Cross-Cultural Adaptation, Reliability and Validity of the Danish Version of the Readiness for Return to Work Instrument

  • Christina Malmose Stapelfeldt
  • Anne-Mette Hedeager Momsen
  • Thomas Lund
  • Therese Koops Grønborg
  • Sheilah Hogg-Johnson
  • Chris Jensen
  • Janne Skakon
  • Merete Labriola


The objective of the present study was to translate and validate the Canadian Readiness for Return To Work instrument (RRTW-CA) into a Danish version (RRTWDK) by testing its test–retest and internal consistency reliability and its structural and construct validity. Cross-cultural adaptation of the six-staged RRTW-CA instrument was performed in a standardised, systematic five-step-procedure; forward translation, panel synthesis of the translation, back translation, consolidation and revision by researchers, and finally pre-testing. This RRTW-DK beta-version was tested for its psychometric properties by intra-class correlation coefficient and standard error of measurement (n = 114), Cronbach’s alpha (n = 471), confirmatory factor analyses (n = 373), and Spearman’s rank correlation coefficient (n = 436) in sickness beneficiaries from a municipal employment agency and hospital wards. The original RRTW-CA stage structure could not be confirmed in the RRTWDK. The psychometric properties were thus inconclusive. The RRTW-DK cannot be recommended for use in the current version as the RRTW construct is questionable. The RRTW construct needs further exploration, preferably in a population that is homogeneous with regard to cause of sickness, disability duration and age.


Rehabilitation Vocational Reproducibility of results Sick leave Surveys and questionnaires Validation studies 



We want to thank Jens Laurids Jensen, Elin Sonne and Helle Holm Marcussen, Jobkompagniet, Silkeborg Municipality for their interest and involvement in this study. Last but not least we are grateful to all participants who kindly used their time answering questionnaires.


We kindly thank The Danish Working Environment Research Fund, which funded this project (20-2013-09).

Compliance with Ethical Standards

Conflict of interest

Author Christina Malmose Stapelfeldt, Anne-Mette Hedeager Momsen, Thomas Lund, Therese Koops Grønborg, Sheilah Hogg-Johnson, Janne Skakon, Chris Jensen and Merete Labriola declare that they have no conflict of interest.

Ethical Approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Approval for the use of questionnaire data was obtained from the Central Region Denmark (Danish Data Protection Agency j. no. 1-16-02-404-14). According to Danish law, approval from the Danish National Committee on Biomedical Research Ethics ( was not relevant as approval is required only for projects using biological material or involving biomedical treatment. Participation in the study was voluntary, and answers were processed anonymously.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Christina Malmose Stapelfeldt
    • 1
    • 2
  • Anne-Mette Hedeager Momsen
    • 1
    • 2
  • Thomas Lund
    • 3
    • 4
  • Therese Koops Grønborg
    • 5
  • Sheilah Hogg-Johnson
    • 6
    • 7
    • 8
  • Chris Jensen
    • 9
    • 10
  • Janne Skakon
    • 11
  • Merete Labriola
    • 1
    • 2
  1. 1.Section for Clinical Social Medicine and Rehabilitation, Department of Public HealthAarhus UniversityAarhus CDenmark
  2. 2.DEFACTUM, Social and Health Services and Labour MarketCentral Region DenmarkAarhus CDenmark
  3. 3.Centre for Social MedicineFrederiksberg and Bispebjerg HospitalFrederiksbergDenmark
  4. 4.Department of Public HealthAarhus UniversityArhus CDenmark
  5. 5.Section for Biostatistics, Department of Public HealthAarhus UniversityAarhus CDenmark
  6. 6.Institute for Work and HealthTorontoCanada
  7. 7.Canadian Memorial Chiropractic CollegeTorontoCanada
  8. 8.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  9. 9.Department of Public Health and NursingNorwegian University of Science and TechnologyTrondheimNorway
  10. 10.National Advisory Unit on Occupational RehabilitationRaulandNorway
  11. 11.Department of Psychology, Work and Organisational PsychologyUniversity of CopenhagenCopenhagen KDenmark

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