Development and validation of the Dutch version of the London Handicap Scale

Abstract

Background:

The London Handicap Scale (LHS) was found to be a valid and reliable scale for measuring participation restrictions in adults.

Objective:

This paper describes the development and assesses the construct-related validity of a Dutch version of the London Handicap Scale (DLHS).

Methods:

The DLHS was tested in 798 adults (mean age: 50.7 years, SD = 14.5, range 16 to 85) and validated with the ‘Impact on Participation and Autonomy’ (IPA) questionnaire, the Dutch version of the EQ-5D and questions concerning comorbidity and use of medical devices. The study population consisted of patients with rheumatoid arthritis, chronic obstructive pulmonary disease (COPD), epilepsy, laryngectomy and multiple sclerosis.

Results:

Feasibility was satisfactory. Large correlations ( $\mathit{\rho }\mathrm{>}0.6$ ) for the DLHS sum score were found with the IPA subscales ‘autonomy outdoors’, ‘perceiving problems’, ‘family role’, autonomy indoors’, ‘work and education’ and with the EQ-5D. The DLHS sum score differs significantly between subgroups based on the number of chronic diseases, number of medical devices and self-reported burden of disease or handicap ( $\mathit{p}\mathrm{<}0.001$ ).

Conclusions:

Based on this evaluation the questionnaire seems feasible and valid for assessing differences in level of participation between subgroups of chronically ill or disabled persons in the Netherlands.