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Journal of Occupational Rehabilitation
Published in: Journal of Occupational Rehabilitation 3/2007

01-09-2007

The Readiness for Return-To-Work (RRTW) scale: Development and Validation of a Self-report Staging Scale in Lost-time Claimants with Musculoskeletal Disorders

Authors: Renée-Louise Franche, Marc Corbière, Hyunmi Lee, F. Curtis Breslin, C. Gail Hepburn

Published in: Journal of Occupational Rehabilitation | Issue 3/2007

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Abstract

Introduction We report on the development and validation of a 22-item scale assessing stage of readiness for return-to-work, the Readiness for Return-to-Work (RRTW) scale. Methods Lost-time claimants (n = 632) completed a telephone survey one month after a work-related musculoskeletal injury. Exploratory and confirmatory factor analyses of readiness items were conducted with two separate samples, and concurrent validity was examined. Results For workers not working, 60% of the variance was explained by four factors—(1) Precontemplation, (2) Contemplation (3) Prepared for Action—Self-evaluative and (4) Prepared for Action—Behavioral. For those working, 58% of the variance was explained by two factors—(1) Uncertain Maintenance and (2) Proactive Maintenance. Confirmatory factor analyses had satisfactory fit indices to confirm the initial model. Concurrent validity of the scale was supported: Relationships of readiness with depressive symptoms, fear-avoidance, pain, and general health, were generally in the hypothesized direction. Conclusions Psychometric properties of the newly developed instrument suggest that the application of the Readiness for Change model to return-to-work is relevant to work disability research. The instrument may facilitate the offer of stage-specific services tailored to injured workers’ needs, and be used for evaluation of return-to-work interventions.
Footnotes
1
Previous analyses [40] have shown that participants consenting to linkage of WSIB data with questionnaire, and non-consenters, were similar with regards to workplace, health status, and work absence variables. However, non-consenters had a lower level of education than consenters. No gender differences were detected, but a significant age-sex interaction was present, with young males being under-represented in consenters.
 
Literature
1.
Krause, N., et al. (2001). Determinants of duration of disability and return-to-work after work-related injury and illness: Challenges for future research. American Journal of Industrial Medicine, 40, 464–484.PubMedCrossRef
2.
Institute of Medicine. (1999). Reducing the burden of injury: Advancing prevention and treatment. Washington, DC: National Academy Press.
3.
Frank, J., et al. (1998). Preventing disability from work-related low-back pain: New evidence gives new hope – if we can just get all the players onside. Canadian Medical Association Journal, 158(12), 1625–1631.PubMed
4.
Krause, N., & Ragland, D. R. (1994). Occupational disability due to low back pain: A new interdisciplinary classification based on a phase model of disability. Spine, 19(9), 1011–1020.PubMedCrossRef
5.
Schultz, I. Z., et al. (2004). Psychosocial factors predictive of occupational low back disability: Towards development of a return-to-work model. Pain, 107(1–2), 77–85.PubMedCrossRef
6.
Corbière, M., & Shen, J. (2006). A systematic review of psychological return-to-work interventions for people with mental health problems and/or physical injuries. Canadian Journal of Community Mental Health, 25(2), 261–288.
7.
Friesen, M. N., et al. (2001). Return-to-work: The importance of human interactions and organizational structures. Work, 17(1), 11–22.PubMed
8.
Spitzer, W. O., et al. (1987). Scientific approach to the assessment and management of activity-related spinal disorders: A monograph for clinicians. Report of the Quebec task force on spinal disorders. 1277. Spine, 12(7S), s4–s55.
9.
Prochaska, J. O., & Diclemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting & Clinical Psychology, 51(3), 390–395.CrossRef
10.
Prochaska, J. O., et al. (1985). Predicting change in smoking status for self-changers. Addictive Behaviors, 10(4), 395–406.PubMedCrossRef
11.
Prochaska, J. O., et al. (1992). Criticisms and concerns of the transtheoretical model in light of recent research. [Review] [19 refs]. British Journal of Addiction, 87(6), 825–828.PubMedCrossRef
12.
Prochaska, J. O., et al. (1988). Measuring processes of change: Applications to the cessation of smoking. Journal of Consulting & Clinical Psychology, 56(4), 520–528.CrossRef
13.
Prochaska, J. O., et al. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychology, 13(1), 39–46.PubMedCrossRef
14.
Velicer, W. F., et al. (1999). Testing 40 predictions from the transtheoretical model. Addictive Behaviors, 24(4), 455–469.PubMedCrossRef
15.
Kerns, R. D., et al. (1997). Readiness to adopt a self-management approach to chronic pain: The Pain Stages of Change questionnaire (PSOCQ). Pain, 72, 227–234.PubMedCrossRef
16.
Keefe, F. J., et al. (2000). Understanding the adoption of arthritis self-management: Stages of change profiles among arthritis patients. Pain, 87(3), 303–313.PubMedCrossRef
17.
Nielson, W. R., et al. (2003). Initial development and validation of a multidimensional pain readiness to change questionnaire. Journal of Pain, 4(3), 148–158.PubMedCrossRef
18.
Biller, N., et al. (2000). Predicting completion of a cognitive-behavioral pain management program by initial measures of a chronic pain patient’s readiness for change. Clinical Journal of Pain, 16(4).
19.
Kidd, P., et al. (2003). The transtheoretical model of change in adolescents: Implications for injury prevention. Journal of Safety Research, 34, 281–288.PubMedCrossRef
20.
Fava, J. L., et al. (1995). Applying the transtheoretical model to a representative sample of smokers. Addictive Behaviors, 20(2), 189–203.PubMedCrossRef
21.
Prochaska, J. O., & Diclemente, C. C. (1992). Stages of change in the modification of problem behaviors. [Review] [75 refs]. Progress in Behavior Modification, 28, 183–218.PubMed
22.
Diclemente, C. C., et al. (1991). The process of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting & Clinical Psychology, 59(2), 295–304.CrossRef
23.
Nigg, C. R., et al. (1999). Stages of change across ten health risk behaviors for older adults. Gerontologist, 39(4), 473–482.PubMed
24.
Rossi, S. R., et al. (1993). Motivational readiness to control weight: The Transtheoretical model of behaviour change. In D. B. Allison (Ed.), Methods for the assessment of eating behaviours and weight related problems. Newbury Park, CA: Sage.
25.
Rossi, S. R., et al. (1994). A processes of change model for weight control for participants in community-based weight loss programs. International Journal of the Addictions, 29(2), 161–177.PubMed
26.
Greene, G. W., et al. (1999). Dietary applications of the stages of change model. [Review] [46 refs]. Journal of the American Dietetic Association, 99(6), 673–678.PubMedCrossRef
27.
Laforge, R. G., et al. (1999). Stage of regular exercise and health-related quality of life. Preventive Medicine, 28(4), 349–360.PubMedCrossRef
28.
Franche, R.-L., & Krause, N. (2002). Readiness for return to work following injury or illness: Conceptualizing the interpersonal impact of health care, workplace, and insurance factors. Journal of Occupational Rehabilitation, 12(4), 233–256.PubMedCrossRef
29.
Franche R.-L., & Krause, N. (2003). Critical factors in recovery and return to work. In T. Sullivan & J. Frank (Eds.), Preventing & managing disabling injury at work (pp. 33–55). New York, USA: Taylor & Francis.
30.
Velicer, W. F., et al. (1998). Smoking cessation and stress management: Applications of the transtheoretical model of behavior change. Homeostasis, 38(5–6), 216–232.
31.
Heather, N., et al. (1993). Predictive validity of the readiness to change questionnaire. Addiction, 88, 1667–1677.PubMedCrossRef
32.
Rollnick, S., et al. (1992). Development of a short ‘readiness to change’ questionnaire for use in brief, opportunistic interventions, among excessive drinkers. British Journal of Addiction, 87, 743–754.PubMedCrossRef
33.
Jensen, M. P., et al. (2000). Further evaluation of the pain stages of change questionnaire: Is the transtheoretical model of change useful for patients with chronic pain? Pain, 86, 255–264.PubMedCrossRef
34.
Carey, K. B., et al. (2004). Assessing readiness to change substance abuse: A critical review of instruments. Clinical Psychology: Science and Practice, 6, 245–266.CrossRef
35.
Waddell, G., et al. (1993). A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain, 52(2), 157–168.PubMedCrossRef
36.
Workplace Safety and Insurance Board (2006). Statistical supplement to the Annual Report 2005.
37.
Statistics Canada. Labour Force Survey Microdata File. [71M0001XCB]. 2006. Canada.
38.
Workplace Safety and Insurance Board 2005 Annual Report (2006). Canada: Workplace Safety and Insurance Board.
39.
Bültmann, U., , et al. (2007). Health status, work limitations, and return-to-work trajectories in injured workers with musculoskeletal disorders. Quality of Life Research, DOI 10.1007/s11130-007-9229-x, July 7 [E-pup ahead of print].
40.
Franche, R.-L., et al. (2007). The impact of early workplace-based return-to-work strategies on work absence duration: A 6-month longitudinal study following an occupational musculoskeletal injury. JOEM (in press).
41.
Gaudette, L. A., et al. (2003). Which workers smoke? Health Reports, 10(3), 35–45.
42.
Ware, J. Jr., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.PubMedCrossRef
43.
Luo, X., Lynn, G. M., Kakouras, I., Edwards, C. L., Pietrobon, R., Richardson, W., & Hey, L. (2003). Reliability, validity, and responsiveness of the short form 12-item survey (SF-12) in patients with back pain. Spine, 28, 1739–1745.PubMedCrossRef
44.
Roland, M., & Morris, R. (1983). A study of the natural history of back pain – part I: Development of a reliable and sensitive measure of disability in low-back pain. Spine, 8(2), 141–144.PubMedCrossRef
45.
Hsieh, C. Y., et al. (1992). Functional outcomes of low back pain: Comparison of four treatment groups in a randomized controlled trial. Journal of Manipulative and Physiological Therapeutics, 15(1), 4–9.PubMed
46.
Jarvikoski, A., et al. (1993). Outcome of a multimodal back treatment programs with and without intensive physical training. Journal of Spinal Disorders, 6(2), 93–98.PubMed
47.
Jensen, M. P., & Karoly, P. (1992). Self-report scales and procedures for assessing pain in adults. In D. C. Turk & R. Melzack (Eds.), Handbook of pain assessment (pp. 135–151). New York: The Guilford Press.
48.
Kopec, J. A., & Esdaile, J. M. (1995). Functional disability scales for back pain. Spine, 20(17), 1943–1949.PubMedCrossRef
49.
Stratford, P. W., et al. (2000). Development and initial validation of the back pain functional scale. Spine, 25(16), 2095–2102.PubMedCrossRef
50.
Solway, S., et al. (2002). The DASH Outcome Measure: User’s Manual. 2nd ed.
51.
Ciccone, D. S., & Just, N. (2001). Pain expectancy and work disability in patients with acute and chronic pain: A test of the fear avoidance hypothesis. The Journal of Pain, 2(3), 181–194.PubMedCrossRef
52.
Crombez, G., et al. (1999). Pain-related fear is more disabling than pain itself: Evidence on the role of pain-related fear in chronic back pain disability. Pain, 80, 329–339.PubMedCrossRef
53.
Von Korff, M., et al. (2000). Assessing global pain severity by self-report in clinical and health services research. Spine, 25(24), 3140–3151.CrossRef
54.
Tabachnick, B. G., & Fidell, L. S. (1996). Using multivariae statistics – Third edition (3rd ed.). California: California State University, Northridge: Haper Collins College Publishers. .
55.
Bentler, P. M. (1995). Structural equations program manual. Encino: Multivariate Software Inc.
56.
Byrne, B. M. (1989). A primer of LISREL: Basic applications and programming for confirmatory factor analytic models. New York: Springer-Verlag.
57.
Hofmann, R. (1995). Establishing factor validity using variable reduction in confirmatory factor analysis. Educational and Psychological Measurement, 55, 572–582.CrossRef
58.
Jõreskog, K. G., & Sorbom, D. (1993). LISREL 8: User’s reference guide. Mooresville, Scientific Software.
59.
Mueller, R. O. (1996). Basic principles of structural equation modeling: An introduction to LISREL and EQS. New York: Springer.
60.
Cassidy, J. D., et al. (2005). Incidence and course of low back pain episodes in the general population. Spine, 30(24), 2817–2823.PubMedCrossRef
61.
Sinclair, S. J., et al. (1997). The effectiveness of an early active intervention program for workers with soft tissue injuries: The Early Claimant Cohort study. Spine, 22(24), 2919–2931.PubMedCrossRef
62.
Carr, J. L., et al. (2006). Is the pain stages of change questionnaire (PSOCQ) a useful tool for predicting participation in a self-management programme? Further evidence of validity, on a sample of UK pain clinic patients. BMC Musculoskeletal Disorders, 7, 1–7.CrossRef
63.
Ash, P., & Goldstein, S. I. (1995). Predictor of returning to work. Bulletin of American Academy of Psychiatry Law, 23(2), 205–210.
64.
Dozois, D. J. A., et al. (1995). Factors associated with rehabilitation outcome in patients with low back pain (LBP): Prediction of employment outcome at 9-month follow-up. Rehab Psych, 40(4), 243–259.CrossRef
65.
Lötters, F., et al. (2006). The prognostic value of depressive symptoms, fear-avoidance, and self-efficacy for duration of lost-time benefits in workers with musculoskeletal disorders. Journal of Occupational and Environmental Medicine, 63(12), 794–801.
66.
Miller, W. R., & Rollnick, S. (1991). Motivational Interviewing. New York.
67.
Abenhaim, L., et al. (1988). Risk of recurrence of occupational back pain over three year follow up. British Journal of Industrial Medicine, 45(12), 829–833.PubMed
68.
Hashemi, L., et al. (1997). Length of disability and cost of workers’ compensation low back pain claims. Journal of Occupational and Environmental Medicine, 39(10), 937–945.PubMedCrossRef
69.
Leigh, J. P., et al. (2001). Costs of occupational injuries and illnesses in California. Preventive Medicine, 32, 393–406.PubMedCrossRef
70.
Joseph, J., et al. (1999). Critical perspectives on the transtheoretical model and stages of change. In J. A. Tucker, D. M. Donovan, & G. A. Marlatt (Eds.), Changing addictive behaviors – bridging clinical and public health strategies (pp. 161–190). New York: Guilford Press.
71.
Frank, J. W., et al. (1996). Disability resulting from occupational low back pain part II: What do we know about secondary prevention? A review of the scientific evidence on prevention after disability begins. Spine, 21(24), 2918–2929.PubMedCrossRef
72.
Loisel, P., et al. (2001). Disability prevention: New paradigm for the management of occupational back pain. Disease Management & Health Outcomes, 9(7), 351–360.CrossRef
73.
Loisel, P. (2005). Intervention for return to work – what is really effective? Scand J Work Environ Health, 31(4), 245–7.PubMed
Metadata
Title
The Readiness for Return-To-Work (RRTW) scale: Development and Validation of a Self-report Staging Scale in Lost-time Claimants with Musculoskeletal Disorders
Authors
Renée-Louise Franche
Marc Corbière
Hyunmi Lee
F. Curtis Breslin
C. Gail Hepburn
Publication date
01-09-2007
Publisher
Springer US
Published in
Journal of Occupational Rehabilitation / Issue 3/2007
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI
https://doi.org/10.1007/s10926-007-9097-9

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