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COPD fits the profile of disabling health conditions. This study aims to validate the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in individuals with COPD. 100 participants with COPD responded to the Brazilian 36-item version of the WHODAS 2.0, as well as the Saint George's Respiratory Questionnaire (SGRQ), and the COPD Assessment Test (CAT). Spirometric data was extracted from medical records. The internal consistency analysis showed coefficients for all WHODAS 2.0 domains with a strong correlation (0.70–0.85) except for Life activities, which had a moderate correlation (coefficient = 0.60). In the construct analysis, the coefficients for the WHODAS and SGRQ domains presented a consistent correlation among them, varying from 0.40 to 0.69. No correlation was evidenced among the WHODAS domains and the spirometric data, highlighting that linear measures fail when associated with the functioning of an individual with COPD. Discriminative analysis revealed a capacity for the WHODAS 2.0 to distinguish among COPD different levels of clinical impact obtained from CAT excluding the Getting along domain. The WHODAS 2.0 shows as a valid instrument that can sensibly assess functioning differences related to the clinical impact classification level in subjects with COPD. WHODAS 2.0 is a valid tool to assess functioning in subjects with COPD. WHODAS 2.0 is sensitive to functioning differences related to classification level and to clinical impact in individuals with COPD. As a Patient-Reported Outcome Measure (PROM), WHODAS 2.0 offers the opportunity to develop clinical patient-centered interventions, improving the health care. As a low-cost, easy-to-use tool, WHODAS can be a useful resource in the process of clinical assessment of patient functioning. [ABSTRACT FROM AUTHOR]

Participation is defined as frequency (measured by attendance and/or variety or diversity of activities) and involvement (participation experience including engagement, motivation, persistence, social connection and affection) in all life situations, and is seen as an essential condition for the development of the child. Children with myelomeningocele have several functional limitations that can lead to restriction of participation. Improving these children's participation requires knowledge about what factors may influence a child's ability to participate in activities of their choice. To verify whether factors such as age, mobility performance, access to assistive technology equipment and the presence of environmental facilitators are associated with the frequency and involvement of young children with myelomeningocele participation at home, daycare/preschool and in the community. A cross-sectional observational study was carried out with children diagnosed with myelomeningocele, between 6 months and 5 years of age. The dependent variables were Frequency and involvement in participation at home, day care/preschool and in the community, as measured by The Young Children's Participation Environment Measure - YC-PEM. The independent variables were age and access to assistive technology equipment collected through interviews with parents and caregivers, mobility performance measured by the questionnaire: Pediatric Assessment of Disability Inventory – Computerized Adaptive Testing (PEDICAT), and environmental facilitators measured by YC-PEM. Data were analyzed using SPSS version 22.0. To verify the associations between age, mobility performance, access to assistive technology equipment and the presence of environmental facilitators with the frequency and involvement of participation, Spearman's correlation was performed, with a significance level of 5%. Sixty-five children and their families (mean age 27.91 (±17.36) months) participated in the study. The presence of environmental facilitators at home increased the child's involvement at home (r=0.30, p=0.01). In the daycare/preschool setting, a significant positive association was found between age (r=0.50, p<0.0001; r=0.55, p<0.0001), mobility performance (r= 0.35, p=0.003; r=0.37, p=0.002) and the presence of environmental facilitators in daycare/preschool (r=0.95, p<0.0001; r=0.98, p <0.0001), with frequency and involvement, respectively. However, there was a negative association between having access to assistive technology equipment and attendance (r=-0.32, p=0.008) and participation involvement (r=-0.36, p=0.03) in daycare/preschool. In relation to the community environment, factors such as age (r=0.40, p=0.001), mobility performance (r=0.26, p=0.03), and the presence of environmental facilitators (r=0, 35, p=0.003) correlated positively with community engagement. Preliminary results indicated that the presence of environmental facilitators increases the participation involvement of children with myelomeningocele in all environments. Older and more mobile children are more involved in daycare/preschool and in the community. However, having access to assistive technology equipment that facilitates mobility worsens the frequency and involvement of participation in the daycare/preschool environment. These findings highlight the role of the environment for the participation of children with myelomeningocele in different contexts, pointing to the need for more facilitators and environmental changes. [ABSTRACT FROM AUTHOR]