Adapting World Health Organization Disability Assessment Schedule 2.0 for Nepal

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Disability is a significant public health concern, particularly in resource-poor settings.
• Disability research is often neglected in countries like Nepal.
• There was a need for a culturally adapted tool to measure disability in Nepal.

Purpose of the Study:

• To translate and culturally adapt the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) into Nepali.
• To validate the Nepali version of WHODAS 2.0 for use in the Nepalese population.
• To provide a reliable instrument for measuring global disability in Nepal.

Main Methods:

• The 12-item WHODAS 2.0 was translated into Nepali using a standard forward-backward protocol.
• Participants with psychiatric disabilities, physical disabilities, and no disabilities were recruited.
• Construct validity was assessed using exploratory factor analysis and parallel analysis; criterion validity was assessed using a quality of life instrument; reliability was measured using Cronbach's alpha.

Main Results:

• A total of 149 participants (61.7% disabled) were included.
• A single-factor structure was adequate for the Nepali WHODAS 2.0, explaining 45.4% of the variance.
• The Nepali WHODAS 2.0 demonstrated good reliability (Cronbach's alpha = 0.89) and satisfactory validity. Significant differences in scores were found between disabled and non-disabled groups.

Conclusions:

• The translated and culturally adapted Nepali WHODAS 2.0 is a valid and reliable instrument.
• The one-factor structure supports its use for measuring general disability.
• This validated tool is now available for epidemiological research on disability in Nepal.