Translation, adaptation, validity and reliability of the Dutch version of the ‘blue flags’ questionnaire

Figures & data

Table 1. The fourteen questions of the Swedish ‘Blue flags’ questionnaire (unrevised English version) linked to the selected categories of the Questionnaire on the Experience and Evaluation of Work (QEEW).

Questions of the ‘Blue Flags’ questionnaire	Category of the QEEW
1. There are clear goals for my work	Task clarity
2. My work contains positive challenges	Problems with the task
3. There are incompatible demands for me at my work	Problems with the task
4. I have control in my work situation	Self-reliance at work
5. I can solve problems that arise at work	Self-reliance at work
6. The work requires me to concentrate all the time and can make decisions	Mental stress
7. My tasks at work are too difficult	Complexity of work
8. I can count on that if necessary, get help and support from my immediate supervisor	Relationship with direct management
9. I can count on that if necessary, get help and support from my colleagues	Relationship with colleagues
10. I can decide how fast I work	Work rate and quantity
11. I have too many tasks, too much work to do	Work rate and quantity
12. Men and women are treated equally at my workplace	Care for well-being
13. Old and young staff are treated equally at my workplace	Care for well-being
14. There has been bullying and harassment at my workplace during the last 6 months	Care for well-being

Figure 1. Flow chart of participating patients in the study.

Table 2. Baseline characteristics of participants who completed T0 (n = 58) and who completed T0 and T1 (n = 51).

	Completed T0^a (n = 58)		Completed T0 and T1^b (n = 51)
Demographic characteristics	N	%	N	%
Gender
Male	23	39.7	19	37.3
Female	35	60.3	32	62.7
Age, mean (SD)	44.7 (11.5)		44.3 (11.1)
Most common types of complaints
Back problems	17	29.3	13	25.5
Shoulder problems	9	15.5	7	13.7
Combination shoulder/neck problems	8	13.8	8	15.7
Neck problems	4	6.9	4	7.8
Other	20	34.5	19	37.3
Duration of complaints
1–4 weeks	9	15.5	8	15.7
5–12 weeks	18	31.0	15	29.4
13 weeks to 6 months	11	19.0	9	17.6
6–12 months	3	5.2	3	5.9
>1 year	17	29.3	16	31.4
Paid working hours per week, mean (SD)	32.5 (7.6)		31.9 (7.5)
Current profession
Healthcare	18	31.0	16	31.4
Administration	12	20.7	12	23.5
ICT	4	6.9	3	5.9
Other	24	41.4	20	39.2
Time in current profession
0–1 year	2	3.4	2	3.9
1–5 years	11	19.0	10	19.6
5–10 years	9	15.5	8	15.7
10–20 years	12	20.7	11	21.6
20–30 years	14	24.1	13	25.5
>30 years	10	17.2	7	13.7
Ongoing sick leave
Yes	5	8.6	4	7.8
No	53	91.4	47	92.2

^a All participants who filled in the first questionnaire (at T0).

^b All participants who filled in the first and the second questionnaire (at T0 and T1).

Table 3. The four factors and satisfactory loadings of the ‘Blue Flags’ questionnaire (n = 58).

Questions of the ‘Blue Flags’ questionnaire	Factor 1	Factor 2	Factor 3	Factor 4
1. There are clear goals for my work	–	–	0.69	–
2. My work contains positive challenges	–	0.66	–	–
3. There are incompatible demands for me at my work	–	–	–	0.81
4. I have control in my work situation	0.68	–	–	–
5. I can solve problems that arise at work	0.65	–	–	–
7. My tasks at work are too difficult	0.64	–	–	–
8. I can count on that if necessary, get help and support from my immediate supervisor	0.81	–	–	–
9. I can count on that if necessary, get help and support from my colleagues	0.84	–	–	–
10. I can decide how fast I work	–	–	0.79	–
11. I have too many tasks, too much work to do	–	–	–	0.88
12. Men and women are treated equally at my workplace	–	0.80	–	–
13. Old and young staff are treated equally at my workplace	–	0.70	–	–
14. There has been bullying and harassment at my workplace during the last 6 months	–	0.77	–	–
Variance explained (initial eigenvalues)	36.6%	14.5%	10.5%	9.2%
Variance explained (rotation sums of squared loadings)	23.7%	20.8%	14.2%	12.0%

Please note that question 6 was deleted.

Extraction method: principal component analysis (PCA). Rotation method: varimax with Kaiser normalisation.

Rotation converged in 6 iteration.

Table 4. The ICC for the total score and the individual subdomains between the ‘Blue Flags’ questionnaire at T0 and T1 (test–retest reliability) and the Spearman’s correlation between the ‘Blue Flags’ questionnaire at T0 and the Questionnaire on the Experience and Evaluation of Work (QEEW) at T0 (item representation).

Questions of the ‘Blue Flags’ questionnaire	ICC for test–retest reliability (level of significance)	ICC for the test–retest reliability of the individual subdomains (level of significance)	Category of the Questionnaire on the Experience and Evaluation of Work	Spearman’s rho/Pearson correlation for item representation (level of significance)
1. There are clear goals for my work.	0.48 (.011)	0.74 (.000)	Task clarity	0.35 (.008)
2. My work contains positive challenges.	0.73 (.000)	–	Problems with the task	0.54 (.000)
3. There are incompatible demands for me at my work.	0.78 (.000)	–	Problems with the task	0.54 (.000)
4. I have control in my work situation.	0.66 (.000)	–	Self-reliance at work	0.47 (.000)
5. I can solve problems that arise at work.	0.47 (.013)	–	Self-reliance at work	0.47 (.000)
7. My tasks at work are too difficult.	0.34 (.073)		Complexity of work	0.40 (.002)
8. I can count on that if necessary, get help and support from my immediate supervisor.	0.85 (.000)	0.84 (.000)	Relationship with direct management	0.74 (.000)
9. I can count on that if necessary, get help and support from my colleagues.	0.78 (.000)	–	Relationship with colleagues	0.61 (.000)
10. I can decide how fast I work.	0.66 (.000)	0.85 (.000)	Work rate and quantity	0.62 (.000)
11. I have too many tasks, too much work to do.	0.73 (.000)		Work rate and quantity	0.62 (.000)
12. Men and women are treated equally at my workplace.	0.77 (.000)	0.66 (.000)	Care for well-being	0.27 (.040)
13. Old and young staff are treated equally at my workplace.	0.51 (.006)	–	Care for well-being	0.27 (.040)
14. There has been bullying and harassment at my workplace during the last 6 months.	0.67 (.000)	–	Care for well-being	0.27 (.040)

Please note that question 6 was deleted.

Table

	Helemaal mee eens				Helemaal mee oneens
	4	3	2	1	0
1. Mijn werk kent duidelijke doelen	□	□	□	□	□	(4-)^a	[ ]
2. Mijn werk bevat positieve uitdagingen	□	□	□	□	□	(4-)	[ ]
3. Op mijn werk worden tegenstrijdige eisen aan mij gesteld	□	□	□	□	□		[ ]
4. Ik heb controle over mijn werksituatie	□	□	□	□	□	(4-)	[ ]
5. Ik kan problemen die op mijn werk ontstaan oplossen	□	□	□	□	□	(4-)	[ ]
6. Mijn taken op het werk zijn te moeilijk	□	□	□	□	□		[ ]
7. Ik kan indien nodig rekenen op hulp en ondersteuning van mijn directe leidinggevende	□	□	□	□	□	(4-)	[ ]
8. Ik kan indien nodig rekenen op hulp en ondersteuning van mijn collega’s	□	□	□	□	□	(4-)	[ ]
9. Ik kan mijn eigen werktempo bepalen	□	□	□	□	□	(4-)	[ ]
10. Ik heb te veel taken, te veel werk te doen	□	□	□	□	□		[ ]
11. Mannen en vrouwen worden op mijn werk gelijk behandeld	□	□	□	□	□	(4-)	[ ]
12. Oude en jonge medewerkers worden op mijn werk gelijk behandeld	□	□	□	□	□	(4-)	[ ]
13. De afgelopen 6 maanden is er op mijn werkplek sprake geweest van pesterijen en intimidatie	□	□	□	□	□		[ ]

^a‘(4-)’ means that the question is positively worded, so the question is scored the opposite way (‘totally agree’ = 0 to ‘totally disagree’ = 4).

Data availability statement

This data is not publicly available, but is available from the corresponding author on reasonable request.