Objective: To develop a bilingual questionnaire (Basque-Spanish) to measure nursing students' stressors in clinical practice.
Methods: Ideas were gathered from nursing students in group discussions. Initially, 287 nursing students from the School of Nursing in San Sebastián (Spain) completed the State-Trait Anxiety Inventory (STAI) and the 55-item version of our questionnaire. After analyzing the items, we selected 41 items for the final version. Some of the subjects completed this final version two (198 = 198) and six months (n = 211) later.
Results: The questionnaire presented high internal consistency (Cronbach's alpha: 0.95), considerable reliability (Spearman's correlation: 0.72 at two months and 0.68 at six months), and acceptable concurrent validity (Spearman's correlation with anxiety: 0.39). Factor analysis produced nine factors, with high internal consistency, which explained 64.4% of the variance. Based on these factors, the main stressors for nursing students in the workplace were produced by lack of competence (11.2%), contact with suffering (9.1%), relationships with tutors, workmates and classmates (8.9%), uncertainty and impotence (7.7%), lack of control in relationships with patients (7.6%), emotional involvement (5.8%), relationships with patients [being harmed by the relationship (5.2%) and patients seeking a close relationship (4.6%)], and overwork (4.3%). Methodological and practice aspects of the questionnaire are discussed, as well as its utility in planning the training of future nurses.
Conclusion: The KEZKAK questionnaire is a useful instrument for measuring nursing students' stressors in clinical practice.