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常见精神障碍缺勤持续时间预测规则的外部验证和更新。

External Validation and Update of a Prediction Rule for the Duration of Sickness Absence Due to Common Mental Disorders.

机构信息

ArboNed Occupational Health Service, PO Box 85091, 3508 AB, Utrecht, The Netherlands.

Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

出版信息

J Occup Rehabil. 2017 Jun;27(2):202-209. doi: 10.1007/s10926-016-9646-1.

Abstract

Purpose The objective of the present study was to validate an existing prediction rule (including age, education, depressive/anxiety symptoms, and recovery expectations) for predictions of the duration of sickness absence due to common mental disorders (CMDs) and investigate the added value of work-related factors. Methods A prospective cohort study including 596 employees who reported sick with CMDs in the period from September 2013 to April 2014. Work-related factors were measured at baseline with the Questionnaire on the Experience and Evaluation of Work. During 1-year follow-up, sickness absence data were retrieved from an occupational health register. The outcome variables of the study were sickness absence (no = 0, yes = 1) at 3 and 6 months after reporting sick with CMDs. Discrimination between workers with and without sickness absence was investigated at 3 and 6 months with the area under the receiver operating characteristic curve (AUC). Results A total of 220 (37 %) employees agreed to participate and 211 (35 %) had complete data for analysis. Discrimination was poor with AUC = 0.69 and AUC = 0.55 at 3 and 6 months, respectively. When 'variety in work' was added as predictor variable, discrimination between employees with and without CMD sickness absence improved to AUC = 0.74 (at 3 months) and AUC = 0.62 (at 6 months). Conclusions The original prediction rule poorly predicted CMD sickness absence duration. After adding 'variety in work', the prediction rule discriminated between employees with and without CMD sickness absence 3 months after reporting sick. This new prediction rule remains to be validated in other populations.

摘要

目的 本研究的目的是验证现有的预测规则(包括年龄、教育、抑郁/焦虑症状和康复预期)是否能预测常见精神障碍(CMD)的病假持续时间,并探讨工作相关因素的附加价值。

方法 一项前瞻性队列研究纳入了 596 名 2013 年 9 月至 2014 年 4 月期间因 CMD 请病假的员工。工作相关因素在基线时使用工作经历和评估问卷进行测量。在 1 年的随访期间,从职业健康登记处检索病假数据。研究的结局变量为报告 CMD 病假后 3 个月和 6 个月的病假(无=0,有=1)。使用受试者工作特征曲线(ROC)下面积(AUC)评估 3 个月和 6 个月时有无病假员工的区分能力。

结果 共有 220 名(37%)员工同意参与,211 名(35%)员工有完整的数据进行分析。AUC 分别为 0.69 和 0.55,区分能力较差。当将“工作多样性”添加为预测变量时,CMD 病假员工与无病假员工之间的区分能力提高至 AUC 分别为 0.74(3 个月)和 0.62(6 个月)。

结论 原始预测规则对 CMD 病假持续时间的预测能力较差。添加“工作多样性”后,该预测规则在报告病假后 3 个月时可区分 CMD 病假员工和无病假员工。该新预测规则仍需在其他人群中进行验证。

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