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

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Abstract

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.

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Acknowledgements

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.

Funding

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

Author information

Authors and Affiliations

  1. Section for Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark

    Christina Malmose Stapelfeldt, Anne-Mette Hedeager Momsen & Merete Labriola

  2. DEFACTUM, Social and Health Services and Labour Market, Central Region Denmark, MarselisborgCentret, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark

    Christina Malmose Stapelfeldt, Anne-Mette Hedeager Momsen & Merete Labriola

  3. Centre for Social Medicine, Frederiksberg and Bispebjerg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark

    Thomas Lund

  4. Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Arhus C, Denmark

    Thomas Lund

  5. Section for Biostatistics, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark

    Therese Koops Grønborg

  6. Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada

    Sheilah Hogg-Johnson

  7. Canadian Memorial Chiropractic College, Toronto, Canada

    Sheilah Hogg-Johnson

  8. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

    Sheilah Hogg-Johnson

  9. Department of Public Health and Nursing, Norwegian University of Science and Technology, Håkon Jarls gate 11, Øya Helsehus, Trondheim, Norway

    Chris Jensen

  10. National Advisory Unit on Occupational Rehabilitation, Haddlandsvegen 20, 3864, Rauland, Telemark, Norway

    Chris Jensen

  11. Department of Psychology, Work and Organisational Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark

    Janne Skakon

Authors
  1. Christina Malmose Stapelfeldt
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  2. Anne-Mette Hedeager Momsen
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  3. Thomas Lund
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  4. Therese Koops Grønborg
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  5. Sheilah Hogg-Johnson
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  6. Chris Jensen
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  7. Janne Skakon
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  8. Merete Labriola
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Corresponding author

Correspondence to Christina Malmose Stapelfeldt.

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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 (http://www.cvk.sum.dk) 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.

Appendix

Appendix

The Readiness for Return to Work Instrument

For all items: Strongly disagree (1), Disagree (2), Neither disagree nor agree (3), Agree (4), Strongly agree (5).

For the items A7, A11 and B8, the scale is reversed.

Part (A) Not working sample

1. “You don’t think you will ever be able to go back to work” *

2. “As far as you’re concerned, there is no point in thinking about returning to work” * §

3. “You are actively doing things now to get back to work” *

4. “Physically, you are starting to feel ready to go back to work” *

5. “You have been increasing your activities at home in order to build up your strength to go back to work” *

6. “You are getting help from others to return to work”

7. “You are not ready to go back to work” *

8. “You have found strategies to make your work manageable so you can return to work” *

9. “You have been wondering if there is something you could do to return to work”

10. “You have a date for your first day back at work” *

11. “You wish you had more ideas about how to get back to work” * §

12. “You’d like to have some advice about how to go back to work” *

13. “As far as you are concerned, you don’t need to go back to work ever” *

* Items with difficulties in the translation process

§ Items adjusted after pre-test in the adapted version of the questionnaire (RRTW-DK)

Stages in Part A

Pre-contemplation (PC) A1, A2, A13

Contemplation (C) A9, A11, A12

Prepared for action self-evaluative (PA-S) A4, A7, A8, A10

Prepared for action behavioural (PA-B) A3, A5, A6

Part (B) Working Sample

1. “You are doing everything you can to stay at work”

2. “You have learned different ways to cope with your pain so that you can stay at work” *

3. “You are taking steps to prevent having to go off job again due to your injury” *

4. “You have found strategies to make your work manageable so you can stay at work”

5. “You are back at work but are not sure you can keep up the effort” *

6. “You worry about having to stop working again due to your injury”

7. “You still find yourself struggling to stay at work due to the effects of your injury”

8. “You are back at work and it is going well” *

9. “You feel you may need help in order to stay at work”

* Items with difficulties in the translation process

§ Items adjusted after pre-test in the adapted version of the questionnaire (RRTW-DK)

Stages in Part B

Uncertain maintenance, items: B5, B6, B7, B8, B9

Proactive maintenance, items: B1, B2, B3, B4

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Stapelfeldt, C.M., Momsen, AM.H., Lund, T. et al. Cross-Cultural Adaptation, Reliability and Validity of the Danish Version of the Readiness for Return to Work Instrument. J Occup Rehabil 29, 325–335 (2019). https://doi.org/10.1007/s10926-018-9790-x

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