Measuring Clients’ Perception of Functional Limitations Using the Perceived Functioning & Health Questionnaire

Abstract

Background The Perceived Functioning & Health (PFH) questionnaire was developed to collect, in a standardized manner, which work activities are limited due to health conditions according to the perception of the client. In this study the questionnaire’s reliability and validity are investigated. Methods The PFH questionnaire is comprised of 147 questions, distributed over 33 scales, pertaining to the client’s psychosocial and physical work limitations. The PFH data of 800 respondents were analyzed: 254 healthy employees, 408 workers on sick leave and 138 recipients of a disability pension. Internal consistency (Cronbach’s α) for the scales was established. The test–retest reliability was examined for the data of 52 recipients of a disability pension who filled out the PFH twice within an interval of 1 month. Validation was established by taking the nature of the limitations as a criterion: mental limitations, physical limitations or a mix of both. To this end, the respondents were divided into groups distinguished on the basis of self-classification, as well as classification on the basis of disease codes given by insurance and occupational health physicians: a “healthy” group, subjects with only physical (“physical” group) or mental limitations (“mental” group) or mixed limitations (“mixed” group). The scale scores of these groups were compared and tested using analyses-of-variance and discriminant analyses. Results The scales were found to have sufficient to good internal consistency (mean Cronbach’s-α = 0.79) and test–retest reliability (mean correlation r = 0.76). Analyses-of-variance demonstrated significant differences between the scores of the mental, physical and healthy groups on most of the expected scales. These results were found both in groups defined by self-classification as well as in groups based on disease codes. Moreover, discriminant analyses revealed that the a priori classification of the respondents into three groups (mental, physical, healthy) for more than 75% of them corresponded with the classification on the basis of scale scores obtained from the questionnaire. Furthermore, limitations due to specific types of complaints (low back pain, fatigue, concentration problems) or diagnosed disorders (musculoskeletal disorders, reactive disorders, endogenous disorders) were clearly reflected in the scores of the related scales of the PFH. Conclusion The psychometric properties of the PFH with respect to reliability and validity were satisfactory. The PFH would appear to be an appropriate instrument for systematically measuring functional limitations in subjects on sick leave and in those receiving disability pensions, and could be used as a starting point in a disability claim procedure.

Use of a Decision Support Tool on Prognosis of Work Ability in Work Disability Assessments: An Experimental Study Among Insurance Physicians

“…Claimants could have interest in a certain outcome of a re-assessment. However, IPs are trained in objective assessment of functional limitations; IPs do not mainly focus their assessment on claimants' self-perceived health complaints and impairments but they use many other factors as well [19][20][21].…”

The importance of disability as a health issue for mid-life women

“…While such studies have contributed substantially to the literature and identified the importance of musculoskeletal functioning and mental health as major factors related to work-related disability, there are limitations in utilizing such databases for population research. First, work-related functioning and disability is often assessed in the context of one’s diagnosis and physical health and do not fully capture the impact of the psychosocial domains of disability [49]. Second, in occupational databases, there is often limited individual-level information about important causes, correlates, or consequences of disability such as that which is available from epidemiologic studies.…”

Evaluating Individual Physical Work Ability: Examples from the Construction Industry

“…In such a programme, the focus should not be solely on early signs of complaints, but also on assessing physical work ability and estimating the scope and nature of possible limitations or restrictions in meeting high physical job demands. Information on work ability [9], work limitations [10] or work functioning [11] is often gathered by questionnaires. However, the usefulness of other methods in gathering knowledge on physical work ability should be explored.…”