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

Study objective: To investigate the cross-cultural validity of London Handi cap Scale in Hong Kong Chinese. Design: Ratings of the utility of 10 hypothetical health scenarios were giv en by groups of HK Chinese subjects. Measured scores were compared with cal culated 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 pati ents, community day-care centre elderly, old age hostel elderly, young disa bled inpatients and young community-dwelling disabled citizens. Main results: There was a close correlation between the mean scores of HK s ubjects and the calculated scores derived from the published UK scale weigh ts, 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 h andicap in mobility, physical dependence, occupation and social integration , but with excellent orientation and economic self sufficiency: ii) older a ge groups gave better scores than younger age groups (p < 0.0005); (2) subj ects with poor subjective health status gave better scores than those with good subjective health status (p = 0.002); (3) subjects related to the medi cal or hospital field, i.e. doctors, medical students and nonmedical hospit al 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 e stimated using scale weights from UK populations developed for the London H andicap Scale. Significant differences in perception of certain handicap sc enarios by different population subgroups deserve further study.