Translation and initial cross-cultural adaptation of the tool for support-gradual return-to-work for persons with chronic musculoskeletal pain to the Swedish setting

Work. 2024 May 9. doi: 10.3233/WOR-230665. Online ahead of print.

Abstract

Background: A well-defined and clear procedure is a key factor supporting return-to-work and enhancing collaboration and understanding between employers and employees. The adaptation of the Tool for Support-Gradual Return to Work, TS-GRTW, addresses relevant cultural aspects valuable for wider adoption.

Objective: develop a Swedish version, the GRTWswe, for implementation and integration into the Swedish labor market's RTW process. This involved translating, culturally adapting, and assessing the appropriateness and utility.

Methods: In the initial step, a double back translation was performed to create an initial translated version. This version was then utilized in individual consultations, accompanied by an agreement questionnaire. For the subsequent step, group consultations were held to refine and customize the tool to suit the Swedish context. Ten occupational therapists completed the questionnaires, with mean agreement scores surpassing three on a four-point scale. Out of these, nine participated in group consultations.

Results: The findings suggest the requirement for specific modifications to the GRTWswe. These adaptations are essential because of cultural differences in organizational structures and reference frameworks. Moreover, participants unanimously agreed to broaden the scope of target groups, encompassing employees without regard for diagnosis and expanding the range of professions that can utilize this tool. This step aims to enhance the tool's applicability and usefulness.

Conclusions: The study found strong alignment between questionnaire responses and group consultations outcomes, affirming the adapted tool's suitability for use in a Swedish context. The tool benefits employers and employees by enhancing communication, encouraging collaboration, and structuring processes, promising lasting improvements to work conditions.

Keywords: Return-to-work; chronic pain; cross cultural comparison; instrument development; occupational therapist; vocational rehabilitation.