Tests of measurement invariance.

BackgroundThere is limited evidence on the reliability and validity of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in an Asian patient population with mental and physical disorders. The current study aimed to examine the psychometric properties of the WHODAS 2.0 among patients with schizophrenia, depression, anxiety, and diabetes.MethodsA total of 1076 patients (M  =  40.9 years, SD  =  14.7) were recruited from the outpatient clinics of a tertiary psychiatric hospital and a primary care clinic. Internal consistency and test-retest reliability, structural validity, convergent validity, agreement, and floor and ceiling effects were examined.ResultsOur confirmatory factor analysis (CFA) showed that the 1-factor model fits our data. Multigroup CFA demonstrated metric and scalar invariance, indicating the scores can be compared across the four conditions. The WHODAS 2.0 scale had excellent reliability in the overall sample and good to excellent reliability across conditions. The test-retest reliability and agreement between self-administered and interviewer-administered modes were good. The WHODAS 2.0 scores had moderate to strong correlations with the Social and Occupational Functioning Scale and the Sheehan Disability Scale scores in the overall sample and across four conditions.ConclusionFindings suggest that the WHODAS 2.0 is a valid tool to measure functioning and disability in those with schizophrenia, anxiety, depression, and diabetes in an Asian patient population.

背景：关于世界卫生组织残疾评估量表2.0（WHODAS 2.0）在亚洲患有身心疾病的患者群体中的可靠性和有效性，现有证据有限。本研究旨在评估WHODAS 2.0在精神分裂症、抑郁症、焦虑症和糖尿病患者群体中的心理测量学特性。方法：共招募了1076名患者（平均年龄40.9岁，标准差14.7），他们来自一家三级精神卫生医院的门诊部和一家初级保健诊所。对内部一致性、重测信度、结构效度、收敛效度、一致性以及地板效应和天花板效应进行了考察。结果：我们的验证性因子分析（CFA）表明，一因子模型与我们的数据拟合良好。多组CFA显示测量不变性和标度不变性，表明得分可以跨四种条件进行比较。WHODAS 2.0量表在总体样本和各条件下的信度均表现出色。自我报告和访谈员报告模式之间的重测信度和一致性良好。WHODAS 2.0得分与总体样本及四种条件下的社会职业功能量表和Sheehan残疾量表得分具有中到强的相关性。结论：研究结果提示，WHODAS 2.0是一种有效的工具，可用于测量亚洲患者群体中患有精神分裂症、焦虑症、抑郁症和糖尿病者的功能状态及残疾程度。