Patterson P Daniel, Weaver Matthew D, Fabio Anthony, Teasley Ellen M, Renn Megan L, Curtis Brett R, Matthews Margaret E, Kroemer Andrew J, Xun Xiaoshuang, Bizhanova Zhadyra, Weiss Patricia M, Sequeira Denisse J, Coppler Patrick J, Lang Eddy S, Higgins J Stephen
Prehosp Emerg Care. 2018 Feb 15;22(sup1):17-27. doi: 10.1080/10903127.2017.1376134. Epub 2018 Jan 11.
This study sought to systematically search the literature to identify reliable and valid survey instruments for fatigue measurement in the Emergency Medical Services (EMS) occupational setting.
A systematic review study design was used and searched six databases, including one website. The research question guiding the search was developed a priori and registered with the PROSPERO database of systematic reviews: "Are there reliable and valid instruments for measuring fatigue among EMS personnel?" (2016:CRD42016040097). The primary outcome of interest was criterion-related validity. Important outcomes of interest included reliability (e.g., internal consistency), and indicators of sensitivity and specificity. Members of the research team independently screened records from the databases. Full-text articles were evaluated by adapting the Bolster and Rourke system for categorizing findings of systematic reviews, and the rated data abstracted from the body of literature as favorable, unfavorable, mixed/inconclusive, or no impact. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology was used to evaluate the quality of evidence.
The search strategy yielded 1,257 unique records. Thirty-four unique experimental and non-experimental studies were determined relevant following full-text review. Nineteen studies reported on the reliability and/or validity of ten different fatigue survey instruments. Eighteen different studies evaluated the reliability and/or validity of four different sleepiness survey instruments. None of the retained studies reported sensitivity or specificity. Evidence quality was rated as very low across all outcomes.
In this systematic review, limited evidence of the reliability and validity of 14 different survey instruments to assess the fatigue and/or sleepiness status of EMS personnel and related shift worker groups was identified.
本研究旨在系统检索文献，以确定用于紧急医疗服务（EMS）职业环境中疲劳测量的可靠且有效的调查工具。
采用系统综述研究设计，检索了六个数据库，包括一个网站。指导检索的研究问题是预先制定的，并在系统综述的PROSPERO数据库中进行了注册：“是否有可靠且有效的工具来测量EMS人员的疲劳？”（2016：CRD42016040097）。感兴趣的主要结果是与标准相关的效度。感兴趣的重要结果包括信度（如内部一致性）以及敏感性和特异性指标。研究团队成员独立筛选数据库中的记录。通过采用Bolster和Rourke系统对系统综述的结果进行分类，对全文进行评估，并将从文献主体中提取的评级数据归类为有利、不利、混合/不确定或无影响。使用推荐分级、评估、制定和评价（GRADE）方法来评估证据质量。
检索策略产生了1257条独特记录。经过全文审查，确定了34项独特的实验性和非实验性研究相关。19项研究报告了10种不同疲劳调查工具的信度和/或效度。18项不同的研究评估了4种不同嗜睡调查工具的信度和/或效度。保留的研究均未报告敏感性或特异性。所有结果的证据质量均被评为极低。
在本系统综述中，发现了有限的证据表明14种不同的调查工具在评估EMS人员及相关轮班工人群体的疲劳和/或嗜睡状态方面具有信度和效度。
