Advertisement

Journal of behavioral assessment

, Volume 3, Issue 1, pp 11–23 | Cite as

The Nursing Stress Scale: Development of an instrument

  • Pamela Gray-Toft
  • James G. Anderson
Article

Abstract

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 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Appley, M. H., and Trumbull, R. (Eds.)Psychological Stress. New York: Appleton-Century-Crofts, 1967.Google Scholar
  2. Bates, E. M., and Moore, B. N. Stress in hospital personnel.Medical Journal of Australia 1975,2, 765–767.Google Scholar
  3. Beszterczey, A. Staff stress on a newly-developed palliative care service.Canadian Psychiatric Association Journal 1977,22, 347–353.Google Scholar
  4. Cartwright, L. K. Sources and effects of stress in health careers. In G. C. Stone, F. Cohen, and N. E. Adler (Eds.),Health Psychology. San Francisco: Jossey-Bass, 1979.Google Scholar
  5. Cassem, N. H., and Hackett, T. P. Sources of tension for the CCU nurse.American Journal of Nursing 1972,72, 1426–1430.Google Scholar
  6. DeMeyer, J. The environment of the intensive care unit.Nursing Forum 1967,6, 262–272.Google Scholar
  7. Edelstein, R. R. Automation: Its effect on the nurse.American Journal of Nursing 1966,66, 2194–2198.Google Scholar
  8. Freudenberger, H. J. Staff burn-out.Journal of Social Issues 1974,30, 159–165.Google Scholar
  9. Gray-Toft, P. A. Effectiveness of a counseling and consultation support program for hospice nurses.Journal of Counseling Psychology 1980,27, 346–354.Google Scholar
  10. Gray-Toft, P. A., and Anderson, J. G. Stress among hospital nursing staff: Its causes and effects.Social Science and Medicine, 1981,15 (in press).Google Scholar
  11. Hay, D., and Oken, D. The psychological stresses of intensive care unit nursing.Psychosomatic Medicine 1972,34, 109–118.Google Scholar
  12. Kornfeld, D. S. Psychiatric problems of an intensive care unit.Medical Clinics of North America 1971,55, 1353–1363.Google Scholar
  13. Kramer, M.Reality Shock: Why Nurses Leave Nursing. St. Louis, Mo.: C. V. Mosby, 1974.Google Scholar
  14. Krug, S. E., Scheier, I. H., and Cattell, R. B.Handbook for the IPAT Anxiety Scale. Champaign, Ill.: Institute for Personality and Ability Testing, 1976.Google Scholar
  15. Lazarus, R. S.Psychological Stress and the Coping Process. New York: McGraw-Hill, 1966.Google Scholar
  16. Malone, M. F. The dilemma of a professional in a bureaucracy.Nursing Forum 1964,3, 36–60.Google Scholar
  17. Maslach, C. Burned-out.Human Behavior 1976,5, 16–22.Google Scholar
  18. Maslach, C. The burn-out syndrome and patient care. In C. A. Garfield (Ed.),Stress and Survival. St. Louis, Mo.: C. V. Mosby, 1979.Google Scholar
  19. Menzies, I. E. P. A case study in the functioning of social systems as a defense against anxiety.Human Relations 1960,13, 95–121.Google Scholar
  20. Meyer, E. Disturbed behavior on medical and surgical wards. In J. Masserman, (Ed.),Science and Psychoanalysis, Vol. V. New York: Grune & Stratton, 1962.Google Scholar
  21. Meyer, E., and Mendelson, M. Psychiatric consultation with patients on a medical and surgical ward: Patterns and processes.Psychiatry 1961,24, 197–220.Google Scholar
  22. National Comission on Nursing and Nursing Education.An Abstract for Action. New York: McGraw-Hill, 1970.Google Scholar
  23. Nichols, G. Job satisfaction and nurses' intentions to remain with or to leave an organization.Nursing Research 1971,20, 218–228.Google Scholar
  24. Nunnally, J. C.Psychometric Theory. New York: McGraw-Hill, 1967.Google Scholar
  25. Price, T. R., and Bergen, B. J. The relationship to death as a source of stress for nurses on a coronary care unit.Omega 1977,8, 229–238.Google Scholar
  26. Quinby, S., and Bernstein, N. R. Identity problems and the adaptation of nurses to severely burned children.American Journal of Psychiatry 1971,128, 58–63.Google Scholar
  27. Revans, R. W.The Hospital as an Organism: A Study in Communications and Morale. New York: Pergamon Press, 1959.Google Scholar
  28. Rummel, R. J.Applied Factor Analysis. Evanston, Ill.: Northwestern University Press, 1970.Google Scholar
  29. Saleh, S., Lee, R. J., and Prien, E. P. Why nurses leave their jobs — An analysis of female turnover.Personnel Administration 1965,27, 25–28.Google Scholar
  30. Schulz, R., and Aderman, D. How the medical staff copes with dying patients: A critical review.Omega 1976,7, 11–21.Google Scholar
  31. Sipprelle, R. C., Gilberg, F. S., and Ascough, J. C. The affect rating scale: Unipolar semantic space components of affective state. Lafayette, Ind.: Department of Psychological Sciences, Purdue University (submitted for publication), 1976.Google Scholar
  32. Smith, P. C., Kendall, L. M., and Hulin, C. L.The Measurement of Satisfaction in Work and Retirement. Chicago: Rand McNally, 1969.Google Scholar
  33. Vreeland, R., and Ellis, G. L. Stresses on the nurse in an intensive care unit.Journal of American Medical Association 1969,208, 332–334.Google Scholar
  34. Wertzel, H., Vollrath, P., Ritz, E., and Ferner, H. Analysis of patient-nurse interaction in hemodialysis units.Journal of Psychosomatic Research 1977,21, 359–366.Google Scholar

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

Personalised recommendations