Psychometric evaluation of the Persian version of the stressor scale for emergency nurses
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Abstract
Background: Emergency department nurses experience unique stressors that contribute to elevated levels of occupational stress. Most existing instruments assess general occupational stress without addressing workplace-specific factors. This study aims to evaluate the psychometric properties of the Farsi version of the Stressor Scale for Emergency Nurses (F-SSEN).
Methods: Face and content validity were assessed by five clinical nurses and five nursing experts, respectively. Construct validity, known group validity, and convergent validity were tested on 198 emergency nurses. The test-retest reliability was evaluated in 21 nurses over a two-week interval. Internal consistency was measured using Cronbach's alpha and McDonald's omega coefficients.
Results: Face and content validity were found to be satisfactory. Exploratory factor analysis (EFA) identified four factors—conflicts, life and death situations, patients' families' actions and reactions, and technical and formal supports—which explained 60.64% of the total variance. Convergent validity showed a correlation of 0.554 between job stress scores based on SSEN and Brief Nursing Stress Scale (BNSS). Known group validity revealed that occupational stress scores were higher in women than in men, and there was a significant negative correlation between occupational stress scores and work experience in the emergency department. Cronbach's alpha and McDonald's omega coefficients were 0.953 and 0.954, respectively, and the intraclass correlation coefficient was 0.943.
Conclusions: The Farsi version of the stressor scale for emergency nurses demonstrates strong psychometric properties, making it reliable for measuring occupational stress in emergency nurses.
1. Happell B, Dwyer T, Reid‐Searl K, Burke KJ, Caperchione CM, Gaskin CJ. Nurses and stress: recognizing causes and seeking solutions. Journal of nursing management. 2013;21(4):638-47.
2. Adriaenssens J, De Gucht V, Maes S. Determinants and prevalence of burnout in emergency nurses: a systematic review of 25 years of research. International journal of nursing studies. 2015;52(2):649-61.
3. Dimitriadou Z, Kostagiolas P, Kritsotakis G, Rikos N, Stavropoulou A, Rovithis M. Occupational stress and coping strategies of the nursing staff of a Public University Hospital during the COVID-19 pandemic. Nursing Practice Today. 2023 Aug 18.
4. Lu D-M, Sun N, Hong S, Fan Y-y, Kong F-y, Li Q-j. Occupational stress and coping strategies among emergency department nurses of China. Archives of psychiatric nursing. 2015;29(4):208-12.
5. Yuwanich N, Akhavan S, Nantsupawat W, Martin L. Experiences of occupational stress among emergency nurses at private hospitals in Bangkok, Thailand. Open Journal of Nursing. 2017;7(6):657-70.
6. Yuwanich N, Sandmark H, Akhavan S. Emergency department nurses’ experiences of occupational stress: A qualitative study from a public hospital in Bangkok, Thailand. Work. 2016;53(4):885-97.
7. Foglia DC, Grassley JS, Zeigler VL. Factors that influence pediatric intensive care unit nurses to leave their jobs. Critical Care Nursing Quarterly. 2010;33(4):302-16.
8. McKinney BK. Withstanding the pressure of the profession. Journal for Nurses in Professional Development. 2011;27(2):69-73.
9. Chang EM, Bidewell JW, Huntington AD, Daly J, Johnson A, Wilson H, et al. A survey of role stress, coping and health in Australian and New Zealand hospital nurses. International journal of nursing studies. 2007;44(8):1354-62.
10. Lin HS, Probst JC, Hsu YC. Depression among female psychiatric nurses in southern Taiwan: main and moderating effects of job stress, coping behaviour and social support. Journal of clinical nursing. 2010;19(15‐16):2342-54.
11. Ward L. Mental health nursing and stress: Maintaining balance. International journal of mental health nursing. 2011;20(2):77-85.
12. Laposa JM, Alden LE, Fullerton LM. Work stress and posttraumatic stress disorder in ED nurses/personnel (CE). Journal of emergency nursing. 2003;29(1):23-8.
13. Davey MM, Cummings G, NEWBURN‐COOK CV, Lo EA. Predictors of nurse absenteeism in hospitals: a systematic review. Journal of nursing management. 2009;17(3):312-30.
14. Rugless MJ, Taylor DM. Sick leave in the emergency department: staff attitudes and the impact of job designation and psychosocial work conditions. Emergency Medicine Australasia. 2011;23(1):39-45.
15. Adriaenssens J, De Gucht V, Maes S. Causes and consequences of occupational stress in emergency nurses, a longitudinal study. Journal of nursing management. 2015;23(3):346-58.
16. Gray-Toft P, Anderson JG. The nursing stress scale: development of an instrument. Journal of behavioral assessment. 1981;3(1):11-23.
17. Osipow SH, Spokane AR. Occupational stress inventory-revised. Odessa, FL: Psychological. 1998:1-15.
18. Yuwanich N, Akhavan S, Nantsupawat W, Martin L, Elfström ML, Sandborgh M. Development and psychometric properties of the stressor scale for emergency nurses. International emergency nursing. 2018;39(2018):77-88.
19. JW. O. Best practices in quantitative methods: Sage. 2008.
20. Comrey AL, Lee HB. A first course in factor analysis: Psychology press; 2013.
21. Sansó N, Vidal-Blanco G, Galiana L. Development and Validation of the Brief Nursing Stress Scale (BNSS) in a Sample of End-of-Life Care Nurses. Nursing Reports. 2021;11(2):311-9.
22. Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross‐cultural health care research: a clear and user‐friendly guideline. Journal of evaluation in clinical practice. 2011;17(2):268-74.
23. Netemeyer RG, Bearden WO, Sharma S. Scaling procedures: Issues and applications: sage publications. 2003; 56(4):1088.
24. Sharif Nia H, Haghdoost AA, Ebadi A, Soleimani MA, Yaghoobzadeh A, Abbaszadeh A, et al. Psychometric properties of the king spiritual intelligence questionnaire (KSIQ) in physical veterans of Iran-Iraq warfare. Journal of Military Medicine. 2015;17(3):145-53.
25. Costello AB, Osborne J. Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical assessment, research, and evaluation. 2019;10(1):7.
26. Hoseinzadeh E, Sharif-Nia H, Ashktorab T, Ebadi A. Development and psychometric evaluation of nurse’s intention to care for patients with infectious disease scale: an exploratory sequential mixed method study. BMC nursing. 2024;23(1):65.
27. Sharif-Nia H, She L, Osborne J, Gorgulu O, Fomani FK, Goudarzian AH. Statistical concerns, invalid construct validity, and future recommendations. Nursing Practice Today. 2024;11(1):16-21.
28. She L, Sharif SP, Nia HS. Psychometric evaluation of the Chinese version of the modified online compulsive buying scale among Chinese young consumers. Journal of Asia-Pacific Business. 2021;22(2):121-33.
29. Yong AG, Pearce S. A beginner’s guide to factor analysis: Focusing on exploratory factor analysis. Tutorials in quantitative methods for psychology. 2013;9(2):79-94.
30. Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of chiropractic medicine. 2016 Jun 1;15(2):155-63.
31. Hancerlioglu S, Konakci G, Aykar FS. Assessing psychometric properties of Turkish version of the stressor scale for emergency nurses. Turkish Journal of Emergency Medicine. 2020;20(2):69-74.
32. Harris PE. The nurse stress index. Work & Stress. 1989;3(4):335-46.
33. Brinkert R. A literature review of conflict communication causes, costs, benefits and interventions in nursing. Journal of nursing management. 2010;18(2):145-56.
34. Azoulay E, Timsit J-F, Sprung CL, Soares M, Rusinova K, Lafabrie A, et al. Prevalence and factors of intensive care unit conflicts: the conflicus study. American journal of respiratory and critical care medicine. 2009;180(9):853-60.
35. Chen Y-C, Guo Y-LL, Lin L-C, Lee Y-J, Hu P-Y, Ho J-J, et al. Development of the nurses’ occupational stressor scale. International journal of environmental research and public health. 2020;17(2):649.
36. Dl S. Health measurement scales. A practical guide to their development and use. 1995:15-27.
37. Dalvand S, Gheshlagh RG, Najafi F, Zahednezhad H, Sayehmiri K. The prevalence of workplace violence against iranian nurses: a systematic review and meta-analysis. Shiraz E-Medical Journal. 2018;19(9): e65923.
38. Anand S, Mejid A. Prevalence and associated factors of work related stress among nurses working in worabe comprehensive and specialized hospital, south west Ethiopia. Prevalence. 2018;3(3):260-66.
39. Osei-Mireku G, Wang X, Lartey J, Sarpong F. Individual differences in experiencing occupational stress—A case study on nurses of Tamale Teaching Hospital (TTH). Open Journal of Business and Management. 2020;8(04):1657.
40. McVicar A. Workplace stress in nursing: a literature review. Journal of advanced nursing. 2003;44(6):633-42.
41. Chang EM, Hancock KM, Johnson A, Daly J, Jackson D. Role stress in nurses: review of related factors and strategies for moving forward. Nursing & health sciences. 2005;7(1):57-65.
2. Adriaenssens J, De Gucht V, Maes S. Determinants and prevalence of burnout in emergency nurses: a systematic review of 25 years of research. International journal of nursing studies. 2015;52(2):649-61.
3. Dimitriadou Z, Kostagiolas P, Kritsotakis G, Rikos N, Stavropoulou A, Rovithis M. Occupational stress and coping strategies of the nursing staff of a Public University Hospital during the COVID-19 pandemic. Nursing Practice Today. 2023 Aug 18.
4. Lu D-M, Sun N, Hong S, Fan Y-y, Kong F-y, Li Q-j. Occupational stress and coping strategies among emergency department nurses of China. Archives of psychiatric nursing. 2015;29(4):208-12.
5. Yuwanich N, Akhavan S, Nantsupawat W, Martin L. Experiences of occupational stress among emergency nurses at private hospitals in Bangkok, Thailand. Open Journal of Nursing. 2017;7(6):657-70.
6. Yuwanich N, Sandmark H, Akhavan S. Emergency department nurses’ experiences of occupational stress: A qualitative study from a public hospital in Bangkok, Thailand. Work. 2016;53(4):885-97.
7. Foglia DC, Grassley JS, Zeigler VL. Factors that influence pediatric intensive care unit nurses to leave their jobs. Critical Care Nursing Quarterly. 2010;33(4):302-16.
8. McKinney BK. Withstanding the pressure of the profession. Journal for Nurses in Professional Development. 2011;27(2):69-73.
9. Chang EM, Bidewell JW, Huntington AD, Daly J, Johnson A, Wilson H, et al. A survey of role stress, coping and health in Australian and New Zealand hospital nurses. International journal of nursing studies. 2007;44(8):1354-62.
10. Lin HS, Probst JC, Hsu YC. Depression among female psychiatric nurses in southern Taiwan: main and moderating effects of job stress, coping behaviour and social support. Journal of clinical nursing. 2010;19(15‐16):2342-54.
11. Ward L. Mental health nursing and stress: Maintaining balance. International journal of mental health nursing. 2011;20(2):77-85.
12. Laposa JM, Alden LE, Fullerton LM. Work stress and posttraumatic stress disorder in ED nurses/personnel (CE). Journal of emergency nursing. 2003;29(1):23-8.
13. Davey MM, Cummings G, NEWBURN‐COOK CV, Lo EA. Predictors of nurse absenteeism in hospitals: a systematic review. Journal of nursing management. 2009;17(3):312-30.
14. Rugless MJ, Taylor DM. Sick leave in the emergency department: staff attitudes and the impact of job designation and psychosocial work conditions. Emergency Medicine Australasia. 2011;23(1):39-45.
15. Adriaenssens J, De Gucht V, Maes S. Causes and consequences of occupational stress in emergency nurses, a longitudinal study. Journal of nursing management. 2015;23(3):346-58.
16. Gray-Toft P, Anderson JG. The nursing stress scale: development of an instrument. Journal of behavioral assessment. 1981;3(1):11-23.
17. Osipow SH, Spokane AR. Occupational stress inventory-revised. Odessa, FL: Psychological. 1998:1-15.
18. Yuwanich N, Akhavan S, Nantsupawat W, Martin L, Elfström ML, Sandborgh M. Development and psychometric properties of the stressor scale for emergency nurses. International emergency nursing. 2018;39(2018):77-88.
19. JW. O. Best practices in quantitative methods: Sage. 2008.
20. Comrey AL, Lee HB. A first course in factor analysis: Psychology press; 2013.
21. Sansó N, Vidal-Blanco G, Galiana L. Development and Validation of the Brief Nursing Stress Scale (BNSS) in a Sample of End-of-Life Care Nurses. Nursing Reports. 2021;11(2):311-9.
22. Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross‐cultural health care research: a clear and user‐friendly guideline. Journal of evaluation in clinical practice. 2011;17(2):268-74.
23. Netemeyer RG, Bearden WO, Sharma S. Scaling procedures: Issues and applications: sage publications. 2003; 56(4):1088.
24. Sharif Nia H, Haghdoost AA, Ebadi A, Soleimani MA, Yaghoobzadeh A, Abbaszadeh A, et al. Psychometric properties of the king spiritual intelligence questionnaire (KSIQ) in physical veterans of Iran-Iraq warfare. Journal of Military Medicine. 2015;17(3):145-53.
25. Costello AB, Osborne J. Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical assessment, research, and evaluation. 2019;10(1):7.
26. Hoseinzadeh E, Sharif-Nia H, Ashktorab T, Ebadi A. Development and psychometric evaluation of nurse’s intention to care for patients with infectious disease scale: an exploratory sequential mixed method study. BMC nursing. 2024;23(1):65.
27. Sharif-Nia H, She L, Osborne J, Gorgulu O, Fomani FK, Goudarzian AH. Statistical concerns, invalid construct validity, and future recommendations. Nursing Practice Today. 2024;11(1):16-21.
28. She L, Sharif SP, Nia HS. Psychometric evaluation of the Chinese version of the modified online compulsive buying scale among Chinese young consumers. Journal of Asia-Pacific Business. 2021;22(2):121-33.
29. Yong AG, Pearce S. A beginner’s guide to factor analysis: Focusing on exploratory factor analysis. Tutorials in quantitative methods for psychology. 2013;9(2):79-94.
30. Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of chiropractic medicine. 2016 Jun 1;15(2):155-63.
31. Hancerlioglu S, Konakci G, Aykar FS. Assessing psychometric properties of Turkish version of the stressor scale for emergency nurses. Turkish Journal of Emergency Medicine. 2020;20(2):69-74.
32. Harris PE. The nurse stress index. Work & Stress. 1989;3(4):335-46.
33. Brinkert R. A literature review of conflict communication causes, costs, benefits and interventions in nursing. Journal of nursing management. 2010;18(2):145-56.
34. Azoulay E, Timsit J-F, Sprung CL, Soares M, Rusinova K, Lafabrie A, et al. Prevalence and factors of intensive care unit conflicts: the conflicus study. American journal of respiratory and critical care medicine. 2009;180(9):853-60.
35. Chen Y-C, Guo Y-LL, Lin L-C, Lee Y-J, Hu P-Y, Ho J-J, et al. Development of the nurses’ occupational stressor scale. International journal of environmental research and public health. 2020;17(2):649.
36. Dl S. Health measurement scales. A practical guide to their development and use. 1995:15-27.
37. Dalvand S, Gheshlagh RG, Najafi F, Zahednezhad H, Sayehmiri K. The prevalence of workplace violence against iranian nurses: a systematic review and meta-analysis. Shiraz E-Medical Journal. 2018;19(9): e65923.
38. Anand S, Mejid A. Prevalence and associated factors of work related stress among nurses working in worabe comprehensive and specialized hospital, south west Ethiopia. Prevalence. 2018;3(3):260-66.
39. Osei-Mireku G, Wang X, Lartey J, Sarpong F. Individual differences in experiencing occupational stress—A case study on nurses of Tamale Teaching Hospital (TTH). Open Journal of Business and Management. 2020;8(04):1657.
40. McVicar A. Workplace stress in nursing: a literature review. Journal of advanced nursing. 2003;44(6):633-42.
41. Chang EM, Hancock KM, Johnson A, Daly J, Jackson D. Role stress in nurses: review of related factors and strategies for moving forward. Nursing & health sciences. 2005;7(1):57-65.
| Issue | Articles in Press | |
| Section | Original Article(s) | |
| Keywords | ||
| Psychometric evaluation occupational stress emergency nurse stressor scale for emergency nurses | ||
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How to Cite
1.
Ghanei Gheshlagh R, Pour Mohammadi N, Dehvan F, Sharif Nia H. Psychometric evaluation of the Persian version of the stressor scale for emergency nurses. NPT. 2025;:X-X.
