Validation of the Chinese version of the perceived medical school stress (PMSS) scale and analysis of the associated factors

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Abstract

Background

In recent decades, mental health and stress among medical students have become a global concern. Currently, China lacks a scale specifically designed to assess stress levels in medical school settings. This study aims to cross-culturally translate and adapt the Perceived Medical School Stress (PMSS) Scale into Chinese, evaluate its psychometric properties in medical schools, and analyze the associated factors of medical students’ stress levels.

Methods

Data collection for the Chinese version of the PMSS was conducted from October to November 2023, among medical students from selected medical schools in North and East China. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the underlying factor structure. Content validity was assessed using the Content Validity Index (CVI). Criterion validity was evaluated with the Chinese version of the Perceived Stress Scale (PSS). Internal consistency was assessed by calculating Cronbach’s alpha coefficient, McDonald’s Omega coefficient, and test-retest reliability. Additionally, relationships between medical school stress and general demographic characteristics, insomnia severity, and self-efficacy were examined.

Results

The final Chinese version of the PMSS supports a two-factor structure with 13 items, defined as “psychological stress and environment” and “resilience and expectations.” The scale’s Content Validity Index (CVI) was 0.980, with a criterion validity of 0.767. The Cronbach’s alpha coefficient was 0.911, McDonald’s Omega coefficient was 0.914, and the test-retest reliability was 0.794. Medical school stress levels showed significant differences based on gender and educational background ( P < 0.05). Stress levels were positively correlated with insomnia severity and negatively correlated with self-efficacy.

Conclusions

The Chinese version of the PMSS is a reliable and valid tool for assessing stress levels among medical students in Chinese medical schools. Female students and those pursuing graduate degrees report higher levels of medical stress. Insomnia severity and self-efficacy significantly influence stress levels among medical students.

Related collections

Most cited references 52

Record: found
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Article: not found

A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research.

Terry Koo, Mae Li (2016)

Intraclass correlation coefficient (ICC) is a widely used reliability index in test-retest, intrarater, and interrater reliability analyses. This article introduces the basic concept of ICC in the content of reliability analysis.

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Record: found
Abstract: found
Article: not found

Validation of the Insomnia Severity Index as an outcome measure for insomnia research.

C. Bastien (2001)

Background: Insomnia is a prevalent health complaint that is often difficult to evaluate reliably. There is an important need for brief and valid assessment tools to assist practitioners in the clinical evaluation of insomnia complaints.Objective: This paper reports on the clinical validation of the Insomnia Severity Index (ISI) as a brief screening measure of insomnia and as an outcome measure in treatment research. The psychometric properties (internal consistency, concurrent validity, factor structure) of the ISI were evaluated in two samples of insomnia patients.Methods: The first study examined the internal consistency and concurrent validity of the ISI in 145 patients evaluated for insomnia at a sleep disorders clinic. Data from the ISI were compared to those of a sleep diary measure. In the second study, the concurrent validity of the ISI was evaluated in a sample of 78 older patients who participated in a randomized-controlled trial of behavioral and pharmacological therapies for insomnia. Change scores on the ISI over time were compared with those obtained from sleep diaries and polysomnography. Comparisons were also made between ISI scores obtained from patients, significant others, and clinicians.Results: The results of Study 1 showed that the ISI has adequate internal consistency and is a reliable self-report measure to evaluate perceived sleep difficulties. The results from Study 2 also indicated that the ISI is a valid and sensitive measure to detect changes in perceived sleep difficulties with treatment. In addition, there is a close convergence between scores obtained from the ISI patient's version and those from the clinician's and significant other's versions.Conclusions: The present findings indicate that the ISI is a reliable and valid instrument to quantify perceived insomnia severity. The ISI is likely to be a clinically useful tool as a screening device or as an outcome measure in insomnia treatment research.

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The content validity index: are you sure you know what's being reported? Critique and recommendations.

Denise F Polit, Cheryl Tatano Beck (2006)

Scale developers often provide evidence of content validity by computing a content validity index (CVI), using ratings of item relevance by content experts. We analyzed how nurse researchers have defined and calculated the CVI, and found considerable consistency for item-level CVIs (I-CVIs). However, there are two alternative, but unacknowledged, methods of computing the scale-level index (S-CVI). One method requires universal agreement among experts, but a less conservative method averages the item-level CVIs. Using backward inference with a purposive sample of scale development studies, we found that both methods are being used by nurse researchers, although it was not always possible to infer the calculation method. The two approaches can lead to different values, making it risky to draw conclusions about content validity. Scale developers should indicate which method was used to provide readers with interpretable content validity information. (c) 2006 Wiley Periodicals, Inc.

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Author and article information

Contributors

Chunguang Liang: amilyliang@163.com

Journal

Journal ID (nlm-ta): BMC Psychol

Journal ID (iso-abbrev): BMC Psychol

Title: BMC Psychology

Publisher: BioMed Central (London )

ISSN (Electronic): 2050-7283

Publication date (Electronic): 13 March 2025

Publication date PMC-release: 13 March 2025

Publication date Collection: 2025

Volume: 13

Electronic Location Identifier: 249

Affiliations

[1 ]School of Nursing, Jinzhou Medical University, ( https://ror.org/02yd1yr68) No 40, Section 3, Songpo Road, Jinzhou, 121001 China

[2 ]Department of Life and Health, Huzhou College, ( https://ror.org/055jk5a41) Huzhou, 313000 Zhejiang China

Article

Publisher ID: 2604

DOI: 10.1186/s40359-025-02604-4

PMC ID: 11908014

PubMed ID: 40082937

SO-VID: 3b9c6b9c-ca1f-42e6-b451-801ebb2b6328

License:

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

History

Date received : 28 August 2024

Date accepted : 11 March 2025

Custom metadata

Keywords: chinese medical student,perceived stress,reliability,validity,insomnia,self-efficacy

Data availability:

Keywords: chinese medical student, perceived stress, reliability, validity, insomnia, self-efficacy