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      Three versions of Perceived Stress Scale: validation in a sample of Chinese cardiac patients who smoke

      1 , 2 , , 1

      BMC Public Health

      BioMed Central

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          Abstract

          Background

          Smoking causes heart disease, the major cause of death in China and Hong Kong. Stress is one major trigger of smoking and relapse, and understanding stress among smoking cardiac patients can therefore help in designing effective interventions to motivate them to quit. The objective of this study was to examine the psychometric properties of the Perceived Stress Scale (PSS), and to compare the appropriateness of the three versions of the scale (PSS-14, PSS-10, and PSS-4) among Chinese cardiac patients who were also smokers.

          Methods

          From March 2002 to December 2004, 1860 cardiac patients who smoked were recruited at the cardiac outpatient clinics of ten acute hospitals in Hong Kong, and 1800 questionnaires were analysed. Participants completed a questionnaire including the PSS, nicotine dependence and certain demographic variables. The psychometric properties of the PSS were investigated: construct validity using confirmatory factor analysis, reliability using Cronbach's alpha and concurrent validity by examining the relationship with smoking- and health-related variables.

          Results

          For all the three versions of the PSS, confirmatory factor analyses corroborated the 2-factor structure of the scale, with the positive and negative factors correlating significantly and negatively to a moderate extent ( r < -0.5), and high Cronbach's alpha values for the two subscales (alpha > 0.5). All the correlations of the two subscales and the smoking- and health-related variables were statistically significant and in the expected directions although of small magnitudes, except daily cigarette consumption.

          Conclusions

          The findings confirmed the satisfactory psychometric properties of all three Chinese versions of PSS. We recommend the use of PSS-10 for research which focuses on the two components of perceived stress, as it shows a higher reliability; and the use of PSS-4 if such partition is not essential and space for multiple measures is limited.

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          Most cited references 27

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          Uses and abuses of coefficient alpha.

           Neal Schmitt (1996)
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            Psychometric properties of a European Spanish version of the Perceived Stress Scale (PSS).

             Eduardo Remor (2006)
            This paper presents evidence from a heterogeneous sample of 440 Spanish adults, for the reliability and validity of a European Spanish version of the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The European Spanish version PSS (14-item) demonstrated adequate reliability (internal consistency, alpha = .81, and test-retest, r = .73), validity (concurrent), and sensitivity. Additional data indicate adequate reliability (alpha = .82, test-retest, r = .77), validity, and sensitivity of a 10-item short version of the PSS.
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              Relationships between perceived stress and health behaviors in a sample of working adults.

               Eric Jeffery,  D. Ng (2003)
              The study examined associations between perceived stress and fat intake, exercise, alcohol consumption, and smoking behaviors. Data were from surveys of 12,110 individuals in 26 worksites participating in the SUCCESS project (D. J. Hennrikus, R. W. Jeffery, & H. A. Lando, 1995), a study of smoking cessation interventions. Linear regression analyses examined cross-sectional associations between stress level and health behaviors. Analyses were stratified by gender and controlled for demographics. High stress for both men and women was associated with a higher fat diet, less frequent exercise, cigarette smoking, recent increases in smoking, less self-efficacy to quit smoking, and less self-efficacy to not smoke when stressed. Stress was not associated with alcohol intake. Findings suggest that the association between stress and disease may be moderated in part by unhealthy behaviors.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2010
                25 August 2010
                : 10
                : 513
                Affiliations
                [1 ]School of Nursing, The University of Hong Kong, LKS Faculty of Medicine Building, Pokfulam, Hong Kong
                [2 ]Department of Community Medicine, School of Public Health, The University of Hong Kong, LKS Faculty of Medicine Building, Pokfulam, Hong Kong
                Article
                1471-2458-10-513
                10.1186/1471-2458-10-513
                2939644
                20735860
                Copyright ©2010 Leung et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Research Article

                Public health

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