Adaptation and validation of the cardiovascular version of the Return-to-Work Obstacles and Self-Efficacy Scale (ROSES-CVD) to the Italian context

Abstract

Purpose

Effective cardiac rehabilitation interventions must provide adequate support to overcome psychosocial return-to-work (RTW) barriers. No validated instrument is available for this aim for cardiovascular patients. The Return-to-work Obstacles and Self-Efficacy Scale (ROSES) measures RTW obstacles workers perceive and the self-efficacy for overcoming them through 46 items and ten dimensions. This study aimed to adapt and validate ROSES for cardiovascular disease (CVD) in the Italian context.

Methods

This prospective study involved 183 CVD working patients at baseline and 121 six months later. ROSES-CVD internal consistency, construct, and predictive validity was evaluated with Cronbach’s α, Confirmatory factor analyses (CFA), and ANCOVAs.

Results

CFAs adequately replicated the original ROSES model (CFI = .92–.96; TLI = .91–.94; RMSEA = .042–.057; SRMR = .046–.071) with α close or higher than .70 for all dimensions. Four ROSES-CVD dimensions significantly predicted the number of days to RTW controlling for age, gender, educational level, and surgery type. Workers who perceived salient RTW obstacles and low self-efficacy in any of these dimensions in mean returned to work from 38 to 53 days later.

Conclusions

The study supported the validity and reliability of ROSES-CVD. This tool can be used in rehabilitation to detect CVD patients at risk of a longer RTW process and define appropriate cardiac rehabilitation intervention.

IMPLICATIONS FOR REHABILITATION

• Vocational rehabilitation interventions should provide tailor-made support to overcome RTW barriers based on individual risk assessment

• The Italian translation of ROSES-CVD is a valid and reliable tool to measure psychosocial barriers to RTW among CVD working patients

• The use of ROSES-CVD would allow detection of CVD patients at risk of longer RTW process

• Administering ROSES-CVD can help focus traditional vocational intervention on individually relevant obstacles to RTW

Keywords:

• Return to work
• cardiovascular rehabilitation
• cardiovascular disease
• questionnaire
• psychosocial factors
• self-efficacy

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Difficult work/life balance was composed of four items. Because Cronbach’s alpha also depends on the number of items, with a short scale it is more likely to find alpha values lower than .70 [27]. To investigate if the alpha value of .68 indicated a severe threat to reliability, we calculated the average inter-item correlation and item-total correlation. The average inter-item correlation was equal to .34, within the recommended range of .15 and .50 [40]. The lowest item-total correlation was equal to .37, above the suggested cut-off of .30 [27].