Validation of the WHODAS 2.0 (36-item) in people recovering from COVID-19 infection
Danielle Hitch1,2, Cathy Said2,3, Elizabeth Hibbert2, Kelli Nicola-Richmond1, Western Health COVID-19 Collaboration2 1Deakin University, Geelong, Victoria, Australia2Western Health, St. Albans, Victoria, Australia 3University of Melbourne, Parkville, Victoria, Australia
Abstract
Background: Valid and reliable outcome measures are urgently needed to understand the impact of COVID-19 on daily life and evaluate the effectiveness of rehabilitation for Australians recovering from COVID-19 infection. This is particularly true for people experiencing Long COVID, which experience significant and sustained disability.
Aim: To establish the measurement properties of the World Health Organisation Disability Assessment Schedule 2.0 (WHODAS) with people recovering from COVID-19.
Method: The WHODAS 2.0 (36 items), vitality scale of the SF-36 and a self-rated 5-point recovery scale were completed by 412 Australians recovering from COVID-19. Appropriate statistical tests for each psychometric property were employed to measure internal consistency (intra-class correlations), convergent and divergent validity (correlation), floor and ceiling effects (frequencies) and known-group validity (t-tests).
Results: Total WHODAS (36 items) scores achieved excellent internal consistency (ICC 0.975 [CI 0.968 – 0.982]) and were closely correlated with self-rated recovery (r=0.804, p<0.001) and SF-36 Vitality scores (r=-0.719, p<0.001). There were no floor or ceiling effects on the total WHODAS score. However, floor effects were found on the Self-Care (43.2%) and Getting Along (27.2%) sub-scales. Significantly different functional profiles were identified between people experiencing no, mild, or clinically significant disability after COVID-19 infection on the total WHODAS score (F=322.959, df = 2, p<0.001) and all sub-scales. Significantly different functional profiles were also identified in relation to time since acute COVID-19 infection (F=5.445, df = 5, p<0.001). Conclusion: This study confirms that the WHODAS is a valid measure of function and disability for people recovering from COVID-19.
Biography
Dr. Danielle Hitch is the leader of the Western Health COVID-19 Collaboration, which is a multidisciplinary partnership of academics, clinicians and lived consumers. She is an occupational therapist and health economist.