World health organization disability assessment schedule 2.0 as an objective assessment tool for predicting return to work after a stroke

Abstract

Purpose: To analyze whether World Health Organization Disability Assessment Schedule 2.0 can be used as an objective assessment tool for predicting the return-to-work status of working-age patients with stroke.

Method: We obtained the data on 2963 patients disabled by stroke (age <60 years) from the Taiwan Data Bank of Persons with Disability for the July 2012–January 2014 period. Of these patients, 119 could return to work, whereas 2844 could not. Demographic data and World Health Organization Disability Assessment Schedule 2.0 standardized scores of patients with stroke who could return to work and those who could not (return to work and nonreturn-to-work groups, respectively) were analyzed and compared using the chi-squared and independent Student’s t-tests. Receiver operating characteristic curve analysis was performed to investigate the prediction accuracy for the return-to-work status, and the optimal cutoff point was determined using the Youden index. Binary logistic regression was employed to determine the predictors of the return-to-work status of patients with stroke.

Results: The World Health Organization Disability Assessment Schedule 2.0 scores in all domains were lower in the return-to-work group than in the nonreturn-to-work group. The receiver operating characteristic curve showed moderate accuracy for all domain-specific scores [area under the curve, 0.6–0.8] and good accuracy for the summary scores of World Health Organization Disability Assessment Schedule 2.0 (area under the curve, >0.8). Binary logistic regression revealed that younger age, less severe stroke and standardized World Health Organization Disability Assessment Schedule 2.0 summary scores below the cutoff points were predictors of the return to work status of working-age patients disabled by stroke.

Conclusions: World Health Organization Disability Assessment Schedule 2.0 can be used as an objective assessment tool for predicting the return-to-work status of working-age patients disabled by stroke. This tool can aid in establishing rehabilitation strategies and goal-setting processes for the return-to-work of patients with stroke.

Implications for rehabilitation

• World Health Organization Disability Assessment Schedule 2.0 summary scores can predict the return-to-work status of working-age patients with stroke.

• Younger age and less severe stroke are associated with the return-to-work status of patients with stroke.

• Lower disability scores of the World Health Organization Disability Assessment Schedule 2.0 items result in a favorable return-to-work status and help in establishing effective rehabilitation strategies for facilitating the return-to-work of young patients with stroke.

Keywords:

• Stroke
• return to work
• predictor
• International Classification of Functioning
• Disability
• and Health
• Taiwan
• World Health Organization Disability Assessment Schedule 2.0

Acknowledgements

We thank Kai-Hsiang Chuang for assistance with manuscript preparation.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by the Ministry of Health and Welfare, Taiwan [Nos. 98M8178, 99M4080, 99M4073, 100M4145, 101M4100, 102M4018, and 103M03F4037].