• Adequate test-retest reliability (ICC = 0.789)

Participants at Vocational Rehab Center (Finger et al., 2014; n = 74; mean age = 37.68 years (12.7))

• Excellent internal consistency (Cronbach’s alpha = 0.887)

“Content validity for the context of VR is assumed due to the fact that the items in the questionnaire were derived from the ICF Core Set for VR. The Core Set was rigorously developed using input from patients, clinicians, experts, and the literature to assess and describe the relevant factors concerning functioning in VR independent of the health condition or VR setting.” (Finger et al., 2014)

“Looking at face validity, professionals rated WORQ to be comprehensive concerning functioning in VR but WORQ seemed to miss additional contextual factors such as work place descriptions or personal factors such as coping strategies. Patients in general appreciated the breadth of coverage of WORQ (face validity), as they felt that the questionnaire allowed them to reflect upon their daily problems in functioning that hinder them to successfully return to work. Through WORQ, the patients felt as it seemed that they were able to express and convey their physical problems as well as their psychosocial issues and needs.” (Finger et al., 2014)

Patients with MSK Conditions in Vocational Rehab (Finger, Wicki-Roten, Leger, & Escorpizo, 2019; n = 89; mean age = 44 years (2.4);  self-reported French version was used)

• SEM for entire group: 0.323 points out of the maximal average score of 10

Patients with MSK Conditions Undergoing Inpatient Rehab (Finger, Escorpizo, & Tennant, 2019; n = 221; mean age = 43.47 years (SD=10.9); self-reported French version was used)

• SEM for entire group: 1.53
• SEM for entire group: 3.05 (using shortened version: WORQ-BRIEF)

Patients with MSK Conditions in Outpatient Physical Therapy (Husmann et al., 2019; n = 51; mean age = 39.96 years (12.9); self-reported German version of WORQ was used)

• SEM for entire group: 13.53 points out of maximal sum score of 400

• MDC for entire group: 8.09% or 32.35 points out of 400.

Patients with MSK Conditions in Vocational Rehab (Finger, Wicki-Roten, Leger, & Escorpizo, 2019; n = 89; mean age = 44 years (2.4); self-reported French version was used)

• Excellent test-retest reliability (ICC = 0.935)
• Excellent test-retest reliability (ICC = 0.913), using shortened version: WORQ-BRIEF

Patients with MSK Conditions in Outpatient Physical Therapy (Husmann et al., 2019; n = 51; mean age = 39.96 years (12.9); self-reported German version of WORQ was used)

• Adequate test-retest reliability (ICC = 0.79)

Mixed MSK Patient Population (Vermeulen et al., 2019; n = 20; self-reported Dutch version was used)

• Adequate test-retest reliability (ICC = 0.85)

Patients with MSK Conditions Undergoing Inpatient Rehab (Finger, Escorpizo, & Tennant, 2019; n = 221; mean age = 43.47 years (SD=10.9); self-reported French version was used)

• Excellent person separation index (ICC = 0.969)
• Excellent person separation index (ICC = 0.918), using shortened version: WORQ-BRIEF

Reliability results – internal consistency of the WORQ

Convergent Validity

Patients with MSK Conditions in Vocational Rehab (Finger, Wicki-Roten, Leger, & Escorpizo, 2019; n = 89; mean age = 44 years (2.4); self-reported French version was used)

• Excellent convergent validity between WORQ and general functioning (r = 0.662)
• Adequate convergent validity between WORQ and Hospital Anxiety and Depression Scales (HADS) ‘anxiety score’ (r = 0.564) and ‘depression score’ (r = 0.57)
• Adequate convergent validity between WORQ and current state of health (r = 0.552)

Patients with MSK Conditions in Outpatient Physical Therapy (Husmann et al., 2019; n = 51; mean age = 39.96 years (12.9); self-reported German version of WORQ was used)

• Excellent convergent validity between WORQ with WHO Disability Assessment Schedule 2.0 version (r = 0.81) and general rating of functioning with NRS 0-10 (r = 0.62)
• Excellent convergent validity between WORQ and EuroQoL Instrument: “Today’s Health” (r = -0.49)
• Excellent convergent validity between WORQ subscale ‘emotion’ with Hospital Anxiety and Depression Scales (r = 0.71)
• Adequate convergent validity between WORQ with Hospital Anxiety and Depression Scales (r = 0.55)
• Adequate convergent validity between WORQ with quality of life as measured by WHO Quality of Life Questionnaire (r = -0.47)
• Poor convergent validity between WORQ and number of comorbidities (r = 0.10)

 Examining Work-Related Functioning in a Physical Therapy Outpatient Clinic: Validity and Reliability of the Work Rehabilitation Questionnaire (WORQ)

1. EQ-5D EuroQol Instrument, HADS Hospital Anxiety and Depression Scales, WHODAS 2.0 WHO Disability Assessment Schedule 2.0 version, NRS numeric rating scale, WHOQoL World Health Organization Quality of Life Questionnaire
2. *Correlation is significant at the 0.05 level
3. **Correlation is significant at the 0.01 level

Mixed MSK Patient Population (Vermeulen et al., 2019; n = 21; patients had either hand/wrist injuries or fibromyalgia; self-reported Dutch version was used)

• Excellent convergent validity between WORQ with Short Form-36 subsections ‘physical functioning’ (r = -0.71), ‘role limitations-physical’ (r = -0.64), and ‘vitality’ (r = -0.65)
• Poor convergent validity between WORQ with Michigan Hand Outcomes Questionnaire subsection ‘work’ (r = 0.25)
• Poor convergent validity between WORQ with Disabilities of the Arm, Shoulder, and Hand subsection ‘optional: work’ (r = 0.28)
• Adequate convergent validity between WORQ with Disabilities of the Arm, Shoulder, and Hand subsection ‘disability/symptom’ (r = 0.56)
• Excellent convergent validity between WORQ ‘social’ factor with Short Form-36 subsection ‘general health’ (r = -0.73)
• Adequate convergent validity between WORQ with Short Form-36 subsections ‘mental health’ (r = -0.43), ‘social functioning’ (r = -0.43), ‘bodily pain’ (r = -0.50), and ‘general health’ (r = -0.39)
• Excellent convergent validity between WORQ ‘Physical’ factor with Short Form-36 subsections ‘physical functioning’ (r = -0.84) and ‘bodily pain’ (r = -0.61)
• Adequate convergent validity between WORQ ‘Cognition’ factor with Short Form-36 subsections ‘vitality’ (r = -0.52), ‘mental health’ (r = -0.57), and ‘social functioning’ (r = -0.58)
• Adequate convergent validity between WORQ ‘Physical’ factor with Short Form-36 subsections ‘role limitations-physical’ (r = -0.59) and ‘vitality’ (r = -0.49)
• Adequate convergent validity between WORQ ‘Mood’ factor with Short Form-36 subsections ‘mental health’ (r = -0.58), physical functioning (r = -0.51), vitality (r = -0.51), and ‘bodily pain’ (r = -0.42)
• Adequate convergent validity between WORQ ‘Emotions’ factor with Short Form-36 subsection ‘role limitations-emotional’ (-0.39) and ‘mental health’ (r = -0.58)
• Poor convergent validity between WORQ ‘Social’ factor with Short Form-36 subsection ‘social functioning’ (r = -0.26)
• Adequate convergent validity between WORQ ‘ADL’ factor with Michigan Hand Outcomes Questionnaire subsection ‘Overall ADL’ (r = -0.49)

Discriminant Validity

Mixed MSK Patient Population (Vermeulen et al., 2019; n = 21; patients had either hand/wrist injuries or fibromyalgia; self-reported Dutch version was used)

• Excellent discriminant validity between WORQ with Michigan Hand Outcomes Questionnaire subsection ‘aesthetics’ (r = -0.08), the Tampa Scale for Kinesiophobia (r = -0.03), and the E-Link Dynamometer (r = 0.17)
• Adequate to excellent discriminant validity between all WORQ factors with Michigan Hand Outcomes Questionnaire subsection ‘satisfaction’ (r = -0.11 to -0.37)
• Excellent discriminant validity between all WORQ factors with Michigan Hand Outcomes Questionnaire subsection ‘aesthetics’ (r = -0.20 to 0.21)
• Adequate to excellent discriminant validity between all WORQ factors with Tampa Scale for Kinesiophobia (r = -0.31 to 0.26)
• Adequate to excellent discriminant validity between all WORQ factors with E-Link Dynamometer (r = -0.02 to 0.34)

Construct validity (n = 21) using Spearman’s rank correlation coefficient

From: Cross-Cultural Adaptation and Psychometric Evaluation of the Dutch Version of the Work Rehabilitation Questionnaire (WORQ-VL)

1. Correlations in bold correspond to an expected high correlation (11 hypotheses convergent validity)
2. Correlations in italic correspond to an expected non or weak correlation (4 hypotheses discrimant validity)
3. *Correlation is significant at the 0.05 level (2-tailed)
4. **Correlation is significant at the 0.01 level (2-tailed)
5. ^aShort-Form Health survey 36 Dutch Language Version
6. ^bMichigan Hand Outcomes Questionnaire, Dutch Language Version
7. ^cDisabilities of the Arm, Shoulder, and Hand
8. ^dTampa Scale for Kinesiophobia

(Vermeulen et al., 2019; n = 21; patients had either hand/wrist injuries or fibromyalgia; self-reported Dutch version was used)

“In the context of the content evaluation, all patients found that WORQ covered all relevant aspects of work-related functioning.” (Finger et al., 2019; n = 89; self-reported French version was used) 94% of patients reported that WORQ covered all relevant topics and 83% found the answer options to be meaningful. They felt that WORQ facilitated a patient-centric approach to their care, because of its comprehensive set of questions allowed them to report their experience as patients. In particular, the work-related issues asked from part one of WORQ were considered valuable, although some participants found it difficult to rate the current support of their employer, given their current sick leave. (Husmann et al., 2019)

• Excellent: No ceiling or floor effect was detected.

The content of the WORQ was compared to individual patient interviews, the Comprehensive ICF Core Set for SCI, and assessment instrument used in VR and SCI. 80% of ICF categories in the WORQ were indicated in at least one of the nine patient interviews; 54% were confirmed by the Comprehensive ICF Core Set for SCI; and 30% were confirmed by four questionnaires (SF36, McGill Pain Questionnaire, Hospital Anxiety and Depression Scale, and Beck Depression inventory). The WORQ proved to have content validity for utility in patients with SCI within the context of VR. WORQ-SELF can be used to assess the functioning and disability of patients in the return to work process. (Bergamaschi et al., 2014)