Cross-sectional validation of the extended Nordic Musculoskeletal Questionnaire in Singapore healthcare workers
Photo by Benjamin Brunner / Unsplash
Key Takeaway
Consider the NMQ-E as a valid and reliable tool for surveillance of work-related musculoskeletal disorders in Singapore healthcare workers.
This cross-sectional study assessed the psychometric properties of the extended Nordic Musculoskeletal Questionnaire (NMQ-E) among 251 nurses and therapists working in two community hospitals in Singapore. The NMQ-E is designed to capture work-related musculoskeletal disorders. The study evaluated internal consistency, test-retest reliability, convergent validity, face validity, and feasibility.
Internal consistency was good, with Cronbach's alpha above 0.81. Test-retest reliability was excellent for the intraclass correlation coefficient (ICC 0.987, 95% CI 0.974–0.994) and moderate to almost perfect for kappa values (0.64–0.95). All a priori hypotheses for convergent validity were confirmed, and item response rates exceeded 97%, indicating high feasibility.
The study did not report limitations, adverse events, or funding sources. As a cross-sectional design, it cannot assess responsiveness to change or predictive validity. The findings support the NMQ-E's use for epidemiological surveillance and occupational health interventions in Singapore's healthcare setting, but generalizability to other populations or settings requires further study.
View Original Abstract ↓
BackgroundWork-related musculoskeletal disorders are highly prevalent among healthcare professionals and contribute to disability, reduced productivity and compromised patient care delivery. The Extended Nordic Musculoskeletal Questionnaire is a comprehensive tool used for gathering data on musculoskeletal symptoms and their impact, however its measurement properties have not been validated in Singapore. This study aimed to evaluate the reliability and validity of the extended Nordic Musculoskeletal Questionnaire in measuring musculoskeletal disorders (MSDs) among healthcare professionals in two community hospitals in Singapore.MethodsA total of 251 nurses and therapists working in two community hospitals were recruited in a cross-sectional study conducted between March 2024 and August 2024, following the Consensus-based Standards for selection of Health Measurement Instruments framework (COSMIN). Face validity was assessed through cognitive debriefing interviews (CDIs). Construct validity was assessed by testing 5 a priori hypotheses with the EQ-5D-5L instrument, using Spearman’s correlation coefficients. Test–retest reliability was evaluated using kappa, observed proportion of agreement and intraclass correlation coefficient (ICC), while the internal consistency was determined using Cronbach’s alpha.ResultsAmong 251 participants (mean age: 34.7, 83.6% females, 7.31 years of working experience), the NMQ-E demonstrated good internal consistency (Cronbach’s alpha above 0.81), and excellent test–retest reliability [ICC = 0.987 (95% CI 0.974–0.994)] with moderate to almost perfect reliability (kappa = 0.64–0.95). All a priori were confirmed in convergent validity assessment. Item response rates exceeded 97%, indicating good feasibility.ConclusionThe NMQ-E is a valid and reliable instrument for assessing work-related musculoskeletal symptoms among healthcare professionals in community hospitals within Singapore. Its application may greatly support epidemiological surveillance and inform occupational health interventions in Singapore’s healthcare setting.
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