Development of the short-hand function sort in vocational rehabilitation

Abstract

The Hand Function Sort (HFS) is a pictorial self-questionnaire with 62 items measuring task self-efficacy in working population. It is a valid and a reliable scale that focuses on upper limb physical function [1] . It is frequently used in order to assess the ability to resume work [1] , [2] . Our goal was to develop a short version of the HFS with less than 30 items to improve its feasibility. Inclusion criteria were as follows: patients aged between 18 and 65 years with chronic pain and various orthopaedic conditions of the upper limb in the aftermath of an accident, who were hospitalized for a vocational rehabilitation. Items were selected using various methods: interviews with patients, experts’ opinions, the Rasch analysis model, detection of the floor/ceiling effect, and measurement of unidimensionality (principal component analysis). In addition, the final version had to include the different levels of effort assessed by the original version. Six experts with over 10 years of clinical experience were consulted (2 physiatrists, 2 physiotherapists, and 2 occupational therapists), 34 patients were interviewed and the questionnaires of 629 patients were analyzed. Of the top-rated items, 25 were selected following a final round with the experts (items: 1, 5–8, 10–14, 23–25, 27, 29, 37, 41, 43, 45, 50–51, 55, 57, 60–61). The internal consistency of the short version was satisfactory (Cronbach's alpha = 0.959). A short version of the HFS was developed. Further studies are needed to verify the reproducibility of the short version, its concurrent validity with the original version and its criterion validity with other clinical scales of the upper limb such as the Disabilities of the Arm, Shoulder and Hand (DASH score).