Purpose: Road traffic injuries (RTIs) are a leading cause of disability in low- and middle-income countries. This study assesses the psychometric properties of 12-item World Health Organization Disability Assessment Schedule (WHODAS) 2.0 among patients with orthopedic injuries from road traffic crashes in Bangladesh across two timepoints after hospital discharge.
Materials and methods: Confirmatory factor analysis (CFA) assessed WHODAS 2.0 construct validity and investigated measurement invariance among a sample of RTI patients at an orthopedic hospital one month and three months post-discharge. Cronbach's alpha measured reliability.
Results: A single-factor structure was identified in CFA for the one-month sample (χ2(53)=894.337, p < 0.001; CFI = 0.989, TLI = 0.986; SRMR = 0.052, RMSEA = 0.151) and the three-month sample (χ2(53)=630.119, p < 0.001; CFI = 1.000, TLI = 1.000; SRMR = 0.022, RMSEA = 0.130). Measurement invariance was supported, and internal consistency was excellent (α > 0.9) at each timepoint. Mean disability score decreased from 37.89 (out of 48, SD = 10.44) one-month post-discharge to 27.19 (SD = 18.10, p < 0.001) three months post-discharge indicating improvement in functional status over time.
Conclusions: WHODAS 2.0 is valid and reliable for measuring disability among patients with RTIs in Bangladesh and has validity for making meaningful comparisons in disability level over time. Future research should include samples with different types of RTIs to strengthen the evidence supporting the use of the instrument.
Keywords: Bangladesh; Road traffic injuries; WHODAS 2.0; disability assessment; measurement invariance; orthopedic injuries; psychometric properties.
Measuring disability among survivors of non-fatal RTIs is necessary to inform tailored rehabilitation services that can reduce the burden of RTIs and facilitate patient recovery and return to pre-injury usual activities.The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 12-item short form is a valid and reliable tool to measure disability among patients with moderate to severe road traffic injuries in Bangladesh.Measurement invariance of the Bengali version of the 12-item WHODAS 2.0 suggests that patients with road traffic injuries interpret the construct of disability and the items in the instrument similarly at different timepoints.WHODAS 2.0 can be used to evaluate the effectiveness of follow-up medical rehabilitation services aimed at improving functional status among patients with orthopedic injuries.