Development and psychometric properties of the stressor scale for emergency nurses

Development and validation of the job stressor scale for specialty nurses

Objectives

Specialty nurses play a crucial role in specialized nursing practice, teaching, management, and research. These nurses often face significant work pressure; therefore, scientifically and effectively assessing their job stress and its sources is vital for enhancing the quality of their work. However, there is currently a dearth of verified assessment tools for measuring job stressors among specialty nurses. Therefore, this study aimed to develop and test an instrument to assess the job stressors applicable to specialty nurses.

Methods

We conducted a multiphase mixed-methods study. The initial scale items were developed from a literature review and structured interviews. The scale was then refined through two rounds of expert consultation (N = 14) and a primary test (N = 20). A main survey (N = 552) was then conducted to evaluate the scale's construct validity and reliability using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA).

Results

The final scale comprises four dimensions with 27 items. The factors included "specialized nursing and work," "workload and time allocation," "patient care," and "work resources and environment." The EFA explained 69.10% of the variance, while the CFA confirmed a good model fit. The content validity index was 0.980 at the scale level and 0.790-1.000 at the item level. The scale's reliability was supported by its high Cronbach's α (0.958), test-retest reliability (0.946), and split-half reliability (0.868).

Conclusion

Our findings indicate that the job stressor scale developed in this study is valid and reliable, and is recommended for use among specialty nurses to assess their stressors.

Traumatic and Routine Stressors in Emergency Nurses: A Turkish Validity and Reliability Study

INTRODUCTION

Emergency nurses face traumatic and stressful events of many different forms and severity. The aim of this study is to test the validity and reliability of the Traumatic and Routine Stressors Scale on Emergency Nurses in Turkey.

METHODS

This methodological study was conducted with 195 nurses who had been working in the emergency service for at least six months and could be reached via an online questionnaire. Opinions of 9 experts were obtained with the translation-back translation method for linguistic validity, and the Davis technique was used for testing content validity. Test-retest analysis was used to test the time-invariance of the scale. Construct validity was evaluated with exploratory and confirmatory factor analyses. The reliability of the scale was evaluated based on item-total correlation and Cronbach's alpha coefficients.

RESULTS

The expert opinions were found to be in agreement with each other. Factor analysis results were acceptable, the Cronbach's alpha coefficients of the scale were 0.890 for the frequency factor, 0.928 for the impact factor, and 0.866 for the total scale. It was determined that the correlation values for the time-invariance of the scale were 0.637 for the frequency factor and 0.766 for the effect factor, and the scale had good test-retest reliability.

DISCUSSION

The Turkish version of the Traumatic and Routine Stressors Scale on Emergency Nurses, has high levels of validity and reliability. We recommend that the scale be used to evaluate the state of being affected by traumatic and routine stressors among emergency service nurses.

The psychometric properties of the Chinese version of the stressor scale for emergency nurses

BACKGROUND

Emergency nurses are experienced specific stress factors. To evaluate stressors of emergency nurses effectively is useful to improve quality of nursing care. This study aimed to translate the stressor scale for emergency nurses into Chinese (C-SSEN) and carry out the reliability and validity test among Chinese emergency nurses.

METHODS

A total of 358 emergency nurses from four hospitals in Tianjin, Henan, and Shandong province of China are recruited through a convenience sampling. The C-SSEN was translated into Chinese applying a classic 'forward-backward' translation method. Reliability (internal consistency, test-retest reliability) and validity (content validity, construct validity) were assessed.

RESULTS

The final version of C-SSEN was rated by the expert panel, indicating good content validity (I-CVI ≥ 0.83, S-CVI = 0.96). The scale had satisfactory content validity, internal consistency (Cronbach's α coefficient = 0.958), and test-retest reliability (intra-class correlation coefficient = 0.824).

CONCLUSION

The C-SSEN is a useful and reliable scale to evaluate stressors among emergency nurses.

Chinese version of the stressor scale for emergency nurse: A methodological study design

AIM

The aim of this study was to modify and test the psychometric properties of the Chinese version of the stressor scale for emergency nurses.

DESIGN

The methodological design was carried out in two phases: (a) form the Chinese version by Delphi method and (b) test the psychometric properties by cross-sectional survey.

METHODS

The translated scale was administered to 420 nurses in Qingdao. Validity was assessed in terms of content validity, calibration correlation validity and construct validity using exploratory factor analysis and confirmatory factor analysis. Internal consistency was estimated using Cronbach α coefficients.

RESULTS

The Chinese version of the SSEN retains 27 items, four common factors were extracted by exploratory factor analysis, and the factor cumulative variance contribution rate was 78.463%. The fitting indexes of the four-factor model of CFA were all in the acceptable range[χ²  = 711.30, df = 312, p < 0.001, χ² /df = 2.280, CFI = 0.933, TLI = 0.924, IFI = 0.933, RMSEA = 0.079 (90% confidence interval = 0.071-0.086)].The item-level content validity index of the Chinese SSEN is 0.89 ~ 1.00; the scale-level content validity index is 0.98; the Cronbach α coefficient of the total table is 0.971 and the split-half reliability is 0.877.

PATIENT OR PUBLIC CONTRIBUTION

The C-SSEN can be used to help nursing managers accurately formulate management measures to improve the stress coping ability of nurses in the ED, stabilize the nursing team and ensure nursing safety.

A causal model of job stress among Thai nurse-midwives

Objective

To test a causal model of job stress among nurse-midwives working in labor and delivery units in Thailand.

Methods

Random and convenience sampling was used to recruit 282 nurse-midwives with at least 6 months of work experience from 16 regional tertiary hospitals in Thailand. Data were collected from May to December 2020. Research instruments with good internal consistency reliability ranged from 0.83 to 0.91 including the Job Stress Scale and the Thai version of the Job Content Questionnaire (TJCQ). Descriptive statistics and a structural equation model were used for data analysis.

Results

Job demands were the strongest predictor of job stress. At the theoretical level, high job control plays a crucial role in directly reducing job stress. However, the present research provides contrary evidence to the theoretical predictions. When nurse-midwives perceive high job control, they perceive pressure to meet the expectations of their supervisors and colleagues. Therefore, high job control can contribute to job stress. Likewise, job support had an indirect effect on job stress among nurse-midwives through job control. The modified model fitted the empirical data (χ 2 = 57.76, df = 22, CMIN/df = 2.62, goodness of fit (GFI) =0.96, adjusted goodness of fit (AGFI) =0.91, comparative fit index (CFI) = 0.95, and root mean square error of approximation (RMSEA) = 0.07). The effects of job demands, job control, and job support on job stress among Thai nurse-midwives can explain 67% of the model's total variance for job stress.

Conclusions

Nurse-midwives who encounter high job demands and less control over their work control suffer from job stress. Job support does not directly affect nurse-midwives’ job stress but influences it through perceived job control. Strategies to decrease job stress among Thai nurse-midwives should focus on how to balance job demands, and enhance job control, and job support.

Occupational stress and its relationship with spiritual coping among emergency department nurses and emergency medical services staff

Introduction

Emergency Department (ED) nurses and Emergency Medical Services (EMS) Staff are faced with several stressors daily, such as the COVID 19 pandemic situation, which affects the health and the quality of services to patients. Spiritual coping with stress is an attempt to overcome the stress on the basis of what is transcendent. The use of spiritual coping strategies helps a person to overcome tensions caused by the work environment.

Objective

The current study aimed to investigate occupational stress and its relationship with spiritual coping among ED nurses and EMS staff.

Materials and methods

This study was descriptive-correlational research. Using convenience sampling methods, 516 ED nurses and EMS staff were enrolled in the study. The study instruments included demographic information, HSE Occupational Stress, and spiritual coping questionnaires. Data were analyzed using SPSSv.22 software and the descriptive statistics, Pearson correlation test, t-test, ANOVA, and multiple linear regression.

Results

The highest and lowest levels of occupational stress were the dimensions of “demand” (2.96 ± 0.65) and “role” (3.89 ± 0.81) respectively. Multiple linear regression analysis showed that positive spiritual coping, negative spiritual coping, workplace, service location, type of employment, and work position were important factors affecting the occupational stress of ED nurses and EMS staff, which accounted for 0.34% of the variance.

Conclusion

The findings showed the need to improve the work environment for ED nurses and EMS staff, including changes in physical working conditions, salaries, and better employment conditions. Training programs are recommended to reduce stress through the use of positive spiritual coping strategies.

The influence of workplace stress and coping on depressive symptoms among registered nurses in Bangladesh

Background

Nurses report high levels of workplace stress, which has been linked to an increased risk for experiencing depressive symptoms. Nurses' workplace stress is also linked to increased absenteeism and decreased job satisfaction.

Objectives

The objectives of this study were to examine: (1) the incidence of depressive symptoms among hospital-based registered nurses in Bangladesh; (2) common sources of workplace stress and their relationships to individual characteristics and depressive symptom scores; and (3) the potential mediating roles of coping strategies in the relationship between workplace stress and depressive symptoms.

Methods

A cross-sectional study design involved three hundred and fifty-two registered nurses. Data were collected using a demographic questionnaire and three standardized tools measuring sources of nurses' workplace stress, coping strategies, and depressive symptoms.

Results

More than half of the participants scored ≥ 16 on the CES-D, which was associated with a major depression episode. Total NSS scores had a small but significant influence on scores on the depression scale. Coping strategies had no mediated effect on the relationship between workplace stress and scores on the depression scale. Low-reliability coefficients for subscales of two of the standardized tools highlight the challenge for researchers in developing countries to address contextual differences that may influence the meanings attached to individual items.

Conclusion

Findings suggest that the mental health of registered nurses in Bangladesh requires immediate attention in part by attending to workplace stressors. Further research should focus on a deeper understanding of Bangladeshi registered nurses' work experiences and the unique contribution that workplace stressors have on their physical and mental health.

The Development and Exploratory Psychometric Properties of the Traumatic and Routine Stressors Scale on Emergency Nurses (TRSS-EN)

Emergency nurses are exposed to traumatic events and routine stressors, both of which can lead to the development of PTSD (Post Traumatic Stress Disorder) symptomatology. However, there are currently no instruments designed to assess the impact and frequency of such sources of stress in nurses. The Traumatic and Routine Stressors Scale on Emergency Nurses (TRSS-EN) was built for this purpose. A sample of 147 emergency nurses from three hospitals in Madrid (Spain) completed this 13-item scale. The analyses showed a factorial structure composed of two factors. The first is characterized by items regarding traumatic and stressful events and procedures of severe magnitude (traumatic stressors), and the second by items related to stressful events and procedures of moderate magnitude (routine stressors) but hypothesized to possess a substantial traumatic potential. Analyses provided evidence of both adequate internal consistency (Cronbach’s α = 0.92; first factor α = 0.91 and second factor α = 0.86) and test–retest reliability. In addition, concurrent validity also proved to be satisfactory. In short, TRSS-EN seems to be a reliable and valid tool in a healthcare emergency nursing setting for screening the frequency and impact of exposure to everyday work-related traumatic stressors, either event-related or routine.

An Examination of the Validity of the Health Risk Screening Tool: Predicting Mortality in People With Intellectual Disabilities

BACKGROUND AND PURPOSE

The Health Risk Screening Tool (HRST) is a 22-item instrument specifically designed to assess the health risk of persons with developmental disabilities. The predictive validity of the HRST was investigated by examining its ability to predict mortality.

METHODS

The sample consisted of 12,582 people with an intellectual or developmental disability residing in Georgia (U.S.). Data were analyzed using survival analysis (Kaplan-Meier estimate and Cox regression) and a binary logistic regression.

RESULTS

All models supported the prognostic value of the six-level health risk classification. The Kaplan-Meier procedure showed clear separation among functions. The Cox proportional hazard regression revealed that hazard is inversely related to the health risk level, even after controlling for potential confounding by gender, ethnicity, and race.

CONCLUSIONS

The HRST can predict mortality. Therefore, it can serve as a basis for establishing healthcare needs and determining nursing care acuity.