The World Health Organization Disability Assessment Schedule as an evaluative tool for chronic traumatic brain injury
Compared to other types of injury, traumatic brain injury (TBI) tends to cause the most severe health issues and long-term negative physical and mental outcomes. In the months and years after TBI, people may experience physical impairments, cognitive and emotional deficits, and difficulties carrying out daily routines and work schedules. As a result, it is important for clinicians to accurate assess patients’ needs in the recovery period so that they can develop targeted treatment plans. The World Health Organization Disability Assessment Schedule (WHODAS 2.0) may provide a standardized, universal tool for evaluating patient outcomes in the TBI recovery period.
To examine the usability of WHODAS 2.0 as a tool for patients with TBI, a group of researchers in Finland administered the assessment to 112 patients who sustained TBI. Because the consequences of TBI can also affect patients’ loved ones, the participants’ significant others also completed WHODAS 2.0. As part of the assessment, the participants answered questions about household tasks, concentration, social life, ability to work, and emotional functioning. After analyzing the results of the assessment, the researchers found that:
- Participants with severe TBI experienced more difficulties in functioning and their ability to work than participants with moderate or mild TBI.
- Those with severe TBI also had more trouble walking, washing themselves, and getting dressed.
- All of the participants, regardless of TBI severity, reported a higher level of emotional impairment than their clinicians reported during medical evaluations. Clinicians were more likely to rate that their patients were physically compromised rather than emotionally impaired.
Participants’ self-ratings with the WHODAS 2.0 tool reveal that people who sustain TBI may experience difficulties completing everyday tasks, maintaining a healthy work and social life, and regulating emotions. Those with severe TBI may be at particular risk for disruptions to daily routines. Importantly, WHODAS 2.0 provides patients and their loved ones with an opportunity to self-report their own experiences, which may not be captured by clinicians’ medical evaluations. In combination with clinical assessments, WHODAS 2.0 is a promising metric for evaluating patient needs and providing clinicians with information about patient needs during the TBI recovery period.
Tarvonen-Schröder S, Tenuovo O, Kaljonen A, et al. Usability of World Health Organization Disability Assessment Schedule in chronic traumatic brain injury. Journal of Rehabilitation Medicine. (May 2018).