Abstract
Objective
To investigate the targeting, scaling, and structural validity of the Work Limitation
Questionnaire (WLQ) using Rasch analysis.
Design
Secondary data analysis.
Setting
Tertiary care hospital.
Participants
The data were sourced from an upper limb specialty clinic of injured workers using
the convenience sampling method and from a national randomized controlled trial investigating
2 surgical options for rotator cuff repair by formal, randomized selection (N=315).
Interventions
Not applicable.
Main Outcome Measures
Work Limitation Questionnaire 25-item version (WLQ-25). The WLQ contains 25 items
measuring a client’s ability to perform specific job demands on a 5-point ordinal
response scale ranging from 0 (difficulty none of the time) to 4 (difficulty all the
time). The average of all 25 items is used as the total score, ranging from 0 to 4,
where higher index scores indicate greater difficulty performing daily work. Subscales
were used to assess time management, physical demands (PD), mental-interpersonal demands,
and output demands.
Results
The Rasch analyses performed on the dataset included the test of fit of residuals,
ordering of item thresholds, Person separation index, differential item functioning
(DIF), dependency, and unidimensionality. The partial credit model was selected for
the current Rasch analysis because the likelihood ratio test was significant at both
the overall questionnaire and the subscale level (P<.001). The WLQ-25 did not fit with the Rasch model (χ2=1715.58; df=125; P<.001) and most of the thresholds were disordered. A series of steps were undertaken
to improve the fit statistic, including item reduction (6 items) and response merging
(9 items). DIF was absent in the revised scale based on sex, age, full- or part-time
employment, and type of employment. Only 3 revised subscales, namely the PD, mental
demands, and interpersonal demands subscales, demonstrated acceptable fit to the Rasch
model.
Conclusions
The WLQ-25 demonstrated substantial misfit from the Rasch model, which could not be
fully mediated. The revised PD, mental demands, and interpersonal demands subscales
could be used to assess these constructs.
Keywords
List of abbreviations:
DIF (differential item functioning), IP (interpersonal demands), LD (local dependency), MD (mental demands), MI (mental-interpersonal demands), PCA (principal component analysis), PD (physical demands), PSI (person separation index), OD (output demands), OMERACT (Outcome Measures in Rheumatology), TM (time management), WLQ-25 (Work Limitation Questionnaire 25-item version)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 09, 2020
Footnotes
Joy C. MacDermid was supported by a CIHR Chair in Gender, Work and Health and the Dr James Roth Research Chair in Musculoskeletal Measurement and Knowledge Translation.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
