title: Validation of performance indicators for rehabilitation of workers with mental health problems.
abstract: OBJECTIVE
  The objective of this study was to evaluate content validity and predictive validity of 11 performance indicators for the rehabilitation of workers with mental health problems.
  
  
  METHODS
  Content validity was assessed by experts who evaluated the validity of the performance indicators in 2 Delphi rounds. Predictive validity was evaluated by relating the performance indicators and their sum score to the outcome of a cohort of 191 employees absent from work as a result of mental health problems. Scores for the performance indicators were obtained by processing registration forms of consultations filled out by occupational physicians.
  
  
  METHODS
  Three outcome measures were used: time to return to work, change in level of fatigue, and patient satisfaction.
  
  
  RESULTS
  Ten of the 11 performance indicators showed adequate content validity according to the expert panel. The evaluation of predictive validity yielded mixed results. One performance indicator did not show sufficient variability and was excluded from further analysis. The sum score of 9 performance indicators and performance on the evaluation of work disabilities were significantly related to a shorter time to return to work (hazard ratio [HR], respectively, 0.7; confidence interval [CI], 0.7-0.9 and 0.5; CI, 0.2-0.9). Adequate care regarding interventions aimed at providers of care in the curative sector was related to a longer time to return to work (HR, 1.8; CI, 1.1-3.0). The linear regression revealed that the sum score was not significantly related to a change in level of fatigue. However, lower quality of overall care was significantly related to moderately higher patient satisfaction (beta=0.18; P<0.05).
  
  
  CONCLUSIONS
  The evaluated performance indicators showed sufficient content validity and overall predictive validity, but no clear relation could be established between individual performance indicators and outcome.
authors.affiliation: Coronel Institute for Occupational and Environmental Health, Academic Medical Centre, AmCOGG, University of Amsterdam, Amsterdam, The Netherlands. K.Nieuwenhuijsen@amc.uva.nl
authors.forename: Karen
authors.initials: K
authors.lastname: Nieuwenhuijsen
authors.forename: Jos H A M
authors.initials: JH
authors.lastname: Verbeek
authors.forename: Angela G E M
authors.initials: AG
authors.lastname: de Boer
authors.forename: Roland W B
authors.initials: RW
authors.lastname: Blonk
authors.forename: Frank J H
authors.initials: FJ
authors.lastname: van Dijk
mesh_terms: D000328:Adult; D003697:Delphi Technique; D005221:Fatigue / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D009426:Netherlands; D009787:Occupational Medicine / Q000592:standards*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D019984:Quality Indicators, Health Care; D018582:Sick Leave