At-risk and intervention thresholds of occupational stress using a visual analogue scale
At-risk and intervention thresholds of occupational stress using a visual analogue scale
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DOI：
10.1371/journal.pone.0178948
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发表时间：
2017-06-06
期刊：
影响因子：
3.7
通讯作者：
Lambert, Celine
中科院分区：
文献类型：
--
作者：
Dutheil, Frederic;Pereira, Bruno;Lambert, Celine
背景视觉模拟量表（VAS）被职业医生广泛应用于临床实践中，以评估工人的感知压力。然而，单一的界限（非黑即白的决定）不足以区分有压力和没有压力的工人。我们探索了一种创新的统计方法，以区分有压力的工人中的高危人群，并通过使用两个截止点来确定紧急需要采取行动的阈值。方法参与者是在年度工作体检期间从五个职业健康中心随机抽样的工人中招募的。我们之前提出了与感知压力量表 (PSS14) 相比的 VAS 压力的单一截止点。当前的研究中使用了类似的方法以及灰色地带方法。灰色区域的下限支持敏感性（“有风险”阈值；解释为需要更密切的监测），上限支持特异性（即“干预”阈值 - 需要采取紧急行动）。结果我们纳入了 500 名工人（49.6% 男性），年龄 40 +/- 11 岁，PSS14 评分为 3.8 +/- 1.4，VAS 评分为 4.0 +/- 2.4。使用受试者工作特征曲线和 PSS 截止分数 7.2，最佳 VAS 阈值为 6.8（敏感性 = 0.89，特异性 = 0.87）。灰色区域的下限和上限分别为 5 和 8.2。结论我们确定了压力 VAS 的两个临床相关临界点：第一个临界点为 5.0，适用于高危人群；第二个临界点为 8.2，超过该临界点就需要采取行动。未来需要调查这一上限与有害事件之间的关系。
BackgroundThe visual analogue scale (VAS) is widely used in clinical practice by occupational physicians to assess perceived stress in workers. However, a single cut-off (black-or-white decision) inadequately discriminates between workers with and without stress. We explored an innovative statistical approach to distinguish an at-risk population among stressed workers, and to establish a threshold over which an action is urgently required, via the use of two cutoffs.MethodsParticipants were recruited during annual work medical examinations by a random sample of workers from five occupational health centres. We previously proposed a single cut-off of VAS stress in comparison with the Perceived Stress Scale (PSS14). Similar methodology was used in the current study, along with a gray zone approach. The lower limit of the gray zone supports sensitivity ("at-risk" threshold; interpreted as requiring closer surveillance) and the upper limit supports specificity (i.e. "intervention" threshold-emergency action required).ResultsWe included 500 workers (49.6% males), aged 40 +/- 11 years, with a PSS14 score of 3.8 +/- 1.4 and a VAS score of 4.0 +/- 2.4. Using a receiver operating characteristic curve and the PSS cut-off score of 7.2, the optimal VAS threshold was 6.8 (sensitivity = 0.89, specificity = 0.87). The lower and upper thresholds of the gray zone were 5 and 8.2, respectively.ConclusionsWe identified two clinically relevant cut-offs on the VAS of stress: a first cut-off of 5.0 for an at-risk population, and a second cut-off of 8.2 over which an action is urgently required. Future investigations into the relationships between this upper threshold and deleterious events are required.