抑郁和焦虑工人样本中常见精神障碍患者工作不稳定性量表的开发和结构效度:Rasch 分析。

IF 2.3 Q1 REHABILITATION Rehabilitation Process and Outcome Pub Date : 2020-07-14 eCollection Date: 2020-01-01 DOI:10.1177/1179572720936664
Louise Danielsson, Robin Fornazar, Kristina Holmgren, Åsa Lundgren Nilsson, Gunnel Hensing
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摘要

背景:常见精神障碍(包括抑郁症和焦虑症)导致的病假率很高。捕捉功能减退的早期迹象有助于调整工作任务和环境,从而支持积极主动的职业和医疗干预方法,防止长期病假的发生。然而,目前很少有测量方法可以识别失衡的早期迹象,也没有针对特定疾病的测量方法。本研究的目的是为常见精神障碍患者制定工作不稳定性量表,并测试该量表的基本心理测量特性:研究对象为 18-65 岁患有抑郁症或焦虑症的在职成年人。量表的开发始于定性访谈(n = 27),访谈结果为二分法自我报告问卷的起草提供了依据。认知汇报(n = 12)用于检查表面效度和修改草案。采用 Rasch 分析法(n = 128)检验了草案的内部结构效度。结果:最初的 63 个项目草案与 Rasch 模型的预期契合度较低。我们逐步删除了拟合度较差或存在局部反应依赖性的项目,最终得到了符合模型预期的单维 34 个项目量表,并且没有出现项目功能差异。人-项阈值分布表明,该量表更适合测量中低度工作不稳定性,而不是测量高度不稳定性。新开发的量表与工作能力指数之间存在显著的中度相关性:在最初的目标样本中,34 个项目的量表显示出了可接受的基本属性和内部构造效度。有必要在更大的样本中对该量表进行进一步验证,包括外部效度测试。
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Development and Construct Validity of the Work Instability Scale for People With Common Mental Disorders in a Sample of Depressed and Anxious Workers: A Rasch Analysis.

Background: Sick leave due to common mental disorders, encompassing depression and anxiety disorders, is high. Capturing early signs of reduced function could aid adjustments of work tasks and environment and, thus, endorse a pro-active approach to occupational and health care interventions to prevent long-term sick-leave spells. However, few measurements exist to identify early signs of imbalance, and none that is illness-specific. The aim of this study was to develop a work instability scale for people with common mental disorders and to test the fundamental psychometric properties of the scale.

Methods: Participants were working adults 18-65 years old with depression or anxiety. The scale development started with qualitative interviews (n = 27) which informed the drafting of a dichotomous, self-report questionnaire. Cognitive debriefing (n = 12) was used to check face validity and modify the draft. Internal construct validity of the draft was tested using Rasch analysis (n = 128). The work ability index was used as a comparator measure.

Results: The initial 63-item draft showed poor fit to Rasch model expectations. Items displaying poor fit or local response dependency were stepwise removed, resulting in a unidimensional 34-item scale fitting the model expectations, and with no differential item functioning. Person-item threshold distribution showed that the scale is better suited to measure low to moderate work instability, than to measure high instability. Correlations between the newly developed scale and the work ability index showed a significant, moderately strong correlation.

Conclusions: In the initial target sample, the 34-item scale showed acceptable fundamental properties and internal construct validity. Further validation of the scale in a larger sample, including tests for external validity, is warranted.

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