Validity and reliability of an online extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E2) to measure nurses' fitness

Abstract

Aims and objectives: To describe modifications to a second extended version of the Nordic Musculoskeletal Questionnaire for online use in nursing populations, and check validity and reliability.

Background: The Nordic Musculoskeletal Questionnaire has been used to assess the severity and impact of musculoskeletal symptoms in occupational groups. The reliability of a previous extended version was established for paper-based, self-administration among nursing students. This current study extended the questionnaire to collect more information regarding musculoskeletal symptoms in all nine body regions and their work-relatedness, as an instrument is needed to gather evidence about the impact of fitness levels on occupational musculoskeletal disorders among nurses.

Design: Psychometric evaluation.

Method: Sixty-five undergraduate nurses completed the online extended Nordic Musculoskeletal Questionnaire twice. Content validity was examined by expert review and construct validity by exploratory factor analysis of 90 responses from the first completion. Reliability was checked by examining internal consistency, kappa statistics, proportions of observed, and positive and negative agreements, intra-class correlation coefficient and standard error of measurement.

Results: The instrument had high internal consistency and exploratory factor analysis revealed it was a relatively homogenous (unidimensional) measure of musculoskeletal symptom severity. Age of onset of symptoms questions were reliable, with high mean intra-class correlation coefficients and low mean standard errors of measurement. Overall, questions showed high mean strengths of agreement and proportions of observed agreement: three-quarters of the prevalence questions and 99% of the severity/impact questions had 10% or fewer disagreements.

Conclusions: Modifications to the Nordic Musculoskeletal Questionnaire and online administration did not diminish its validity or reliability for obtaining information about the severity of nurses' musculoskeletal symptoms.

Relevance to clinical practice: Occupational musculoskeletal disorders are an issue for nurses. This questionnaire can be used to monitor nurses' musculoskeletal health, and in musculoskeletal disorder prevention studies.

Keywords: Nordic Musculoskeletal Questionnaire; musculoskeletal symptoms; nurses; reliability; validity.