A Review of Self-Report Instruments Measuring Health-Related Work Productivity

Abstract

Health impairment often leads to work impairment in the form of both absenteeism and presenteeism (i.e. reduced productivity while at work). Several self-report productivity instruments have been designed over the past few years to measure the impact of illness on productivity at work and/or in non-work activities. In a review of the literature we identified six generic subjective instruments - the Endicott Work Productivity Scale, Health and Labor Questionnaire, Health and Work Questionnaire, Health and Work Performance Questionnaire, Work Limitations Questionnaire (WLQ) and the Work Productivity and Activity Impairment Questionnaire (WPAI) - that could theoretically be used in any working population. These instruments were usually validated against other subjective measures (such as health-related QOL). Each productivity instrument has benefits in certain research settings, but the psychometric properties of the WPAI have been assessed most extensively. It was the most frequently used instrument and has also been modified to measure productivity reductions associated with specific diseases (e.g. allergic rhinitis, gastro-oesophageal reflux disease, chronic hand dermatitis). The WLQ has also been tested extensively to measure the general health impact and impact of specific conditions. Two migraine-specific subjective instruments were also identified: the Migraine Disability Assessment questionnaire and the Migraine Work and Productivity Loss Questionnaire, of which the latter was found to have better psychometric properties. Productivity outcomes are useful in that they characterise the impact of an illness in the workplace and show the effect of treatment on productivity. Evidence of psychometric properties and generalisability of different instruments was found to a varying degree. Thus, further research is needed to assess the accuracy and usefulness of individual instruments in certain research settings. Health-related productivity has been increasingly recognised as an important component of the burden of illness associated with a given disease; without it, one cannot reliably assess this burden.

Measuring Health-Related Productivity Loss

“…8 In a 2004 review of 6 self-reported productivity loss instruments, the WLQ was one of 2 instruments reported to offer a significant advantage over others as a result of extensive testing and the ability to measure general health impact and impact of specific conditions. 9 Research has shown that the WLQ has relatively strong validity and reliability, has been used in a variety of workplace settings with a variety of health risks and conditions, and may be most useful in general employee populations. 10 Productivity loss related to presenteeism was measured with the question: ''In the past 2 weeks, how much of the time did your physical health or emotional problems make it difficult for you to do the following?''…”

Common Mental Disorders in the Workforce: Recent Findings from Descriptive and Social Epidemiology

“…Indirect attempts have included creating proxy measures from existing symptom and quality-of-life questionnaires (5) and defining it as simply the absence of sick leave in persons with health conditions (6,7). Measures that assess presenteeism directly are of interest here; their descriptions and psychometric properties are available in 2 recent reviews (8,9). These direct measures include measures analogous to loss days, asking about the number of days in which activities were impaired (cutback days).…”

The Brazilian Portuguese version of the Work Productivity and Activity Impairment: General Health (WPAI-GH) Questionnaire

“…(Marque Sim ou Não, se for Não, pule para a questão 6) As próximas questões se referem aos últimos sete dias, não incluindo o dia de hoje 2) Durante os últimos sete dias, quantas horas você deixou de trabalhar por causa dos seus problemas de saúde? Inclua as horas não trabalhadas quando você esteve doente, chegou atrasado, saiu mais cedo etc., por causa de sua saúde ou problemas digestivos.…”

“…[4][5][6] Most of the time, these instruments relate to individuals who are working on a formal basis or receiving regular pay and they do not include vo luntary work or housework, although most authors highlight the importance of such measurements. 7 Moreover, from researchers working on this issue, there is a generalized need for validated measurement tools for work productivity and techniques to translate these measurements into costs.…”