Description

The World Health Organization Disability Assessment Schedule (WHODAS 2.0) is a standardized self-report assessment instrument developed by the World Health Organization (WHO) to evaluate functioning and disability. It is based on the conceptual framework of the International Classification of Functioning, Disability and Health (ICF), which adopts a biopsychosocial approach to describe individual functioning and limitations.

According to the ICF framework, disability is not defined solely by the presence of a disease or health condition, but by the interaction between health status, personal characteristics, environmental factors, and the individual’s ability to participate in everyday life.

Objective

The primary objective of the WHODAS 2.0 is to provide a general measure of functioning and disability and to assess the impact of health-related conditions on daily life activities.

The scale collects information regarding difficulties experienced by individuals due to various health conditions, including diseases, chronic or temporary health problems, injuries, psychological or emotional difficulties, and problems related to alcohol or substance use.

The WHODAS 2.0 can be applied across different populations regardless of diagnosis, making it a universal instrument for assessing disability and functional limitations.

Structure and Content

The WHODAS 2.0-36 consists of 36 items organized into six domains of functioning:

Cognition and Communication: Evaluates difficulties related to understanding, learning, concentrating, remembering, and communicating.

Mobility: Assesses difficulties related to standing, moving around, and physical mobility.

Self-Care: Examines the ability to maintain personal hygiene, dressing, eating, and independent functioning.

Getting Along with Others: Evaluates interpersonal relationships, social interactions, and communication with other people.

Life Activities: Assesses difficulties in daily activities, including household responsibilities, work, and educational activities.

Participation in Society: Examines involvement in social activities and the impact of health conditions on participation in community and social life.

Scoring Method

The WHODAS 2.0 uses a 5-point Likert scale for responses, ranging from:

1 = No difficulty

to

5 = Extreme difficulty or inability to perform the activity.

Participants indicate the degree of difficulty they experienced while performing the activities during the previous 30 days.

The total score is converted into a standardized scale ranging from 0 to 100, where:

0 indicates no disability

and

100 indicates complete disability.

Higher scores represent greater functional limitations and increased disability.

Data Analysis and Use

The WHODAS 2.0 provides information regarding the level of difficulty individuals experience in daily activities and social participation.

All participants complete the questionnaire, except for specific items of the Life Activities domain, which are completed only by individuals who are employed or students.

The collected data can be analysed to evaluate:

the overall level of disability,

differences in functioning between population groups,

relationships between disability and health-related variables,

and changes in functioning following interventions.

Statistical analyses may include descriptive statistics, comparisons between groups, correlation analyses, and evaluation of psychometric properties.

Validity and Reliability

The WHODAS 2.0 demonstrates excellent psychometric properties and has been validated internationally across different cultural and clinical populations.

The Greek translation was developed by Koumbouros, Sakellari, Papageorgiou, and Lagiou.

Validity studies have shown that the instrument performs well in comparison with other disability and health-status assessment tools, as well as with clinical evaluations and related functional assessments.

The internal consistency of the WHODAS 2.0 is exceptionally high. For the six domains, Cronbach’s alpha coefficients range from 0.94 to 0.96, while the total WHODAS score demonstrates an overall reliability coefficient of α = 0.98.

Applications

The WHODAS 2.0 can be applied in clinical practice, rehabilitation programmes, epidemiological studies, public health research, and evaluation of healthcare interventions.

It is particularly useful for assessing disability independently of diagnosis, monitoring changes in functioning over time, evaluating treatment outcomes, and supporting decisions regarding healthcare and social support needs.

References

World Health Organization (WHO). WHO Disability Assessment Schedule 2.0 (WHODAS 2.0).

Koumbouros, I., Sakellari, E., Papageorgiou, E., & Lagiou, A. Greek Translation of WHODAS 2.0.