title: Adaptation and cross-cultural validation of the rheumatoid arthritis work instability scale (RA-WIS).
abstract: BACKGROUND
  Despite recent advances, work disability in rheumatoid arthritis (RA) remains common. Work disability is frequently preceded by a period of work instability characterised by a mismatch between an individual's functional abilities and job demands. This could raise the risk of work disability if not resolved. A work instability scale for RA (RA-WIS) has previously been developed to screen for this risk. The objective of this study was the adaptation of this scale into French, Dutch and German.
  
  
  METHODS
  Different language versions of the RA-WIS were produced through a process of forward and back translations. The new scales were tested for face validity. English data from the original developmental study was pooled with data generated through postal surveys in each country. The internal construct and cross-cultural validity of the new scales were assessed using Rasch analysis, including differential item functioning (DIF) by culture.
  
  
  RESULTS
  The pooled data showed good fit to the Rasch model and demonstrated strict unidimensionality. DIF was found to be present for six items, but these appeared both to cancel out at the test level and have only a marginal effect on the test score itself.
  
  
  CONCLUSIONS
  The RA-WIS was shown to be robust to adaptation into different languages. Data fitted Rasch model expectations and strict tests of unidimensionality. This project and the continuing work on further cross-cultural adaptations have the potential to help ensure clinicians across Europe are able to support RA patients to achieve their potential in work through early identification of those most at risk.
authors.affiliation: Department of Musculoskeletal and Rehabilitation Medicine, University of Leeds, D Floor, Martin Wing, Leeds General Infirmary, Leeds LS1 3EX, UK. gilworths@aol.com
authors.forename: G
authors.initials: G
authors.lastname: Gilworth
authors.forename: P
authors.initials: P
authors.lastname: Emery
authors.forename: L
authors.initials: L
authors.lastname: Gossec
authors.forename: T P M
authors.initials: TP
authors.lastname: Vliet Vlieland
authors.forename: F C
authors.initials: FC
authors.lastname: Breedveld
authors.forename: A J
authors.initials: AJ
authors.lastname: Hueber
authors.forename: G
authors.initials: G
authors.lastname: Schett
authors.forename: A
authors.initials: A
authors.lastname: Tennant
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000523:psychology / Q000534:rehabilitation*; D001294:Attitude to Health; D003431:Cross-Cultural Comparison; D004651:Employment / Q000523:psychology; D005260:Female; D005602:France; D005858:Germany; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011594:Psychometrics; D015203:Reproducibility of Results; D014938:Work Capacity Evaluation