Abstract
Purpose
This study aims to develop a scale to assess the stress of nurses caring for terminally
ill children and to test the validity and reliability of the scale.
Background
Nurses caring for children experience various stressors that are different from those
experienced by nurses caring for adult patients. It is important to understand the
level of stress of nurses caring for dying children and their families. Instruments
to measure these stress levels, however, are not available.
Design
This study used a methodological approach.
Method
The initial items were identified through literature reviews and in-depth interviews.
Content validation of the items was evaluated by seven experts. Participants were
357 pediatric nurses working at 11 institutions in six cities. Data were analyzed
using item analysis, exploratory and confirmatory factor analysis, internal consistency,
and test–retest. This study followed the STROBE checklist.
Findings
The final scale consisted of 22 items chosen and classified into 5 factors (psychological
difficulties, conflict with parents, difficulties in communication, lack of end-of-life
care knowledge, and restricted working environment), which explained 61.13% of the
total variance. The 5-subscale model was validated by confirmatory factor analysis.
Cronbach's alpha for the total item was 0.90, and the intra-class correlation coefficient
was 0.89.
Conclusion
This scale can be used to contribute toward the assessment of stress among nurses
performing end-of-life care for children.
Practice implications
This scale will contribute to the improvement of the quality of life of not only nurses,
but also children and their families in pediatric settings.
Keywords
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Article info
Publication history
Published online: June 16, 2020
Accepted:
May 11,
2020
Received in revised form:
May 11,
2020
Received:
November 1,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
