Development of the Global Disability Scale (Glo.Di.S): preliminary results

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Abstract

Background

The assessment of functioning and disability is an important part of the clinical evaluation, since it measures disease burden and reflects the effectiveness of therapeutic planning and interventions. The aim of the current study was to develop such a self-report instrument on the basis of a review of the literature, and compatible with the WHO approach.

Material and methods

The review of the literature led to the development of the Global Disability Scale (Glo.Di.S) with 25 items assessing different aspects of disability. The study sample included 728 persons from vulnerable populations (homeless, jobless, very low income, single parent families etc.; (29.12% males and 70.88% females; aged 55.96 ± 15.22 years). The protocol included also the STAI and the CES-D. The statistical analysis included factor analysis item analysis and ANCOVA.

Results

The factor analysis revealed the presence of 4 factors explaining 71% of total variance (Everyday functioning, Social and interpersonal functioning, Severity and Mental disability). Chronbach’s alpha for the whole scale was 0.95 and for subscales were 0.74–0.94.

Discussion

The results of the current study suggest that the Glo.Di.S. has the potential to serve as a reliable and valid tool for assessing functioning and disability. Further research is needed to prove that it could be useful across countries, populations and diseases, and whether it provides data that are culturally meaningful and comparable. It can be used in surveys and in clinical research settings and it can generate information of use in evaluating health needs and the effectiveness of interventions to reduce disability and improve health.

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Validation of the "World Health Organization Disability Assessment Schedule, WHODAS-2" in patients with chronic diseases

Olatz Garin, Jose Ayuso-Mateos, Josué Almansa … (2010)

Background The WHODAS-2 is a disability assessment instrument based on the conceptual framework of the International Classification of Functioning, Disability, and Health (ICF). It provides a global measure of disability and 7 domain-specific scores. The aim of this study was to assess WHODAS-2 conceptual model and metric properties in a set of chronic and prevalent clinical conditions accounting for a wide scope of disability in Europe. Methods 1,119 patients with one of 13 chronic conditions were recruited in 7 European centres. Participants were clinically evaluated and administered the WHODAS-2 and the SF-36 at baseline, 6 weeks and 3 months of follow-up. The latent structure was explored and confirmed by factor analysis (FA). Reliability was assessed in terms of internal consistency (Cronbach's alpha) and reproducibility (intra-class correlation coefficients, ICC). Construct validity was evaluated by correlating the WHODAS-2 and SF-36 domains, and comparing known groups based on the clinical-severity and work status. Effect size (ES) coefficient was used to assess responsiveness. To assess reproducibility and responsiveness, subsamples of stable (at 6 weeks) and improved (after 3 moths) patients were defined, respectively, according to changes in their clinical-severity. Results The satisfactory FA goodness of fit indexes confirmed a second order factor structure with 7 dimensions, and a global score for the WHODAS-2. Cronbach's alpha ranged from 0.77 (self care) to 0.98 (life activities: work or school), and the ICC was lower, but achieved the recommended standard of 0.7 for four domains. Correlations between global WHODAS-2 score and the different domains of the SF-36 ranged from -0.29 to -0.65. Most of the WHODAS-2 scores showed statistically significant differences among clinical-severity groups for all pathologies, and between working patients and those not working due to ill health (p < 0.001). Among the subsample of patients who had improved, responsiveness coefficients were small to moderate (ES = 0.3-0.7), but higher than those of the SF-36. Conclusions The latent structure originally designed by WHODAS-2 developers has been confirmed for the first time, and it has shown good metric properties in clinic and rehabilitation samples. Therefore, considerable support is provided to the WHODAS-2 utilization as an international instrument to measure disability based on the ICF model.

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Assessing psychiatric impairment in primary care with the Sheehan Disability Scale.

Megan León, D Sheehan, Donna Farber … (1996)

Several recent studies have documented that substantial functional impairment is associated with many of the mental disorders seen in primary care. However, brief measures of mental health-related functional impairment are not commonly applied in primary care settings. The Sheehan Disability Scale (SDS), a three-item instrument for assessing such impairment, is evaluated in this study. A psychometric analysis of the SDS was conducted with a sample of 1001 primary care patients at Kaiser Permanente In Oakland, California. The SDS and the Symptom Driven Diagnostic System for Primary Care assessments were completed. The internal consistency reliability of the SDS is high, with coefficient alpha of 0.89. The construct validity was substantiated in two ways. A one-factor model fit the data quite well. Furthermore, patients with each of six psychiatric disorders had significantly higher impairment scores than those who did not. Finally, over 80 percent of the patients with mental disorder diagnoses had an elevated SDS score and nearly 50 percent of those with elevated SDS scores had at least one disorder. The psychometric properties of the SDS were evaluated in primary care. The internal consistency reliability was high. The analyses also lend empirical support for the construct validity. The scale is a sensitive tool for identifying primary care patients with mental health-related functional impairment, who would warrant a diagnostically-oriented mental health assessment.

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Reliability and psychometric properties of the Greek translation of the State-Trait Anxiety Inventory form Y: Preliminary data

Konstantinos N Fountoulakis, Marina Papadopoulou, Soula Kleanthous … (2006)

Background The State-Trait Anxiety Inventory form Y is a brief self-rating scale for the assessment of state and trait anxiety. The aim of the current preliminary study was to assess the psychometric properties of its Greek translation. Materials and methods 121 healthy volunteers 27.22 ± 10.61 years old, and 22 depressed patients 29.48 ± 9.28 years old entered the study. In 20 of them the instrument was re-applied 1–2 days later. Translation and Back Translation was made. The clinical diagnosis was reached with the SCAN v.2.0 and the IPDE. The Symptoms Rating Scale for Depression and Anxiety (SRSDA) and the EPQ were applied for cross-validation purposes. The Statistical Analysis included the Pearson Correlation Coefficient and the calculation of Cronbach's alpha. Results The State score for healthy subjects was 34.30 ± 10.79 and the Trait score was 36.07 ± 10.47. The respected scores for the depressed patients were 56.22 ± 8.86 and 53.83 ± 10.87. Both State and Trait scores followed the normal distribution in control subjects. Cronbach's alpha was 0.93 for the State and 0.92 for the Trait subscale. The Pearson Correlation Coefficient between State and Trait subscales was 0.79. Both subscales correlated fairly with the anxiety subscale of the SRSDA. Test-retest reliability was excellent, with Pearson coefficient being between 0.75 and 0.98 for individual items and equal to 0.96 for State and 0.98 for Trait. Conclusion The current study provided preliminary evidence concerning the reliability and the validity of the Greek translation of the STAI-form Y. Its properties are generally similar to those reported in the international literature, but further research is necessary.

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Author and article information

Journal

Journal ID (nlm-ta): Ann Gen Psychiatry

Journal ID (iso-abbrev): Ann Gen Psychiatry

Title: Annals of General Psychiatry

Publisher: BioMed Central

ISSN (Electronic): 1744-859X

Publication date Collection: 2012

Publication date (Electronic): 17 May 2012

Volume: 11

Page: 14

Affiliations

[1 ]Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Pylaia 55535, Greece

[2 ]Lab of Medical Informatics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

[3 ]Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

Article

Publisher ID: 1744-859X-11-14

DOI: 10.1186/1744-859X-11-14

PMC ID: 3434028

PubMed ID: 22594786

SO-VID: 70b56036-eb17-4cdf-b434-ba8a370c7209

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Development of the Global Disability Scale (Glo.Di.S): preliminary results

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Abstract

Background

Material and methods

Results

Discussion

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Journal of Disability Research

Most cited references 76

Validation of the "World Health Organization Disability Assessment Schedule, WHODAS-2" in patients with chronic diseases

Assessing psychiatric impairment in primary care with the Sheehan Disability Scale.

Reliability and psychometric properties of the Greek translation of the State-Trait Anxiety Inventory form Y: Preliminary data

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