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At-risk and intervention thresholds of occupational stress using a visual analogue scale
Dutheil, Frederic Pereira, Bruno Moustafa, F. Naughton, Geraldine Lesage, Francois-Xavier Lambert, Céline
Dutheil, Frederic
Pereira, Bruno
Moustafa, F.
Naughton, Geraldine
Lesage, Francois-Xavier
Lambert, Céline
Abstract
Background The visual analogue scale (VAS) is widely used in clinical practice by occupational physicians to assess perceived stress in workers. However, a single cut-off (black-or-white decision) inadequately discriminates between workers with and without stress. We explored an innovative statistical approach to distinguish an at-risk population among stressed workers, and to establish a threshold over which an action is urgently required, via the use of two cutoffs. Methods Participants were recruited during annual work medical examinations by a random sample of workers from five occupational health centres. We previously proposed a single cut-off of VAS stress in comparison with the Perceived Stress Scale (PSS14). Similar methodology was used in the current study, along with a gray zone approach. The lower limit of the gray zone supports sensitivity ("at-risk" threshold; interpreted as requiring closer surveillance) and the upper limit supports specificity (i.e. "intervention" threshold-emergency action required). Results We included 500 workers (49.6% males), aged 40±11 years, with a PSS14 score of 3.8±1.4 and a VAS score of 4.0±2.4. Using a receiver operating characteristic curve and the PSS cut-off score of 7.2, the optimal VAS threshold was 6.8 (sensitivity = 0.89, specificity = 0.87). The lower and upper thresholds of the gray zone were 5 and 8.2, respectively. Conclusions We identified two clinically relevant cut-offs on the VAS of stress: a first cut-off of 5.0 for an at-risk population, and a second cut-off of 8.2 over which an action is urgently required. Future investigations into the relationships between this upper threshold and deleterious events are required.
Keywords
adult, emergency, female, human, job stress, male, occupational health, medical examination, visual analog scale, worker, employment, mental stress, risk factors, middle aged, stress, psychological
Date
2017
Type
Journal article
Journal
PLoS ONE
Book
Volume
12
Issue
6
Page Range
1-13
Article Number
ACU Department
Collections
Relation URI
Source URL
Event URL
Open Access Status
Open access
License
CC BY 4.0
File Access
Open