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Stanford Presenteeism Scale-13

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Purpose

The Stanford Presenteeism Scale (SPS-13) is a 13-item scale measuring health-related productivity in a diverse employee population. The purpose of the instrument is to determine presenteeism due to a specific health condition over a 4-week period.

Link to Instrument

https://eprovide.mapi-trust.org/instruments/13-item-stanford-presenteeism-scale

Acronym SPS-13

Area of Assessment

General Health
Occupational Performance

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Not Free

Actual Cost

$0.00

CDE Status

Not a CDE—last searched 12/11/2023.

Populations

Musculoskeletal Conditions
Non-Specific Patient Population

Key Descriptions

  • Instrument begins with individual’s identifying a primary health condition from the 10-item list provided which will then be the focus for the remaining questions. Conditions listed are the following: (1) Allergies; (2) Arthritis or joint pain/stiffness; (3) Asthma; (4) Back or neck disorder; (5) Breathing disorder (bronchitis, emphysema); (6) Depression/anxiety or emotional disorder; (7) Diabetes, heart or circulatory problem (artery disease, high blood pressure, angina); (8) Migraines/chronic headaches; (9) Stomach or bowel disorder; and (10) Other.
  • Three subscales: the Work Output Score (WOS), the Work Impairment Score (WIS), and the absence attributed to the ‘primary’ health condition.
  • Unlike former versions of instrument, this version focuses on knowledge-based and production-based workers.
  • There are two dimensions/factors for the WIS: “Completing Work” factor made up of positively worded items, and “Avoiding Distractions” factor made up of negatively worded items.
  • Responses to the items in the “Completing Work” factor are reverse coded. (Higher scores resulting in greater impaired presenteeism)
  • WIS measures the respondent’s degree of impairment of their primary health condition, which is calculated as the sum of the responses to the 10 Likert-type questions. WIS scores range between 0-100.
  • WOS measures the percentage of respondent’s productivity in a 4-week period with regard to their primary health condition. WOS scores are based on a 100-point scale.
  • Absenteeism is measured by asking respondents the number of hours they have been absent from work as a result of their primary health condition in the past 4 weeks.
  • A Japanese version of the instrument is available

Number of Items

13

Time to Administer

5-10 minutes

Required Training

No Training

Age Ranges

Adults

18 - 64

years

Older Working Adults

65 +

years

Instrument Reviewers

Summarized by UW-Madison OT students Yazmin Castruita Rios, MRC, BS and Yunzhen Huang, MS under the direction of Susan Smedema, PhD, CRC, LPC, UW-Madison.

ICF Domain

Activity
Participation

Measurement Domain

General Health

Professional Association Recommendation

None found--last searched 12/11/2023.

Considerations

  • Despite studies evaluating the instrument’s reliability and validity, there is still concerns about generalizability.
  • Significant gender and age differences have been observed in the WIS subscales, with men reporting marginally less impaired presenteeism and a trend in less impaired presenteeism reported as employee’s age increases. Influence of gender and age is unknown due to unclear meaningfulness of gender difference due to the small size of such difference, and age differences possibly being a result of perception. 
  • As a result of the instrument assessing health-related productivity loss within a 4-week period, it can be an issue for respondents who are able to compensate lost productivity over a longer period than four weeks.
  • Does not assess lost productivity for unpaid work.
  • Uncertain to what extent respondents are able to precisely attribute productivity loss to only one specific health condition. 
  • Very limited psychometric evidence to date.

 

Non-Specific Patient Population

back to Populations

Normative Data

Workers/General Population: (Turpin et al, 2004; n = 7,797)

  • Significant main effect for sex (p < 0.05) and WIS: Men (20.6) reporting marginally less impaired presenteeism than women (21.3).
  • Significant main effect for age and WIS (p < 0.05) showcasing a trend for less impaired presenteeism being reported as employee’s age increases (WIS scores ranged from 22.2 at less than 25 years of age, to 19.8 at age 56 and older.)
  • Significant difference between the WIS reported for persons with arthritis/joint pain in knowledge-based jobs (18.67) and persons with arthritis/joint pain in production-based jobs (22.48; t = 3.175; p < 0.002). The magnitude of the difference was fairly large (about 20%).
    • Large, but statistically insignificant differences were observed for other primary health conditions such as asthma, most likely due to small cell sizes.

 

Employees at Two Enterprises: (Yamashita & Arakida, 2008, First survey to 359 female employees in enterprise A with inclusion criteria of presence of some health conditions and answers to all 10 items on the WIS; age groups from 20-29 to 50+; 187 (52.1%) full-time; job type = clerks (51.0%), production-based workers (39.4%), technicians (3.1%), and others (6.5%). Second test-retest survey to 50 female employees (33 responses) with inclusion criteria the presence of some health conditions at both time points, mean age = 40.6 (9.8), 80% were occupational health staff. Japanese sample.)

 

Mean scores of WIS, WOS, and hours of sickness absenteeism (n = 359)

Component/factor

Mean (SD)

Work impairment score

30.8 (17.1)

Work output score

80.2 (13.1)

Sickness absenteeism (hours)

5.2 (9.9)

 

 

Work impairment scores by age, all subjects

Age Group (yr)/Total

n (%)

Mean (SD)

<=29

56 (15.6)

33.1 (17.8)

30-39

90 (25.1)

35.0 (17.1)

40-49

89 (24.8)

31.4 (15.8)

>=50

124 (34.5)

26.2 (17.0)

Total

359 (100.0)

30.8 (17.1)

F = 5.3, p < 0.01

 

Work impairment scores by age, full-time workers

Age Group (yr)/Total

n (%)

Mean (SD)

<=29

55 (98.2)

33.1 (17.8)

30-39

79 (87.8)

34.5 (16.7)

40-49

44 (49.4)

35.2 (16.7)

>=50

9 (7.3)

25.6 (20.5)

Total

187 (52.1)

33.8 (17.1)

F = 0.85, p > 0.05

 

Work impairment scores by age, part-time workers*

Age Group (yr)/Total

n (%)

Mean (SD)

<=29

1 (1.8)

35

30-39

11 (12.2)

38.2 (20.4)

40-49

45 (50.6)

27.8 (13.9)

>=50

115 (92.7)

26.2 (16.8)

Total

172 (47.9)

27.4 (16.5)

F = 2.71, p > 0.05

*ANOVA among part-time workers performed by excluding a subject less than 30 years old.

Test/Retest Reliability

Employees at Two Enterprises: (Yamashita & Arakida, 2008, n = 33, Japanese sample)

  • Acceptable test-retest reliability for the WIS: (ICC = 0.86; r = 0.83, p < 0.001)
  • Acceptable test-retest reliability for the Work Output Score (WOS): (ICC = 0.91; r = 0.789, p < 0.001)  

Internal Consistency

Workers/General population: (Turpin et al., 2004); n = 7,797)

  • Excellent: Cronbach's alpha coefficient for the WIS was 0.82*.

*Reliability improved marginally to 0.83 in overall population and types of job when an item was removed (“were you unable to take satisfaction in your work”).

 

Employees at Two Enterprises: (Yamashita & Arakida, 2008, n = 359, Japanese sample)

  • Excellent: Cronbach's alpha of WIS was 0.87
  • Excellent: Cronbach's alpha of WIS in full-time workers was 0.88
  • Excellent: Cronbach's alpha of WIS in part-time workers was 0.85

Criterion Validity (Predictive/Concurrent)

Predictive validity:

Workers/General Population: (Turpin et al, 2004; n = 7,797)

  • Poor predictive validity between health care use/expenditures and absenteeism or presenteeism metrics (r < 0.10 for all) 
  • Significant and robust positive relationship between the WIS and number of hours of absenteeism self-reported on the SPS 
  • Correlations between administrative-report payroll absenteeism and WIS were not significant 

 

Concurrent validity:

Workers/General Population: (Turpin et al, 2004; n = 7,797)

  • Adequate concurrent validity between WIS and the Work Limitations Questionnaire (WLQ) Overall Index (r = 0.50) 
  • Poor to adequate concurrent validity between WIS and the four subscales of the WLQ: output demands scale (r = 0.49), mental/ interpersonal demands (r = 0.41), physical demands (r = 0.37), and time management (r = 0.20). 

Construct Validity

Construct Validity:

Workers/General Population: (Turpin et al., 2004); n = 7,797)

  • SPS appeared to be valid for both knowledge- and production-based jobs, yet there are important differences between them. The first factor of WIS for knowledge-based jobs (Completing Work) accounted for 93% of the variance in WIS scores, while the second factor of WIS (Avoiding Distraction) accounted 95% of variance in WIS scores in production-based jobs. Thus, all ten items of WIS are essential to assess and account for impairments in presenteeism.

Employees at Two Enterprises: (Yamashita & Arakida, 2008, n = 359, Japanese sample)

  • Factorial analysis of the WIS data identified two factors: “completing work” and “avoiding distraction.”
    • These two factors accounted for a cumulative 50.8% of the variance—49.9% for full-time workers and 51.9% for part-time workers

 

Convergent Validity:

Workers/General population: (Turpin et al., 2004); n = 7,797)

  • Convergent validity was assessed through the comparison of the WIS and WOS with health status
  • WIS was significantly correlated to all eight SF-36 subscales: physical functioning (r = -0.25), role limitations-physical (r = -0.35), pain (r = -0.33), general health (r = -0.45), vitality (r = -0.61), social functioning (r = -0.56), role limitations-emotional (r = -0.51), and general mental health (r = -0.62) 
    • Some differences between production- and knowledge-based jobs on the above correlations, but the trends are similar. 
  • WLQ had lower correlations with the SF-36 subscores in comparison to the SPS (total population range: 0.31-0.44; knowledge-based jobs range = 0.15 to 0.40, higher correlations on mental health questions; production-based jobs range = 0.29 to 0.56

Employees at Two Enterprises: (Yamashita & Arakida, 2008, n = 359, Japanese sample)

  • Poor to Adequate convergent validity between the Work Impairment Score (WIS) and The Medical Outcomes Study 36-item Short Form Health Survey (SF-36)

 

Pearson’s correlation coefficients between WIS and SF-36 subscores

SF-36 subscores

r

Physical functioning

-0.13a

Role-physical

-0.37b

Bodily pain

-0.32b

Social functioning

-0.38b

General health perceptions

-0.38b

Vitality

-0.46b

Role-emotional

-0.46b

Mental Health

-0.43b

ap < 0.05 (Poor), bp < 0.01 (Adequate)

 

  • Excellent convergent validity between WIS and WOS (r = -0.66**) 
  • Poor convergent validity between WIS and Job Content Questionnaire subscores for demand (r = 0.13*), support (r = 0.22**), and daily hassles (r = 0.29**) 
  • Adequate negative correlations between WIS and job satisfaction (r = -0.39**) 

*p < 0.05, **p < 0.01

Musculoskeletal Conditions

back to Populations

Internal Consistency

Musculoskeletal Conditions: (Roy et al., 2011)

  • Excellent: Cronbach’s alpha ranged between 0.82 and 0.87 for the Work Impaired Score (WIS) subscale.

Construct Validity

Convergent validity:

Musculoskeletal Conditions: (Roy et al., 2011)

  • Low to moderate correlations between SPS-13, WLQ-25, and SF-36 were observed. 
  • Adequate to excellent correlations were obtained between the presenteeism scales of EWPS, SPS-13, AND WLQ-25 (r = 0.55 to 0.69) 

 

Content Validity

“It was concluded that the instrument presented acceptable validity content, but WIS score should be interpreted carefully. WIS score demonstrated significant differences across sex and age, with men claiming slightly less impaired presenteeism and a trend for less reported impaired presenteeism with increasing age of employees.” (Roy et al., 2011)

Bibliography

Roy, J. S., Desmeules, F., & MacDermid, J. C. (2011). Psychometric properties of presenteeism scales for musculoskeletal disorders: a systematic review. Journal of rehabilitation medicine, 43(1), 23-31. https://doi.org/10.2340/16501977-0643

Turpin, R. S., Ozminkowski, R. J., Sharda, C. E., Collins, J. J., Berger, M. L., Billotti, G. M., Baase, C. M., Olson, M. J., & Nicholson, S. (2004). Reliability and validity of the Stanford Presenteeism Scale. Journal of Occupational and Environmental Medicine, 46(11), 1123-1133. doi: 10.1097/01.jom.0000144999.35675.a0

Yamashita, M., & Arakida, M. (2008). Reliability and validity of the Japanese version of the Stanford Presenteeism Scale in female employees at 2 Japanese enterprises. Journal of occupational health, 50(1), 66-69. https://doi.org/10.1539/joh.50.66

 

 

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