Department of Neurology, Hospital Universitario Gregorio Marañón, Madrid, Spain.
Department of Neurology, Hospital Universitario Puerta del Mar, Cádiz, Spain.
Mult Scler Relat Disord. 2018 May;22:115-119. doi: 10.1016/j.msard.2018.04.003. Epub 2018 Apr 3.
Unemployment is a significant problem for people with multiple sclerosis (MS). The MS Work Difficulties Questionnaire (MSWDQ-23) is a self-report tool to assess work-related problems in people with MS across three domains: physical, psychological/cognitive, and external barriers. The aim of this study was to assess the psychometric properties of the Spanish version of the MSWDQ-23.
A multicentre, non-interventional, cross-sectional study in adult patients with relapsing-remitting multiple sclerosis (RRMS) or primary progressive (PPMS) multiple sclerosis (McDonald 2010 criteria) was conducted. Socio-demographic and clinical characteristics as well as health-related quality of life using the 29-item Multiple Sclerosis Impact Scale (MSIS-29) were collected.
A total of 201 subjects were studied (mean age: 43.9 years, 60% female, 86% with RRMS). Median Expanded Disability Status Scale (EDSS) (score: 2.0 [IQR: 1.0-3.5]). The employment rate was 47.3% (n = 95). The MSWDQ-23 was feasible (90% response rate), with high internal consistency and test-retest reliability (Cronbach's alpha = 0.94 and intraclass correlation coefficient-ICC > 0.87). MSWDQ-23 scores significantly and positively correlated with EDSS and both MSIS-29 physical and psychological subscales scores, showing an adequate convergent validity. Regarding construct validity, scores of patients with PPMS were higher than those of patients with RRMS, reaching statistically significance in MSWDQ-23 physical barriers domain and total scores.
The Spanish version of the MSWDQ-23 shows appropriate feasibility, reliability, and discriminative performance as a patient-reported outcome. MSWDQ-23 may be a valuable addition to measure the impact of a comprehensive spectrum of difficulties experienced by people with MS in the workplace.
失业是多发性硬化症（MS）患者面临的一个重大问题。MS 工作困难问卷（MSWDQ-23）是一种自我报告工具，用于评估 MS 患者在三个领域（身体、心理/认知和外部障碍）的工作相关问题。本研究旨在评估 MSWDQ-23 的西班牙版本的心理测量特性。
这是一项多中心、非干预性、横断面研究，纳入了复发缓解型多发性硬化症（RRMS）或原发性进展型多发性硬化症（PPMS）患者（2010 年 McDonald 标准）。收集了社会人口统计学和临床特征以及使用 29 项多发性硬化症影响量表（MSIS-29）评估的健康相关生活质量。
共纳入 201 例患者（平均年龄：43.9 岁，60%为女性，86%为 RRMS）。中位扩展残疾状况量表（EDSS）评分（得分：2.0[四分位距：1.0-3.5]）。就业率为 47.3%（n=95）。MSWDQ-23 具有可行性（90%的应答率），内部一致性和重测信度高（Cronbach's alpha=0.94，组内相关系数-ICC>0.87）。MSWDQ-23 评分与 EDSS 以及 MSIS-29 躯体和心理分量表评分均显著正相关，具有良好的聚合效度。在结构有效性方面，PPMS 患者的评分高于 RRMS 患者，在 MSWDQ-23 躯体障碍领域和总分上达到统计学意义。
MSWDQ-23 的西班牙版本具有适当的可行性、可靠性和区分性能，可作为患者报告的结果。MSWDQ-23 可能是衡量 MS 患者在工作场所中经历的各种困难的一个有价值的补充工具。
