RESUMO
INTRODUCTION: The aim of the present study was to report on the prevalence of disability and its association with sociodemographic factors among welfare benefit applicants in Greece. The study also compared the disability scores between different health conditions using the WHODAS 2.0 (12-item version), a biopsychosocial-model-based measure. METHODS: The Greek WHODAS 2.0, 12-item version, was administered by interview. A three-member medical committee assessed the medical records of the applicants and assigned a disability percentage based on the biomedical measure of disability percentage determination (Barema scale). RESULTS: The majority of the participants were female (56.65%). Certain health conditions were presented more frequently among welfare benefit applicants (mental health disorders and neoplasms). The domains with the highest rate of difficulty were the "participation" and "life activities" domains. Significant differences were found between WHODAS 2.0 and Barema scores for all eight different health condition categories. The factorial ANOVA (8x2) showed a significant interaction effect between health condition category and gender with respect to the WHODAS 2.0 score (F = 19.033, p <.001, η2 = 0.13). The WHODAS 2.0 score was negatively correlated to gender, years of studies, and marital status and positively correlated to age, working status, and the Barema score. The results revealed that male participants with a partner who were younger, had more studies, were actively working, and had a lower Barema score would have lower WHODAS scores. CONCLUSION: Sociodemographic characteristics of welfare benefit applicants are associated with disability levels based on WHODAS 2.0. Certain health conditions, like mental health or neuromusculoskeletal conditions, are associated with higher disability scores. There are differences between the biopsychosocial and the biomedical approaches to disability assessment. The implementation of WHODAS 2.0 may contribute to a better understanding of the lived experience of patients and is a feasible and efficient tool. Combining biomedical and biopsychosocial approaches may enhance the procedures of disability assessment and help in the development of policies that support people with disabilities.
RESUMO
INTRODUCTION: The International Classification of Functioning, Disability, and Health (ICF) provides a framework for the biopsychosocial model of disability and was developed by the World Health Organization (WHO). The World Health Organization Disability Assessment Schedule (WHODAS 2.0) is an ICF-based tool that measures health and disability at the population level or in clinical practice. The aim of the study was to examine the psychometric properties of the Greek version of the WHODAS 2.0 (12-item) administered to 10,163 adults who had applied for welfare benefits in three regions of Greece. METHODS: The WHODAS 2.0, administered by interview was the primary outcome variable. Principal axis factoring (PAF) and confirmatory factor analysis (CFA) assessed the data fit to the model (construct validity). The correlation between Barema disability percentage (assessed by a three-member medical committee) and WHODAS 2.0 score and the correlation between WHODAS 2.0 score and the number of comorbidities were also examined (concurrent validity). Cronbach's alpha was used to assess the internal consistency of the questionnaire. Floor and ceiling effects were also examined. RESULTS: Internal consistency was acceptable (Cronbach's alpha=0.918). A significant association was found between Barema disability percentage and the WHODAS 2.0 score. Factor analysis showed a clear two-factor solution (PAF and CFA), while no floor or ceiling effects were evident. CONCLUSION: The Greek version of the 12-item WHODAS 2.0 was found to be reliable and valid in a wide sample of applicants for welfare benefits.
