Initial assessment of rehabilitation needs using the WHODAS 2.0 in Estonia.

Abstract

Given the growing number of people with disabilities in Estonia, an initial rehabilitation needs assessment instrument that included the World Health Organization Disability Assessment Schedule (WHODAS 2.0) was developed and tested to determine its feasibility in assessing social rehabilitation needs. WHODAS 2.0 items were complemented with questions about the nature of disability-related problems with regard to personal, social and environmental aspects of functioning. Four rehabilitation specialists assessed 101 persons' needs in face-to-face interviews. Data were analyzed using descriptive statistics and thematic analysis. The comprehensive initial assessment instrument tested was sufficiently informative to assess functioning and identify social rehabilitation and other social needs. Participants had difficulty in understanding some WHODAS 2.0 items, and coding and scoring respondents' answers using WHODAS 2.0 frames of reference proved challenging for interviewers. The WHODAS 2.0 is mainly related to health conditions. Complementing it with questions about the nature and severity of the difficulties social rehabilitation service applicants experienced added essential information for planning interventions. A well conceived, holistic initial assessment that addresses biological, psychological, sociocultural and environmental factors can provide substantial information for targeting services to meet a person's rehabilitation needs. The WHODAS 2.0 is a useful framework for conducting initial assessments, but since it focuses on health needs, supplementing it with additional items about personal, social and environmental factors may be necessary to address services needs from social, vocational and other rehabilitation perspectives. Rehabilitation specialists must be well prepared to use the WHODAS 2.0 and conduct the overall assessment, including providing clear instructions and support to applicants applying for services.