Psychometric determination of job stress in health occupations

The primary purpose of this study was to develop an instrument to measure stress in health occupations. The effects of job stress on productivity, health insurance utilization, workers' compensation claims, and turnover cost organizations billions of dollars annually. Given that health occupations are subject to high levels of stress and that the workforce is experiencing labor shortages, healthcare organizations are especially interested in human resource development programs that deal with identifying, acknowledging, and managing occupational stress. Development of the instrument was accomplished by an extensive review of related literature, feedback from subject matter experts using the Delphi technique, pilot testing of a proposed instrument, and field-testing the instrument on a national sample. A 14-member Delphi panel examined a list of 117 stressors from a review of literature. The panel reached a consensus on 3 8 items that formed the pilot version of the scale. The pilot scale was administered to 181 RNs, 10 pharmacists, and 25 radiologic technologists working at a hospital in Chattanooga, Tennessee. Based on a factor analysis, the scale was administered to 2,000 RNs, 500 pharmacists, and 500 radiologic technologists employed by subsidiary hospitals of HCA, Inc., an international healthcare organization. The subsequent factor analysis resulted in the Health Occupations Stress Scale consisting of 18 items and 4 subscales.