Introduction: Along with the social and economic challenges posed by an aging society, creating w... more Introduction: Along with the social and economic challenges posed by an aging society, creating work conditions that allow persons to stay healthy and work into old age has become a major task of Western societies. Retaining employment after returning to work is particularly difficult for individuals with a disability, as evidenced by the high rate of premature labor market dropout. Individuals with acquired brain injury (ABI) exemplify this challenge, as it often impairs cognitive, technical, and interpersonal abilities crucial in today's labor market. To effectively support these individuals, vocational integration practitioners require comprehensive knowledge of risk factors for premature labor market dropout and effective strategies for sustainable work. Objective This study aimed to identify perceived risk factors and related service gaps regarding sustainable work for people with ABI, as reported by affected individuals, employers, vocational integration professionals, and...
PURPOSE Work participation remains challenging for people with spinal cord injury (SCI), as refle... more PURPOSE Work participation remains challenging for people with spinal cord injury (SCI), as reflected in lower employment rates compared to the general population. To promote work participation for people with SCI, practitioners and policymakers need a better understanding of the factors associated with sustaining work in the long term. This study aimed to identify such factors. MATERIALS AND METHODS Scoping review synthesizing quantitative and qualitative research published between 2000 and 2021. The databases searched were PubMed, CINAHL Complete, PsycINFO, Scopus, and Web of Science. RESULTS Initially, 1221 articles were identified. Three quantitative studies investigating socio-demographic and injury-related factors and eight qualitative studies exploring mainly personal and environmental facilitators and barriers to working in the long term were retained. The results of the quantitative studies showed the importance of time since injury, age, and education. The qualitative findings emphasized the positive influence of self-advocacy, managing health behaviors, and a supportive work environment. Main barriers were time organization and societal attitudes. CONCLUSIONS Future interventions should address the identified factors to promote working in the long term of people with SCI. Policymakers should adapt and enforce legal standards that address environmental and social barriers to creating supportive work environments for persons with SCI.Implications for rehabilitationPeople with spinal cord injury (SCI) experience difficulties in maintaining employment.Personal factors identified as crucial for working in the long term, such as self-advocacy and self-management of health behaviors, should be strengthened by future interventions.People with SCI should be offered a supportive work environment with work accommodations and flexible working hours to facilitate their labor market participation.
International Journal of Environmental Research and Public Health, 2019
The assessment of work-related functioning is a key process in vocational rehabilitation to ident... more The assessment of work-related functioning is a key process in vocational rehabilitation to identify specific domains of disability that can be considered within return to work strategies. The Work Rehabilitation Questionnaire (WORQ) was developed to evaluate work-related functioning based on the International Classification of Functioning, Disability, and Health (ICF) framework and is available in different languages. The aim of this study was to assess the French version of the WORQ using item response theory to further validate the scale. Rasch analysis of WORQ and the WORQ-BRIEF (a brief version of the WORQ) was performed using a calibration sample of 221 persons with musculoskeletal injuries. A four-testlet solution indicated the unidimensionality of WORQ, with no differential item functioning for age, education, physical job demands, and injury severity. Reliability was 0.969 and 0.918 for WORQ and WORQ-BRIEF, respectively. The minimal detectable change was calculated to be 4....
PURPOSE Maintaining work in the long term represents a major challenge for people with acquired b... more PURPOSE Maintaining work in the long term represents a major challenge for people with acquired brain injury (ABI) as evidenced by a high rate of premature labour market dropouts. The present study aimed to compile factors associated with working in the long term after sustaining an ABI. MATERIALS AND METHODS We carried out a scoping review synthesizing quantitative and qualitative research conducted between 2000 and 2021. Databases searched comprised PubMed, CINAHL Complete, PsycINFO, Scopus, and Web of Science. RESULTS Ten quantitative and nine qualitative studies were included, all but one from high-resource countries. Quantitative research predominantly comprised longitudinal follow-ups on individuals' work status several years post ABI onset, showing an effect of injury-related and sociodemographic factors. Qualitative studies mostly dealt with work maintenance and revealed a key role of cognitive difficulties, psychological personal factors (e.g., adequate coping strategies) and environmental factors (e.g., flexible work schedules, supportive colleagues). CONCLUSIONS The factors identified in our review should receive particular attention in vocational integration and job retention programs to support work participation of people with ABI in the long term. There is a need for measures that regularly monitor and promote a good match between individuals and their work environment.Implications for RehabilitationPeople with acquired brain injury (ABI) often have long-lasting and invisible injury-related difficulties that hamper their labour market participation.Factors identified as positively associated with working in the long term, such as coping strategies and self-awareness, should be strengthened.Future interventions should educate affected persons, employers and health care professionals about long-lasting injury-related difficulties and promote a supportive work environment for people with ABI.Prolonged availability of vocational services could be beneficial for supporting work maintenance of people with ABI.
PURPOSE (1) To perform a cross-cultural adaptation of Work Rehabilitation Questionnaire to Russia... more PURPOSE (1) To perform a cross-cultural adaptation of Work Rehabilitation Questionnaire to Russian (WORQ-R); (2) to report the psychometric properties of WORQ-R in patients with traumatic spinal cord injury (TSCI). MATERIALS AND METHODS WORQ is designed to evaluate the work functioning of individuals who are engaged in vocational rehabilitation. We performed a formal cross-cultural adaptation of WORQ from English to Russian utilizing a standardized 3-step approach. We examined the psychometric properties of WORQ-R in terms of its reliability and construct validity through the use of classical and modern test theory in the TSCI population. RESULTS The adaptation process achieved equivalence between Russian and English versions of WORQ. WORQ-R proved to cover major issues concerning functioning in vocational rehabilitation and was simple to understand. The internal consistency of WORQ-R was good (Cronbach's Alpha = 0.83). Rasch analysis confirmed the unidimensionality of the WORQ-scale and high reliability (PSI = 0.97) based on a testlet solution. WORQ-R score showed a strong negative correlation with the Functional Independence Measure, moderate negative correlation with the Spinal Cord Independence Measure Version III and the SF-36, moderate positive correlation with the Spinal Cord Injury Secondary Conditions Scale. CONCLUSIONS WORQ-R showed good validity and reliability in persons with TSCI allowing vocational professionals to have comprehensive information on vocational functioning.IMPLICATIONS FOR REHABILITATIONSCI is a disabling condition that causes impairments in body structure and function leading to activity limitations and participation restrictions.WORQ is a generic tool that allows for an assessment of work-related aspects of functioning in different populations of persons with disabilities.This study demonstrates the psychometric properties of the Russian version of WORQ in the SCI population.WORQ-R is recommended as a tool to describe the biopsychosocial and related vocational background to gain a better understanding of needs among SCI persons in terms of vocational rehabilitation.
Study design Longitudinal, population-based survey. Objective To examine determinants of between-... more Study design Longitudinal, population-based survey. Objective To examine determinants of between-person differences in labor market participation of individuals with spinal cord injury (SCI) living in Switzerland and their potential importance for policy. Setting Community. Methods Longitudinal information on labor market participation (i.e., paid work or not) was obtained from 1198 and 1035 individuals of working-age participating in the 2012 and 2017 SwiSCI community survey, respectively. Determinants of between-person variation in labor market participation were examined using mixed effects logistic regression, controlling for within-person variation. Employment rates were predicted using counterfactual data for modifiable determinants. Results The employment rate was 56% for the 2012 and 61% for the 2017 survey. Labor market participation was affected mostly by static (sex, nationality, SCI severity), temporal (age), dynamic (education level, functional independence, chronic pain), and policy-related (general pension, disability pension level) determinants. Counterfactual (what-if) predictions indicated the highest improvement of employment rates for strategies that increase functional independence (up to 6% increase), foster education (5%), reduce chronic pain (2%), or promote a shift to partial disability pensions (15%). Conclusions Between-person variation in labor market participation of persons with SCI is influenced by various temporal, static, dynamic, and policy-related determinants. Our results suggest that policy strategies aimed at enhancing the employment rate of the Swiss SCI population may particularly invest in programs promoting functional independence, education, and partial pension levels that are more adequate for ensuring sustainable employment.
Purpose Musculoskeletal disorders (MSDs) are often associated with long-term sick leave, producti... more Purpose Musculoskeletal disorders (MSDs) are often associated with long-term sick leave, productivity loss, and reduced work functioning. However, measures that assess work-related functioning are sparse. Objective To assess the psychometric properties of the Work Rehabilitation Questionnaire (WORQ)-German version in patients with MSDs in an outpatient physical therapy practice. Methods Psychometric study including patients with MSDs with restricted work participation. Data was collected in a single physical therapy outpatient clinic. For construct validity, we developed a priori hypotheses on the correlation between the functioning part of WORQ (40 items) and other questionnaires with similar concepts. For test-retest reliability, WORQ was administered twice, 7 days apart. We examined internal consistency (Cronbach's Alpha) and Minimal Detectable Change (MDC). Feasibility of WORQ was examined using feedback from patients and physical therapists. Results There were 51 study participants. Test-retest of WORQ sum score was 0.80 (p < 0.01) (Spearman's rho). Internal consistency was 0.94 and MDC established at 9.2%. WORQ correlated with general health (r = − 0.49), with HADS (r = 0.55), and with quality of life (WHOQOL) (r = − 0.47). WORQ had the highest correlation with WHODAS 2.0 (r = 0.81). Patients rated WORQ as easy to answer and meaningful to their experience. Conclusions When evaluating self-reported work-related functioning, the WORQ-German version was demonstrated to be a valid, reliable, and easy to administer questionnaire for our sample of patients with MSDs in an outpatient PT clinic.
Purpose The Work Rehabilitation Questionnaire (WORQ) is a patient-reported instrument to assess w... more Purpose The Work Rehabilitation Questionnaire (WORQ) is a patient-reported instrument to assess work related functioning in vocational rehabilitation (VR) and work, based on the International Classification of Functioning, Disability and Health (ICF) core set for VR. The objective of this study was to cross-culturally adapt WORQ to French and to evaluate its psychometric properties. Methods The cross-cultural adaptation followed a dual-panel approach. Psychometrics was examined in one VR-centre in the French speaking part of Switzerland. Test-retest reliability was analyzed with intraclass correlation coefficient (ICC), internal consistency was assessed with Cronbach's alpha. Construct validity was determined by convergence to the self-reported general functioning scale and the Hospital Anxiety and Depression Scales (HADS). The association of patient's return-to-work expectation within 6-months and having a case manager was examined. The usability of WORQ-French was tested in 10 VR patients. Results Eighty-nine patients with musculoskeletal injuries were included. WORQ-French showed excellent internal consistency (0.968) and a high test-retest reliability (0.935). WORQ-French was positively associated with self-reported general functioning (r = 0.662) and both HADS scales (r = 0.56-0.57). Neither the patient's return-to-work expectation nor having a case manager were significantly correlated with WORQ-French. Usability in terms of understandability of questions and response options was found to be good. Seven patients rated the length of WORQ-French as good, while two found the instrument a little too long and one found it too long. Conclusions WORQ French is a valid, reliable, and easy to administer instrument to assess self-reported work functioning given our study setting and sample characteristics.
In the last few years the International Classification of Functioning, Disability and Health (ICF... more In the last few years the International Classification of Functioning, Disability and Health (ICF) has become a widely known and useful reference classification in vocational rehabilitation. It would be equally important to know which aspects of work-related health information cannot be assigned to distinct ICF categories. The objective of this study is to examine the concepts derived from three studies conducted within the ICF Core Set for vocational rehabilitation project, which could not be linked to distinct ICF codes in order to complement the current understanding of functioning in vocational rehabilitation. Secondary data analysis of the concepts from the systematic literature review, expert survey and patient focus group study of the ICF Core Set for vocational rehabilitation project that were marked as nd = not definable, nc = not covered or pf = personal factor. Nd-concepts were assigned to the biopsychosocial model of the ICF; additional ICF categories were formulated whe...
Background The Comprehensive ICF Core Set for vocational rehabilitation (VR) is a list of essenti... more Background The Comprehensive ICF Core Set for vocational rehabilitation (VR) is a list of essential categories on functioning based on the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF), which describes a standard for interdisciplinary assessment, documentation, and communication in VR. Objective The aim of this study was to examine the content validity of the Comprehensive ICF Core Set for VR from the perspective of physical therapists. Design A 3-round email survey was performed using the Delphi method. Methods A convenience sample of international physical therapists working in VR with work experience of ≥2 years were asked to identify aspects they consider as relevant when evaluating or treating clients in VR. Responses were linked to the ICF categories and compared with the Comprehensive ICF Core Set for VR. Results Sixty-two physical therapists from all 6 WHO world regions responded with 3,917 statements that were subse...
Traumatic brain injury (TBI) impacts on all aspects of the injured person’s lived experience incl... more Traumatic brain injury (TBI) impacts on all aspects of the injured person’s lived experience including work participation. Considering that a majority of persons who survive a TBI are of working age, the person with TBI still has many years to fulfill his vocational potential. Recognizing the individual factors that contribute to increasing vocational potential in persons following a TBI as well as understanding the dynamic interaction of influencing factors can facilitate the planning and implementation of strategies and interventions. The International Classification of Functioning, Disability and Health (ICF), an internationally accepted standard for describing functioning of individuals with a health condition, can provide the foundation for identifying factors and understanding how their interaction contributes to an increased or reduced potential for work participation. Using a hypothetical case example (based on clinical experience), this chapter demonstrates the use of the ICF-based Work Rehabilitation Questionnaire or WORQ (self-report version) together with the ICF Core Set for TBI for facilitating interprofessional communication, assessing work-oriented functioning in VR, creating an ICF-based functioning profile (Categorical Profile), and setting appropriate VR goals.
This chapter will introduce the reader to an example on how an assessment instrument, based on th... more This chapter will introduce the reader to an example on how an assessment instrument, based on the International Classification of Functioning, Disability, and Health can be developed. It lines out the reasoning behind the development of the new instrument as well as the methodology that was used. The instrument is a questionnaire designed to evaluate functioning in vocational rehabilitation – the Work Rehabilitation Questionnaire (WORQ).
BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) holds gr... more BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) holds great promise for providing rehabilitation disciplines with an interdisciplinary language. In order to facilitate its use in clinical practice of physiotherapy a first version of relevant ICF-Intervention categories was developed. OBJECTIVE: This study’s aim was to investigate which and with which frequency ICF-intervention categories contained in the 1. version for physiotherapists are represented in clinical practice. METHOD: The study was conducted as a retrospective, cross-sectional, multi-centered study. Convenience sample: 300 clinical records of patients with musculoskeletal conditions, from 62 different Swiss institutions, in proportion to Switzerland’s population distribution across 3 language regions. All treatment objectives were associated with ICF-categories. All categories represented in more than 5 % of the documents were listed in intervention categories. RESULTS: 45 institutions participated in the study. 99 clinical records from acute, 101 from rehabilitation and 80 records from community health care situations were obtained. 38 second level categories for the acute context, 46 for the rehabilitation and 38 for the long term context constitute the ICF-intervention categories for musculoskeletal health conditions. CONCLUSION: ICF-Intervention categories can express physical therapy treatment objectives in an interdisciplinary, comprehensible language.
BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) is consi... more BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) is considered a useful tool to overcome differences amongst health professionals, and to facilitate a mutual understanding of patient’s health problem and its treatment. In preliminary studies, a first version of ICF intervention categories for physical therapists was developed. OBJECTIVE: The aim of this study was to investigate which intervention categories of the first version are represented in the clinical practice of physical therapists treating patients with internal-medicine conditions. METHODS: The study was designed as a retrospective cross-sectional multicentered study. 77 institutions in Switzerland were asked to send a total of 300 selected clinical records describing patients with internal medicine conditions. RESULTS: The analysis of 280 patients’ records from 54 institutions enabled identification of 36 ICF intervention categories in acute, 41 in rehabilitation and 38 in long-term context. CONCLUSIONS: The ICF intervention categories identified in this study can help to define core competence of the physical therapy profession. The definition of ICF intervention categories represents a first step towards a standardization of treatment documentation. In this, they meet the demand of health care providers regarding quality of documentation on health care services.
Introduction: Along with the social and economic challenges posed by an aging society, creating w... more Introduction: Along with the social and economic challenges posed by an aging society, creating work conditions that allow persons to stay healthy and work into old age has become a major task of Western societies. Retaining employment after returning to work is particularly difficult for individuals with a disability, as evidenced by the high rate of premature labor market dropout. Individuals with acquired brain injury (ABI) exemplify this challenge, as it often impairs cognitive, technical, and interpersonal abilities crucial in today's labor market. To effectively support these individuals, vocational integration practitioners require comprehensive knowledge of risk factors for premature labor market dropout and effective strategies for sustainable work. Objective This study aimed to identify perceived risk factors and related service gaps regarding sustainable work for people with ABI, as reported by affected individuals, employers, vocational integration professionals, and...
PURPOSE Work participation remains challenging for people with spinal cord injury (SCI), as refle... more PURPOSE Work participation remains challenging for people with spinal cord injury (SCI), as reflected in lower employment rates compared to the general population. To promote work participation for people with SCI, practitioners and policymakers need a better understanding of the factors associated with sustaining work in the long term. This study aimed to identify such factors. MATERIALS AND METHODS Scoping review synthesizing quantitative and qualitative research published between 2000 and 2021. The databases searched were PubMed, CINAHL Complete, PsycINFO, Scopus, and Web of Science. RESULTS Initially, 1221 articles were identified. Three quantitative studies investigating socio-demographic and injury-related factors and eight qualitative studies exploring mainly personal and environmental facilitators and barriers to working in the long term were retained. The results of the quantitative studies showed the importance of time since injury, age, and education. The qualitative findings emphasized the positive influence of self-advocacy, managing health behaviors, and a supportive work environment. Main barriers were time organization and societal attitudes. CONCLUSIONS Future interventions should address the identified factors to promote working in the long term of people with SCI. Policymakers should adapt and enforce legal standards that address environmental and social barriers to creating supportive work environments for persons with SCI.Implications for rehabilitationPeople with spinal cord injury (SCI) experience difficulties in maintaining employment.Personal factors identified as crucial for working in the long term, such as self-advocacy and self-management of health behaviors, should be strengthened by future interventions.People with SCI should be offered a supportive work environment with work accommodations and flexible working hours to facilitate their labor market participation.
International Journal of Environmental Research and Public Health, 2019
The assessment of work-related functioning is a key process in vocational rehabilitation to ident... more The assessment of work-related functioning is a key process in vocational rehabilitation to identify specific domains of disability that can be considered within return to work strategies. The Work Rehabilitation Questionnaire (WORQ) was developed to evaluate work-related functioning based on the International Classification of Functioning, Disability, and Health (ICF) framework and is available in different languages. The aim of this study was to assess the French version of the WORQ using item response theory to further validate the scale. Rasch analysis of WORQ and the WORQ-BRIEF (a brief version of the WORQ) was performed using a calibration sample of 221 persons with musculoskeletal injuries. A four-testlet solution indicated the unidimensionality of WORQ, with no differential item functioning for age, education, physical job demands, and injury severity. Reliability was 0.969 and 0.918 for WORQ and WORQ-BRIEF, respectively. The minimal detectable change was calculated to be 4....
PURPOSE Maintaining work in the long term represents a major challenge for people with acquired b... more PURPOSE Maintaining work in the long term represents a major challenge for people with acquired brain injury (ABI) as evidenced by a high rate of premature labour market dropouts. The present study aimed to compile factors associated with working in the long term after sustaining an ABI. MATERIALS AND METHODS We carried out a scoping review synthesizing quantitative and qualitative research conducted between 2000 and 2021. Databases searched comprised PubMed, CINAHL Complete, PsycINFO, Scopus, and Web of Science. RESULTS Ten quantitative and nine qualitative studies were included, all but one from high-resource countries. Quantitative research predominantly comprised longitudinal follow-ups on individuals' work status several years post ABI onset, showing an effect of injury-related and sociodemographic factors. Qualitative studies mostly dealt with work maintenance and revealed a key role of cognitive difficulties, psychological personal factors (e.g., adequate coping strategies) and environmental factors (e.g., flexible work schedules, supportive colleagues). CONCLUSIONS The factors identified in our review should receive particular attention in vocational integration and job retention programs to support work participation of people with ABI in the long term. There is a need for measures that regularly monitor and promote a good match between individuals and their work environment.Implications for RehabilitationPeople with acquired brain injury (ABI) often have long-lasting and invisible injury-related difficulties that hamper their labour market participation.Factors identified as positively associated with working in the long term, such as coping strategies and self-awareness, should be strengthened.Future interventions should educate affected persons, employers and health care professionals about long-lasting injury-related difficulties and promote a supportive work environment for people with ABI.Prolonged availability of vocational services could be beneficial for supporting work maintenance of people with ABI.
PURPOSE (1) To perform a cross-cultural adaptation of Work Rehabilitation Questionnaire to Russia... more PURPOSE (1) To perform a cross-cultural adaptation of Work Rehabilitation Questionnaire to Russian (WORQ-R); (2) to report the psychometric properties of WORQ-R in patients with traumatic spinal cord injury (TSCI). MATERIALS AND METHODS WORQ is designed to evaluate the work functioning of individuals who are engaged in vocational rehabilitation. We performed a formal cross-cultural adaptation of WORQ from English to Russian utilizing a standardized 3-step approach. We examined the psychometric properties of WORQ-R in terms of its reliability and construct validity through the use of classical and modern test theory in the TSCI population. RESULTS The adaptation process achieved equivalence between Russian and English versions of WORQ. WORQ-R proved to cover major issues concerning functioning in vocational rehabilitation and was simple to understand. The internal consistency of WORQ-R was good (Cronbach's Alpha = 0.83). Rasch analysis confirmed the unidimensionality of the WORQ-scale and high reliability (PSI = 0.97) based on a testlet solution. WORQ-R score showed a strong negative correlation with the Functional Independence Measure, moderate negative correlation with the Spinal Cord Independence Measure Version III and the SF-36, moderate positive correlation with the Spinal Cord Injury Secondary Conditions Scale. CONCLUSIONS WORQ-R showed good validity and reliability in persons with TSCI allowing vocational professionals to have comprehensive information on vocational functioning.IMPLICATIONS FOR REHABILITATIONSCI is a disabling condition that causes impairments in body structure and function leading to activity limitations and participation restrictions.WORQ is a generic tool that allows for an assessment of work-related aspects of functioning in different populations of persons with disabilities.This study demonstrates the psychometric properties of the Russian version of WORQ in the SCI population.WORQ-R is recommended as a tool to describe the biopsychosocial and related vocational background to gain a better understanding of needs among SCI persons in terms of vocational rehabilitation.
Study design Longitudinal, population-based survey. Objective To examine determinants of between-... more Study design Longitudinal, population-based survey. Objective To examine determinants of between-person differences in labor market participation of individuals with spinal cord injury (SCI) living in Switzerland and their potential importance for policy. Setting Community. Methods Longitudinal information on labor market participation (i.e., paid work or not) was obtained from 1198 and 1035 individuals of working-age participating in the 2012 and 2017 SwiSCI community survey, respectively. Determinants of between-person variation in labor market participation were examined using mixed effects logistic regression, controlling for within-person variation. Employment rates were predicted using counterfactual data for modifiable determinants. Results The employment rate was 56% for the 2012 and 61% for the 2017 survey. Labor market participation was affected mostly by static (sex, nationality, SCI severity), temporal (age), dynamic (education level, functional independence, chronic pain), and policy-related (general pension, disability pension level) determinants. Counterfactual (what-if) predictions indicated the highest improvement of employment rates for strategies that increase functional independence (up to 6% increase), foster education (5%), reduce chronic pain (2%), or promote a shift to partial disability pensions (15%). Conclusions Between-person variation in labor market participation of persons with SCI is influenced by various temporal, static, dynamic, and policy-related determinants. Our results suggest that policy strategies aimed at enhancing the employment rate of the Swiss SCI population may particularly invest in programs promoting functional independence, education, and partial pension levels that are more adequate for ensuring sustainable employment.
Purpose Musculoskeletal disorders (MSDs) are often associated with long-term sick leave, producti... more Purpose Musculoskeletal disorders (MSDs) are often associated with long-term sick leave, productivity loss, and reduced work functioning. However, measures that assess work-related functioning are sparse. Objective To assess the psychometric properties of the Work Rehabilitation Questionnaire (WORQ)-German version in patients with MSDs in an outpatient physical therapy practice. Methods Psychometric study including patients with MSDs with restricted work participation. Data was collected in a single physical therapy outpatient clinic. For construct validity, we developed a priori hypotheses on the correlation between the functioning part of WORQ (40 items) and other questionnaires with similar concepts. For test-retest reliability, WORQ was administered twice, 7 days apart. We examined internal consistency (Cronbach's Alpha) and Minimal Detectable Change (MDC). Feasibility of WORQ was examined using feedback from patients and physical therapists. Results There were 51 study participants. Test-retest of WORQ sum score was 0.80 (p < 0.01) (Spearman's rho). Internal consistency was 0.94 and MDC established at 9.2%. WORQ correlated with general health (r = − 0.49), with HADS (r = 0.55), and with quality of life (WHOQOL) (r = − 0.47). WORQ had the highest correlation with WHODAS 2.0 (r = 0.81). Patients rated WORQ as easy to answer and meaningful to their experience. Conclusions When evaluating self-reported work-related functioning, the WORQ-German version was demonstrated to be a valid, reliable, and easy to administer questionnaire for our sample of patients with MSDs in an outpatient PT clinic.
Purpose The Work Rehabilitation Questionnaire (WORQ) is a patient-reported instrument to assess w... more Purpose The Work Rehabilitation Questionnaire (WORQ) is a patient-reported instrument to assess work related functioning in vocational rehabilitation (VR) and work, based on the International Classification of Functioning, Disability and Health (ICF) core set for VR. The objective of this study was to cross-culturally adapt WORQ to French and to evaluate its psychometric properties. Methods The cross-cultural adaptation followed a dual-panel approach. Psychometrics was examined in one VR-centre in the French speaking part of Switzerland. Test-retest reliability was analyzed with intraclass correlation coefficient (ICC), internal consistency was assessed with Cronbach's alpha. Construct validity was determined by convergence to the self-reported general functioning scale and the Hospital Anxiety and Depression Scales (HADS). The association of patient's return-to-work expectation within 6-months and having a case manager was examined. The usability of WORQ-French was tested in 10 VR patients. Results Eighty-nine patients with musculoskeletal injuries were included. WORQ-French showed excellent internal consistency (0.968) and a high test-retest reliability (0.935). WORQ-French was positively associated with self-reported general functioning (r = 0.662) and both HADS scales (r = 0.56-0.57). Neither the patient's return-to-work expectation nor having a case manager were significantly correlated with WORQ-French. Usability in terms of understandability of questions and response options was found to be good. Seven patients rated the length of WORQ-French as good, while two found the instrument a little too long and one found it too long. Conclusions WORQ French is a valid, reliable, and easy to administer instrument to assess self-reported work functioning given our study setting and sample characteristics.
In the last few years the International Classification of Functioning, Disability and Health (ICF... more In the last few years the International Classification of Functioning, Disability and Health (ICF) has become a widely known and useful reference classification in vocational rehabilitation. It would be equally important to know which aspects of work-related health information cannot be assigned to distinct ICF categories. The objective of this study is to examine the concepts derived from three studies conducted within the ICF Core Set for vocational rehabilitation project, which could not be linked to distinct ICF codes in order to complement the current understanding of functioning in vocational rehabilitation. Secondary data analysis of the concepts from the systematic literature review, expert survey and patient focus group study of the ICF Core Set for vocational rehabilitation project that were marked as nd = not definable, nc = not covered or pf = personal factor. Nd-concepts were assigned to the biopsychosocial model of the ICF; additional ICF categories were formulated whe...
Background The Comprehensive ICF Core Set for vocational rehabilitation (VR) is a list of essenti... more Background The Comprehensive ICF Core Set for vocational rehabilitation (VR) is a list of essential categories on functioning based on the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF), which describes a standard for interdisciplinary assessment, documentation, and communication in VR. Objective The aim of this study was to examine the content validity of the Comprehensive ICF Core Set for VR from the perspective of physical therapists. Design A 3-round email survey was performed using the Delphi method. Methods A convenience sample of international physical therapists working in VR with work experience of ≥2 years were asked to identify aspects they consider as relevant when evaluating or treating clients in VR. Responses were linked to the ICF categories and compared with the Comprehensive ICF Core Set for VR. Results Sixty-two physical therapists from all 6 WHO world regions responded with 3,917 statements that were subse...
Traumatic brain injury (TBI) impacts on all aspects of the injured person’s lived experience incl... more Traumatic brain injury (TBI) impacts on all aspects of the injured person’s lived experience including work participation. Considering that a majority of persons who survive a TBI are of working age, the person with TBI still has many years to fulfill his vocational potential. Recognizing the individual factors that contribute to increasing vocational potential in persons following a TBI as well as understanding the dynamic interaction of influencing factors can facilitate the planning and implementation of strategies and interventions. The International Classification of Functioning, Disability and Health (ICF), an internationally accepted standard for describing functioning of individuals with a health condition, can provide the foundation for identifying factors and understanding how their interaction contributes to an increased or reduced potential for work participation. Using a hypothetical case example (based on clinical experience), this chapter demonstrates the use of the ICF-based Work Rehabilitation Questionnaire or WORQ (self-report version) together with the ICF Core Set for TBI for facilitating interprofessional communication, assessing work-oriented functioning in VR, creating an ICF-based functioning profile (Categorical Profile), and setting appropriate VR goals.
This chapter will introduce the reader to an example on how an assessment instrument, based on th... more This chapter will introduce the reader to an example on how an assessment instrument, based on the International Classification of Functioning, Disability, and Health can be developed. It lines out the reasoning behind the development of the new instrument as well as the methodology that was used. The instrument is a questionnaire designed to evaluate functioning in vocational rehabilitation – the Work Rehabilitation Questionnaire (WORQ).
BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) holds gr... more BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) holds great promise for providing rehabilitation disciplines with an interdisciplinary language. In order to facilitate its use in clinical practice of physiotherapy a first version of relevant ICF-Intervention categories was developed. OBJECTIVE: This study’s aim was to investigate which and with which frequency ICF-intervention categories contained in the 1. version for physiotherapists are represented in clinical practice. METHOD: The study was conducted as a retrospective, cross-sectional, multi-centered study. Convenience sample: 300 clinical records of patients with musculoskeletal conditions, from 62 different Swiss institutions, in proportion to Switzerland’s population distribution across 3 language regions. All treatment objectives were associated with ICF-categories. All categories represented in more than 5 % of the documents were listed in intervention categories. RESULTS: 45 institutions participated in the study. 99 clinical records from acute, 101 from rehabilitation and 80 records from community health care situations were obtained. 38 second level categories for the acute context, 46 for the rehabilitation and 38 for the long term context constitute the ICF-intervention categories for musculoskeletal health conditions. CONCLUSION: ICF-Intervention categories can express physical therapy treatment objectives in an interdisciplinary, comprehensible language.
BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) is consi... more BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) is considered a useful tool to overcome differences amongst health professionals, and to facilitate a mutual understanding of patient’s health problem and its treatment. In preliminary studies, a first version of ICF intervention categories for physical therapists was developed. OBJECTIVE: The aim of this study was to investigate which intervention categories of the first version are represented in the clinical practice of physical therapists treating patients with internal-medicine conditions. METHODS: The study was designed as a retrospective cross-sectional multicentered study. 77 institutions in Switzerland were asked to send a total of 300 selected clinical records describing patients with internal medicine conditions. RESULTS: The analysis of 280 patients’ records from 54 institutions enabled identification of 36 ICF intervention categories in acute, 41 in rehabilitation and 38 in long-term context. CONCLUSIONS: The ICF intervention categories identified in this study can help to define core competence of the physical therapy profession. The definition of ICF intervention categories represents a first step towards a standardization of treatment documentation. In this, they meet the demand of health care providers regarding quality of documentation on health care services.
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