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Development and Validation of the 34-Item Disability Screening Questionnaire (DSQ-34) for Use in Low and Middle Income Countries Epidemiological and Development Surveys

PloS one, 2015-12, Vol.10 (12), p.e0143610-e0143610 [Peer Reviewed Journal]

COPYRIGHT 2015 Public Library of Science ;COPYRIGHT 2015 Public Library of Science ;2015 Trani et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Distributed under a Creative Commons Attribution 4.0 International License ;2015 Trani et al 2015 Trani et al ;ISSN: 1932-6203 ;EISSN: 1932-6203 ;DOI: 10.1371/journal.pone.0143610 ;PMID: 26630668

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  • Title:
    Development and Validation of the 34-Item Disability Screening Questionnaire (DSQ-34) for Use in Low and Middle Income Countries Epidemiological and Development Surveys
  • Author: Trani, Jean-François ; Babulal, Ganesh Muneshwar ; Bakhshi, Parul
  • Hill, Philip C
  • Subjects: Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biostatistics ; Change detection ; Consistency ; Cross-Cultural Comparison ; Data Collection ; Developed Countries ; Developing countries ; Disabilities ; Disability ; Disability Evaluation ; Disabled people ; Disabled Persons ; Epidemiology ; Epilepsy ; Error analysis ; Error detection ; Estimates ; Factor analysis ; Female ; Humanities and Social Sciences ; Humans ; Income ; India ; LDCs ; Male ; Mathematical analysis ; Medical screening ; Medicine ; Mental disorders ; Middle Aged ; Nepal ; Participation ; People with disabilities ; Polls & surveys ; Quality of life ; Questionnaires ; Rehabilitation ; Reliability ; Reproducibility of Results ; Screening ; Social sciences ; Standard error ; Stigma ; Studies ; Surveys ; Surveys and Questionnaires ; Well construction ; Young Adult
  • Is Part Of: PloS one, 2015-12, Vol.10 (12), p.e0143610-e0143610
  • Description: Although 80% of persons with disabilities live in low and middle-income countries, there is still a lack of comprehensive, cross-culturally validated tools to identify persons facing activity limitations and functioning difficulties in these settings. In absence of such a tool, disability estimates vary considerably according to the methodology used, and policies are based on unreliable estimates. The Disability Screening Questionnaire composed of 27 items (DSQ-27) was initially designed by a group of international experts in survey development and disability in Afghanistan for a national survey. Items were selected based on major domains of activity limitations and functioning difficulties linked to an impairment as defined by the International Classification of Functioning, Disability and Health. Face, content and construct validity, as well as sensitivity and specificity were examined. Based on the results obtained, the tool was subsequently refined and expanded to 34 items, tested and validated in Darfur, Sudan. Internal consistency for the total DSQ-34 using a raw and standardized Cronbach's Alpha and within each domain using a standardized Cronbach's Alpha was examined in the Asian context (India and Nepal). Exploratory factor analysis (EFA) using principal axis factoring (PAF) evaluated the lowest number of factors to account for the common variance among the questions in the screen. Test-retest reliability was determined by calculating intraclass correlation (ICC) and inter-rater reliability by calculating the kappa statistic; results were checked using Bland-Altman plots. The DSQ-34 was further tested for standard error of measurement (SEM) and for the minimum detectable change (MDC). Good internal consistency was indicated by Cronbach's Alpha of 0.83/0.82 for India and 0.76/0.78 for Nepal. We confirmed our assumption for EFA using the Kaiser-Meyer-Olkin measure of sampling well above the accepted cutoff of 0.40 for India (0.82) and Nepal (0.82). The criteria for Bartlett's test of sphericity were also met for both India (< .001) and Nepal (< .001). Estimates of reliability from the two countries reached acceptable levels of ICC of 0.75 (p<0.001) for India of 0.77 for Nepal (p<0.001) and good strength of agreement for weighted kappa (respectively 0.77 and 0.79). The SEM/MDC was 0.80/2.22 for India and 0.96/2.66 for Nepal indicating a smaller amount of measurement error in the screen. In Nepal and India, the DSQ-34 shows strong psychometric properties that indicate that it effectively discriminates between persons with and without disabilities. This instrument can be used in association with other instruments for the purpose of comparing health outcomes of persons with and without disabilities in LMICs.
  • Publisher: United States: Public Library of Science
  • Language: English
  • Identifier: ISSN: 1932-6203
    EISSN: 1932-6203
    DOI: 10.1371/journal.pone.0143610
    PMID: 26630668
  • Source: Geneva Foundation Free Medical Journals
    HAL SHS: Archive ouverte en Sciences de l'Homme et de la Société (Open Access)
    PLoS
    Hyper Article en Ligne (HAL) (Open Access)
    MEDLINE
    PubMed Central
    ProQuest Central
    DOAJ Directory of Open Access Journals
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