A Dutch validation study of the Multiple Sclerosis Work Difficulties Questionnaire in relapsing remitting multiple sclerosis

Abstract

Purpose: The current study aimed to evaluate the psychometric properties of the Dutch version of the Multiple Sclerosis Work Difficulties . Methods: Two hundred and thirty-nine employed persons with multiple sclerosis (MS) and 59 healthy controls completed the MSWDQ-23. To verify the factor structure, a confirmatory factor analysis was conducted. To assess construct validity, the MSWDQ-23 scores were correlated to measures of physical disability, fatigue, cognitive and neuropsychiatric problems, depression, health-related quality of life, and work-related variables. MSWDQ-23 scores were compared within different age groups, gender, education levels, and job types. Predictive validity was assessed using a logistic regression analysis to predict a deterioration in employment status after one year based on MSWDQ-23 scores. Results: The internal consistency of the MSWDQ-23 was acceptable (a ¼ 0.913, 95% CI ¼ 0.897-0.928) and the results indicated a fair fit. The MSWDQ-23 showed acceptable construct validity, confirming 94% of the hypotheses. The total scale and the psychological/cognitive subscale were able to predict a deterioration in employment status after one year (v 2 (1)¼18.164, p < 0.001). Conclusions: The Dutch version of the MSWDQ-23 is a valid and internally consistent instrument to measure self-reported work difficulties in persons with MS. ä IMPLICATIONS FOR REHABILITATIONThe Dutch version of the 23-item Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ-23) is a reliable and valid tool to measure self-reported work difficulties in people with multiple sclerosis (MS). More psychological and cognitive work difficulties are predictive of a deteriorated employment status after one year. The MSWDQ-23 is a helpful tool for researchers and (occupational) health professionals to identify current work difficulties in persons with MS and identify persons at risk for a deterioration in employment one year later.

A Greek Validation Study of the Multiple Sclerosis Work Difficulties Questionnaire-23

“…Indeed, with increasing age, more work barriers were reported, which is consistent with the expected physical, mental, and cognitive effects of prolonged disease duration, as well as aging [ 39 , 40 ]. Interestingly, the effect of sex was not significant, which was corroborated also by other similar studies [ 19 , 21 ]. This can be ascribed to the gender equality in Greece, such that men and women face similar workplace circumstances.…”

“…By utilizing CFA, this study verified the original three-factor structure of the Greek version of the MSWDQ-23. Furthermore, in accordance with previous validation studies, the Greek version of this instrument showed excellent internal consistency [ 17 , 18 , 19 , 20 , 21 ]. Importantly, there were no missing data, indicating that the Greek version of MSWDQ-23 is a highly feasible instrument.…”

“…This was indicated by its significant correlations with disease duration, disability, cognitive function, fatigue, psychological status, and MS-related and overall health status. Higher work difficulties were associated with higher EDSS, poorer cognitive function, more fatigue, stress, anxiety, and depression, and poorer quality of life and health status, a finding that was supported by the results of prior studies [ 17 , 18 , 19 , 20 , 21 ]. Since cognitive changes may predict the long-term clinical evolution of MS [ 44 , 45 ], it was not surprising that they were also associated with working difficulties.…”

“…Convergent validity was examined by correlating MSWDQ-23 scores with disease status variables (disease duration and EDSS), cognitive test scores (i.e., SDMT, GVLT, BVMT-R), and questionnaire scores (MFIS, DASS-21, MSIS-29, and EQ-5D). Correlation coefficients of >0.7, 0.51–0.7, 0.31–0.5, and 0.1–0.3 were considered very large, large, moderate, and small, respectively [ 21 , 37 ]. Cronbach’s alpha was produced to assess internal consistency.…”

“…The Multiple Sclerosis Work Difficulties Questionnaire 23 (MSWDQ-23) [ 17 ] is a shortened version of a 50-item questionnaire that evaluates various domains of working difficulties, categorized into three key dimensions (physical, psychological/cognitive, and external barriers). This 23-item questionnaire has adequate psychometric properties, including good internal consistency and construct validity, and has been validated for use in several languages [ 18 , 19 , 20 , 21 ]. This questionnaire enables the detection of MS-related occupational difficulties and has been suggested to be predictive of poor employment outcomes [ 22 , 23 ].…”