Development and application of a specialized scale of occupational stressors for medical staff

Abstract

ObjectiveTo develop a professional occupational stress scale for medical staff （CSSM） and test its reliability and validity， so as to provide a technical tool for the evaluation and management of medical staff occupational stress.MethodsThe initial index item pool was formed by literature retrieval， in-depth interview and expert evaluation. Pre-survey questionnaires were distributed in April 2021， stratified sampling was used to randomly select 1 tertiary hospital， 2 secondary hospitals and 1 community health service center in Shanghai. Sampling was performed according to the number of medical staff in all level hospitals and the proportion of doctors， nurses and medical technicians. 848 valid questionnaires were collected. Item differentiation method， correlation analysis and exploratory factor analysis were used to filter the pre-survey item pool and form a formal scale. From June to July 2021， stratified sampling method was used to carry out formal survey with formal scale， and the reliability and validity of the scale were verified. A total of 5 510 valid questionnaires were collected. Confirmatory factor analysis was used to test the construct validity of the scale. Job burnout， sleep disorder and job demand-autonomy （-support） model occupational stress scales were used as calibration scales， respectively. Pearson correlation analysis was used to test the scale's calibration validity and aggregate validity， and Cronbach's α coefficient was used to evaluate the scale's reliability.ResultsThrough project differentiation method， correlation analysis， exploratory factor analysis on the preliminary survey item pool， we produced the formal scale of 7 dimensions and 32 items， respectively， including "career development"， "interpersonal relationship"， "working overtime and work-life imbalance"， "physical environment"， "the doctor-patient relationship"， "social environment"， "work load". The cumulative variance contribution rate of common factors in exploratory factor analysis was 65.937%， and the factor loading value of each item ranged from 0.513 to 0.880. The scale was used for formal investigation to verify the reliability and validity of the scale. The goodness of fit index （GFI）， comparative fit index （CFI） and root mean square error of approximation （RMSEA） were 0.913， 0.909 and 0.064， respectively. The scores of the scale and all dimensions were positively correlated with the scores of occupational stress in the mode of job burnout， sleep disorder symptoms and job demand-autonomy （r=0.235‒0.754， P<0.05）. The Cronbach's α coefficients of the total amount table and each dimension ranged from 0.743 to 0.937， showing good reliability and validity.ConclusionCSSM has good reliability and validity， which provides a measurement and assessment tool for the targeted prevention of occupational stress in medical staff. The popularization and use of this scale in other regions need further verification.

Keywords

• medical staff
• occupational stress
• occupational stressor
• scale development
• scale application