Beierlein V, Köllner V, Neu R, Schulz H
Stiftungslehrstuhl Klinische Versorgungsforschung, Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf.
Reha-Zentrum Seehof, Teltow.
Rehabilitation (Stuttg). 2016 Dec;55(6):348-356. doi: 10.1055/s-0042-120232. Epub 2016 Dec 6.
The assessment of work pressures is of particular importance in psychosomatic rehabilitation. An established questionnaire is the Occupational Stress and Coping Inventory (German abbr. AVEM), but it is quite long and with regard to scoring time-consuming in routine clinical care. It should therefore be tested, whether a shortened version of the AVEM can be developed, which is able to assess the formerly described three second-order factors of the AVEM, namely and sufficiently reliable and valid, and which also may be used for screening of patients with prominent work-related behavior and experience patterns. Data were collected at admission from consecutive samples of three hospitals of psychosomatic rehabilitation ( = 10,635 patients). The sample was randomly divided in two subsamples (design and validation sample). Using exploratory principal component analyses in the design sample, items with the highest factor loadings for the three new scales were selected and evaluated psychometrically using the validation sample. Possible Cut-off values ought to be derived from distribution patterns of scores in the scales. Relationships with sociodemographic, occupational and diagnosis-related characteristics, as well as with patterns of work-related experiences and behaviors are examined. The three performed principal component analyses explained in the design sample on the respective first factor between 31 % and 34 % of the variance. The selected 20 items were assigned to the 3-factor structure in the validation sample as expected. The three new scales are sufficiently reliable with values of Cronbach's α between 0,84 and 0,88. The naming of the three new scales is based on the names of the secondary factors. Cut-off values for the identification of distinctive patient-reported data are proposed. Main advantages of the proposed shortened version AVEM-3D are that with a considerable smaller number of items the three main dimensions of relevant work-related behavior and experience patterns can be reliably measured. The proposed measure is simple and economic to use and interpret. Based on the present sample we provide means and standard deviations as reference at admission of psychosomatic rehabilitation. As a limitation it should be mentioned that further evaluation of reliability, validity and sensitivity to change restricted to the items of the shortened version is necessary. The practicability and validity of the proposed cut-off values cannot yet be conclusively assessed. Finally, the validity of the AVEM-3D in groups of indications other than psychosomatic patients and in healthy persons remains to be examined.
在身心康复中,工作压力评估尤为重要。一种已确立的问卷是职业压力与应对量表(德语缩写为AVEM),但它篇幅较长,在常规临床护理中评分耗时。因此,应测试是否可以开发一个AVEM的简化版本,该版本能够充分可靠且有效地评估AVEM先前描述的三个二阶因素,即 以及 ,并且还可用于筛查具有突出工作相关行为和经历模式的患者。从三家身心康复医院的连续样本(n = 10,635名患者)入院时收集数据。样本被随机分为两个子样本(设计样本和验证样本)。在设计样本中使用探索性主成分分析,选择在三个新量表上具有最高因子载荷的项目,并使用验证样本进行心理测量评估。可能的临界值应从量表得分的分布模式中得出。研究与社会人口学、职业和诊断相关特征以及与工作相关经历和行为模式的关系。在设计样本中进行的三次主成分分析在各自的第一个因子上解释了31%至34%的方差。所选的20个项目在验证样本中如预期那样被分配到三因素结构中。这三个新量表足够可靠,克朗巴哈α值在0.84至0.88之间。这三个新量表的命名基于二阶因素的名称。提出了用于识别独特患者报告数据的临界值。所提议的简化版AVEM - 3D的主要优点是,通过数量大幅减少的项目,可以可靠地测量相关工作相关行为和经历模式的三个主要维度。所提议的测量方法使用和解释简单且经济。基于当前样本,我们提供了身心康复入院时的均值和标准差作为参考。作为一个局限性,应该提到有必要进一步评估仅限于简化版项目的信度、效度和对变化的敏感性。所提议的临界值的实用性和效度尚未得到最终评估。最后,AVEM - 3D在身心疾病患者以外的适应症组和健康人群中的效度仍有待研究。