5 completion of the study. The Institutional Review Board (IRB) of the study team and the six participating hospitals approved the protocols and procedures used in this research study. A copy of the consent was emailed to each participant for their records (Hersch et al, 2016). Measurement Methods and Instruments Used in Research Nursing Stress Scale (NSS) The NSS was the main instrument used to measure the dependant variable of nursing related stress. The NSS provides a total stress score based on the 34 items for situational stress in nursing. The scale also provides seven subscales that also provide a total stress score to identify areas where nurses experience increased stress (Gray-Toft & Anderson, 1981). The subscales include; "death and dying, conflict with physicians, inadequate preparation, lack of support, conflict with other nurses, work load, and uncertainty concerning treatment" (Hersch et al, 2016, p. 21) The level of measurement used in the NSS is a metric ordinal scale (Gray et al, 2017) According to Gray-Toft and Anderson (1981) the NSS and its subscale totals are reliable based on test-retest and four internal consistency measures. The reliability of the NSS has an excellent Cronbach's alpha (α) of .90. The validity of the NSS was correlated with the coping with stress scale (α = .70), Symptoms of distress scale (α = .86), and the work limitations questionnaire that has an overall a = .78 (Hersch et al, 2016). Symptoms of distress The symptoms of distress scale uses an ordinal level of measurement for its 15 questions based on physical or emotional symptom of distress such as, muscle tension and nervousness. Based on the past 30 days, it uses a 4 point Likert scale for frequency of symptoms felt. Based on the scale where 1 equals nearly every day and 4 equals never, a higher score would equal less
6 stress. The reliability of the symptoms of distress scale has a good Cronbach's alpha of .86 and no validity was identified in the research (Hersch et al, 2016). Coping with stress The coping with stress scale is similar to the symptoms of distress scale by using a 4 point Likert scale as an ordinal level of measurement and higher scores indicate better outcomes. Coping with stress scale has 12 questions based on coping strategies for difficult events. The reliability of the coping with stress scale has an acceptable Cronbach's alpha of .70 and no validity was identified in the research (Hersch et al, 2016). Work Limitations Questionnaire (WLQ) The WLQ has been tested and retested by Lerner et al (2001) for validity and reliability. Validity was tested by comparing scores of their surveyed participants and then perform a cross- sectional survey to test reliability and construct validity (Lerner et al, 2001). The tool contains 25 items with 4 subcategories and participants based their answers on the extent stress affected the activity noted in the tool. An ordinal level of measurement was used. The Cronbach's alpha ranged from .73 in the meeting time and scheduling demand subcategory to α .85 the ability to keep up with quality and quantity demands of work category. The validity of the WLQ was
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- Fall '16
- Denise Cauble
- Nursing, Hersch