The assessment of physical independence handicap: experience in a community disablement survey

Two approaches to the ascertainment of physical independence handicap have been explored using data from a survey of disablement in the population. The survey used a two-stage methodology with an initial postal shift to ascertain those with selected disabilities, a stratified random sample of whom were followed-up with an in-depth interview. The first approach to handicap was direct ascertainment of the scale categories by means of a question in the interview schedule. The second approach was to synthesize the scale categories from the answers to interview questions about disabilities in activities of daily living and other relevant factors. The final synthesized algorithm gave a 75% match within one scale point with the direct question and 85% agreement with receipt of attendance allowance, a state benefit paid to those meeting certain criteria for dependence on others. The lessons learned from the work have been incorporated in a revised and expanded scale, which is suggested as a starting point for revision of physical independence dimension of handicap.