Construct validity of the Danish version of the Work Rehabilitation Questionnaire (WORQ)-sensitivity and specificity of the objectively tested physical capacity items

Assessing Work Functioning in Patients with Persistent Low Back Pain: Exploring the Structural Validity of the Work Rehabilitation Questionnaire

PURPOSE

Assessing work functioning in patients with persistent low back pain (LBP) is important for understanding their ability to engage in work-related activities. This study aims to evaluate the item characteristics, factor structure, and internal consistency of the Work Rehabilitation Questionnaire (WORQ) in patients with persistent LBP.

METHODS

Four hundred and twenty-five individuals with LBP completed the WORQ. Item characteristics, exploratory factor analysis (EFA), and consistency were performed to identify the underlying factors.

RESULTS

Missing responses were < 2% for each item. The analysis revealed three factors: psychological wellbeing, physical functioning, and cognitive ability. The factors demonstrated strong internal consistency, with Cronbach's alpha values ranging from 0.88 to 0.93 and McDonald's Omega from 0.92 to 0.96. Fifteen items did not fit into any identified factors, suggesting their potential value in screening functioning levels beyond the factors.

CONCLUSIONS

The WORQ is a valid instrument for evaluating work limitations in individuals with persistent LBP. Further research should assess its responsiveness to changes from interventions that target workability. Advancing this knowledge has the potential to promote work rehabilitation and improve the quality of life for patients with persistent LBP.

Translation and cross-cultural adaptation of the Work Rehabilitation Questionnaire (WORQ) into Danish

Purpose

This study aimed to translate and cross-culturally adapt the work rehabilitation questionnaire (WORQ) into Danish to examine the internal consistency and test-retest reliability of the Danish WORQ and, second, to test the feasibility of WORQ in the Danish context of vocational rehabilitation.

Methods

The translation was performed in a dual-panel approach. The panel consisted of a bilingual physician, a university student in psychology, a layperson, a specialist in social work and rehabilitation, and a professor in social medicine. The international classification of functioning, disability, and health (ICF) codes were cross-evaluated to secure that there was a high level of agreement of ICF codes for each specific WORQ item in the Danish and English version. The content validity was evaluated by the clinical physicians at an outpatient clinic in social medicine and by the case managers at a municipality job center. Data for the examination of the internal consistency and test-retest reliability were collected at the Holbæk municipality from citizens in the working age. The test-retest took place 14 days apart. The internal consistency and test-retest reliability were tested conducting Cronbach's alpha, intraclass correlation, and Spearman's correlation analyses.

Results

The panel experienced only minor challenges in the translation process, leading to minor modifications. The cross-evaluation of coding in the Danish WORQ compared with the initial English version only found small deviations, while the remaining coding agreed between the initial English and the Danish items. The panel argued to add sub-codes to culturally adapt to the transportation forms generally used in Denmark. The general perception among the participating patients and citizens at the job center as well as the clinical physicians and case managers was that the WORQ was easy, understandable, and meaningful.

Conclusions

This study showed that the Danish WORQ have a high content validity and usability. Nonetheless, the Danish WORQ needs to be validated against well-acknowledged tools for assessing functional ability specific to work and in general.