Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20230091-en
Brazilian Journal of Pain
Original Article

Validation of the Brazilian version of the World Health Organization Disability Assessment Schedule in women with chronic pelvic pain

Validação da versão brasileira do World Health Organization Disability Assessment Schedule em mulheres com dor pélvica crônica 

Gleiciane Aguiar Brito; Natany Santos Martins; Isabella Parente Ribeiro Frota; Mayle Andrade Moreira; Simony Lira do Nascimento

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Abstract

BACKGROUND AND OBJECTIVES: Chronic pelvic pain (CPP) is a persistent pain perceived in structures related to the pelvis. It is often associated with negative functioning consequences that generate disability. There are currently no validated tools in the literature for measuring functioning according to the theoretical-conceptual model presented by the International Classification of Functioning, Disability and Health (ICF) for patients with CPP. The objective of this study was to test the measurement properties of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) for women with CPP.
METHODS: This is a validation study. The auxiliary instruments used in the validation process of the WHODAS 2.0 were: the 12-item Short-Form Health Survey (SF-12), the Numerical Pain Rating Scale, and a form with sociodemographic and clinical data. Internal consistency was analyzed using Cronbach's alpha coefficient, construct validity was assessed using Spearman's correlation coefficient, discriminative validity was analyzed using the analysis of variance, and test-retest reliability was analyzed using the Intra-class Correlation Coefficient (ICC).
RESULTS: The study included 128 women with CPP. Reliability analysis showed satisfactory results in terms of internal consistency (a=0.71 to 0.94) and excellent in test-retest reliability (IIC= 0.69 to 0.91). Validity analysis showed a strong to moderate correlation in construct validity between the total WHODAS score and the physical (rho=0.7, p<0.001) and mental components of the SF-12 (rho-0.67, p<0.0001), and statistically significant values for discriminative validity according to pain intensity in the last 30 days.
CONCLUSION: The WHODAS 2.0 instrument proved to be a reliable and valid questionnaire for investigating the functioning and disability of women with CPE

Keywords

Disability and health, International Classification of Functioning, Pelvic pain, Validation study

Resumo

JUSTIFICATIVA E OBJETIVOS: A dor pélvica crônica (DPC) é uma dor persistente percebida em estruturas relacionadas à pelve. Está frequentemente associada a consequências negativas que geram incapacidade, entretanto, atualmente não existem ferramentas validadas para medir a funcionalidade segundo a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) em pacientes com DPC. O objetivo deste estudo foi testar as propriedades de medida do World Health Organization Disability Assessment Schedule (WHODAS 2.0) para mulheres com DPC. 
MÉTODOS: Trata-se de um estudo de validação. Os instrumentos utilizados no processo de validação do WHODAS 2.0 foram: o 12-item Short-Form Health Survey (SF-12), a Escala Numérica da Dor e um formulário com dados sociodemográficos e clínicos. A consistência interna foi analisada pelo coeficiente alfa de Cronbach, a validade de construto foi avaliada pelo coeficiente de correlação de Spearman, a validade discriminativa foi analisada pela Análise de Variância e a confiabilidade teste-reteste foi analisada pelo coeficiente de correlação intraclasse (ICC). 
RESULTADOS: O estudo incluiu 128 mulheres com DPC. As análises de confiabilidade mostraram resultados satisfatórios em termos de consistência interna (a=0,71 a 0,94) e excelentes na confiabilidade teste-reteste (ICC=0,69 a 0,91). As análises de validade mostraram uma correlação forte a moderada na validade de construto entre o escore WHODAS total e os componentes físicos (rho=0,7, p<0,001) e mentais do SF-12 (rho=0,67, p<0,0001) e valores significativos para validade discriminativa de acordo com a intensidade da dor nos últimos 30 dias.
CONCLUSÃO: O instrumento WHODAS 2.0 mostrou-se um questionário confiável e válido para investigar a funcionalidade de mulheres com DPC.

Palavras-chave

Classificação Internacional de Funcionalidade, Dor pélvica, Estudo de validação, Incapacidade e saúde

References

1 Chronic Pelvic Pain: ACOG Practice Bulletin, Number 218. Obstet Gynecol. 2021;135(3):e98-109.

2 Zondervan KT, Yudkin PL, Vessey M P, Jenkinson C P, Dawes MG, Barlow DH, Kennedy SH. The community prevalence of chronic pelvic pain in women and associated illness behaviour. Br J Gen Pract. 2001;51(468):541-7.

3 Ahangari A. Prevalence of chronic pelvic pain among women: an updated review. Pain Physician. 2014;17(2):E141-7.

4 Ayorinde AA, Macfarlane GJ, Saraswat L, Bhattacharya S. Chronic pelvic pain in women: an epidemiological perspective. Womens Health (Lond). 2015;11(6):851-64.

5 Silva G P, Nascimento AL, Michelazzo D, Alves Junior F F, Rocha MG, Silva JC, Reis FJ, Nogueira AA, Poli Neto OB. High prevalence of chronic pelvic pain in women in Ribeirão Preto, Brazil and direct association with abdominal surgery. Clinics (Sao Paulo). 2011;66(8):1307-12.

6 Coelho LS, Brito LM, Chein MB, Mascarenhas TS, Costa J P, Nogueira AA, Poli-Neto OB. Prevalence and conditions associated with chronic pelvic pain in women from São Luís, Brazil. Braz J Med Biol Res. 2014;47(9):818-25.

7 Nnoaham KE, Hummelshoj L, Webster P, d’Hooghe T, de Cicco Nardone F, de Cicco Nardone C, Jenkinson C, Kennedy SH, Zondervan KT; World Endometriosis Research Foundation Global Study of Women’s Health consortium. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril. 2011;96(2):366-73.e8.

8 Fourquet J, Báez L, Figueroa M, Iriarte RI, Flores I. Quantification of the impact of endometriosis symptoms on health-related quality of life and work productivity. Fertil Steril. 2011;96(1):107-12.

9 Soliman AM, Coyne KS, Gries KS, Castelli-Haley J, Snabes MC, Surrey ES. The effect of endometriosis symptoms on absenteeism and presenteeism in the workplace and at home. J Manag Care Spec Pharm. 2017;23(7):745-54.

10 Fontes AP, Fernandes AA, Botelho MA. Funcionalidade e incapacidade: aspectos conceptuais, estruturais e de aplicaão da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). Rev Port Saude Publica. 2010;28(2):171-8.

11 Castro SS, Leite C F. Saúde e Deficiência Manual do WHO Disability Assessment Schedule. In: Organização Mundial da Saúde. 3rd ed. 2015. 90p.

12 WHO. Measuring health and disability : manual for WHO Disability Assessment Schedule (WHODAS 2.0)/edited by Üstün TB, Kostanjsek N, Chatterji S. J Rehm. World Health Organization. 2010;2023;21. Available from: https://apps.who.int/iris/handle/10665/43974.

13 Carlozzi NE, Kratz AL, Downing NR, Goodnight S, Miner JA, Migliore N, Paulsen JS. Validity of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in individuals with Huntington disease (HD). Qual Life Res. 2015;24(8):1963-71.

14 Guilera G, Gómez-Benito J, Pino O, Rojo JE, Cuesta MJ, Martínez-Arán A, Safont G, Tabarés-Seisdedos R, Vieta E, Bernardo M, Crespo-Facorro B, Franco M, Rejas J. Utility of the World Health Organization Disability Assessment Schedule II in schizophrenia. Schizophr Res. 2012;138(2-3):240-7.

15 Schlote A, Richter M, Wunderlich MT, Poppendick U, Möller C, Schwelm K, Wallesch C W. WHODAS II with people after stroke and their relatives. Disabil Rehabil. 2009;31(11):855-64.

16 Garin O, Ayuso-Mateos JL, Almansa J, Nieto M, Chatterji S, Vilagut G, Alonso J, Cieza A, Svetskova O, Burger H, Racca V, Francescutti C, Vieta E, Kostanjsek N, Raggi A, Leonardi M, Ferrer M; MHADIE consortium. Validation of the “World Health Organization Disability Assessment Schedule, WHODAS-2” in patients with chronic diseases. Health Qual Life Outcomes. 2010;19;8:51.

17 Smedema SM, Yaghmaian RA, Ruiz D, Muller V, Umucu E, Chan F. Psychometric validation of the world health organization disability assessment schedule 2.0-12-item Version in persons with fibromyalgia syndrome. J Rehabil. 2016;82(3):28-35.

18 Barbosa KSS, Castro SS, Leite C F, Nacci FR, Accioly M F. Validation of the Brazilian version of the World Health Organization Disability Assessment Schedule 2.0 for individuals with HIV/AIDS. Cien Saude Colet. 2020;25(3):837-44.

19 Silva C, Coleta I, Silva AG, Amaro A, Alvarelhão J, Queirós A, Rocha N. Adaptation and validation of WHODAS 2.0 in patients with musculoskeletal pain. Rev Saude Publica. 2013;47(4):752-8.

20 Kutlay S, Küçükdeveci AA, Elhan AH, Oztuna D, Koç N, Tennant A. Validation of the World Health Organization disability assessment schedule II (WHODAS-II) in patients with osteoarthritis. Rheumatol Int. 2011;31(3):339-46.

21 Silva TFCE, Medeiros PMSS, Leite CF, Castro SS, Nunes ACL, Jesus-Moraleida FR. Is it time to rethink disability assessment in low back pain? Reliability, internal consistency, and construct validity of the Brazilian WHODAS 2.0 for chronic low back pain. Physiother Res Int. 2023;25:e2025.

22 Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63(7):737-45.

23 Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307-10.

24 Camelier AA. Avaliação da QV relacionada à saúde em pacientes com DPOC: estudo de base populacional com o SF-12 na cidade de São Paulo / SF-12 health related quality of life in COPD patients: a population-based study in São Paulo-SP. 2004;151.

25 Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220-33.

26 Jenkinson C, Layte R, Jenkinson D, Lawrence K, Petersen S, Paice C, Stradling J. A shorter form health survey: can the SF-12 replicate results from the SF-36 in longitudinal studies? J Public Health Med. 1997;19(2):179-86.

27 Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain. 1983;16(1):87-101.

28 Wang L, Xiao Y, Urman RD, Lin Y. Cold pressor pain assessment based on EEG power spectrum. SN Appl Sci. 2020;12;2(12).

29 Bland JM, Altman DG. Cronbach’s alpha. BMJ. 1997;314(7080):572.

30 Hart SL, Albiani JJ, Crangle CJ, Torbit LA, Varma MG. Development and assessment of the constipation-related disability scale. Aliment Pharmacol Ther. 2012;35(1):183-92.

31 Morris LD, Grimmer-Somers KA, Louw QA, Sullivan MJ. Cross-cultural adaptation and validation of the South African Pain Catastrophizing Scale (SA-PCS) among patients with fibromyalgia. Health Qual Life Outcomes. 2012;10:137.

32 de Las Mercedes Villa Rosero CY, Mazin SC, Nogueira AA, Vargas-Costales JA, Rosa-E-Silva JC, Candido-Dos-Reis FJ, Poli-Neto OB. Prevalence of chronic pelvic pain and primary dysmenorrhea in women of reproductive age in Ecuador. BMC Womens Health. 2022;22(1):363.

33 Da Luz RA, de Deus JM, Conde DM. Quality of life and associated factors in Brazilian women with chronic pelvic pain. J Pain Res. 2018;11:1367-74.

34 Guan Y, Yu G, Wang G, Bai Z. The negative effect of urologic chronic pelvic pain syndrome on female sexual function: a systematic review and meta-analysis. Int Urogynecol J. 2019;30(11):1807-16.

35 Salomão AE, Leite C F, Castro SS, Shimano SGN, Silveira LS, Pereira K. World Health Organization Disability Assessment Schedule (WHODAS 2.0): validação para adultos com baixa visão. Saúde Desenvolv Hum. 2021;9(1):1-10.

36 Garin O, Ayuso-Mateos JL, Almansa J, Nieto M, Chatterji S, Vilagut G, Alonso J, Cieza A, Svetskova O, Burger H, Racca V, Francescutti C, Vieta E, Kostanjsek N, Raggi A, Leonardi M, Ferrer M; MHADIE consortium. Validation of the “World Health Organization Disability Assessment Schedule, WHODAS-2” in patients with chronic diseases. Health Qual Life Outcomes. 2010;8:51.

37 Stucki G, Bickenbach J. Functioning: the third health indicator in the health system and the key indicator for rehabilitation. Eur J Phys Rehabil Med. 2017;53(1):134-8.
 


Submitted date:
08/07/2023

Accepted date:
10/05/2023

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