Development and validation of an instrument to measure stress among older adult nursing students: The Student Nurse Stressor-15 (SNS-15) Scale

Abstract

Aims and objectives: To report the development, testing and validation of an instrument to assess the stressors experienced by student nurses during their older adult clinical placements.

Background: The world's population of older adults is accelerating rapidly, with associated increased healthcare demands and a growing need for skilled nursing staff. However, this sector fails to attract adequate numbers of nursing graduates which is leading to a significant gap between nursing supply and demand. Older adult care is considered to be less attractive than other specialties and accompanied by more sources of stress.

Design: A quantitative design was used.

Methods: Data were collected from a cohort of Irish student nurses (n = 242) completing older adult clinical placements as part of their undergraduate degree. Exploratory and confirmatory factor analysis examined the instrument's underlying latent structure. Discriminant validity was investigated using a confirmatory factor analysis model with covariates. STROBE guidelines for cross-sectional studies informed reporting of this paper's research.

Results: Factor analyses identified two factors relating to "Knowledge and Workload" and "Resources," which were assessed by nine and six items, respectively. Discriminant validity analyses found a significant relationship between age and the workload and knowledge factor, and between year of programme and the resources factor. The new instrument was labelled the Student Nurse Stressor-15 (SNS-15) Scale.

Conclusions: The SNS-15 contained some overlap with stressors from extant general student nurse stress instruments and a number of unique stressors encountered in older adult care. Future research directions are discussed.

Relevance to clinical practice: The SNS-15 may assist stakeholders in nurse education and practice with the development of undergraduate degree programmes and clinical placements, and ultimately, in improving patient care and student retention.

Keywords: clinical placements; older adults; stress; stressors; student nurses.