【摘要】：目的：了解南昌市小學教師疲勞和慢性疲勞綜合征（CFS）的流行現(xiàn)狀和分布特征；探討CFS的相關因素；提供依疲勞自評量表（FSAS）篩查CFS的最佳診斷界值；為針對小學教師開展CFS的防治工作和進一步的研究提供參考。 方法：采用分層抽樣，抽取南昌市10所小學共934名教師，獲取有效問卷893份。分別用自編一般情況調(diào)查表、CFS相關因素調(diào)查表、CFS自評表（依1994美國CDC診斷標準設計）、疲勞程度分級量表及FSAS進行調(diào)查，再由心身醫(yī)學科醫(yī)生對可疑CFS者進行逐一回訪以明確診斷。分析調(diào)查對象的疲勞和CFS的患病現(xiàn)狀和分布特點；采用logistic回歸模型篩選CFS的相關因素，通過繪制受試者工作特征（ROC）曲線分析疲勞自評量表鑒別CFS的最佳截斷值及相應的靈敏度、特異度等指標。 結(jié)果：（1）89.47%的小學教師感覺有不同程度的疲勞，以輕型為主，CFS的檢出率為12.88%[95%CI（10.68%～15.07%）]，有隨年齡增加而上升的趨勢，，不同性別之間檢出率差異無統(tǒng)計學意義。 （2）疲勞得分的多因素線性回歸分析提示年齡、目前工作壓力、對現(xiàn)職工作滿意度、體育鍛煉和娛樂活動5個因素與疲勞程度存在線性關系。 （3）多因素logistic回歸分析顯示，年齡≥50歲（OR=2.438）、與學生家長關系緊張（OR=6.360）是CFS的主要危險因素，而對目前工作環(huán)境滿意（OR=0.637）、經(jīng)常參加娛樂活動（OR=0.151）、遇到煩惱時向他人求助（OR=0.726）是CFS的保護因素。 （4）通過ROC曲線獲得疲勞得分作為CFS診斷的最佳截斷值為39.2分，靈敏度為76.52%，特異度為75.45%，曲線下面積為0.817[95%CI（0.778，0.855）]。 結(jié)論：（1）南昌市小學教師疲勞現(xiàn)象較普遍，CFS的檢出率較高，并有隨年齡增加而升高的趨勢。 （2）利用快速、簡便易于推廣的疲勞得分自評表來鑒別CFS的方法具有較高的靈敏度和特異度，可用于CFS病例的早期篩查。 （3）改善學生家長關系、教師工作環(huán)境，適度參加娛樂活動、及時煩惱釋放可能有助于預防CFS的發(fā)生。 （4）教師疲勞和CFS的防控應從政府、社會、學校和個人多個層面上進行綜合干預。
[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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