Journal of behavioral assessment

, Volume 3, Issue 1, pp 11–23

The Nursing Stress Scale: Development of an instrument

  • Pamela Gray-Toft
  • James G. Anderson

DOI: 10.1007/BF01321348

Cite this article as:
Gray-Toft, P. & Anderson, J.G. Journal of Behavioral Assessment (1981) 3: 11. doi:10.1007/BF01321348


Despite increased recognition of the stress experienced by hospital nursing staffs and its effects on burnout, job satisfaction, turnover, and patient care, few instruments exist that can be used to measure stress. This paper describes the development of an instrument, the Nursing Stress Scale (NSS). It consists of 34 items that describe situations that have been identified as causing stress for nurses in the performance of their duties. It provides a total stress score as well as scores on each of seven subscales that measure the frequency of stress experienced by nurses in the hospital environment. The Nursing Stress Scale was administered to 122 nurses on five hospital units. Factor analysis indicated seven major sources of stress that closely paralleled the conceptual categories of stress on which the scale was based. Test-retest reliability as well as four measures of internal consistency indicated that the Nursing Stress Scale and its seven subscales are reliable. Validity was determined by correlating the total score from the Nursing Stress Scale with measures of trait anxiety, job satisfaction, and nursing turnover hypothesized to be related to stress. In addition, the ability of the scale to differentiate hospital units and groups of nurses known to experience high levels of stress resulting in staff turnover was examined.

Key words

nursing stress staff burnout anxiety job satisfaction turnover 

Copyright information

© Plenum Publishing Corporation 1981

Authors and Affiliations

  • Pamela Gray-Toft
    • 1
  • James G. Anderson
    • 2
  1. 1.Department of Medical ResearchMethodist Hospital of Indiana, Inc.Indianapolis
  2. 2.Department of Sociology and AnthropologyPurdue UniversityWest Lafayette