World Health Organization Disability Assessment Schedule (WHODAS 2.0) - 12-item Version

What is the WHODAS 2.0?

The WHODAS 2.0, or the WHO Disability Assessment Schedule 2.0, is a standardized, generic assessment instrument developed by the World Health Organization (2021). It is designed to measure health and disability across diverse cultural contexts (Üstün et al., 2010). Rooted in the International Classification of Functioning, Disability, and Health (ICF), the WHODAS 2.0 reliably assesses key domains of daily functioning, including self-care, communicating and thinking skills, and participation in social activities (Federici et al., 2016; Garin et al., 2010).

This disability assessment tool is widely used by medical professionals to evaluate an individual’s health status and disability levels, making it integral to disability assessments in both clinical and research settings. WHODAS 2.0 generates a summary score, reflecting the overall impact of health conditions on an individual's ability to function. Its flexibility allows application in diverse health scenarios, including physical, neurological, and mental health evaluations.

Moreover, the World Health Organization disability assessment schedule offers two versions differing in length and mode of administration, enhancing its adaptability. Its reliability and cross-cultural validity have been established through systematic field studies, enabling consistent measurement of health and disability levels globally. WHODAS 2.0 provides valuable data for interventions by assessing the same individual's disability or health status over time, aiding clinicians and researchers in improving health outcomes and planning interventions effectively.

The 36- and 12-item WHODAS 2.0 versions

The WHODAS 2.0 comes in two versions: the 36-item version and the 12-item version, each serving different needs based on the setting and purpose of the assessment (World Health Organization, 2023). The 36-item version is the most detailed, covering six domains of functioning, including cognition, mobility, self-care, social interactions, life activities, and participation. It allows for the calculation of overall functioning and specific domain scores, making it highly effective for assessing health status and providing a comprehensive disability assessment. This version, which takes around 20 minutes to administer, is available in interviewer, self-administered, and proxy forms, enabling flexibility in assessing disability.

The 12-item version, in contrast, is a quicker, more streamlined tool ideal for surveys or brief assessments of overall functioning. It offers a snapshot of the patient’s health status, explaining 81% of the variance of the 36-item version. It is particularly useful for measuring communication and thinking activities, as well as other key areas of life. With an average interview time of just 5 minutes, it’s an efficient option for a disability assessment schedule 2.0.

Both versions can be tailored to various administration methods, including self-report and proxy assessment, making them suitable for different community activities and settings.

How does it work?

Carepatron’s WHODAS 2.0 template contains the 36-item version. It allows medical professionals to seamlessly assess a patient's health and disability status. The process is straightforward and can be completed using the app, ensuring consistency and efficiency in evaluating outcomes.

Step 1: Access and use the template

To get started, click “Use template” in the Carepatron app. This will open the WHODAS 2.0 resource where you can fill it out or make necessary customizations before printing it for the patient. The template is easily accessible and user-friendly.

Step 2: Introduce the template to the patient

When you present the WHODAS 2.0 template to the patient, explain its purpose clearly. Inform them that the assessment is designed to measure their health status and the impact of any disabilities they may experience. This ensures they understand the process and its importance.

Step 3: Discuss how the assessment works

Explain how the WHODAS 2.0 works by asking the patient to rate their level of difficulty in daily activities. Emphasize that the template covers various aspects, including self-care, communication, and mobility. This step is crucial in ensuring the patient is comfortable with the assessment process.

Step 4: Gather and interpret the results

After the patient completes the assessment, gather the responses and interpret the results. The WHODAS 2.0 provides a summary score reflecting their overall disability level. This score is vital in understanding the patient’s health condition and planning effective interventions or treatments.

Step 5: Provide further patient education and next steps

Once the assessment is complete, provide the patient with further education on their results. Discuss any interventions or next steps based on the findings, and offer guidance on managing their health and disability. This helps the patient take proactive steps towards improving their quality of life.

Scoring and interpretation

The WHODAS 2.0 uses two primary scoring methods: simple scoring and complex scoring (item-response-theory, IRT) to assess disability. The simple scoring method is straightforward, where each item response is assigned a score (none = 0, mild = 1, moderate = 2, severe = 3, extreme = 4), and the scores are summed across all domains. This method provides a quick overview of disability levels and is suitable for busy clinical settings.

For a more detailed analysis, the IRT-based scoring method is used, which accounts for the varying difficulty of each item. It assigns different weights to responses based on severity, calculating a summary score through an algorithm. This method involves summing recoded item scores within each domain, followed by the summing of all domain scores, and converting the final result into a metric from 0 to 100, where 0 represents no disability, and 100 indicates full disability. This detailed approach helps in assessing health status across various conditions, including mental and neurological disorders, providing a nuanced disability profile.

Benefits of using the WHODAS 2.0 template

The WHODAS 2.0 template offers several benefits for healthcare professionals when assessing disability and health status. As a standardized, reliable tool, it allows clinicians to evaluate functional disability across a wide range of conditions, including mental, neurological, and addictive disorders such as posttraumatic stress disorder (PTSD) and chronic diseases.

The template helps identify patients experiencing severe difficulty in areas like domestic responsibilities, mobility, and communication. Its applicability in both clinical and general population settings to measure disability makes it versatile for various healthcare environments.

Moreover, the template also provides valuable insights into the impact of interventions by measuring functional improvement over time. Occupational therapists and other healthcare professionals can use WHODAS 2.0 to track changes in functioning, comparing individual scores to general disability factor norms. This tool also helps clinicians monitor the effectiveness of treatment while offering a comprehensive view of a patient's disability status. Overall, it facilitates better decision-making and tailored treatment planning.

References

Garin, O., Ayuso-Mateos, J., Almansa, J., Nieto, M., Chatterji, S., Vilagut, G., Alonso, J., Cieza, A., Svetskova, O., Burger, H., Racca, V., Francescutti, C., Vieta, E., Kostanjsek, N., Raggi, A., Leonardi, M., & Ferrer, M. (2010). Validation of the “World Health Organization Disability Assessment Schedule, WHODAS-2” in patients with chronic diseases. Health and Quality of Life Outcomes (Health Qual Life Outcomes), 8(1), 51. https://doi.org/10.1186/1477-7525-8-51

Federici, S., Bracalenti, M., Meloni, F., & Luciano, J. V. (2016). World Health Organization disability assessment schedule 2.0: An international systematic review. Disability and Rehabilitation, 39(23), 2347–2380. https://doi.org/10.1080/09638288.2016.1223177

Üstün, T. B., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J., Saxena, S., von Korff, M., & Pull, C. (2010). Developing the World Health Organization Disability Assessment Schedule 2.0. Bulletin of the World Health Organization (Bull World Health Organ), 88(11), 815–823. https://doi.org/10.2471/blt.09.067231

World Health Organization. (2012, June 16). Measuring health and disability: Manual for WHO Disability Assessment Schedule (WHODAS 2.0). https://www.who.int/publications/i/item/measuring-health-and-disability-manual-for-who-disability-assessment-schedule-(-whodas-2.0)

World Health Organization. (2023). WHO Disability Assessment Schedule (WHODAS 2.0). https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health/who-disability-assessment-schedule