Department of Public and Occupational Health and The EMGO Institute for Health and Care Research, VU University Medical Centre, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
J Occup Rehabil. 2009 Sep;19(3):231-7. doi: 10.1007/s10926-009-9178-z. Epub 2009 Apr 25.
A 3-item screening instrument called the Distress Screener was developed for early identification of distress among employees on sick leave. The Distress Screener consists of three items obtained from the distress subscale of the four-dimensional symptom questionnaire (4DSQ). This study assessed an optimal cut-off point and validated the Distress Screener by relating it to the 4DSQ and to medical diagnoses.
171 sick-listed employees filled in the Distress Screener and the 4DSQ (containing four subscales: distress, depression, anxiety and somatisation) and medical diagnoses were obtained from occupational physicians (OPs). The optimal cut-off point was assessed by computing sensitivity and specificity values. Validity was assessed by relating the Distress Screener score to the scores on 4DSQ subscales. In addition scores were compared to mental health medical diagnoses and the degree of similarity between two repeated measurements was obtained.
Using the 4DSQ distress score >10 as reference standard, the optimal cut-off point of the Distress Screener was > or =4. Regarding validity, a high correlation (0.82) existed between the Distress Screener and the 4DSQ distress subscale and it was significantly different from the correlations with the other 4DSQ subscales. Also a high correlation existed for the test-retest reliability (0.83). Furthermore, a high score on the Distress Screener seemed to be related to the medical diagnosis 'Stress-related complaints'. All low scores seemed to be related to the medical diagnosis 'Other complaints'. Sensitivity (0.85) and specificity (0.78) values, and positive and negative predictive values of the screener were comparable to those of the 4DSQ distress subscale.
The Distress Screener is a valid instrument for use by the OP during consulting time as a quick scan for early identification of distress in employees on sick leave. The cut-off point > or =4 is useful for early identification of distress in employees on sick leave.
开发了一个名为“痛苦筛查器”的三项目筛查工具，用于早期识别请病假员工的痛苦。痛苦筛查器由来自四维度症状问卷（4DSQ）痛苦分量表的三个项目组成。本研究通过与 4DSQ 和医疗诊断相关联，评估了最佳截断点并验证了痛苦筛查器。
171 名请病假的员工填写了痛苦筛查器和 4DSQ（包含四个分量表：痛苦、抑郁、焦虑和躯体化），并从职业医生（OPs）处获得了医疗诊断。通过计算敏感性和特异性值来评估最佳截断点。通过将痛苦筛查器评分与 4DSQ 分量表的评分相关联来评估有效性。此外，还将评分与心理健康医疗诊断进行了比较，并获得了两次重复测量之间的相似程度。
使用 4DSQ 痛苦评分>10 作为参考标准，痛苦筛查器的最佳截断点为>或=4。关于有效性，痛苦筛查器与 4DSQ 痛苦分量表之间存在高度相关性（0.82），与其他 4DSQ 分量表的相关性显著不同。测试-再测试的可靠性也存在高度相关性（0.83）。此外，高得分似乎与“与压力相关的投诉”的医疗诊断有关。所有低得分似乎都与“其他投诉”的医疗诊断有关。筛查器的敏感性（0.85）和特异性（0.78）值以及阳性和阴性预测值与 4DSQ 痛苦分量表相当。
痛苦筛查器是 OP 在咨询时间内使用的有效工具，可快速扫描以早期识别请病假员工的痛苦。截断点>或=4 可用于早期识别请病假员工的痛苦。
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