Entwicklung einer Kurzversion des Spinal Function Sort (M-SFS): Ein Mixed-Method-Ansatz^{[*] , [**]}

Zusammenfassung

Hintergrund: Der Spinal Function Sort (SFS) ist ein bebilderter Fragebogen mit 50 Fragen zur Erhebung der selbsteingeschätzten Leistungsfähigkeit in Bezug auf wirbelsäulenbelastende Tätigkeiten. Der 1989 vom Arbeitspsychologen Leonard Matheson entwickelte SFS wird im Rahmen der Evaluation der funktionellen Leistungsfähigkeit (EFL) verwendet. Vorherige Studien empfehlen eine Verkürzung und Überarbeitung des bestehenden Fragebogens.

Ziel: Entwicklung einer modifizierten Version des Spinal Function Sorts (M-SFS) zur Messung der arbeitsbezogenen Überzeugungen von Patienten mit chronischen LWS-Schmerzen.

Methode: Es wurde ein aus 3 verschiedenen Methoden bestehendes Mixed-Method-Design (M1–M3) gewählt. Die Teilnehmer wurden in Einzelinterviews befragt, wie häufig sie die Aktivitäten der 50 SFS-Fragen innerhalb 1 Woche durchführen und welche Haltungen und Bewegungen der Wirbelsäule mit ihren Rückenschmerzen verbunden sind (M1). Quantitative Analysen von vorher bereits erhobenen SFS-Fragebogendaten beinhalteten interne Konsistenzprüfung, Eindimensionalität, probabilistische Testtheorie (Item response) sowie Untersuchungen von Boden- und Deckeneffekten (M2). Experten bewerteten die Fragen des SFS nach ihrer Relevanz (M3). Die Ergebnisse dieser Methoden (M1–M3) wurden in einem Summenscore zusammengefasst und als Entscheidungsgrundlage zur Reduktion der Fragenanzahl verwendet.

Ergebnisse: Aus Einzelinterviews mit 17 Teilnehmern konnten 8 neue Fragen erschlossen werden (M1). Quantitative Analysen aus einem 565 Teilnehmer beinhaltenden Datenset (M2) zeigten eine sehr hohe interne Konsistenz aller Fragen (Cronbach Alpha = 0,98) auf, was auf eine Fragenredundanz hinweist; Eindimensionalität der SFS-Fragen wurde durch eine Hauptkomponentenanalyse (PCA) unterstützt; eine Rasch-Analyse bestätigte gute Werte in der probabilistischen Testtheorie (Item response), und Bodeneffekte fanden sich für 4 Fragen zum Heben von sehr schweren Gewichten. Die Experten bestimmten einstimmig 8 der 50 SFS-Fragen als relevant (M3). Aus dem ursprünglichen SFS-Fragebogen erreichten 12 Fragen den vorher festgelegten Richtwert von 9 Punkten.

Schlussfolgerung: Mittels Mixed Method Design wurde eine modifizierte Version des SFS mit 20 Fragen entwickelt. Die Messeigenschaften des M-SFS müssen noch überprüft werden, bevor dieser in der klinischen Praxis eingesetzt werden kann.

Abstract

Background: The Spinal Function Sort (SFS) is an illustrated questionnaire including 50 questions for assessing the perceived functional ability regarding activities with negative impact on the spinal column. The SFS developed by the Leonard Matheson in 1989 is used within the scope of the assessment of functional ability. Previous studies recommend a shortened and revised version.

Objective: To develop a modified version of the Spinal Function Sort measuring perceived functional ability for work-related activities in patients with chronic low back pain.

Methods: A mixed method design consisting of methods (M) was performed. In interviews, participants were asked which postures in daily life were related to their back pain and how often they perform the activities of the 50 SFS items in one week (M1). Quantitative analysis of previously obtained SFS data consisted of measuring floor and ceiling effect, internal consistency with all and half of the items, item-to-total correlations, principal component analysis (PCA) and Rasch analysis (M2). Experts rated the SFS items based on relevance (M3). Based on the results of M a total score for each item of the SFS was calculated, and merged with the results of the interviews (M4).

Results: From interviews with 17 participants, eight new items emerged (M 1). Quantitative analysis of 565 data sets (M 2) demonstrated a floor effect of four items of very heavy material handling. Cronbach's alpha was 0.98 for all, and 0.96 for half of the items, indicating item redundancy. Item-to-total correlations values were > 0.6. Good item response was confirmed by Rasch analysis. Unidimensionality of the SFS was supported by results of PCA. Experts rated all items as relevant (M 3). From the original SFS, 12 items confirmed an adequate total score.

Conclusions: A modified version of the SFS with 20 items has been developed. The reliability and validity of this modified version should be tested.

Schlüsselwörter

Rückenschmerzen - Selbstwirksamkeitsüberzeugungen - Fragebogen - Arbeit

Key words

back pain - self-efficacy beliefs - questionnaire - work

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