德国版护士工作不稳定性量表（Nurse-WIS）的预测值和其他质量标准 - 前瞻性队列研究的随访调查结果。
Predictive values and other quality criteria of the German version of the Nurse-Work Instability Scale (Nurse-WIS) - follow-up survey findings of a prospective study of a cohort of geriatric care workers.
机构信息
Competence Centre for Epidemiology and Health Services Research in Nursing (CVcare), University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building O17, Hamburg, 20246, Germany.
Competence Centre for Epidemiology and Health Services Research in Nursing (CVcare), University Medical Center Hamburg-Eppendorf, Martinistr. 52, Building O17, Hamburg, 20246, Germany ; Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services, Department of Occupational Health Research, Pappelallee 35/37, Hamburg, 22089, Germany.
出版信息
J Occup Med Toxicol. 2014 Sep 11;9:30. doi: 10.1186/s12995-014-0030-9. eCollection 2014.
BACKGROUND
Until now there has been a lack of effective screening instruments for health care workers at risk. To counteract the forecast shortage for health care workers, the offer of early interventions to maintain their work ability will become a central concern. The Nurse-Work Instability Scale (Nurse-WIS) seems to be suitable as a screening instrument and therefore a prospective study of a cohort of nursing staff from nursing homes was undertaken to validate the Nurse-Work Instability Scale (Nurse-WIS).
METHODS
The follow-up data was used to test the sensitivity, specificity and the predictive values of the Nurse-WIS. The participants answered a questionnaire in the baseline investigation (T1) and in a follow-up 12 month after baseline. The hypothesis was that geriatric care workers with an increased risk according to the Nurse-WIS in T1 would be more likely to have taken long-term sick leave or drawn a pension for reduced work capacity in T2.
RESULTS
396 persons took part in T1 (21.3% response), 225 in T2 (42.3% loss-to-follow-up). In T1, 28.4% indicated an increased risk according to the Nurse-WIS. In T2, 10.2% had taken long-term sick leave or had drawn a pension for reduced work capacity. The sensitivity is 73.9% (95%-CI 55.7%-92.3%), the specificity is 76.7% (95%-CI 71.2%-82.8%). The ROC AUC indicated a moderate precision for the scale, at 0.74 (95%-CI 0.64-0.84). The PPV of the Nurse-WIS is 26.6%, and the NPV is 96.3%. For those with an increased risk according to the Nurse-WIS, the probability in T2 of long-term sick leave or a pension for reduced work capacity is around eight times higher (OR 8.3, 95%-CI 2.90-23.07). Persons who had indicated a long-term sick leave or made an application for a pension for reduced work capacity in T1 had a 17 times higher risk (OR 17.4, 95%-CI 3.34-90.55).
CONCLUSION
The German version of the Nurse-WIS appears to be a valid instrument with satisfactory predictive capabilities for recording an impending long-term sick leave. Whether the Nurse-WIS can be used as a screening tool which helps to design risk adjusted prevention programs for the afflicted nurse should be studied.
背景
到目前为止，缺乏针对有风险的医护人员的有效筛选工具。为了应对医护人员短缺的预测，提供早期干预措施以维持其工作能力将成为一个核心关注点。护士工作不稳定性量表（Nurse-WIS）似乎是一种合适的筛选工具，因此对养老院的护理人员进行了前瞻性队列研究，以验证护士工作不稳定性量表（Nurse-WIS）。
方法
使用随访数据来测试护士工作不稳定性量表（Nurse-WIS）的灵敏度、特异性和预测值。参与者在基线调查（T1）和基线后 12 个月回答了一份问卷。假设根据 T1 中的护士工作不稳定性量表（Nurse-WIS）风险增加的老年护理人员更有可能在 T2 中请长期病假或因工作能力下降而领取养老金。
结果
396 人参加了 T1（21.3%的回复率），225 人参加了 T2（42.3%的失访率）。在 T1 中，28.4%的人根据护士工作不稳定性量表（Nurse-WIS）显示出风险增加。在 T2 中，10.2%的人请了长期病假或因工作能力下降而领取养老金。灵敏度为 73.9%（95%CI 55.7%-92.3%），特异性为 76.7%（95%CI 71.2%-82.8%）。ROC AUC 表明该量表的精度为中等，为 0.74（95%CI 0.64-0.84）。护士工作不稳定性量表（Nurse-WIS）的阳性预测值为 26.6%，阴性预测值为 96.3%。对于根据护士工作不稳定性量表（Nurse-WIS）显示出风险增加的人来说，T2 中请长期病假或因工作能力下降而领取养老金的可能性大约高八倍（OR 8.3，95%CI 2.90-23.07）。在 T1 中表示请长期病假或申请减少工作能力养老金的人，其风险高出 17 倍（OR 17.4，95%CI 3.34-90.55）。
结论
德语版的护士工作不稳定性量表（Nurse-WIS）似乎是一种有效的工具，具有令人满意的预测能力，可记录即将到来的长期病假。护士工作不稳定性量表（Nurse-WIS）是否可以用作筛选工具，以帮助为受影响的护士设计风险调整预防计划，还需要进一步研究。
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