Questionnaires



Fear-Avoidance Beliefs Questionnaire (FABQ)

 

Here are some of the things which other patients have told us about their pain. For each statement please indicate any number from 0 to 6 to say how much physical activities such as bending, lifting, walking or driving affect or would affect your pain.

0 1 2 3 4 5 6
Completely

disagree

Unsure Completely

agree

Sources: Waddell, G. et coll. (1993). A fear-avoidance beliefs questionnaire and the role of fear-avoidance belief in chronic low back pain and disability.  Pain, 52, 157-168.

Note: Available in Waddell et al (1993) but minor modifications were made (“back” was removed in three places) to be applied to all MSDs, as Oyeflaten et al (2008) probably did.

Oyeflaten I, Hysing M, Eriksen HR. Prognostic factors associated with return to work following multidisciplinary vocational rehabilitation. J Rehabil Med. 2008;40(7):548-54.

The following statements are about how your normal work affects or would affect your pain.








 


 



Fear-Avoidance Beliefs Questionnaire (FABQ)

 

Here are two things which other patients have told us about their pain. For each of them please indicate any number from 0 to 6 to say how much physical activities or would affect your pain.

0 1 2 3 4 5 6
Completely

disagree

Unsure Completely

agree

Source: Waddell, G. et coll. (1993). A fear-avoidance beliefs questionnaire and the role of fear-avoidance belief in chronic low back pain and disability.  Pain, 52, 157-168.

Note: Available in Waddell et al (1993) but minor modifications were made (“back” was removed in three places) to be applied to all MSDs, as Oyeflaten et al (2008) probably did.

Oyeflaten I, Hysing M, Eriksen HR. Prognostic factors associated with return to work following multidisciplinary vocational rehabilitation. J Rehabil Med. 2008;40(7):548-54.

The following statements are about how your normal work affects or would affect your pain.

My work makes or would make my pain worse


My work might harm my injury








 


 

Personal Factor: RTW expectations or Expectations of duration of sick leave
Single questions

Download the tool (fr) Download the tool (en) (tool ☆)

 

Description:

The factor RTW expectations or Expectation of duration of sick leave can be measured by two independent questions, at the user’s option, depending on what is being predicted (return to work or duration of absence).

Scientific criteria (score: 2/6):

Face validity √; Construct validity by factor analyses Ø; Convergent validity Ø; Internal consistency Ø; Test-retest reliability Ø; Predictive validity √.

Usability criteria (Score: 4/4):

Administration time √; Ease of administration √; Ease of interpretation √; Accessibility √.

For return to work prediction:
To what extent do you think you will return to work?

Scale: 1. Low; 2. Moderate; 3. Strong; 4. I don’t know.

For predicting the duration of sick leave:
When do you think you are likely to return to work?

Scale: 1 point = within 1 month; …12 points = within 12 months or more.

Score calculation: Single score for each question

Both questions are available by downloading the questionnaire (top of the table) in a more user-friendly format

  • Target users: researchers and health professionals
  • Target population: MSDs and CMDs
  • Language: English (translated into French by the research team)
  • Evaluation method: self-reported questionnaire
  • Mode of administration: not specified
  • Training required for the administration of the tool: no
  • Feasibility
    • Administration time: < 1 min.
    • Ease of use: yes
  • Standards for interpreting scores:
    Not available

 


 

Facteur personnel : Sentiment d’efficacité concernant le retour au travail
Échelle d’évaluation du Sentiment d’Efficacité personnelle concernant le Retour Au Travail (SERAT)

Télécharger l’outil (fr) Télécharger l’outil (en) (outil ☆☆☆)

 

Description :

Le facteur Sentiment d’efficacité concernant le retour au travail peut être évalué avec le questionnaire « Return-to-Work Self-Efficacy Scale ». Il est composé de 10 points mesurant le sentiment d’efficacité lors du retour au travail sous trois angles : 5 points évaluant la capacité à demander de l’aide du superviseur, 3 points évaluant la gestion la douleur et 2 points évaluant la capacité à demander de l’aide aux collègues.

Critères scientifiques (score : 6/6) :

Validité apparente √; Validité de construit par analyses factorielles √; Validité convergente √; Cohérence interne √; Fidélité test-retest Ø; Validité prédictive √.

Critères d’applicabilité (score : 3/4) :

Temps de passation Ø; Facilité à administrer √; Facilité à interpréter √; Accessibilité √.

Le questionnaire complet est accessible dans Brouwer, Amick, Lee, Franche et Hogg-Johnson (2015) ou en téléchargeant le questionnaire (haut du tableau) présenté dans un format plus convivial.

Voici quelques exemples tirés des 10 points en question :

  • Suggérer à mon supérieur immédiat des mesures pour réduire mes symptômes.
  • Demeurer en poste après être retourné au travail.
  • Faire part de mes limitations physiques à mes collègues de travail.

Échelle de Likert en 5 points :

  • Sur une échelle de 1 à 5, quel est votre niveau de confiance à l’égard de chacun des énoncés suivants ?
    • 1. Pas du tout confiant
    • 5. Tout à fait confiant

Calcul du score :

  • Faire la somme des scores des 10 points, donnant un score total allant de 10 à 50.
  • Utilisateurs cibles : chercheurs et professionnels de la santé

 

  • Population cible : TMS
  • Langue : anglais (traduit en français par l’équipe de recherche)

 

  • Mode d’évaluation : questionnaire auto-rapporté
  • Mode d’administration : par téléphone ou en face à face

 

  • Formation requise pour l’administration de l’outil : non

 

  • Faisabilité
    • Temps de passation : < 4 min.
    • Facilité : oui

 

  • Normes pour interpréter les scores : un score plus haut indique un meilleur sentiment d’efficacité.

 


 

Personal factor: Return to work self-efficacy
Self-efficacy for return to work questionnaire (SERW)

Download the tool (fr) Download the tool (en) (tool ☆☆☆)

 

Description:

The return-to-work self-efficacy factor can be evaluated with the “Self-efficacy for return to work questionnaire. It includes 8 items measuring the worker’s perception of his ability to perform his work despite specific obstacles (e.g. pain, lack of support from colleagues).

Scientific criteria (score: 4/6):

Face validity √; Construct validity by factor analyses Ø; Convergent validity √; Internal consistency √; Test-retest reliability Ø; Predictive validity √.

Usability criteria ( score: 4/4):

Administration time √; Ease of administration √; Ease of interpretation √; Accessibility √.

The full questionnaire is available in the article or by downloading the questionnaire (top of the table) presented in a more user-friendly format. Here are a few examples from the 8 items:

 

How confident are you to do your job …

  1. … when you have a lot of pain?

6. … when tension is present at work?
7. … when you must work under pressure?

 

Percentage scale from 0 to 100 :

  • 0% = Not at all confident, 50% = Moderately confident and 100% = Totally confident.

Score calculation:

Several methods can be used:

  • 0-100 dichotomized 0-49 vs 50-100 (Dionne et al., 2007)
  • Separate into units of 10 continuous points (Dionne et al., 2007)

The total score is 0-800, but it is divided by 8 to get a score ranging from 0-100 (Richard, Dionne, & Nouwen, 2011

  • Target users: researchers and health professionals
  • Target population: MSD (back pain)
  • Language: French and English
  • Evaluation method: self-reported questionnaire
  • Mode of administration: by telephone or face to face
  • Training required for the administration of the tool: no
  • Feasibility
    • Administration time: < 3 min.
  • Ease of use: yes
  • Standards for interpreting scores:
    • 0-49: low self-efficacy regarding return to work (Dionne et al., 2007)
    • 50-100: high self-efficacy regarding return to work (Dionne et al., 2007)

A higher score indicates a higher self-efficacy regarding return to work (Richard et al., 2011).

 


 

Personal factor: Return to work self-efficacy
Return-to-work self-efficacy questionnaire (RTW-SE) 11 items

Download the tool (fr) Download the tool (en) (tool ☆☆)

Description:

The Return-to-work self-efficacy factor can be assessed with the Return-to-work self-efficacy questionnaire.

Scientific criteria (score: 6/6):

Face validity √; Construct validity by factor analyses √; Convergent validity √; Internal consistency √; Test-retest reliability √; Predictive validity √.

Usability Criteria (Score: 2/4):

Administration time Ø; Ease of administration √; Ease of interpretation Ø; Accessibility √.a

The full questionnaire is available in the article Lagerveld, Blonk, Brenninjmeijer and Schaufeli (2010), or by downloading the questionnaire (top of the table) presented in a more user-friendly format. Here are some examples of the 11 items:

 

If I resumed my work fully tomorrow I expect that…

  • I won’t be able to complete my work tasks due to my emotional state*.
  • I will be able to concentrate on my work.
  • I will be able to cope with work pressure.

*inverted items

Scale:

1 Strongly disagree;
2 Moderately disagree;
3 Slightly disagree;
4 Slightly agree;
5 Moderately agree;
6 Strongly agree.

Calculation of the score: add up the scores, considering the reversed items, then divide by 11 to get the average

  • Target users: researchers and health professionals
  • Target population: CMDs
  • Language: English (translated into French by the research team)
  • Evaluation method: self-reported questionnaire
  • Mode of administration: by telephone or face to face
  • Training required for the administration of the tool: no
  • Feasibility
    • Administration time: ˂ 4 min.
    • Ease: yes, but be careful with the calculation of the score (reversed items)
  • Standards for interpreting scores:
    • An average score of 4.5 indicates a high level of self-efficacy.

 


 

Personal factor: Return to work self-efficacy
Return-to-Work Obstacles and Self-Efficacy Scale (ROSES)

Access the full questionnaire (tool ☆☆)(outil ☆☆)

Description:

The Return-to-work self-efficacy factor can be evaluated with the Return-to-Work Obstacles and Self-Efficacy Scale (46 items). This questionnaire aims to evaluate the obstacles perceived during the return to work (Part A) and how the worker feels able to overcome them (Part B).

Scientific Criteria (Score: 5/6):

Face validity √; Construct validity by factor analyses √; Convergent validity Ø; Internal consistency √; Test-retest reliability √; Predictive validity √.

Usability Criteria (Score: 2/4):

Administration time Ø; Ease of administration Ø; Ease of interpretation √; Accessibility √.

The complete questionnaire is available at http://www.mentalhealthwork.ca/

  • Go to YOUR WEB SPACE > STAKEHOLDERS and log in
  • If you don’t have an account, register for free

The 46 items cover 10 dimensions: (1) fear of a relapse (4 items), (2) cognitive difficulties (3 items), (3) medication-related difficulties (3 items), (4) job demands (7 items), (5) feeling of organizational injustice (4 items), (6) difficult relation with the immediate supervisor (7 items), (7) difficult relations with co-workers (7 items), (8) difficult relations with insurance company (4 items), (9) difficult work/life balance (4 items), (10) loss of motivation to return to work (3 items).

 

Part A (Perceived obstacles to RTW): Likert scale: 1= Not an obstacle to 7= Big obstacle.

 

Part B (Self-efficacy beliefs about overcoming them): Likert scale: 1= Not at all capable to to 7= Completely capable.

 

Calculation of the scores: Remember that if we want to calculate the self-efficacy score (Part B), we must only consider the answers in Part B. The average score for each of the 10 dimensions is calculated by summing the scores for the items in the dimension ÷ by the number of items in that same dimension, which gives a score ranging from 1 to 7.

  • Target users: Researchers and health professionals
  • Target population: One version is available for MSDs and another for CMDs
  • Language: French, English, Italian
  • Evaluation method: Self-reported questionnaire
  • Mode of administration: Telephone, face-to-face, online
  • Training required for the administration of the tool: no
  • Feasibility
    • Administration time: 20 min.
    • Ease of use: yes
  • Standards for interpreting scores:

score of 3 or less (over 7) = considered problematic