Return-to-Work Self-Efficacy Scale Return to Work Self Efficacy Scale (RTWSE Scale) LinkedInThis field is for validation purposes and should be left unchanged.This questionnaire has been prepared to collect information about your return-to-work self-efficacy. Select the number that most closely matches your situation. First NameLast NameDate I feel confident to talk to a supervisor if problems occur during return to work. 1 2 3 4 5 1 = Not confident at all, 5 = Totally confident. I feel confident that I can discuss with a supervisor about things that contribute to pain. 1 2 3 4 5 1 = Not confident at all, 5 = Totally confident. I feel confident to explain any physical limitations I may have to a supervisor. 1 2 3 4 5 1 = Not confident at all, 5 = Totally confident. I feel confident to suggest ways to reduce discomfort to a supervisor. 1 2 3 4 5 1 = Not confident at all, 5 = Totally confident. I feel confident that I will be able to remain once back at work. 1 2 3 4 5 1 = Not confident at all, 5 = Totally confident. I feel confident that I can continue working despite pain. 1 2 3 4 5 1 = Not confident at all, 5 = Totally confident. I feel confident that I can avoid re-injury. 1 2 3 4 5 1 = Not confident at all, 5 = Totally confident. I feel confident that I can manage pain effectively while at work. 1 2 3 4 5 1 = Not confident at all, 5 = Totally confident. I feel confident that I can get co-workers to help me. 1 2 3 4 5 1 = Not confident at all, 5 = Totally confident. I feel confident that I can explain my physical limitations to co-workers. 1 2 3 4 5 1 = Not confident at all, 5 = Totally confident.
