Validation of the Nursing Stress Scale: Current Stressors in the Health Care Environment in the USA and Spain

Abstract

Background:

Nursing is one of the most stressful occupations today and the pandemic brought new stressors that still prevail.

Objective:

The present study aimed to adapt and validate the Nursing Stress Scale. The adaptation consists of 2 main aspects: (1) including stressors that arose during the COVID-19 pandemic and remain and (2) reducing the length of the scale to make it easier and faster to respond to.

Methods:

This cross-sectional study was conducted in 2 countries: Spain and the United States. The invariant structure of the 5 dimensions of the scale has been tested through a multigroup confirmatory factor analysis (CFA), using a sample of 660 nurses from different countries and hospitals. Content validity was established through expert judgment. Construct, convergent, and discriminant validity were tested through confirmatory factor analyses, average variance extracted (AVE), and correlations, and reliability was tested with Cronbach alphas and composite reliability.

Results:

Results from the CFA supported the construct validity and the invariant structure of the 5 dimensions of the questionnaire. Convergent validity was assessed using the AVE, which yielded values above 0.50. Discriminant validity was also established, as the square root of the AVE for each dimension exceeded the intercorrelations among the dimensions in the model. Finally, internal consistency of the scale was verified through Cronbach’s alpha coefficients, all exceeding .70.

Conclusions:

Stress among nurses continues to be a serious problem that has been aggravated after COVID-19. This scale is a valuable tool for quickly and reliably assessing current stressors for nurses.