Development and Validation of the Brief Nursing Stress Scale (BNSS) in a Sample of End-of-Life Care Nurses

Abstract

Nursing has been identified as a very stressful profession. Specifically in end-of-life care, nurses frequently experience stressful situations related to death and dying. This study aims to develop and validate a short scale of stress in nurses, the Brief Nursing Stress Scale. A cross-sectional survey of Spanish end-of-life care professionals was conducted; 129 nurses participated. Analyses included a confirmatory factor analysis of the Brief Nursing Stress Scale, estimation of reliability, relation with sex, age and working place, and the estimation of a structural equation model in which BNSS predicted burnout and work satisfaction The confirmatory factor analysis showed an adequate fit: χ2(9) = 20.241 (p = 0.017); CFI = 0.924; SRMR = 0.062; RMSEA = 0.098 [0.040,0.156]. Reliability was 0.712. Women and men showed no differences in stress. Younger nurses and those working in hospital compared to homecare showed higher levels of stress. A structural equation model showed nursing stress positively predicted burnout, which in turn negatively predicted work satisfaction. Nursing stress also had an indirect, negative effect on work satisfaction. The Brief Nursing Stress Scale showed adequate estimates of validity, reliability, and predictive power in a sample of end-of-life care nurses. This is a short, easy-to-use measure that could be employed in major batteries assessing quality of healthcare institutions.