Sinikka Tarvonen-Schröder, Olli Tenovuo, Anne Kaljonen, Katri Laimi
Department of Rehabilitation and Brain Trauma, Turku University Hospital, PO Box 52, FI-20521 Turku, Finland. E-mail: sinikka.tarvonen-schroder@tyks.fi
DOI: 10.2340/16501977-2345

Objectives: To investigate functioning measured with the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2. 0) in patients with mild, moderate and severe traumatic brain injury, and to compare patients’ experiences with assessments made by their significant others and by consultant neurologists.
Methods: A total of 112 consecutive patients with traumatic brain injury (29 mild, 43 moderate, 40 severe) and their significant others completed a 12-item WHODAS 2. 0 survey. A neurologist assessed functioning with the International Classification of Functioning, Disability and Health minimal generic set.
Results: The total patient and proxy WHODAS 2. 0 sum score was rated as severe, and impairments in household tasks, learning, community life, emotional functions, concentrating, dealing with strangers, maintaining friendships, and working ability as around moderate in all 3 severity groups. In standing, walking, washing, and dressing oneself the reported impairments increased from mild in mild traumatic brain injury to moderate in severe traumatic brain injury. A neurologist rated the overall functioning, working ability, and motor activities most impaired in severe traumatic brain injury, while there were no between-group differences in energy and drive functions and emotional functions.
Conclusion: Patients with chronic traumatic brain injury perceive a diversity of significant difficulties in activities and participation irrespective of the severity of the injury. We recommend assessing disability in traumatic brain injury with the short and understandable WHODAS 2. 0 scale, when planning client-oriented services.

Functioning of patients with traumatic brain injury was assessed with two simple questionnaires: the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the 7-item International Classification of Functioning, Disability and Health minimal generic set. Patients and their significant others rated the overall disability as severe, with difficulties in household tasks, learning, emotions, participation, relationships, and working ability. Even after mild traumatic brain injury patients may report remarkable cognitive and emotional difficulties. In more severe injury, physical motor functions are also often impaired. We recommend assessing disability in traumatic brain injury with the WHODAS 2.0 scale when planning client-oriented services.