Ann Rehabil Med.  2016 Feb;40(1):111-119. 10.5535/arm.2016.40.1.111.

Monitoring of Functioning Status in Subjects With Chronic Stroke in South Korea Using WHODAS II

• Kwon SY
• Hong SE
• Kim EJ
• Kim CH
• Joa KL
• Jung HY

• KMID: 2155173
• DOI: http://doi.org/10.5535/arm.2016.40.1.111

Abstract

OBJECTIVE
To follow up the long-term functioning in a community through assessing personal background and status based on the International Classification of Functioning, Disability and Health (ICF) after a stroke, by using a Korean version of World Health Organization Disability Assessment Scale II (K-WHODAS II).
METHODS
We surveyed 146 patients diagnosed at the first-onset of acute stroke and discharged after Inha University Hospital, and 101 patients answered the K-WHODAS II survey. We analyzed the relationship of six functioning domains of K-WHODAS II with K-MMSE (Korean version of Mini-Mental State Examination) and K-MBI (Korean version of Modified Barthel Index) at admission and discharge, and personal background. All subjects were divided into five groups, according to the disease durations, to assess the functional changes and the differences of K-MMSE and K-MBI at the admission and discharge.
RESULTS
K-MBI and K-MMSE at admission and discharge showed no significant differences in all five groups, respectively (p>0.05), reflecting no baseline disparity for long-term follow-up. All subjects showed positive gains of K-MBI and K-MMSE at discharge (p<0.05). The six functioning domains and total scores of K-WHODAS II had decreasing trends until 3 years after the stroke onset, but rose thereafter. Higher scores of K-MBI and K-MMSE, younger age, women, working status, higher educational level, and living with a partner were correlated with lower scores of K-WHODAS II (p<0.05).
CONCLUSION
The long-term functioning after stroke was affected not only by cognitive and motor status in hospital, but also by certain kinds of personal background. K-WHODAS II may be used to monitor functioning status in a community and to assess personal backgrounds in subjects with chronic stroke.

Keyword

Stroke; Functioning; Activity; Participation; Assessment

MeSH Terms

Female
Follow-Up Studies
Humans
International Classification of Functioning, Disability and Health
Korea*
Stroke*
Women, Working
World Health Organization

Figure

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  Fig. 1 The flow chart of subject enrollment and statistical analysis. K-WHODAS II, World Health Organization Disability Assessment Scale II; K-MBI, Korean version of Modified Barthel Index; K-MMSE, Korean version of Mini-Mental State Examination.

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  Fig. 2 Comparison of each K-MBI and K-MMSE of five groups at admission and discharge. The discharged patients were divided into five groups according to the time elapsed from the onset of stroke to when they completed the K-WHODAS II questionnaire. These five groups showed no significant difference as we compared their K-MBI and K-MMSE at admission and discharge, respectively (p>0.05). ANOVA was applied to compare functioning domains among the five groups. a)At admission, b)at discharge. K-MBI, Korean version of Modified Barthel Index; K-MMSE, Korean version of Mini-Mental State Examination; K-WHODAS II, Korean version of World Health Organization Disability Assessment Scale II.

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  Fig. 3 Long-term follow-up of K-WHODAS II (Korean version of World Health Organization Disability Assessment Scale II) after stroke onset. The trends of the K-WHODAS II changes among the five groups after stroke onset were analyzed. The sustaining trends of the scores of each of the six functioning domains of the K-WHODAS II and the sum of them were maintained until about 3 years after the stroke onset, but declined thereafter. The domain of social participation showed an exceptionally earlier decline from 25 months after onset. ANOVA was applied to compare functioning domains among the five groups.

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