Occupational and Environmental Health Division, State University, 3800 Woodward Avenue, Suite 808, Detroit, MI 48201, USA.
J Am Board Fam Med. 2010 Mar-Apr;23(2):212-9. doi: 10.3122/jabfm.2010.02.090132.
We conducted a cross-sectional survey of 4 primary care MetroNet centers in metropolitan Detroit. Our objective was to describe the causal role of fatigue in the relationship among stress, stress resiliency, and perceived health in primary care. Fatigue is a public health problem that has been linked to stress and poor health. The causal role of fatigue between stress and perceived health is unknown.
Four hundred surveys were distributed to adult patients in 4 primary care centers in metropolitan Detroit between 2006 and 2007. Internal consistency reliabilities and principal factor analyses were calculated for the key psychological scales. Perceived health is the primary outcome. Path models were used to study the relationship among stress, fatigue, and perceived health. We also modeled the impact of select stress resiliency factors including sleep, recovery, and social support.
Of the 400 distributed surveys, 315 (78.7%) had a response rate of 70% or more and were included in the analysis. Respondents were predominantly middle aged (median age, 43 years); female (58.7%); and African American (52.0%). The majority worked full time (56.5%); did not have a college degree (77.7%); and were not married (55.2%). Fatigue was reported by 59% of respondents, 42.7% of which was unexplained. The path model supported the causal role of fatigue between stress and perceived health. The positive effects of sleep, recovery, and social support on fatigue, stress, and perceived health were validated.
Fatigue was common in this metropolitan primary care environment and completely mediated the relationship between stress and poor perceived health. Therefore, stress, when significant enough to cause fatigue, may lead to poor health.
我们对底特律都会区的 4 个初级保健 MetroNet 中心进行了横断面调查。我们的目的是描述疲劳在初级保健中压力、压力适应能力和感知健康之间的关系中的因果作用。疲劳是一个公共卫生问题，与压力和健康状况不佳有关。疲劳与感知健康之间的压力因果关系尚不清楚。
2006 年至 2007 年，在底特律都会区的 4 个初级保健中心向成年患者分发了 400 份调查问卷。为关键心理量表计算了内部一致性信度和主成分分析。感知健康是主要结果。路径模型用于研究压力、疲劳和感知健康之间的关系。我们还模拟了包括睡眠、恢复和社会支持在内的某些压力适应能力因素对模型的影响。
在分发的 400 份调查中，有 315 份（78.7%）的回复率为 70%或更高，并且被纳入分析。受访者主要为中年（中位数年龄，43 岁）；女性（58.7%）；和非裔美国人（52.0%）。大多数人全职工作（56.5%）；没有大学学历（77.7%）；未婚（55.2%）。59%的受访者报告疲劳，其中 42.7%的疲劳是无法解释的。路径模型支持疲劳在压力和感知健康之间的因果作用。睡眠、恢复和社会支持对疲劳、压力和感知健康的积极影响得到了验证。
在这个大都市初级保健环境中，疲劳很常见，完全介导了压力与不良感知健康之间的关系。因此，当压力大到足以引起疲劳时，可能会导致健康状况不佳。
