Validação do WHODAS 2.0 para pessoas com hanseníase acompanhadas em um centro de referência de Fortaleza

Abstract

INTRODUCTION: Leprosy is a disease caused by Mycobacterium leprae. The disease can progress with facial, upper and lower limb deformities. Brazil operates in constant surveillance and treatment of new and old cases, but still without data on the functionality status of these patients. The use of instruments that assess the performance in specific activities and restrictions on participation in life situations allows an understanding of the impact of diseases on the individual's health. OBJECTIVES: To validate the use of the WHODAS 2.0 instrument for use in individuals with leprosy. Describe the clinical and sociodemographic profile and identify factors associated with activity limitation and quality of life in people with leprosy. METHOD: Validation study of WHODAS 2.0 in individuals with leprosy. 155 individuals were interviewed, using WHODAS 2.0, WHOQOL-bref, SALSA and sociodemographic data sheet. Medical records were accessed to collect data on degree of disability and eye-hand-foot score (EHF). The psychometric properties analyzed were internal consistency (Cronbach's α), criterion validity (WHODAS 2.0 x GI and WHODAS 2.0 x OMP) and convergent and divergent constructs (WHODAS 2.0, WHOQOL-bref and SALSA). Clinical and sociodemographic data were analyzed under the quality of life and activity limitation outcomes. The accepted confidence interval was 95% with an error of 5%. RESULTS: The predominance of sociodemographic and clinical characteristics found was: men (68,3%), married people (33,5%), who did not work (34,8%), average age 47,9 years and average education of 7 years, multibacillary classification (89,6%), dimorphic clinical form (52,7%), smear microscopy (96,5%), degree of disability 0 (42,2%), mean 1.59 for EHF score, 7.4 skin lesions and 1.4 affected nerves. WHODAS 2.0 had an average of 29,4 points, with the Participation domain being the most affected. WHOQOL-bref resulted in an average of 55,7 points, with the Physical and Environmental domains as the most compromised. SALSA, on the other hand, had an average of 36 points with the largest deficit in the Work domain. Cronbach's α ranged from 0.76 to 0.91. Correlations test were moderate in most domains tested. Between the total value of the scales there was a moderate and strong correlation. There was a significant result between WHODAS 2.0 and degree of disability. The correlation between WHODAS 2.0 and EHF score showed a weak, but significant, result. In limiting quality of life, females had the lowest medians; there was no differentiation by operational classification; age showed a weak correlation with the Social domain and the number of skin lesions showed a weak correlation with the Environmental domain and total WHOQOL-bref score. In the limitation of activity, the female sex presented a greater general and domain deficit; there was no differentiation by operational classification; age, years of study, number of skin lesions and EHF score showed a weak but significant correlation with SALSA. CONCLUSION: WHODAS 2.0 has valid and reliable psychometric characteristics to be used in people with leprosy. Quality of life was influenced by sex, age and number of skin lesions. Activity limitation was influenced by sex, age, years of schooling, degree of disability, EHF score, and number of skin lesions.