Validation of the World Health Organization Disability Assessment Schedule 2.0 in adults with spinal cord injury in Taiwan

Study design: Psychometric study including exploratory factor analysis and Rasch analysis. Objective: The aim of the present study was to examine the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in terms of its dimensionality and metric properties in a sample of people with spinal cord injury (SCI). Setting: Two hundred and thirty-nine hospitals in Taiwan Methods: Secondary analysis of cross-sectional data from the National Disability Determination System in Taiwan, including data of individuals with more than 1-year chronic spinal cord injury and over 18 years of age. We would ask the all 6 domains of WHODAS 2.0, except those participants who were not working in present, based on the WHODAS 2.0 manual. Results: Data from 521 persons were included. The internal consistency of WHODAS 2.0 was high for all six domains (Cronbach’s α between 0.87–0.99). The exploratory factor analysis supported the original six domain structure of WHODAS 2.0 to a large extent. Rasch analysis provided domain scores usable for measurement at the individual level and an overall WHODAS 2.0 score that takes into account the multidimensionality of the instrument. Conclusions: WHODAS 2.0 provides a reliable and valid instrument to measure relevant aspects of “activity and participation” in the context of functioning in people with SCI in Taiwan and may guide their rehabilitation.