Volume 29, Issue 3 (Summer 2021)                   Avicenna J Nurs Midwifery Care 2021, 29(3): 245-255 | Back to browse issues page

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Safari Shirazi M, Sadeghzadeh M, Abbasi M. Psychometric Properties of Persian Version of Condensed Nurses' Occupational Stress Scale in Covid-19 Pandemic Period. Avicenna J Nurs Midwifery Care 2021; 29 (3) :245-255
URL: http://nmj.umsha.ac.ir/article-1-2288-en.html
1- Master Student, Department of general psychology in the Salman Farsi University, Kazeroon, Fars, Iran , maryam.safaree@gmail.com
2- Assistant Professor, Department of Psychology, Salman Farsi University, Kazeroon, Fars, Iran
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✅ Condensed Nurses' Occupational Stress Scale has acceptable psychometric properties in Iranian society and can be used as a useful tool in research related to nurses' occupational stress.

Extended Abstract:   (1052 Views)

Nursing is recognized in all countries as a job with high occupational stress. Therefore, the existence of tools to assess this occupational stress can contribute research into nurses’ mental health. The purpose of this study is to review the Persian version of a newer questionnaire designed to measure nurses' job stress. This tool is actually a short version of the Condensed Nurses'Occupational Stress Scale (NOSS), which was designed by Chen et al. in 2013 and revised in 2020 [29]. The aim of this study was to investigate the factor structure and psychometric parameters of the Nurses Occupational Stress Scale - a short version among Iranian nurses during the COVID-19 pandemic.


Materials and Methods

In this cross-sectional study, 224 nurses working in two hospitals in Shiraz, Iran, which were chosen as care centers for patients with coronavirus, were selected by convenience sampling method and completed the Condensed Nurses' Occupational Stress Scale. SPSS 22 (SPSS Inc., Chicago, IL., USA) and AMOS software were used to analyze the data.



The results of exploratory factor analysis using principal components method and confirmatory factor analysis confirmed the two-factor structure of “stresses related to environmental-organizational factors” and “stresses related to high workload’ in the Persian version of the Nurses' Occupational Stress Scale. In addition, Chronbach’s alpha and McDonald omega were used to determine internal consistency, Chronbach’s alpha and McDonald's omega coefficients for the whole scale (α: 0.94 and ω: 0.95) and two subscales of “stresses related to environmental-organizational factors” (α: 0.91 and ω: 0.91) and “Stresses related to high workload” (α: 0.90 and ω: 0.91) were within acceptable limits.

Figure 1. Rock curve diagram related to factor analysis Persian version of the short form of Condensed Nurses Job Stress Questionnaire (NOSS) 
Figure 1. Rock curve diagram related to factor analysis Persian version of the short form of Condensed Nurses Job Stress Questionnaire (NOSS)
Figure 2. Factor structure related to the Persian version of the short form of Nurses' Job Stress Questionnaire 
Figure 2. Factor structure related to the Persian version of the short form of Nurses' Job Stress Questionnaire


The aim of this study was to investigate the factor structure and psychometric parameters of the Condensed Nurses'Occupational Stress Scale (NOSS) among Iranian nurses during the COVID-19 pandemic. The main version of this questionnaire includes 21 items and 9 subscales of job claims, job-family conflicts, insufficient support from colleagues or patient caregivers, violence and coercion in the workplace, organizational issues, job risks, day-off, disability and basic physiological needs. The original questionnaire was designed by Chen et al. in 2013, and its short form was revised in 2020.
This questionnaire has two important strengths compared to similar tools that have been used in domestic research to measure nurses' job stress. First, it enables nurses to assess job stress with fewer items, and second, it provides a wider range of nurses' day-to-day job concerns, such as having or not having regular rest time, the number of in-call shifts, overtime nursing leave, and day-off issues. However, it should be borne in mind that the present study's findings, which was conducted at the time of the COVID-19 pandemic and with the participation of nurses working in two centers dedicated to patients with COVID-19, provide a two-factor structure in the Persian version of the short-form questionnaire.
This issue makes the Persian version of the short form of the Nurses' Job Stress Questionnaire somewhat different from the original version. However, after a study by Chen et al., Which emphasizes the existence of nine different stressors in assessing this questionnaire of nurses' professional lives, studies such as Xiang et al. [25] Used only a total score of nurses' job stress and did not re-examine its factor structure. However, both exploratory and confirmatory factor analysis processes performed in the present study emphasize the adequacy of this factor structure and its optimal fit with the data.
However, in explaining why this different factor structure is possible, one can rely on the special circumstances that governed the professional life of nurses after the COVID-19 epidemic. In other words, it is possible that the pandemic conditions of COVID-19, which according to various studies, have undergone unprecedented changes in the professional life stresses of nurses [24, 23, 21] in Iran, led to a new classification in the stressors of nurses' professional life. This new classification can be a reason for the two-factor structure of the short-form of the Nurses' Job Stress Questionnaire in the present study. Except for question number five, which has been removed from the Persian version due to simultaneous exposure to two factors, the other items related to this questionnaire are placed next to each other in a two-factor arrangement, the two main factors being "environmental-organizational stress" and "stress" related to the high volume of work.
In other words, it can be said that among Iranian nurses who have been nursing patients with COVID-19 in recent months and during the pandemic, the distinction between different sources of job stress has disappeared and led to the perception of this stress in the form of two general factors. However, based on the findings of the present study and the methods used to examine the internal consistency of the whole scale and its two subscales (calculation of Cronbach's alpha and McDonald omega) can be compared to the significant reliability of the Persian version of the short-form of Condensed Nurses'Occupational Stress Scale (NOSS). 



Condensed Nurses' Occupational Stress Scale has acceptable psychometric properties in Iranian society and can be useful in research related to nurses' occupational stress. 



All nurses working in Hazrat Ali Asghar (AS) and Shahid Chamran hospitals in Shiraz, especially Ms. Sharifi, an expert in the clinical education development unit of Shahid Chamran hospital, and Mr. Haghgoo, the educational supervisor of Hazrat Ali Asghar (AS) hospital, who patiently conducted this research are appreciated. We sincerely thank them for their help. It is noteworthy that this research project was carried out obtaining the code of ethics (IR.IAU.KAU.REC.1399.051) from the ethics committee in biomedical research of the Islamic Azad University, Kazerun Branch.


Conflicts of Interest

The authors declared no conflict of interest.

Type of Study: Original Research | Subject: Nursing
Received: 2021/02/2 | Accepted: 2021/04/22 | Published: 2021/09/21

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