The Development and Exploratory Psychometric Properties of the Traumatic and Routine Stressors Scale on Emergency Nurses (TRSS-EN)

Abstract

Emergency nurses are exposed to traumatic events and routine stressors, both of which can lead to the development of PTSD (Post Traumatic Stress Disorder) symptomatology. However, there are currently no instruments designed to assess the impact and frequency of such sources of stress in nurses. The Traumatic and Routine Stressors Scale on Emergency Nurses (TRSS-EN) was built for this purpose. A sample of 147 emergency nurses from three hospitals in Madrid (Spain) completed this 13-item scale. The analyses showed a factorial structure composed of two factors. The first is characterized by items regarding traumatic and stressful events and procedures of severe magnitude (traumatic stressors), and the second by items related to stressful events and procedures of moderate magnitude (routine stressors) but hypothesized to possess a substantial traumatic potential. Analyses provided evidence of both adequate internal consistency (Cronbach’s α = 0.92; first factor α = 0.91 and second factor α = 0.86) and test–retest reliability. In addition, concurrent validity also proved to be satisfactory. In short, TRSS-EN seems to be a reliable and valid tool in a healthcare emergency nursing setting for screening the frequency and impact of exposure to everyday work-related traumatic stressors, either event-related or routine.

Frequency of Exposure to Traumatic Events and Routine Stressors, Coping Strategies and PTSD Symptoms on Emergency Nurses

“…Each factor (traumatic stressors and routine stressors) has 3 indexes (impact, frequency and total impact), in total six indexes. The scale has high internal consistency (Cronbach's Alpha = 0.92), adequate test-retest reliability and satisfactory concurrent validity [26].…”

“…The Traumatic and Routine Stressors Scale on Emergency Nurses (TRSS-EN) [26], is a 13-item measure that was used to simultaneously assess frequency (frequency of expo-sure) and severity (emotional impact) to common traumatic events and routine stressors associated with trauma in the daily work of emergency nurses during the previous six months. Frequency of exposure is indicated on a 7-point Likert scale, where 1 is "fewer than three times in six months" and 7 is "every day" (Frequency scale), and emotional impact of the stressful event is indicated using a second 7-point Likert scale, where 1 is "without emotional impact" and 7 is "maximum emotional impact" (Impact scale).…”

The Nursing Stress Scale-Spanish Version: An Update to Its Psychometric Properties and Validation of a Short-form Version in Acute Care Hospital Settings

“…There are instruments that measure the same concept of “stress”, such as the Depression Anxiety Stress Scales (DASS) [ 18 ], General Health Questionnaire (GHQ) [ 19 ], Perceived Stress Scale (PSS) [ 20 ], Karasek Job Content Questionnaire (JCQ) [ 21 ], Occupational Stress in Remote Area Nursing: Development of the Remote Area Nursing Stress Scale (RANSS) [ 22 ], or Traumatic and Routine Stressors Scale on Emergency Nurses (TRSS-EN) [ 23 ]. However, they have certain limitations: some of them are not designed for the work context (e.g., DASS, GHQ) and others, although they assess the work environment, are not specifically adapted to the healthcare environment, such as the PSS and JCQ questionnaires.…”