0.54-0.92)	0.90*

	WHODAS 2.0 - Domains
	1	2	3	4	5.1	5.2	6	Total
WHOQOL
PD	-0.44*	-0.60*	-0.33*	-0.43*	-0.40*	-0.01	-0.53*	-0.62*
PSD	-0.28*	-0.30*	-0.24	-0.48*	-0.33*	-0.02	-0.43*	-0.47*
SD	-0.18	0.03	-0.16	-0.22	-0.34*	-0.06	-0.24	-0.25
ED	-0.29*	-0.24	-0.18	-0.29*	-0.27*	-0.16	-0.34*	-0.40*
Total	-0.37*	-0.34*	-0.32*	-0.48*	-0.45*	-0.09	-0.49	-0.56*

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[1] Corresponding address: Laís Sampaio Silveira - Av. Capitão Manoel Prata, 641 - Uberaba (MG), Brazil - ZIP Code: 38022-120 - E-mail: lais_silveira_20@hotmail.com