The Chinese Localization Of Work-ability Support Scale And Its Application In Return To Work Of Young And Middle-Aged Stroke Patients

Objectives(1)To translate the Work-ability Support Scale(WSS)into Chinese and revise according to Chinese cultural background,and to evaluate its reliability and validity in young and middle-aged stroke patients.(2)Part A of WSS was used to investigate the ability of young and middle-aged stroke patients to return to work,and to explore the influencing factors.(3)Part B of WSS was used to explore the influence of factors related to return to work of young and middle-aged stroke patients.MethodsThis study consists of two parts.The first part:the scale was translated into Chinese version by translation and back translation.The cross-cultural adjustment of WSS was conducted by four parts:the original author consultation,expert consultation,pre-investigation and discussion of the research group.In the phase of reliability and validity test,403 young and middle-aged stroke patients from three community health service centers in Zhengzhou were selected as participants.IBM SPSS statistics 21.0 and IBM SPSS Amos 21.0 were used for data analysis.Pearson correlation analysis method and critical ratio method were used to analyze WSS items.Content validity and structure validity(exploratory and confirmatory factor analysis)were used to test the validity.Reliability test included internal consistency test(Cronbach's a coefficient)and inter rater consistency test(kappa coefficient).The second part:this study included 214 young and middle-aged stroke patients from three community health service centers in Zhengzhou.The investigation tools were general information questionnaire,modified Rankin scale and WSS.SPSS 21.0 was used for data analysis:the general data of the subjects were described by frequency and composition ratio;the ability of return-to-work and related factors were described by means of mean±standard deviation(x±s).T-test and one-way ANOVA were used to analyze the difference of patients' ability of return-to-work with different demography,disease or work-related data.Multiple linear regression analysis was conducted with the scores of each domain of patients' ability of return-to-work as the dependent variable and the general data of patients as the independent variable to explore the influencing factors of patients'ability to return to work.In addition,in order to analyze the influencing factors of whether young and middle-aged stroke patients return to work or not,t-test and ?2 test were used to select statistically significant independent variables,and logistic regression analysis was used to analyze the influencing factors of patients' return to work.ResultsFor the first part:except for items B8 and B10-12,the correlation coefficient between other items and the total score of the scale was greater than 0.4(P<0.01).The decision value of all items in the scale reached 3.0(P<0.001).The S-CVI of part A and part B were 0.94 and 0.90,respectively.Three common factors were extracted from part A of the scale to explain 67.747%of the total variation,and part B to explain 56.056%of the total variation.The results of confirmatory factor analysis show that the load of each factor was good,and the fitting indexes of part a structure model were as follows:for part A,?2idf=1716.SRMR=0.044,GFI=0.909,AGFI=0.873,?CFI=0.966,NFI=0.924,RMSEAF=0.059.for part B,?2/df=1.885,SRMR=0.057,GFI=0.933,AGFI=0.894,CFI=0.928,NFI=0.863,RMSEA=0.065.Except for items B10 and B8,the kappa coefficients of other items were more than 0.60(P<0.01);the Cronbach's ? coefficients of part A of WSS in Chinese version were 0.932,and the Cronbach's ? coefficients of all dimensions were 0.862-0.910.Cronbach's ? coefficient of part B was 0.766,and Cronbach's ? coefficients of dimensions were 0.645-0.803.For the second part:the scores of domains-physical,thinking and communication,social and behavioral of the young and middle-aged stroke patients were(20.07±6.07),(20.47±7.86)and(23.72±9.16)respectively.The results of multiple linear regression analysis showed that the degree of disability and stroke type were the influencing factors of physical related ability to return-to-work,explaining 18.8%total variation;the degree of disability,education,stroke frequency and stroke type were the influencing factors of thinking and communication related ability to return-to-work,explaining 29.3%total variation;degree of disability,education,stroke frequency and duration of illness is the influencing factor of social and behavioral related ability to return-to-work,explaining 17.6%total variation.52 cases(24.3%)had returned to work,162 cases(75.7%)had not returned to work.After t-test ?2-test and logistic regression analysis,the factors that affect the outcome of their return to work included:physiological related ability to return to work(OR=0.907,95%CI:0.850?0.968,P<0.05),work willingness(OR=1.776,95%CI:1.037?3.042,P<0.05),confidence(OR=2.886,95%CI:1.560?5.341,P<0.05)and other personal factors,work factors-occupation type(OR=4.261,95%CI:1.283?14.154,P<0.05),employer factors(OR=2.251,95%CI:1.244-4.072,P<0.05),and family factors supported by relatives and friends(OR=1.758,95%CI:1.029?3.004,P<0.05).Conclusions(1)The Chinese version of Work-Ability Support Scale(WSS),which has been adapted to Chinese culture,has good reliability and validity,and can be accepted and applied in return-to-work of young and middle-aged stroke patients in China.(2)The ability of young and middle-aged stroke patients to return to work includes physical,thinking and communication,social and behavioral.The influencing factors include the degree of physical disability,education,stroke type and frequency,and the duration of illness.(3)The rate of patients returning to work needs to be improved.the factors that affect the outcome of their return to work included:ability to return to work,work willingness,confidence and other personal factors,occupation type,employer factors,occupational support and rehabilitation work factors,and family factors supported by relatives and friends.