title: ICF disability measured by WHO-DAS II in three community diagnostic groups in Madrid, Spain.
abstract: OBJECTIVE
  The planning, provision and monitoring of medical and support services for patient groups with chronic ailments may require disability assessment and registration. The purpose of this study was to assess disability in three groups of patients with chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF) or stroke.
  
  
  METHODS
  Convenience samples of consecutive patients diagnosed with COPD (102), CHF (99), and stroke (99) were taken from 1,053 primary care users in the southern area of the autonomous region of Madrid. The patients were informed of the study and were assessed in their homes by trained field workers using the World Health Organization Disability Assessment Schedule II (WHO-DAS II).
  
  
  RESULTS
  None of the groups had patients with extreme disability on their global WHO-DAS II scores. The prevalence of severe disability differed among the groups and was highest for stroke and CHF (33.33% and 29.29%, respectively) and lowest for COPD (14.71%). The three groups shared two similar traits, namely, a higher prevalence of disability among women than men, and a specific pattern by domain, with the highest prevalence of severe/extreme limitations being found in household life activities and mobility. Severe restrictions in Social Participation were more frequent in patients with stroke and CHF. The group with moderate disability according to the global WHODAS II score (n=94) showed a high prevalence of severe limitations in mobility, life activities and self-care.
  
  
  CONCLUSIONS
  Disability among non-institutionalized persons with COPD, CHF and stroke is frequent and shows gender- and domain-related patterns similar to those described in a population-based study performed using the WHO-DAS II in elderly persons in Spain. ICF-validated disability categories could be useful in epidemiological surveys, individual assessments and primary care data monitoring systems.
authors.affiliation: National Center for Epidemiology, and CIBERNED, Carlos III Institute of Health, Madrid, Spain. jpedro@isciii.es
authors.forename: Jesús
authors.initials: J
authors.lastname: de Pedro-Cuesta
authors.forename: Ángel
authors.initials: Á
authors.lastname: Alberquilla
authors.forename: Javier
authors.initials: J
authors.lastname: Virués-Ortega
authors.forename: Montserrat
authors.initials: M
authors.lastname: Carmona
authors.forename: Enrique
authors.initials: E
authors.lastname: Alcalde-Cabero
authors.forename: Graciela
authors.initials: G
authors.lastname: Bosca
authors.forename: Fernando
authors.initials: F
authors.lastname: López-Rodríguez
authors.forename: Pilar
authors.initials: P
authors.lastname: García-Sagredo
authors.forename: Luis
authors.initials: L
authors.lastname: García-Olmos
authors.forename: Carlos H
authors.initials: CH
authors.lastname: Salvador
authors.forename: José Luis
authors.initials: JL
authors.lastname: Monteagudo
mesh_terms: D000203:Activities of Daily Living; D002908:Chronic Disease; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000145:classification* / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D038801:International Classification of Diseases; D007398:Interpersonal Relations; D008297:Male; D051346:Mobility Limitation; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012737:Sex Factors; D012944:Social Support; D013030:Spain / Q000453:epidemiology; D020521:Stroke / Q000150:complications*; D014944:World Health Organization