Development of the Prevent for Work Questionnaire (P4Wq) for the assessment of musculoskeletal risk factors in the workplace: part 2-pilot study for questionnaire development and validation

Francesco Langella, Daniele Vanni, Morten Høgh, Thorvaldur Skuli Palsson, Steffan Wittrup McPhee Christensen, Pablo Bellosta-López, Jorge Hugo Villafañe, Palle Schlott Jensen, Priscila de Brito Silva, Pablo Herrero, Paolo Barletta, Victor Domenéch-García, Pedro Berjano, Prevent for Work Study Group, Francesco Langella, Daniele Vanni, Morten Høgh, Thorvaldur Skuli Palsson, Steffan Wittrup McPhee Christensen, Pablo Bellosta-López, Jorge Hugo Villafañe, Palle Schlott Jensen, Priscila de Brito Silva, Pablo Herrero, Paolo Barletta, Victor Domenéch-García, Pedro Berjano, Prevent for Work Study Group

Abstract

Objective: The aim of this study was to develop a multifactorial, self-report questionnaire: Prevent for Work Questionnaire (P4Wq). The questionnaire is intended for screening for risk factors in work-related musculoskeletal disorders (WMSDs).

Design: Data were collected from otherwise healthy workers employed in three service areas at a specialist hospital in Italy: healthcare, administration and ancillary services.

Setting and participants: In all, 115 participants were enrolled (67% women; average age 41.5±9.94 years). The content of the tool for WMSDs was derived from three participation rounds of analysis involving a select group of experts who identified the questionnaire domains and items. Participants responded to 89 items in addition to the EuroQol 5 Dimensions Questionnaire (EQ-5D-5L), Fear-Avoidance Beliefs Questionnaire (FABq) and Oswestry Disability Index (ODI). The proportion of missing data and the distribution of responses were analysed for each item. Items with a discrimination index >0.40 and an interitem correlation <0.80 were retained. Factor analysis was performed using the VARIMAX rotation method, factor extraction, and identification, assignment of items to subscales, and assignment of scores to items. Internal consistency, reliability, construct validity and face validity were also assessed.

Results: A total of 52 items were included in the factor analysis and four subscales identified: Physical Stress Subscore (six items); Mental Stress Subscore (six items); Job Satisfaction Subscore (four items) and Kinesiophobia/Catastrophizing Subscore (four items). The items in the final questionnaire version had a factor loading >0.7. The questionnaire consisted of 20 items with good internal consistency (Cronbach's alpha 0.81-0.91), reliability (weighted kappa coefficient 0.617-1.00), good construct validity (EQ-5D-5L, r=-0.549, p<0.001; ODI, r=0.549, p<0.001; FABq work, r=0.688, p<0.001) and satisfactory face validity (universal validity index 96.04%).

Conclusion: The P4Wq is a 20-item, multifactorial self-report risk assessment questionnaire. It may provide a useful tool for screening for WMSDs by specifically addressing back disorders. It investigates risks for individual workers and may inform educational programmes and preventive strategies tailored to a worker's needs.

Trial registration number: NCT04192604.

Keywords: back pain; health & safety; mental health; musculoskeletal disorders; risk management.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Overview of the workflow of the literature review and the Delphi process for the pilot study. JSS, Job Satisfaction Subscore; KCS, Kinesiophobia/Catastrophizing Subscore; MSS, Mental Stress Subscore; PSS, Physical Stress Subscore.
Figure 2
Figure 2
Pearson’s correlation for a negative association with the indicator of the quality of life (EQ-5D-VAS (EuroQol Group General health status score-Visual Analogue Scale)) and a positive association with disability index (ODI (Oswestry Disability Index)) and work-related pain (FABq (Fear-Avoidance Beliefs Questionnaire)). The associations are statistically significant for all variables (two-tailed, p

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