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Cross-cultural validation of the London Handicap Scale in Hong Kong Chinese

Department of Medicine and Geriatrics, Shatin Hospital, New Territories, Hong Kong, UK

Rowan Harwood

Department of the Health Care of the Elderly, Queen's Medical Centre, Nottingham, UK,

Jean Woo

Fai Yeung

Department of Medicine and Geriatrics, Shatin Hospital, New Territories, Hong Kong, UK

Shah Ebrahim

University Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London, UK

Study objective: To investigate the cross-cultural validity of London Handicap Scale in Hong Kong Chinese.

Design: Ratings of the utility of 10 hypothetical health scenarios were given by groups of HK Chinese subjects. Measured scores were compared with calculated scores from published scale weights of London Handicap Scale, which were based on utility ratings made by UK subjects.

Setting: A rehabilitation hospital in Hong Kong.

Subjects: A total of 164 HK Chinese, comprising doctors, medical students, nonmedical hospital staff, geriatric day hospital stroke and nonstroke patients, community day-care centre elderly, old age hostel elderly, young disabled inpatients and young community-dwelling disabled citizens.

Main results: There was a close correlation between the mean scores of HK subjects and the calculated scores derived from the published UK scale weights, apart from one scenario (Pearson's correlation coefficient r = 0.87 p = 0.001). The correlations were high for all subgroups, between which there was good consensus. Measured utilities were significantly different between subgroups for only one scenario. For this scenario of moderate to severe handicap in mobility, physical dependence, occupation and social integration, but with excellent orientation and economic self sufficiency: (1) older age groups gave better scores than younger age groups (p < 0.0005); (2) subjects with poor subjective health status gave better scores than those with good subjective health status (p = 0.002); (3) subjects related to the medical or hospital field, i.e. doctors, medical students and nonmedical hospital staff, gave worse scores than other subject groups (p < 0.0005).

Conclusion: The concept of handicap applies across cultures. Perception of severity of selected real life handicap scenarios by HK Chinese were well estimated using scale weights from UK populations developed for the London Handicap Scale. Significant differences in perception of certain handicap scenarios by different population subgroups deserve further study.

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