Development and validation of World Health Organization Assessment Schedule 2.0 for persons with disabilities having community rehabilitation services in Hong Kong.

Abstract

The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a generic instrument aligned with the International Classification of Functioning, Disability and Health (ICF). Existing Chinese versions are not fully applicable to the Hong Kong sociolinguistic context. This study aimed to translate, culturally adapt, and preliminarily evaluate the psychometric properties of a Hong Kong Traditional Chinese version of WHODAS 2.0 (WHODAS 2.0 TC-HK). WHODAS 2.0 was translated using forward-backward procedures. A convenience sample of 177 adults with disabilities receiving community rehabilitation services completed WHODAS 2.0 TC-HK, the SF-36 TC-HK, and WHOQOL-BREF TC-HK. Internal consistency, test-retest reliability, convergent and concurrent validity were examined. Construct validity was explored using confirmatory factor analysis (CFA) based on the original six-domain model. Internal consistency was good across domains (Cronbach's α = 0.86-0.89). Test-retest reliability was moderate to good (ICC = 0.59-0.87). WHODAS 2.0 TC‑HK showed moderate negative correlations with SF‑36 TC‑HK and WHOQOL‑BREF TC‑HK domains, supporting convergent and concurrent validity. Confirmatory factor analysis of the 32‑item version demonstrated suboptimal model fit, indicating only partial support for the original factor structure. WHODAS 2.0 TC‑HK demonstrates good reliability and acceptable convergent and concurrent validity among adults receiving community rehabilitation services in Hong Kong. However, structural validity of the instrument remains preliminary and requires further investigation in larger and more diverse samples, particularly for the complete 36‑item version.