Cross-cultural validation of the Student Nurse Stress Index Scale

A descriptive survey targeting student nurses in China

Lina Guo (Lead / Corresponding author), Martyn C. Jones, Yanjin Liu (Lead / Corresponding author), Suyuan Yv, Yiru Zhu, Yvru Guo

Research output: Contribution to journalArticle

Abstract

Background: Currently, relatively little is known regarding the sources and levels of stress experienced by nursing students in China. This is largely because there is no reliable and valid, culturally appropriate measure of student nurse' stress. A culturally acceptable, Chinese Version of the Student Nurse Stress Index Scale (SNSI-CHI), with established reliability and validity, is needed to identify sources of stress in Chinese nursing students.

Methods: This validation study used a cross-sectional descriptive survey design. Stratified cluster random sampling was used to collect data from August 2017 to January, 2018 from 1100 nursing students in Henan Province, China. A demographic questionnaire, SNSI-CHI and Perceived Stress Scale (PSS-14) were administered. Exploratory and confirmatory factor analysis was carried out on two randomly selected samples (each N = 538) from the overall return. The content, construct, predictive and concurrent validity of the translated SNSI-CHI were examined.

Results: 1076 nursing students returned the survey (97.82% response rate). The average total score of SNSI-CHI was 58.455 ± 13.903. The internal consistency, test-retest reliability and content validity of the SNSI-CHI was excellent with a content validity index of 0.954. A four factor simple structure was revealed and confirmed using exploratory (explaining 75% of the variance) and confirmatory factor analysis (x2/df = 1.347, GFI = 0.956, AGFI = 0.945, RMR = 0.032, RMSEA = 0.025, NFI = 0.974, IFI = 0.993, TLI = 0.992, CFI = 0.993). This structure, i.e. academic load, clinical concerns, interface worries and personal problems compared well with the original SNSI. The SNSI-CHI totals and subscales showed good concurrent and predictive validity with the PSS-14 as comparator or criterion. A score of higher than 65 on the SNSI-CHI indicates high levels of perceived stress symptoms. Some 10.5% of respondents experience high levels of stressful demand. Sensitivity and specificity values of 71.7% and 75.1% respectively, demonstrated good predictive validity.

Limitations: This study sample was confined to the Henan Province, which may limit its generalizability. A larger and more diverse sample is needed in the future research.

Conclusions: The SNSI-CHI is both reliable and valid and culturally appropriate for use in China and its structure enables cross-cultural comparison.

Original languageEnglish
Pages (from-to)31-38
Number of pages8
JournalJournal of Affective Disorders
Volume251
Early online date7 Mar 2019
DOIs
Publication statusPublished - 15 May 2019

Fingerprint

Nursing Students
China
Nurses
Reproducibility of Results
Students
Statistical Factor Analysis
Cross-Cultural Comparison
Validation Studies
Cross-Sectional Studies
Demography
Sensitivity and Specificity
Surveys and Questionnaires

Keywords

  • Nursing student
  • Stress
  • Reliability
  • Validity
  • Cross-cultural comparison

Cite this

@article{a3225fff10a04dc8b9b30e11fd02fec6,
title = "Cross-cultural validation of the Student Nurse Stress Index Scale: A descriptive survey targeting student nurses in China",
abstract = "Background: Currently, relatively little is known regarding the sources and levels of stress experienced by nursing students in China. This is largely because there is no reliable and valid, culturally appropriate measure of student nurse' stress. A culturally acceptable, Chinese Version of the Student Nurse Stress Index Scale (SNSI-CHI), with established reliability and validity, is needed to identify sources of stress in Chinese nursing students.Methods: This validation study used a cross-sectional descriptive survey design. Stratified cluster random sampling was used to collect data from August 2017 to January, 2018 from 1100 nursing students in Henan Province, China. A demographic questionnaire, SNSI-CHI and Perceived Stress Scale (PSS-14) were administered. Exploratory and confirmatory factor analysis was carried out on two randomly selected samples (each N = 538) from the overall return. The content, construct, predictive and concurrent validity of the translated SNSI-CHI were examined.Results: 1076 nursing students returned the survey (97.82{\%} response rate). The average total score of SNSI-CHI was 58.455 ± 13.903. The internal consistency, test-retest reliability and content validity of the SNSI-CHI was excellent with a content validity index of 0.954. A four factor simple structure was revealed and confirmed using exploratory (explaining 75{\%} of the variance) and confirmatory factor analysis (x2/df = 1.347, GFI = 0.956, AGFI = 0.945, RMR = 0.032, RMSEA = 0.025, NFI = 0.974, IFI = 0.993, TLI = 0.992, CFI = 0.993). This structure, i.e. academic load, clinical concerns, interface worries and personal problems compared well with the original SNSI. The SNSI-CHI totals and subscales showed good concurrent and predictive validity with the PSS-14 as comparator or criterion. A score of higher than 65 on the SNSI-CHI indicates high levels of perceived stress symptoms. Some 10.5{\%} of respondents experience high levels of stressful demand. Sensitivity and specificity values of 71.7{\%} and 75.1{\%} respectively, demonstrated good predictive validity.Limitations: This study sample was confined to the Henan Province, which may limit its generalizability. A larger and more diverse sample is needed in the future research.Conclusions: The SNSI-CHI is both reliable and valid and culturally appropriate for use in China and its structure enables cross-cultural comparison.",
keywords = "Nursing student, Stress, Reliability, Validity, Cross-cultural comparison",
author = "Lina Guo and Jones, {Martyn C.} and Yanjin Liu and Suyuan Yv and Yiru Zhu and Yvru Guo",
note = "No Funding.",
year = "2019",
month = "5",
day = "15",
doi = "10.1016/j.jad.2019.03.017",
language = "English",
volume = "251",
pages = "31--38",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier",

}

Cross-cultural validation of the Student Nurse Stress Index Scale : A descriptive survey targeting student nurses in China. / Guo, Lina (Lead / Corresponding author); Jones, Martyn C.; Liu, Yanjin (Lead / Corresponding author); Yv, Suyuan; Zhu, Yiru; Guo, Yvru.

In: Journal of Affective Disorders, Vol. 251, 15.05.2019, p. 31-38.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cross-cultural validation of the Student Nurse Stress Index Scale

T2 - A descriptive survey targeting student nurses in China

AU - Guo, Lina

AU - Jones, Martyn C.

AU - Liu, Yanjin

AU - Yv, Suyuan

AU - Zhu, Yiru

AU - Guo, Yvru

N1 - No Funding.

PY - 2019/5/15

Y1 - 2019/5/15

N2 - Background: Currently, relatively little is known regarding the sources and levels of stress experienced by nursing students in China. This is largely because there is no reliable and valid, culturally appropriate measure of student nurse' stress. A culturally acceptable, Chinese Version of the Student Nurse Stress Index Scale (SNSI-CHI), with established reliability and validity, is needed to identify sources of stress in Chinese nursing students.Methods: This validation study used a cross-sectional descriptive survey design. Stratified cluster random sampling was used to collect data from August 2017 to January, 2018 from 1100 nursing students in Henan Province, China. A demographic questionnaire, SNSI-CHI and Perceived Stress Scale (PSS-14) were administered. Exploratory and confirmatory factor analysis was carried out on two randomly selected samples (each N = 538) from the overall return. The content, construct, predictive and concurrent validity of the translated SNSI-CHI were examined.Results: 1076 nursing students returned the survey (97.82% response rate). The average total score of SNSI-CHI was 58.455 ± 13.903. The internal consistency, test-retest reliability and content validity of the SNSI-CHI was excellent with a content validity index of 0.954. A four factor simple structure was revealed and confirmed using exploratory (explaining 75% of the variance) and confirmatory factor analysis (x2/df = 1.347, GFI = 0.956, AGFI = 0.945, RMR = 0.032, RMSEA = 0.025, NFI = 0.974, IFI = 0.993, TLI = 0.992, CFI = 0.993). This structure, i.e. academic load, clinical concerns, interface worries and personal problems compared well with the original SNSI. The SNSI-CHI totals and subscales showed good concurrent and predictive validity with the PSS-14 as comparator or criterion. A score of higher than 65 on the SNSI-CHI indicates high levels of perceived stress symptoms. Some 10.5% of respondents experience high levels of stressful demand. Sensitivity and specificity values of 71.7% and 75.1% respectively, demonstrated good predictive validity.Limitations: This study sample was confined to the Henan Province, which may limit its generalizability. A larger and more diverse sample is needed in the future research.Conclusions: The SNSI-CHI is both reliable and valid and culturally appropriate for use in China and its structure enables cross-cultural comparison.

AB - Background: Currently, relatively little is known regarding the sources and levels of stress experienced by nursing students in China. This is largely because there is no reliable and valid, culturally appropriate measure of student nurse' stress. A culturally acceptable, Chinese Version of the Student Nurse Stress Index Scale (SNSI-CHI), with established reliability and validity, is needed to identify sources of stress in Chinese nursing students.Methods: This validation study used a cross-sectional descriptive survey design. Stratified cluster random sampling was used to collect data from August 2017 to January, 2018 from 1100 nursing students in Henan Province, China. A demographic questionnaire, SNSI-CHI and Perceived Stress Scale (PSS-14) were administered. Exploratory and confirmatory factor analysis was carried out on two randomly selected samples (each N = 538) from the overall return. The content, construct, predictive and concurrent validity of the translated SNSI-CHI were examined.Results: 1076 nursing students returned the survey (97.82% response rate). The average total score of SNSI-CHI was 58.455 ± 13.903. The internal consistency, test-retest reliability and content validity of the SNSI-CHI was excellent with a content validity index of 0.954. A four factor simple structure was revealed and confirmed using exploratory (explaining 75% of the variance) and confirmatory factor analysis (x2/df = 1.347, GFI = 0.956, AGFI = 0.945, RMR = 0.032, RMSEA = 0.025, NFI = 0.974, IFI = 0.993, TLI = 0.992, CFI = 0.993). This structure, i.e. academic load, clinical concerns, interface worries and personal problems compared well with the original SNSI. The SNSI-CHI totals and subscales showed good concurrent and predictive validity with the PSS-14 as comparator or criterion. A score of higher than 65 on the SNSI-CHI indicates high levels of perceived stress symptoms. Some 10.5% of respondents experience high levels of stressful demand. Sensitivity and specificity values of 71.7% and 75.1% respectively, demonstrated good predictive validity.Limitations: This study sample was confined to the Henan Province, which may limit its generalizability. A larger and more diverse sample is needed in the future research.Conclusions: The SNSI-CHI is both reliable and valid and culturally appropriate for use in China and its structure enables cross-cultural comparison.

KW - Nursing student

KW - Stress

KW - Reliability

KW - Validity

KW - Cross-cultural comparison

U2 - 10.1016/j.jad.2019.03.017

DO - 10.1016/j.jad.2019.03.017

M3 - Article

VL - 251

SP - 31

EP - 38

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -