Evaluation and Preliminary Validity of the Perceived Stress Scale (PSS-14)
Abstract:
Background: Stress is conceptualized as a set of psychophysiological responses to demanding stimuli, which, when persistent, can result in significant adverse health outcomes. Pediatric healthcare professionals represent a particularly vulnerable group due to occupational stress often associated with suboptimal coping mechanisms, impacting both their well-being and the quality of care provided to patients. Despite a universally accepted instrument for assessing stress within this population, the Perceived Stress Scale (PSS-14) has emerged as a promising measure. However, its inconsistent factorial solutions across studies underscore the necessity of evaluating its psychometric properties within specific local contexts to ensure valid and reliable interpretation. The present study seeks to adapt and preliminarily validate the PSS-14 for pediatric healthcare professionals.
Methods: The PSS-14 was reviewed both theoretically and empirically, and a pilot test was conducted in four pediatric emergency departments in Chile with 65 healthcare professionals. Confirmatory factor analyses of the original unidimensional and bifactorial models were performed based on contemporary evidence. Qualitative and quantitative results were contrasted to conclude on the relevance of using the scale for emergency healthcare personnel.
Results: The results of the factorial analysis of the unidimensional model showed a poorfit of the data (χ² = 366.782, df = 77, p < 0.001, RMSEA = 0.24, CFI = 0.787, TLI = 0.748, and SRMR = 0.14). The bifactorial model showed promising results (χ² = 143.212, df = 63, p < 0.001; RMSEA = 0.14, CFI = 0.94; TLI = 0.92; SRMR = 0.06). This bifactorial model suggested two underlying dimensions of perceived stress: one of positive coping with stress and another of negative coping. However, five problematic items were identified. Perceptions about time control and each daily event, as well as the behavior of thinking about pending tasks, would not be appropriate in the work of a pediatric emergency department, where uncertainty is part of the daily norm and not considered a problematic source of stress compared to other elements of their daily routine.
Conclusions: Preliminary results showed that the bifactorial model, which distinguishes between positive and negative coping with stress, had a better fit than the unidimensional model. However, some items were problematic, such as those related to time control and pending tasks, as they are not relevant in the context of pediatric emergencies, where uncertainty is common. The results suggest that the use of the scale should take into account the contextual characteristics of the work for an adequate stress assessment
