南昌市小学教师慢性疲劳综合征现状及相关因素研究

发布时间：2019-01-19 20:32

【摘要】：目的：了解南昌市小学教师疲劳和慢性疲劳综合征（CFS）的流行现状和分布特征；探讨CFS的相关因素；提供依疲劳自评量表（FSAS）筛查CFS的最佳诊断界值；为针对小学教师开展CFS的防治工作和进一步的研究提供参考。 方法：采用分层抽样，抽取南昌市10所小学共934名教师，获取有效问卷893份。分别用自编一般情况调查表、CFS相关因素调查表、CFS自评表（依1994美国CDC诊断标准设计）、疲劳程度分级量表及FSAS进行调查，再由心身医学科医生对可疑CFS者进行逐一回访以明确诊断。分析调查对象的疲劳和CFS的患病现状和分布特点；采用logistic回归模型筛选CFS的相关因素，通过绘制受试者工作特征（ROC）曲线分析疲劳自评量表鉴别CFS的最佳截断值及相应的灵敏度、特异度等指标。 结果：（1）89.47%的小学教师感觉有不同程度的疲劳，以轻型为主，CFS的检出率为12.88%[95%CI（10.68%～15.07%）]，有随年龄增加而上升的趋势，，不同性别之间检出率差异无统计学意义。 （2）疲劳得分的多因素线性回归分析提示年龄、目前工作压力、对现职工作满意度、体育锻炼和娱乐活动5个因素与疲劳程度存在线性关系。 （3）多因素logistic回归分析显示，年龄≥50岁（OR=2.438）、与学生家长关系紧张（OR=6.360）是CFS的主要危险因素，而对目前工作环境满意（OR=0.637）、经常参加娱乐活动（OR=0.151）、遇到烦恼时向他人求助（OR=0.726）是CFS的保护因素。 （4）通过ROC曲线获得疲劳得分作为CFS诊断的最佳截断值为39.2分，灵敏度为76.52%，特异度为75.45%，曲线下面积为0.817[95%CI（0.778，0.855）]。 结论：（1）南昌市小学教师疲劳现象较普遍，CFS的检出率较高，并有随年龄增加而升高的趋势。 （2）利用快速、简便易于推广的疲劳得分自评表来鉴别CFS的方法具有较高的灵敏度和特异度，可用于CFS病例的早期筛查。 （3）改善学生家长关系、教师工作环境，适度参加娱乐活动、及时烦恼释放可能有助于预防CFS的发生。 （4）教师疲劳和CFS的防控应从政府、社会、学校和个人多个层面上进行综合干预。
[Abstract]:Objective: to investigate the prevalence and distribution of fatigue and chronic fatigue syndrome (CFS) among primary school teachers in Nanchang City, explore the related factors of CFS, and provide the best diagnostic threshold for CFS screening by (FSAS). For primary school teachers to carry out the prevention and control of CFS and further research to provide a reference. Methods: 934 teachers from 10 primary schools in Nanchang were sampled by stratified sampling and 893 valid questionnaires were obtained. A self-designed general situation questionnaire, a CFS related factor questionnaire, a CFS self-assessment scale (designed according to the 1994 US CDC diagnostic criteria), a fatigue rating scale and a FSAS scale were used. Then the suspected CFS patients were visited one by psychosomatic doctors to make sure the diagnosis. The present situation and distribution of fatigue and CFS were analyzed. Logistic regression model was used to screen the related factors of CFS, and the best truncation value, sensitivity and specificity of CFS were identified by drawing the (ROC) curve of the subjects' operating characteristics. Results: (1) 89.47% of the primary school teachers felt fatigue, mainly light, the detection rate of CFS was 12.88% [95%CI (10.68% 15.07%)]. There was no significant difference in detection rate between sexes. (2) the multiple factor linear regression analysis of fatigue score indicated that five factors, such as age, current work pressure, job satisfaction, physical exercise and recreational activities, had a linear relationship with fatigue degree. (3) multivariate logistic regression analysis showed that age 鈮

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