Skip to main content

Advertisement

Log in

Psychometric Properties of the Obstacles to Return-to-Work Questionnaire in a Brazilian context

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Purpose To evaluate the psychometric properties of the Obstacles to Return-to-Work Questionnaire (ORTWQ) among Brazilian workers on sick-leave due to musculoskeletal disorders. Methods Confirmatory factor analysis was conducted to evaluate the factor structure validity of the ORTWQ. Model fit indices and salience of factor loadings were assessed. The convergent validity was estimated using the Average Variance Extracted (AVE) and Composite Reliability (CR). The correlational analysis was verified using the Spearman Correlation between the ORTWQ and other specific tools. Discriminant Validity, internal consistency, stability (test–retest) and floor/ceiling effect were also assessed. Results A total of 301 participants completed the ORTWQ with a mean age of 45.0 (9.9) years. After refinement, the factor structure indexes of the oblique model were [χ2/df = 1.8; CFI = 0.9; TLI = 0.9; PGFI = 0.7; PCFI = 0.8; RMSEA = 0.05 (90% CI 0.05–0.06)]. Only Depression, Physical Workload and Perceived Prognosis subscales presented suitable AVE indices: 0.63, 0.51 and 0.52 respectively. The correlations between ORTWQ and the other questionnaires were appropriate for almost all subscales. Reliability evaluation showed adequate estimates for all subscales except for the Worry Due to Sick-Leave (CR = 0.45; α = 0.44; ICC = 0.69). A higher order hierarchical model is suggested, in order to estimate an overall score to ORTWQ in a Brazilian population. Conclusions The psychometric properties of the Brazilian version of the ORTWQ were evaluated and after refinement, the validity, reliability and floor/ceiling effects indexes were suitable when applied to a sample of Brazilian workers on sick-leave due to musculoskeletal disorders. However, the factor structure presented some issues regarding convergent and discriminant validity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Monteiro MS, Alexandre NM, Ilmarinen J, Rodrigues CM. Work ability and musculoskeletal disorders among workers from a public health institution. Int J Occup Saf Ergon. 2009;15(3):319–24.

    Article  PubMed  Google Scholar 

  2. Punnett L, Wegman DH. Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. J Electromyogr Kinesiol. 2004;14(1):13–23.

    Article  PubMed  Google Scholar 

  3. Loisel P, Buchbinder R, Hazard R, Keller R, Scheel I, van Tulder M, et al. Prevention of work disability due to musculoskeletal disorders: the challenge of implementing evidence. J Occup Rehabil. 2005;15(4):507–24.

    Article  PubMed  Google Scholar 

  4. Coutu MF, Durand MJ, Loisel P, Dupuis G, Gervals S. Measurement properties of a new quality of life measure for patients with work disability associated with musculoskeletal pain. J Occup Rehabil. 2005;15(3):295–312.

    Article  CAS  PubMed  Google Scholar 

  5. Marhold C, Linton SJ, Melin L. Identification of obstacles for chronic pain patients to return to work: evaluation of a questionnaire. J Occup Rehabil. 2002;12(2):65–75.

    Article  PubMed  Google Scholar 

  6. Iles RA, Davidson M, Taylor NF. Psychosocial predictors of failure to return to work in non-chronic non-specific low back pain: a systematic review. Occup Environ Med. 2008;65(8):507–17.

    Article  CAS  PubMed  Google Scholar 

  7. Gray H, Adefolarin AT, Howe TE. A systematic review of instruments for the assessment of work-related psychosocial factors (Blue Flags) in individuals with non-specific low back pain. Man Ther. 2011;16(6):531–43.

    Article  PubMed  Google Scholar 

  8. Pransky G, Gatchel R, Linton SJ, Loisel P. Improving return to work research. J Occup Rehabil. 2005;15(4):453–7.

    Article  PubMed  Google Scholar 

  9. Loisel P, Durand MJ, Berthelette D, Vézina N, Baril R, Gagnon D, et al. Disability prevention—new paradigm for the management of occupational back pain. Dis Manag Health Outcomes. 2001;9(7):351–60.

    Article  Google Scholar 

  10. Linton SJ. Early identification and intervention in the prevention of musculoskeletal pain. Am J Ind Med. 2002;41(5):433–42.

    Article  PubMed  Google Scholar 

  11. Gatchel RJ. Musculoskeletal disorders: primary and secondary interventions. J Electromyogr Kinesiol. 2004;14(1):161–70.

    Article  PubMed  Google Scholar 

  12. Marois E, Durand MJ. Does participation in interdisciplinary work rehabilitation programme influence return to work obstacles and predictive factors? Disabil Rehabil. 2009;31(12):994–1007.

    Article  PubMed  Google Scholar 

  13. Beaton D, Bombardier C, Guillemin F, Ferraz MB. Recommendations for the cross-cultural adaptation of the DASH & Quick DASH outcome measures. Institute for Work & Health, Toronto 2007, pp 1–45. http://dash.iwh.on.ca/system/files/X-CulturalAdaptation-2007.pdf. Accessed 01 Feb 2015.

  14. Streiner DL, Norman GR, Cairney J. Health measurements scales. A pratical guide to their development and use. 5th ed. New York: Oxford University; 2015.

    Google Scholar 

  15. Milani D, Hirayama MS, Souza AC, Alexandre NMC. Obstacles to return-to-work questionnaire: Cross-cultural adaptation to Brazilian context. Cien Saude Colet. 2016 (In press). http://cienciaesaudecoletiva.com.br/artigos/artigo_int.php?id_artigo=15791.

  16. American Educational Research Association, American Psychological Association, & National Council on Measurement in Education, & Joint Committee on Standards for Educational and Psychological Testing. Washington, DC: AERA; 2014.

  17. Terwee CB, Mokkink LB, Knol DL, Ostelo RW, Bouter LM, de Vet HC. Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checlist. Qual Life Res. 2011;21:651–7.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Anastasi A. Psychological testing. 6th ed. New York: Macmillan Publishing Company; 1988.

    Google Scholar 

  19. Whoqol Group. The development of the World Health Organization quality of life assessment instrument (the WHOQOL). In: Orley J, Kuyken W, editors. Quality of life assessment:international perspectives. Heidelberg: Springer; 1994. p. 41–57.

    Chapter  Google Scholar 

  20. Fleck MP, Leal OF, Louzada S, Xavier M, Chachamovich E, Vieira G, et al. Development of the Portuguese version of the OMS evaluation instrument of quality of life. Rev Bras Psiquiatr. 1999;21(1):19–28.

    Article  Google Scholar 

  21. Hartrick CT, Kovan JP, Shapiro S. The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract. 2003;3(4):310–6.

    Article  PubMed  Google Scholar 

  22. Sousa FF, Silva JA. The metric of pain: theoretical and methodological issues. Rev Dor. 2005;6(1):469–513.

    Google Scholar 

  23. Tait RC, Chibnall JT. Development of a brief version of the survey of pain attitudes. Pain. 1997;70(2–3):229–35.

    Article  CAS  PubMed  Google Scholar 

  24. Pimenta CAD, Kurita GP, da Silva EM, da Cruz DALM. Validity and reliability of the survey of pain attitudes (SOPA-28 items) in the Portuguese Language. Rev Esc Enferm Usp. 2009;43:1070–8.

    Google Scholar 

  25. van Veldhoven M, Broersen S. Measurement quality and validity of the “Need for Recovery Scale”. Occup Environ Med. 2003;60:3–9.

    Article  Google Scholar 

  26. Moriguchi CS, Alem MER, van Veldhoven M, Coury HJCG. Cultural adaptation and psychometric properties of Brazilian Need for Recovery Scale. Rev Saude Publica. 2010;44(1):131–9.

    Article  PubMed  Google Scholar 

  27. Waddell G, Newton M, Henderson I, Somerville D, Main CJ. A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low-back-pain and disability. Pain. 1993;52(2):157–68.

    Article  CAS  PubMed  Google Scholar 

  28. Abreu AM, Faria CD, Cardoso SM, Teixeira-Salmela LF. The Brazilian version of the fear avoidance beliefs questionnaire. Cad Saude Publica. 2008;24(3):615–23.

    Article  PubMed  Google Scholar 

  29. Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B. The job content questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol. 1998;3(4):322–55.

    Article  CAS  PubMed  Google Scholar 

  30. Alves MGD, Chor D, Faerstein E, Lopes CS, Werneck GL. Short version of the “job stress scale”: a Portuguese-language adaptation. Rev Saude Publica. 2004;38(2):164–71.

    Article  PubMed  Google Scholar 

  31. Cooper CL, Williams J. A validation-study of the OSI on a blue-collar sample. Stress Med. 1991;7(2):109–12.

    Article  Google Scholar 

  32. Swan JA, Demoraes LFR, Cooper CL. Developing the occupational stress indicator (OSI) for Use in Brazil—a report on the reliability and validity of the translated OSI. Stress Med. 1993;9(4):247–53.

    Article  Google Scholar 

  33. de Barros EN, Alexandre NM. Cross-cultural adaptation of the Nordic musculoskeletal questionnaire. Int Nurs Rev. 2003;50(2):101–8.

    Article  PubMed  Google Scholar 

  34. Hair JF, Black WC, Babin B, Anderson RE, Tatham RL. Multivariate data analysis. 7th ed. New York: Prentice Hall; 2009.

    Google Scholar 

  35. Kim KH. The relation among fit indices, power, and sample size in structural equation modeling. Struct Equ Model. 2005;12(3):368–90.

    Article  Google Scholar 

  36. Guenther WC. Desk calculation of probabilities for distribution of sample correlation-coefficient. Am Stat. 1977;31(1):45–8.

    Google Scholar 

  37. Terwee CB, Bot SDM, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.

    Article  PubMed  Google Scholar 

  38. Maroco J. Analysis of Structural Equation: Theoretical Basis, Software & Applications. (Title in Portuguese: Análise de Equações Estruturais: Fundamentos teóricos, Software e Aplicações). 2nd ed. Pêro Pinheiro: Report Number; 2014.

  39. Kline RB. Principles and practice of structural equation modeling. 3rd ed. New York: Guilford; 2011.

    Google Scholar 

  40. Schultz IZ, Stowell AW, Feuerstein M, Gatchel RJ. Models of return to work for musculoskeletal disorders. J Occup Rehabil. 2007;17(2):327–52.

    Article  PubMed  Google Scholar 

  41. Wasiak R, Young AE, Roessler RT, McPherson KM, van Poppel MN, Anema JR. Measuring return to work. J Occup Rehabil. 2007;17(4):766–81.

    Article  PubMed  Google Scholar 

  42. Williams B, Onsman A, Brown T. Exploratory factor analysis: a five-step guide for novices. JEPHC. 2010;8(3):1–13.

    Google Scholar 

  43. Fornell C, Larcker DF. Evaluating structural equation models with unobservable variables and measurement error. J Mark Res. 1981;18(1):39–50.

    Article  Google Scholar 

  44. Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale: Lawrence Erlbaum Associates Inc; 1988.

    Google Scholar 

  45. Kuo H-H. Probability and stochastics series: white noise distribution theory—Book 5. Boca Raton: CRC Press; 1996.

    Google Scholar 

  46. Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ. Evaluating the use of exploratory factor analysis in psychological research. Psychol Methods. 1999;4(3):272–99.

    Article  Google Scholar 

  47. Tabachnick BG, Fidell LS. Using multivariate statistics. 6th ed. Boston: Allyn & Bacon; 2007.

    Google Scholar 

  48. Costello AB, Osborne JW. Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Assess Res Eval. 2005;10:1–9.

    Google Scholar 

  49. Campbell P, Bishop A, Dunn KM, Main CJ, Thomas E, Foster NE. Conceptual overlap of psychological constructs in low back pain. Pain. 2013;154(9):1783–91.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Martus P, Jakob O, Rose U, Seibt R, Freude G. A comparative analysis of the work ability index. Occup Med. 2010;60(7):517–24.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

We sincerely thank the Work Disability Prevention CIHR (Canadian Institutes of Health Research) Strategic Training Program, the Brazilian research agencies: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) and the Conselho Nacional de Desenvolvimento Tecnológico (CNPq). A special thanks to Dr Susan E. Peters, for her diligent and meticulous contributions, advices and English editing of the final version of this study.

Funding

DM was a trainee of Work Disability Prevention Program from 2012 to 2014 and has also funded by CAPES/CNPq to the Fellow of Doctoral Exchange Program by the Science without borders. Process number: 248514/2013-0.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Daniela Milani PhD, MSc, RN.

Ethics declarations

Conflict of interest

DM, NMCA, SHJ and JADBC declare that they have no conflict of interest.

Ethical Approval

All procedures performed in this study were in accordance with ethical standards and with the 1964 Helsinki declaration and its later amendments. The research project of this study was submitted and approved by the University of Campinas Ethics Committee. (Protocol number: 143.694/2012 and amendments (607.710/2014)).

Informed Consent

All participants signed two copies of consent form and the ORTWQ developers authorized the implementation of its cross-cultural adaptation and its use in Brazil.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Milani, D., Alexandre, N.M.C., Campos, J.A.D.B. et al. Psychometric Properties of the Obstacles to Return-to-Work Questionnaire in a Brazilian context. J Occup Rehabil 27, 530–546 (2017). https://doi.org/10.1007/s10926-016-9684-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-016-9684-8

Keywords

Navigation