Département des Relations Industrielles, Université Laval, Québec, Canada.
J Occup Rehabil. 2012 Mar;22(1):27-50. doi: 10.1007/s10926-011-9318-0.
Over the last decades, psychosocial factors were identified by many studies as significant predictive variables in the development of disability related to common low back disorders, which thus contributed to the development of biopsychosocial prevention interventions. Biopsychosocial interventions were supposed to be more effective than usual interventions in improving different outcomes. Unfortunately, most of these interventions show inconclusive results. The use of screening questionnaires was proposed as a solution to improve their efficacy. The aim of this study was to validate a new screening questionnaire to identify workers at risk of being absent from work for more than 182 cumulative days and who are more susceptible to benefit from prevention interventions.
Injured workers receiving income replacement benefits from the Quebec Compensation Board (n = 535) completed a 67-item questionnaire in the sub-acute stage of pain and provided information about work-related events 6 and 12 months later. Reliability and validity of the 67-item questionnaire were determined respectively by test-retest reliability and internal consistency analysis, as well as by construct validity analyses. The Cox regression model and the maximum likelihood method were used to fix a model allowing calculation of a probability of absence of more than 182 days. Criterion validity and discriminative capacity of this model were calculated.
Sub-sections from the 67-item questionnaire were moderately to highly correlated 2 weeks later (r = 0.52-0.80) and showed moderate to good internal consistency (0.70-0.94). Among the 67-item questionnaire, six sub-sections and variables (22 items) were predictive of long-term absence from work: fear-avoidance beliefs related to work, return to work expectations, annual family income before-taxes, last level of education attained, work schedule and work concerns. The area under the ROC curve was 73%.
The significant predictive variables of long-term absence from work were dominated by workplace conditions and individual perceptions about work. In association with individual psychosocial variables, these variables could contribute to identify potentially useful prevention interventions and to reduce the significant costs associated with LBP long-term absenteeism.
过去几十年，许多研究发现心理社会因素是导致常见下腰痛相关残疾发展的重要预测变量，这促成了生物心理社会预防干预的发展。生物心理社会干预应该比常规干预更能有效改善各种结果。不幸的是，这些干预中的大多数显示出不确定的结果。提出使用筛查问卷是提高其疗效的一种解决方案。本研究的目的是验证一种新的筛查问卷，以识别因疼痛而处于亚急性阶段并可能从预防干预中受益的工人，这些工人缺勤超过 182 天的累积天数的风险更高。
从魁北克赔偿委员会（n=535）领取收入替代福利的受伤工人在疼痛亚急性阶段完成了一份包含 67 个项目的问卷，并在 6 个月和 12 个月后提供了与工作相关事件的信息。通过测试 - 再测试可靠性和内部一致性分析，以及结构有效性分析，确定了 67 项问卷的可靠性和有效性。使用 Cox 回归模型和最大似然法建立一个可以计算缺勤超过 182 天的概率的模型。计算了该模型的标准有效性和判别能力。
问卷的子部分在两周后相关性中等至高度（r=0.52-0.80），并且具有中等至良好的内部一致性（0.70-0.94）。在 67 项问卷中，有六个子部分和变量（22 个项目）可预测长期缺勤：与工作相关的恐惧回避信念、重返工作的期望、税前家庭年收入、最后受教育程度、工作时间表和工作顾虑。ROC 曲线下面积为 73%。
长期缺勤的显著预测变量主要由工作场所条件和个人对工作的看法决定。与个人心理社会变量结合使用，这些变量可以有助于确定潜在有用的预防干预措施，并减少与 LBP 长期缺勤相关的重大成本。
