Danielsson Louise, Fornazar Robin, Holmgren Kristina, Lundgren Nilsson Åsa, Hensing Gunnel
Research Unit, Angered Hospital, Gothenburg, Sweden.
Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Rehabil Process Outcome. 2020 Jul 14;9:1179572720936664. doi: 10.1177/1179572720936664. eCollection 2020.
Sick leave due to common mental disorders, encompassing depression and anxiety disorders, is high. Capturing early signs of reduced function could aid adjustments of work tasks and environment and, thus, endorse a pro-active approach to occupational and health care interventions to prevent long-term sick-leave spells. However, few measurements exist to identify early signs of imbalance, and none that is illness-specific. The aim of this study was to develop a work instability scale for people with common mental disorders and to test the fundamental psychometric properties of the scale.
Participants were working adults 18-65 years old with depression or anxiety. The scale development started with qualitative interviews (n = 27) which informed the drafting of a dichotomous, self-report questionnaire. Cognitive debriefing (n = 12) was used to check face validity and modify the draft. Internal construct validity of the draft was tested using Rasch analysis (n = 128). The work ability index was used as a comparator measure.
The initial 63-item draft showed poor fit to Rasch model expectations. Items displaying poor fit or local response dependency were stepwise removed, resulting in a unidimensional 34-item scale fitting the model expectations, and with no differential item functioning. Person-item threshold distribution showed that the scale is better suited to measure low to moderate work instability, than to measure high instability. Correlations between the newly developed scale and the work ability index showed a significant, moderately strong correlation.
In the initial target sample, the 34-item scale showed acceptable fundamental properties and internal construct validity. Further validation of the scale in a larger sample, including tests for external validity, is warranted.
因常见精神障碍（包括抑郁症和焦虑症）导致的病假率很高。捕捉功能下降的早期迹象有助于调整工作任务和环境，从而支持采取积极主动的方法进行职业和医疗保健干预，以防止长期病假。然而，几乎没有测量方法来识别失衡的早期迹象，也没有针对特定疾病的测量方法。本研究的目的是为患有常见精神障碍的人群开发一种工作不稳定量表，并测试该量表的基本心理测量特性。
参与者为18至65岁患有抑郁症或焦虑症的在职成年人。量表开发始于定性访谈（n = 27），这些访谈为二分法自报告问卷的起草提供了信息。认知反馈（n = 12）用于检查表面效度并修改草案。使用拉施分析（n = 128）测试草案的内部结构效度。工作能力指数用作比较指标。
最初的63项草案显示与拉施模型预期的拟合度较差。逐步删除显示拟合度差或局部反应依赖性的项目，得到一个符合模型预期的34项单维量表，且不存在项目功能差异。人-项目阈值分布表明，该量表更适合测量低至中度的工作不稳定，而不是高度不稳定。新开发的量表与工作能力指数之间的相关性显示出显著的中度强相关。
在最初的目标样本中，34项量表显示出可接受的基本特性和内部结构效度。有必要在更大的样本中对该量表进行进一步验证，包括外部效度测试。
