Cross Cultural Validation of Work Productivity and Activity Impairment Questionnaire in Lupus Patients From Latin America

OBJECTIVE: The objective of this study is to perform a cross-cultural validation of the Work Productivity and Activity Impairment (WPAI-Lupus v2.0) questionnaire in Latin American individuals with systemic lupus erythematosus (SLE), using data from the GLADEL cohort. METHODS: GLADEL 2.0 is an observational cohort of SLE patients ≥ 18 years old. Clinical data, disease activity (SLEDAI-2 K), damage index (SDI), physician's global assessment (PGA) and patient-reported outcomes (WPAI-Lupus v2.0, LupusQoL), were assessed at baseline and during follow-up. Construct validity was evaluated through Spearman correlations with SLEDAI-2 K, SDI and LupusQoL. Internal consistency was assessed using Cronbach's alpha and responsiveness over 12 months was analyzed using the Wilcoxon signed-rank test. Appropriate statistical tests (p < 0.05) were performed using R software, version 4.4.0. RESULTS: Among 1083 patients, 684 were evaluated at baseline and at 12 months. Cronbach's alpha values were: absenteeism 0.54; presenteeism 0.64; overall work impairment 0.62; activity impairment 0.62. WPAI-Lupus v2.0 scores correlated with SLEDAI-2 K (p < 0.001) and negatively with LupusQoL domains. Moderate correlations were observed between activity impairment and physical health, pain and planning (r ≈ -0.52 to -0.58). Presenteeism and overall work impairment also showed moderate correlations with physical health and pain domains (r ≈ -0.49 to -0.53). WPAI-Lupus v2.0 was sensitive to change over 12 months (p = 0.001) for all domains except intimate relationship. CONCLUSIONS: WPAI-Lupus v2.0 demonstrated good validity, internal consistency, and responsiveness. It correlated with disease activity and quality of life, supporting the WPAI-Lupus v2.0 as a valid tool to assess work and activity impairment in Latin American patients with SLE.

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Journal
International Journal of Rheumatic Diseases
Published
2026-04-01
DOI
https://doi.org/10.1111/1756-185x.70641
Primary Topic
Systemic Lupus Erythematosus Research
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article
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article

Cross Cultural Validation of Work Productivity and Activity Impairment Questionnaire in Lupus Patients From Latin America

V. Arturi, Patricia Langjahr, Loreto Massardo, J. C. Segovia Martinez et al.
International Journal of Rheumatic Diseases
Systemic Lupus Erythematosus Research
article

Cross Cultural Validation of Work Productivity and Activity Impairment Questionnaire in Lupus Patients From Latin America

V. Arturi, Patricia Langjahr, Loreto Massardo, J. C. Segovia Martinez, Guillermo Pons‐Estel, Armando Calvo Quiroz, Gerardo Quintana‐López, Álvaro Danza, María Emilia Sattler, Cintia Otaduy, Ana Carolina de Oliveira e Silva Montandon, W. Patiño Grageda, Rosana Quintana, Andrese Aline Gasparin, Yaneli Juárez-Vicuña, Mario Pérez Cristóbal, Eduardo Martín‐Nares, LAISSA CRISTINA ALVES ALVINO, Romina Nieto, Gisela C. Subils, Ingris del Pilar Peláez-Ballestas, J. N. Cieza Calderón, Edgard Torres dos Reis Neto, J. Serventi, Maria E Crespo Espindola, I. Guerra Herrera, Nicolás Pérez, Gustavo Aroca Martínez, Luciana Parente, Ignacio García de la Torre, Carina Pizzarossa, Rodamin Alvarez, Micaela Cosatti, Diana Fernández‐Ávila, Erika Palacios Santillan, Marcos A. Vazquez, Manuel F. Ugarte‐Gil, Jorge A. Esquivel‐Valerio, Verónica Saurit, Carlos E. Toro‐Gutiérrez, Hellen Medina, Lucia Hernández, Eduardo F. Borba, Reyna E. Sánchez Briones, José A. Gómez‐Puerta, Luciana González Lucero, Bernardo A. Pons‐Estel, Carlos Abud Mendoza, Carlos A. Cañas Davila, Angela Duarte
article en

Abstract

OBJECTIVE: The objective of this study is to perform a cross-cultural validation of the Work Productivity and Activity Impairment (WPAI-Lupus v2.0) questionnaire in Latin American individuals with systemic lupus erythematosus (SLE), using data from the GLADEL cohort. METHODS: GLADEL 2.0 is an observational cohort of SLE patients ≥ 18 years old. Clinical data, disease activity (SLEDAI-2 K), damage index (SDI), physician's global assessment (PGA) and patient-reported outcomes (WPAI-Lupus v2.0, LupusQoL), were assessed at baseline and during follow-up. Construct validity was evaluated through Spearman correlations with SLEDAI-2 K, SDI and LupusQoL. Internal consistency was assessed using Cronbach's alpha and responsiveness over 12 months was analyzed using the Wilcoxon signed-rank test. Appropriate statistical tests (p < 0.05) were performed using R software, version 4.4.0. RESULTS: Among 1083 patients, 684 were evaluated at baseline and at 12 months. Cronbach's alpha values were: absenteeism 0.54; presenteeism 0.64; overall work impairment 0.62; activity impairment 0.62. WPAI-Lupus v2.0 scores correlated with SLEDAI-2 K (p < 0.001) and negatively with LupusQoL domains. Moderate correlations were observed between activity impairment and physical health, pain and planning (r ≈ -0.52 to -0.58). Presenteeism and overall work impairment also showed moderate correlations with physical health and pain domains (r ≈ -0.49 to -0.53). WPAI-Lupus v2.0 was sensitive to change over 12 months (p = 0.001) for all domains except intimate relationship. CONCLUSIONS: WPAI-Lupus v2.0 demonstrated good validity, internal consistency, and responsiveness. It correlated with disease activity and quality of life, supporting the WPAI-Lupus v2.0 as a valid tool to assess work and activity impairment in Latin American patients with SLE.

International Journal of Rheumatic DiseasesVol. 29(4)
National University of Salta (AR), Universidade Federal do Rio Grande do Sul (BR), Mexican Social Security Institute (MX), Universidad Nacional de Córdoba (AR), Universidad Autónoma de Nuevo León (MX), Universidad de la República de Uruguay (UY), Universidad de Guadalajara (MX), Universidad Peruana Cayetano Heredia (PE), Universidade Federal de Pernambuco (BR), Hospital Italiano de Buenos Aires (AR), Hospital General de México (MX), San Sebastián University (CL), Hospital Padre Américo (PT), Hospital Nacional Cayetano Heredia (PE), Hospital Fernández (AR), Hospital de Clínicas de Porto Alegre (BR), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (MX), Fundación Valle del Lili (CO), Hospital del Salvador (CL), Hospital Universitário Pedro Ernesto (BR), Instituto Nacional de Enfermedades Respiratorias (MX), Hospital Ramos Mejía (AR), Centro Científico Tecnólogico - Rosario (AR), Hospital Central Dr. Ignacio Morones Prieto (MX), Instituto de Diagnóstico e Investigaciones Metabólicas (AR), Hospital Provincial de Rosario (AR), Hospital Clínic de Barcelona (ES), Hospital Italiano La Plata (AR), Universidad Simón Bolívar (CO), Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (AR), Servicio Diabetología Hospital Córdoba (AR), Fundacion Instituto de Reumatologia Fernando Chalem (CO), Instituto Cardiovascular de Rosario (AR), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR), Hospital Privado (AR), Hospital de Clínicas (UY), Hospital Base Guillermo Almenara Irigoyen (PE), St Martins Hospital (GB), Hospital Universitario Nacional de Colombia (CO), Instituto Nacional de Cardiología (MX), Fundacion Allende (AR), St. Joseph’s Healthcare Hamilton (CA), Universidade Federal de Goiás (BR), Icesi University (CO), Universidad Nacional de Asunción (PY), Universidade Federal de São Paulo (BR)
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Systemic Lupus Erythematosus Research
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