Validity and reliability of the Sinhalese version of the perceived stress scale questionnaire among Sri Lankans

Balapuwaduge Isuru Layan Madusanka Mendis; Palihaderu Arachchige Dineth Supasan Palihaderu; Panduka Karunanayake; Dilan Amila Satharasinghe; Jayasekara Mudiyanselage Krishanthi Jayarukshi Kumari Premarathne; Wajjakkara Kankanamlage Ruwin Rangeeth Dias; Iyanthimala Harshini Rajapakse; Avanti Sulochana Hapugalle; Wanasinghe Ranhettige Sasanka Anjalee Karunaratne; Agulugaha Gamage Yohan Nipuna Binendra; Kelaniya Bandaralage Pubudu Pradeep Kumara; Galathura Samanabaddage Dasun Prabhashwara; Upul Senarath; Swee Keong Yeap; Wan Yong Ho; Arosha Sampath Dissanayake

doi:10.3389/fpsyg.2023.1152002

Validity and reliability of the Sinhalese version of the perceived stress scale questionnaire among Sri Lankans

Front Psychol. 2023 Jun 16:14:1152002. doi: 10.3389/fpsyg.2023.1152002. eCollection 2023.

Authors

Balapuwaduge Isuru Layan Madusanka Mendis¹, Palihaderu Arachchige Dineth Supasan Palihaderu¹, Panduka Karunanayake², Dilan Amila Satharasinghe¹, Jayasekara Mudiyanselage Krishanthi Jayarukshi Kumari Premarathne³, Wajjakkara Kankanamlage Ruwin Rangeeth Dias⁴, Iyanthimala Harshini Rajapakse⁵, Avanti Sulochana Hapugalle⁴, Wanasinghe Ranhettige Sasanka Anjalee Karunaratne⁴, Agulugaha Gamage Yohan Nipuna Binendra⁴, Kelaniya Bandaralage Pubudu Pradeep Kumara⁴, Galathura Samanabaddage Dasun Prabhashwara⁴, Upul Senarath⁶, Swee Keong Yeap⁷, Wan Yong Ho⁸, Arosha Sampath Dissanayake⁹

Affiliations

¹ Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya, Sri Lanka.
² Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
³ Department of Livestock and Avian Sciences, Faculty of Livestock, Fisheries and Nutrition, Wayamba University of Sri Lanka, Makandura, Gonawila, Sri Lanka.
⁴ Department of North Indian Music, Faculty of Music, University of the Visual and Performing Arts, Colombo, Sri Lanka.
⁵ Department of Psychiatry, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
⁶ Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
⁷ China-ASEAN College of Marine Sciences, Xiamen University Malaysia, Sepang, Selangor, Malaysia.
⁸ Division of Biomedical Sciences, Faculty of Science and Engineering, University of Nottingham Malaysia, Semenyih, Malaysia.
⁹ Department of Clinical Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.

Abstract

Introduction: Despite the availability of validated psychometrics tools to assess depression, there has not been any validated and reliable tool established to test perceived stress among Sri Lankans. The objective of this study is to test the validity and reliability of the Sinhalese Version of the Sheldon Cohen Perceived Stress Scale.

Materials and methods: Standard and systematic procedures were adopted to translate the original English version of the Perceived Stress Scale-10 questionnaire into Sinhalese. Consecutive sampling was employed to recruit the Type 2 Diabetes mellitus (T2DM) sample (n = 321), and a convenient sampling was used to recruit the Age and Sex matched Healthy Controls (ASMHC) (n = 101) and the Healthy Community Controls (HCC) groups (n = 75). Cronbach alpha was used to assess internal consistency and reliability was determined using test-retest method utilizing Spearman's correlation coefficient. Sensitivity was evaluated by comparing the mean scores of the Sinhalese Perceived Stress Scale (S-PSS-10) and Sinhalese Patient Health Questionnaire (S-PHQ-9) scores. Post-hoc comparisons were done using Bonferroni's method. Mean scores were compared between the T2DM, ASMHC, and HCC groups using the independent t-test. Explanatory Factor Analysis (EFA) was conducted using the principal component and Varimax rotation while the Confirmatory Factor Analysis (CFA) was performed to assess the goodness-of-fit of the factor structure extracted from the EFA. Concurrent validity was assessed using the Pearson correlation between the S-PSS-10 and Patient Health Questionnaire measured by S-PHQ-9 (p < 0.05).

Results: Cronbach alpha values of the three groups T2DM, ASMHC and HCC were 0.85, 0.81, and 0.79, respectively. Results of the ANOVA test suggested that there was a significant difference in the mean scores between groups (p < 0.00). EFA analysis revealed the existence of two factors with eigenvalues greater than 1.0. The factor loadings for the items ranged from 0.71-0.83. The CFA analysis demonstrated a good model fit for the two-factor model S-PSS-10. The S-PSS-10 significantly correlated with S-PHQ-9, indicating an acceptable concurrent validity.

Conclusion: Findings revealed that the S-PSS-10 questionnaire can be used to screen perceived stress among the majority of the Sri Lankan Sinhalese-speaking population specially with chronic illnesses. Further studies with higher sample sizes across different populations would enhance the validity and reliability of S-PSS-10.

Keywords: Sinhala; Sri Lanka; Type 2 Diabetes Mellitus; perceived stress; psychometric; validation.