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A Greek validation study of the Multiple Sclerosis Work Difficulties Questionnaire-23


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Bakirtzis, C, Artemiadis, A, Nteli, A, Boziki, MK, Karakasi, M-V, Honan, C ORCID: 0000-0001-5735-4270, Messinis, L, Nasios, G, Dardiotis, E and Grigoriadis, N 2021 , 'A Greek validation study of the Multiple Sclerosis Work Difficulties Questionnaire-23' , Healthcare, vol. 9, no. 7 , pp. 1-10 , doi: 10.3390/healthcare9070897.

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The Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) is a self-reportinstrument developed to assess barriers faced by People with Multiple Sclerosis (PwMS) in theworkplace. The aim of this study was to explore the psychometric properties of the Greek versionof the MSWDQ-23. The study sample consisted of 196 PwMS, all currently working in part- orfull-time jobs. Participants underwent clinical examination and cognitive screening with the BriefInternational Cognitive Assessment for Multiple Sclerosis (BICAMS) and completed self-reportmeasures of fatigue, psychological functioning, and quality of life, along with the MSWDQ-23questionnaire. Confirmatory Factor Analysis (CFA) was performed, and goodness-of-fit measureswere used to evaluate construct validity. Convergent validity was checked by correlating MSWDQ-23scores with study measures. Cronbach’s alpha value was produced to assess internal consistency.CFA yielded a model with a fair fit confirming the three-factor structure of the instrument. Higherwork difficulties were associated with higher Expanded Disability Status Scale (EDSS) scores, poorercognitive function, more fatigue, stress, anxiety, and depression, and poorer health status, supportingthe convergent validity of MSWDQ-23. Internal consistency (Cronbach’s alpha = 0.94) and test–retest reliability (ICC = 0.996, 95%, CI = 0.990–0.998) were excellent. The Greek MSWDQ-23 can beconsidered a valid patient-reported outcome measure and can be used in interventions aiming toimprove the vocational status of PwMS.

Item Type: Article
Authors/Creators:Bakirtzis, C and Artemiadis, A and Nteli, A and Boziki, MK and Karakasi, M-V and Honan, C and Messinis, L and Nasios, G and Dardiotis, E and Grigoriadis, N
Keywords: multiple sclerosis, employment, patient-reported outcome, MSWDQ-23, validation
Journal or Publication Title: Healthcare
Publisher: MDPI AG
ISSN: 2227-9032
DOI / ID Number: 10.3390/healthcare9070897
Copyright Information:

Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons 4.0 International (CC BY 4.0) license (

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