Topical Seminar 2

Topical Seminar 2:
Measuring work functioning: towards cross-national comparisons and applications in different worker populations

Session chair(s): Ben Amick III

Schedule Details

Monday September 29
13:45 - 15:15 Afternoon Concurrent Sessions (M O13 - M O24 and Seminar 2)
Topic: Work Functioning
Room C

Seminar Objectives

Sustaining labour market participation with productive work functioning (WF) in developed countries presents a major challenge for policymakers, healthcare professionals, insurers, unions, employers, workers and their families. Preservation of healthy and productive WF across the lifespan is recognized as a top priority for maintaining a healthy economy and building a nation’s wealth. Due to the ageing workforce, retirement age increases and advances in medical treatment, more vulnerable workers will need to be part of the solution. Yet, the tools to manage the targets attainment are too coarse to track success and highlight successful innovative programs. Measures are needed to examine “functioning at work” as a key indicator of sustained and active labour force participation. Work functioning is determined by the joint influence of work and health and should be viewed as a continuum rather than a dichotomy. Work functioning tools should enable healthcare professionals, policymakers, HR managers, employers and other stakeholders to support active labour force participation. Moreover, comparisons across European countries are not available, but needed by policymakers and other stakeholders.

In this symposium, we will present results from studies conducted in Spain, Sweden, and the Netherlands. We propose a session focused on systematic approaches for the cross-cultural translation and adaptation as well as the evaluation of measurement properties of a work functioning measure. Moreover, the application of the concept of work functioning in different worker populations, i.e., general working population and workers who returned to work after sickness absence due to common mental disorders, will be discussed. The goal of the symposium is to encourage cross-national comparative research and to provide researchers, healthcare professionals, HR managers, employers and other stakeholders with better knowledge about work functioning in different worker populations.

Layout of seminar:
Short introduction by chair - 2 minutes;
4 presentations - 12 minutes each with 5 minutes discussion;
General discussion moderated by chair - 20 minutes

Presentation 1: Reliability, validity and responsiveness of the Spanish version of the work role functioning questionnaire

Presented by: José M Ramada Rodilla

Authors

Ramada Rodilla JM1,2, Serra Pujadas C1,2, Amick III B3,4, Bültmann U4,5, Delclos Clanchet GL1,6

  1. CiSAL - Center for Research in Occupational Health. University Pompeu Fabra. Barcelona, Spain
  2. Occupational Health Service. Parc de Salut Mar. Barcelona, Spain
  3. Institute for Work & Health, Toronto, Canada
  4. Department of Health Policy and Management, Robert Stempel College of Public Health & Social Work. Florida International University, Miami, USA
  5. Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen. Groningen, The Netherlands
  6. Southwest Center for Occupational and Environmental Health, the University of Texas School of Public Health. Houston, USA.

Abstract

Background

Health-related work functioning is the worker’s ability to meet job demands for a given health status. Quality validated measurement tools are needed to assess how workers function at work along their professional life and to evaluate interventions to adapt job conditions to the worker’s skills and health. The Work Role Functioning Questionnaire (WRFQ) is an instrument to measure self-perceived difficulties to meet job demands in active workers; given a certain health status. The WRFQ has an evidence base of quality studies assessing its measurement properties in different languages, but not yet in Spanish. Hence, the aim of this study was to validate the WRFQ in a general working Spanish-speaking population (WRFQ-SpV).

Methods

A cross-sectional study was conducted among 455 active workers of a general working population to evaluate the reliability and validity of the WRFQ-SpV. A longitudinal survey with 102 participants was carried out to examine responsiveness. The consensus-based standards on measurement properties of measurement tools (COSMIN) guided the design of the process.

Results

The WRFQ-SpV showed adequate applicability, good face and content validity. Internal consistency was very good (Cronbach alpha=0.98). The original five factor structure of the WRFQ-SpV reflected fair dimensionality of the construct (Chi square, 1445.8; 314 degrees of freedom; root mean square error of approximation [RMSEA] =0.08; comparative fit index [CFI] >0.95 and weighed root mean residual [WRMR]>0.90). The test–retest reliability showed good reproducibility of the outcomes (0.77 ≤ intraclass correlation coefficient [ICC]≤0.93) and standard error of measurement [SEM]=7.10). For construct validation, all formulated hypotheses were confirmed differentiating groups with different jobs, health conditions and ages. Seven hypotheses (out of six) were confirmed, verifying that the WRFQ-SpV was able to detect true changes over time.

Conclusions

The WRFQ-SpV is a reliable and valid instrument to measure health-related work functioning in daily practice and research in occupational health. Suggestive evidence about its possible use in evaluative studies was found. More research is needed to examine the instrument responsiveness for groups who do not experience health improvement or deteriorate.

Presentation 2: Predictors of successful work functioning in the general working population

Presented by: Femke Abma

Authors

Abma FI1, van der Klink JJL1, Amick III B2,3, Bültmann U1

  1. University Medical Center Groningen, University of Groningen. Groningen, The Netherlands
  2. Institute for Work & Health. Toronto, Canada
  3. Department of Health Policy and Management. Robert Stempel College of Public Health & Social Work. Florida International University. Miami, USA

Abstract

Background

Work functioning is the interplay between work and health. To help workers to stay at work in a healthy, productive and sustainable way and to develop interventions to improve work functioning, it is important to have insight in predictors of successful work functioning. The aim of this study is to identify predictors of successful work functioning in the general working population.

Methods

A longitudinal study was conducted in the general working population. Data was collected at baseline and at 3 month follow-up. Work functioning was assessed with the Work Role Functioning Questionnaire 2.0 (WRFQ). The WRFQ total score was categorized as: 0-90; >90 ≤95; and >95-100 (the latter was defined as ‘successful work functioning’). A stepwise multiple ordinal logistic regression analysis was performed to examine relationships between potential predictors and the dependent variable (successful work functioning). Potential predictors included were baseline work functioning, mental health, fatigue, decision latitude, work engagement, and work ability.

Results

In model 1 (WRFQ baseline, mental health and fatigue), only WRFQ baseline (OR=1.16, 95% Confidence Interval (CI)=1.07-1.24) was a significant predictor for successful work functioning. The addition of decision latitude in the second model did not change this. In the final model, work ability (OR=2.07, 95%CI=1.22-3.49) was added and predicted together with WRFQ baseline successful work functioning.

Conclusions

Baseline work functioning and work ability are predictive for future successful work functioning. However, research has shown that it is difficult to change work ability. The concept of work functioning, reflecting the interplay between work demands and health, might provide better information for the design of interventions to improve work functioning.

Presentation 3: Cross-cultural adaptation of the work role functioning questionnaire to Swedish– reliability and validity

Presented by: Linda Ahlstrom

Authors

Ahlstrom L1, Abma F2, Bultmann U2, Amick B3,4, Hagberg, M1

  1. Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  2. University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
  3. Institute for Work & Health. Toronto, Canada
  4. Department of Health Policy and Management. Robert Stempel College of Public Health & Social Work. Florida International University. Miami, USA

Abstract

Background

The Work Role Functioning Questionnaire (WRFQ) is a tool that can be used to evaluate the degree to which a person experiences difficulty in performing their work due to mental and/or physical health disorder. The tool is developed to detect the impact of individuals’ health problems on their work outcome. The aim of this study was to translate and adapt WRFQ for the Swedish context.

Methods

The English version was translated to Swedish by two certified translators. A Swedish version was constructed combining the two translators’ versions. Two new certified translators conducted a back translation to English. By comparing the original English with the two back translated versions a modified Swedish version was constructed. To test the reliability 1000 randomly selected people from the Swedish population registry (men and women) age 20-65 years were send an invitation to participate in the research study. In the invitation it was stated that respondents had to answer the questionnaire two times if they decided to take part. There were 154 persons willing to participate in the study and received questionnaires at their home address. In addition to the WRFQ-Swe, the survey included Work Ability Index, demand-control –social support, questions of self-efficacy, self-perceived stress, and an affect scale.

Results

141 participants completed the first questionnaire (T1), and 133 completed the second questionnaire (T2), resulting in N=133 complete questionnaires for test-retest analysis.

Conclusions

A Swedish cross-cultural adapted version of Work Role Functioning Questionnaire has been constructed. Reliability and validity data of the WRFQ-Swe have been assessed.

Presentation 4: Looking beyond return to work: work functioning in workers who returned to work after sickness absence due to common mental disorders

Presented by: Ute Bültmann

Authors

Bültmann U1, Abma FI1, Amick III B2,3, van der Klink JJL1, Arends I1

  1. University Medical Center Groningen, University of Groningen. Groningen, The Netherlands
  2. Institute for Work & Health. Toronto, Canada
  3. Department of Health Policy and Management. Robert Stempel College of Public Health & Social Work. Florida International University. Miami, USA

Abstract

Background

Workers with common mental disorders (CMDs) are vulnerable to adverse work outcomes, such as sickness absence, work disability, and reduced on-the-job productivity. While several studies have examined the effects of interventions to facilitate return to work (RTW) in workers with CMD, little is known about the functioning of workers in the post RTW phase. The few studies looking beyond RTW focus mainly on mental health, while knowledge on health-related work functioning is lacking. More information on health-related work functioning after RTW is needed to prioritize and target efforts of (occupational) health care professionals and the workplace to assist and support workers after RTW. The aim of this study was to investigate health-related work functioning in workers who returned to work after sickness absence due to CMDs during 1-year follow-up.

Methods

This longitudinal study was conducted within a cluster-randomized controlled trial, evaluating the SHARP-at work intervention. The intervention was developed to prevent recurrent sickness absence in workers who returned to work after sickness absence due to CMDs. The study comprised 158 participants, aged 18 to 63 years, with partial or full RTW and occupational physician-diagnosed CMD. Health-related work functioning was measured with the Work Role Functioning Questionnaire at baseline, 3, 6 and 12 months follow-up. To examine differences in work functioning between the treatment and control group, linear mixed models with unstructured covariance matrices were used.

Results

Health-related work functioning improved in both groups over time; from 66.92 to 79.43 and 61.01 to 74.68 in the treatment and control group, respectively. The treatment group reported better work functioning at 12 months compared to the control group. No significant group x time interaction was found.

Conclusions

Both groups showed low scores on health-related work functioning at baseline, but improved during the 1-year follow-up. Despite improvement over time, work functioning scores are rather low compared to the healthy population and should receive careful attention of (occupational) health care professionals and the workplace to support workers after their return to work.