Readiness for Return-To-Work (RRTW) scale: development and validation of a self-report staging scale in lost-time claimants with musculoskeletal disorders

INTRODUCTION: We report on the development and validation of a 22-item scale assessing stage of readiness for return-to-work, the Readiness for Return-to-Work (RRTW) scale. METHODS: Lost-time claimants (n = 632) completed a telephone survey one month after a work-related musculoskeletal injury. Exploratory and confirmatory factor analyses of readiness items were conducted with two separate samples, and concurrent validity was examined. RESULTS: For workers not working, 60% of the variance was explained by four factors--(1) Precontemplation, (2) Contemplation (3) Prepared for Action-Self-evaluative and (4) Prepared for Action-Behavioral. For those working, 58% of the variance was explained by two factors--(1) Uncertain Maintenance and (2) Proactive Maintenance. Confirmatory factor analyses had satisfactory fit indices to confirm the initial model. Concurrent validity of the scale was supported: relationships of readiness with depressive symptoms, fear-avoidance, pain, and general health, were generally in the hypothesized direction. CONCLUSIONS: Psychometric properties of the newly developed instrument suggest that the application of the Readiness for Change model to return-to-work is relevant to work disability research. The instrument may facilitate the offer of stage-specific services tailored to injured workers' needs, and be used for evaluation of return-to-work interventions