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Journal of Occupational Rehabilitation

, Volume 17, Issue 3, pp 450–472 | Cite as

The Readiness for Return-To-Work (RRTW) scale: Development and Validation of a Self-report Staging Scale in Lost-time Claimants with Musculoskeletal Disorders

  • Renée-Louise Franche
  • Marc Corbière
  • Hyunmi Lee
  • F. Curtis Breslin
  • C. Gail Hepburn
Article

Abstract

Introduction We report on the development and validation of a 22-item scale assessing stage of readiness for return-to-work, the Readiness for Return-to-Work (RRTW) scale. Methods Lost-time claimants (n = 632) completed a telephone survey one month after a work-related musculoskeletal injury. Exploratory and confirmatory factor analyses of readiness items were conducted with two separate samples, and concurrent validity was examined. Results For workers not working, 60% of the variance was explained by four factors—(1) Precontemplation, (2) Contemplation (3) Prepared for Action—Self-evaluative and (4) Prepared for Action—Behavioral. For those working, 58% of the variance was explained by two factors—(1) Uncertain Maintenance and (2) Proactive Maintenance. Confirmatory factor analyses had satisfactory fit indices to confirm the initial model. Concurrent validity of the scale was supported: Relationships of readiness with depressive symptoms, fear-avoidance, pain, and general health, were generally in the hypothesized direction. Conclusions Psychometric properties of the newly developed instrument suggest that the application of the Readiness for Change model to return-to-work is relevant to work disability research. The instrument may facilitate the offer of stage-specific services tailored to injured workers’ needs, and be used for evaluation of return-to-work interventions.

Keywords

Return-to-work Musculoskeletal Readiness for change Work disability Workers’ compensation Measurement 

References

  1. 1.
    Krause, N., et al. (2001). Determinants of duration of disability and return-to-work after work-related injury and illness: Challenges for future research. American Journal of Industrial Medicine, 40, 464–484.PubMedCrossRefGoogle Scholar
  2. 2.
    Institute of Medicine. (1999). Reducing the burden of injury: Advancing prevention and treatment. Washington, DC: National Academy Press.Google Scholar
  3. 3.
    Frank, J., et al. (1998). Preventing disability from work-related low-back pain: New evidence gives new hope – if we can just get all the players onside. Canadian Medical Association Journal, 158(12), 1625–1631.PubMedGoogle Scholar
  4. 4.
    Krause, N., & Ragland, D. R. (1994). Occupational disability due to low back pain: A new interdisciplinary classification based on a phase model of disability. Spine, 19(9), 1011–1020.PubMedCrossRefGoogle Scholar
  5. 5.
    Schultz, I. Z., et al. (2004). Psychosocial factors predictive of occupational low back disability: Towards development of a return-to-work model. Pain, 107(1–2), 77–85.PubMedCrossRefGoogle Scholar
  6. 6.
    Corbière, M., & Shen, J. (2006). A systematic review of psychological return-to-work interventions for people with mental health problems and/or physical injuries. Canadian Journal of Community Mental Health, 25(2), 261–288.Google Scholar
  7. 7.
    Friesen, M. N., et al. (2001). Return-to-work: The importance of human interactions and organizational structures. Work, 17(1), 11–22.PubMedGoogle Scholar
  8. 8.
    Spitzer, W. O., et al. (1987). Scientific approach to the assessment and management of activity-related spinal disorders: A monograph for clinicians. Report of the Quebec task force on spinal disorders. 1277. Spine, 12(7S), s4–s55.Google Scholar
  9. 9.
    Prochaska, J. O., & Diclemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting & Clinical Psychology, 51(3), 390–395.CrossRefGoogle Scholar
  10. 10.
    Prochaska, J. O., et al. (1985). Predicting change in smoking status for self-changers. Addictive Behaviors, 10(4), 395–406.PubMedCrossRefGoogle Scholar
  11. 11.
    Prochaska, J. O., et al. (1992). Criticisms and concerns of the transtheoretical model in light of recent research. [Review] [19 refs]. British Journal of Addiction, 87(6), 825–828.PubMedCrossRefGoogle Scholar
  12. 12.
    Prochaska, J. O., et al. (1988). Measuring processes of change: Applications to the cessation of smoking. Journal of Consulting & Clinical Psychology, 56(4), 520–528.CrossRefGoogle Scholar
  13. 13.
    Prochaska, J. O., et al. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychology, 13(1), 39–46.PubMedCrossRefGoogle Scholar
  14. 14.
    Velicer, W. F., et al. (1999). Testing 40 predictions from the transtheoretical model. Addictive Behaviors, 24(4), 455–469.PubMedCrossRefGoogle Scholar
  15. 15.
    Kerns, R. D., et al. (1997). Readiness to adopt a self-management approach to chronic pain: The Pain Stages of Change questionnaire (PSOCQ). Pain, 72, 227–234.PubMedCrossRefGoogle Scholar
  16. 16.
    Keefe, F. J., et al. (2000). Understanding the adoption of arthritis self-management: Stages of change profiles among arthritis patients. Pain, 87(3), 303–313.PubMedCrossRefGoogle Scholar
  17. 17.
    Nielson, W. R., et al. (2003). Initial development and validation of a multidimensional pain readiness to change questionnaire. Journal of Pain, 4(3), 148–158.PubMedCrossRefGoogle Scholar
  18. 18.
    Biller, N., et al. (2000). Predicting completion of a cognitive-behavioral pain management program by initial measures of a chronic pain patient’s readiness for change. Clinical Journal of Pain, 16(4).Google Scholar
  19. 19.
    Kidd, P., et al. (2003). The transtheoretical model of change in adolescents: Implications for injury prevention. Journal of Safety Research, 34, 281–288.PubMedCrossRefGoogle Scholar
  20. 20.
    Fava, J. L., et al. (1995). Applying the transtheoretical model to a representative sample of smokers. Addictive Behaviors, 20(2), 189–203.PubMedCrossRefGoogle Scholar
  21. 21.
    Prochaska, J. O., & Diclemente, C. C. (1992). Stages of change in the modification of problem behaviors. [Review] [75 refs]. Progress in Behavior Modification, 28, 183–218.PubMedGoogle Scholar
  22. 22.
    Diclemente, C. C., et al. (1991). The process of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting & Clinical Psychology, 59(2), 295–304.CrossRefGoogle Scholar
  23. 23.
    Nigg, C. R., et al. (1999). Stages of change across ten health risk behaviors for older adults. Gerontologist, 39(4), 473–482.PubMedGoogle Scholar
  24. 24.
    Rossi, S. R., et al. (1993). Motivational readiness to control weight: The Transtheoretical model of behaviour change. In D. B. Allison (Ed.), Methods for the assessment of eating behaviours and weight related problems. Newbury Park, CA: Sage.Google Scholar
  25. 25.
    Rossi, S. R., et al. (1994). A processes of change model for weight control for participants in community-based weight loss programs. International Journal of the Addictions, 29(2), 161–177.PubMedGoogle Scholar
  26. 26.
    Greene, G. W., et al. (1999). Dietary applications of the stages of change model. [Review] [46 refs]. Journal of the American Dietetic Association, 99(6), 673–678.PubMedCrossRefGoogle Scholar
  27. 27.
    Laforge, R. G., et al. (1999). Stage of regular exercise and health-related quality of life. Preventive Medicine, 28(4), 349–360.PubMedCrossRefGoogle Scholar
  28. 28.
    Franche, R.-L., & Krause, N. (2002). Readiness for return to work following injury or illness: Conceptualizing the interpersonal impact of health care, workplace, and insurance factors. Journal of Occupational Rehabilitation, 12(4), 233–256.PubMedCrossRefGoogle Scholar
  29. 29.
    Franche R.-L., & Krause, N. (2003). Critical factors in recovery and return to work. In T. Sullivan & J. Frank (Eds.), Preventing & managing disabling injury at work (pp. 33–55). New York, USA: Taylor & Francis.Google Scholar
  30. 30.
    Velicer, W. F., et al. (1998). Smoking cessation and stress management: Applications of the transtheoretical model of behavior change. Homeostasis, 38(5–6), 216–232.Google Scholar
  31. 31.
    Heather, N., et al. (1993). Predictive validity of the readiness to change questionnaire. Addiction, 88, 1667–1677.PubMedCrossRefGoogle Scholar
  32. 32.
    Rollnick, S., et al. (1992). Development of a short ‘readiness to change’ questionnaire for use in brief, opportunistic interventions, among excessive drinkers. British Journal of Addiction, 87, 743–754.PubMedCrossRefGoogle Scholar
  33. 33.
    Jensen, M. P., et al. (2000). Further evaluation of the pain stages of change questionnaire: Is the transtheoretical model of change useful for patients with chronic pain? Pain, 86, 255–264.PubMedCrossRefGoogle Scholar
  34. 34.
    Carey, K. B., et al. (2004). Assessing readiness to change substance abuse: A critical review of instruments. Clinical Psychology: Science and Practice, 6, 245–266.CrossRefGoogle Scholar
  35. 35.
    Waddell, G., et al. (1993). A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain, 52(2), 157–168.PubMedCrossRefGoogle Scholar
  36. 36.
    Workplace Safety and Insurance Board (2006). Statistical supplement to the Annual Report 2005.Google Scholar
  37. 37.
    Statistics Canada. Labour Force Survey Microdata File. [71M0001XCB]. 2006. Canada.Google Scholar
  38. 38.
    Workplace Safety and Insurance Board 2005 Annual Report (2006). Canada: Workplace Safety and Insurance Board.Google Scholar
  39. 39.
    Bültmann, U., , et al. (2007). Health status, work limitations, and return-to-work trajectories in injured workers with musculoskeletal disorders. Quality of Life Research, DOI 10.1007/s11130-007-9229-x, July 7 [E-pup ahead of print].Google Scholar
  40. 40.
    Franche, R.-L., et al. (2007). The impact of early workplace-based return-to-work strategies on work absence duration: A 6-month longitudinal study following an occupational musculoskeletal injury. JOEM (in press).Google Scholar
  41. 41.
    Gaudette, L. A., et al. (2003). Which workers smoke? Health Reports, 10(3), 35–45.Google Scholar
  42. 42.
    Ware, J. Jr., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.PubMedCrossRefGoogle Scholar
  43. 43.
    Luo, X., Lynn, G. M., Kakouras, I., Edwards, C. L., Pietrobon, R., Richardson, W., & Hey, L. (2003). Reliability, validity, and responsiveness of the short form 12-item survey (SF-12) in patients with back pain. Spine, 28, 1739–1745.PubMedCrossRefGoogle Scholar
  44. 44.
    Roland, M., & Morris, R. (1983). A study of the natural history of back pain – part I: Development of a reliable and sensitive measure of disability in low-back pain. Spine, 8(2), 141–144.PubMedCrossRefGoogle Scholar
  45. 45.
    Hsieh, C. Y., et al. (1992). Functional outcomes of low back pain: Comparison of four treatment groups in a randomized controlled trial. Journal of Manipulative and Physiological Therapeutics, 15(1), 4–9.PubMedGoogle Scholar
  46. 46.
    Jarvikoski, A., et al. (1993). Outcome of a multimodal back treatment programs with and without intensive physical training. Journal of Spinal Disorders, 6(2), 93–98.PubMedGoogle Scholar
  47. 47.
    Jensen, M. P., & Karoly, P. (1992). Self-report scales and procedures for assessing pain in adults. In D. C. Turk & R. Melzack (Eds.), Handbook of pain assessment (pp. 135–151). New York: The Guilford Press.Google Scholar
  48. 48.
    Kopec, J. A., & Esdaile, J. M. (1995). Functional disability scales for back pain. Spine, 20(17), 1943–1949.PubMedCrossRefGoogle Scholar
  49. 49.
    Stratford, P. W., et al. (2000). Development and initial validation of the back pain functional scale. Spine, 25(16), 2095–2102.PubMedCrossRefGoogle Scholar
  50. 50.
    Solway, S., et al. (2002). The DASH Outcome Measure: User’s Manual. 2nd ed.Google Scholar
  51. 51.
    Ciccone, D. S., & Just, N. (2001). Pain expectancy and work disability in patients with acute and chronic pain: A test of the fear avoidance hypothesis. The Journal of Pain, 2(3), 181–194.PubMedCrossRefGoogle Scholar
  52. 52.
    Crombez, G., et al. (1999). Pain-related fear is more disabling than pain itself: Evidence on the role of pain-related fear in chronic back pain disability. Pain, 80, 329–339.PubMedCrossRefGoogle Scholar
  53. 53.
    Von Korff, M., et al. (2000). Assessing global pain severity by self-report in clinical and health services research. Spine, 25(24), 3140–3151.CrossRefGoogle Scholar
  54. 54.
    Tabachnick, B. G., & Fidell, L. S. (1996). Using multivariae statistics – Third edition (3rd ed.). California: California State University, Northridge: Haper Collins College Publishers. .Google Scholar
  55. 55.
    Bentler, P. M. (1995). Structural equations program manual. Encino: Multivariate Software Inc.Google Scholar
  56. 56.
    Byrne, B. M. (1989). A primer of LISREL: Basic applications and programming for confirmatory factor analytic models. New York: Springer-Verlag.Google Scholar
  57. 57.
    Hofmann, R. (1995). Establishing factor validity using variable reduction in confirmatory factor analysis. Educational and Psychological Measurement, 55, 572–582.CrossRefGoogle Scholar
  58. 58.
    Jõreskog, K. G., & Sorbom, D. (1993). LISREL 8: User’s reference guide. Mooresville, Scientific Software.Google Scholar
  59. 59.
    Mueller, R. O. (1996). Basic principles of structural equation modeling: An introduction to LISREL and EQS. New York: Springer.Google Scholar
  60. 60.
    Cassidy, J. D., et al. (2005). Incidence and course of low back pain episodes in the general population. Spine, 30(24), 2817–2823.PubMedCrossRefGoogle Scholar
  61. 61.
    Sinclair, S. J., et al. (1997). The effectiveness of an early active intervention program for workers with soft tissue injuries: The Early Claimant Cohort study. Spine, 22(24), 2919–2931.PubMedCrossRefGoogle Scholar
  62. 62.
    Carr, J. L., et al. (2006). Is the pain stages of change questionnaire (PSOCQ) a useful tool for predicting participation in a self-management programme? Further evidence of validity, on a sample of UK pain clinic patients. BMC Musculoskeletal Disorders, 7, 1–7.CrossRefGoogle Scholar
  63. 63.
    Ash, P., & Goldstein, S. I. (1995). Predictor of returning to work. Bulletin of American Academy of Psychiatry Law, 23(2), 205–210.Google Scholar
  64. 64.
    Dozois, D. J. A., et al. (1995). Factors associated with rehabilitation outcome in patients with low back pain (LBP): Prediction of employment outcome at 9-month follow-up. Rehab Psych, 40(4), 243–259.CrossRefGoogle Scholar
  65. 65.
    Lötters, F., et al. (2006). The prognostic value of depressive symptoms, fear-avoidance, and self-efficacy for duration of lost-time benefits in workers with musculoskeletal disorders. Journal of Occupational and Environmental Medicine, 63(12), 794–801.Google Scholar
  66. 66.
    Miller, W. R., & Rollnick, S. (1991). Motivational Interviewing. New York.Google Scholar
  67. 67.
    Abenhaim, L., et al. (1988). Risk of recurrence of occupational back pain over three year follow up. British Journal of Industrial Medicine, 45(12), 829–833.PubMedGoogle Scholar
  68. 68.
    Hashemi, L., et al. (1997). Length of disability and cost of workers’ compensation low back pain claims. Journal of Occupational and Environmental Medicine, 39(10), 937–945.PubMedCrossRefGoogle Scholar
  69. 69.
    Leigh, J. P., et al. (2001). Costs of occupational injuries and illnesses in California. Preventive Medicine, 32, 393–406.PubMedCrossRefGoogle Scholar
  70. 70.
    Joseph, J., et al. (1999). Critical perspectives on the transtheoretical model and stages of change. In J. A. Tucker, D. M. Donovan, & G. A. Marlatt (Eds.), Changing addictive behaviors – bridging clinical and public health strategies (pp. 161–190). New York: Guilford Press.Google Scholar
  71. 71.
    Frank, J. W., et al. (1996). Disability resulting from occupational low back pain part II: What do we know about secondary prevention? A review of the scientific evidence on prevention after disability begins. Spine, 21(24), 2918–2929.PubMedCrossRefGoogle Scholar
  72. 72.
    Loisel, P., et al. (2001). Disability prevention: New paradigm for the management of occupational back pain. Disease Management & Health Outcomes, 9(7), 351–360.CrossRefGoogle Scholar
  73. 73.
    Loisel, P. (2005). Intervention for return to work – what is really effective? Scand J Work Environ Health, 31(4), 245–7.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Renée-Louise Franche
    • 1
    • 2
  • Marc Corbière
    • 3
  • Hyunmi Lee
    • 1
  • F. Curtis Breslin
    • 1
    • 2
  • C. Gail Hepburn
    • 4
  1. 1.Institute for Work & HealthTorontoCanada
  2. 2.Department of Public Health SciencesUniversity of TorontoTorontoCanada
  3. 3.Rehabilitation DepartmentUniversity of SherbrookeLongueuilCanada
  4. 4.Department of PsychologyUniversity of LethbridgeLethbridgeCanada

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