Validation of the WHO Disability Assessment Schedule (WHODAS 2.0) 12-item tool against the 36-item version for measuring functioning and disability associated with pregnancy and history of severe maternal morbidity

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Abstract
Objective To validate the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) 12‐item tool against the 36‐item version for measuring functioning and disability associated with pregnancy and the occurrence of maternal morbidity. Methods This is a secondary analysis of the Brazilian retrospective cohort study on long‐term repercussions of severe maternal morbidity (SMM) among women who delivered at a tertiary facility (COMMAG study). We compared WHODAS‐12 and WHODAS‐36 scores of women with and without SMM using measures of central tendency and variability, tests for instruments’ agreement (Bland‐Altman plot), confirmatory factor analysis (CFA), and Cronbach alpha coefficient for internal consistency. Results The COMMAG study enrolled 638 women up to 5 years postpartum. Although the median WHODAS‐36 and ‐12 scores for all women were statistically different (13.04 and 11.76, respectively; P<0.001), there was a strong linear correlation between them. Furthermore, the mean difference and the differences in variance analyses demonstrated agreement of total scores between the two versions. CFA demonstrated how the WHODAS‐12 questions are divided into six previously defined factors and Cronbach alpha showed good internal consistency. Conclusion WHODAS‐12 demonstrated agreement with WHODAS‐36 for total score and was a good instrument for screening functioning and disability among postpartum women, with and without SMM.
Funding Information
  • Brazilian National Research Council (471142/2011-5)
  • Bill and Melinda Gates Foundation
  • Human Reproduction Programme WHO

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