Skip to main content
Top
Published in: Journal of Occupational Medicine and Toxicology 1/2020

Open Access 01-12-2020 | Research

Development and psychometric testing of an observation-based assessment tool focusing on work-related stressors among health professionals: the STRAIN-External Observation of work Stressors

Authors: Karin A. Peter, Esther Stadelmann, Jos M. G. A. Schols, Ruud J. G. Halfens, Sabine Hahn

Published in: Journal of Occupational Medicine and Toxicology | Issue 1/2020

Login to get access

Abstract

Background

Health professionals are especially affected by various stressors in their daily work, such as a high workload, physical and emotional challenges. The aim of this study was to develop and test the validity, reliability and usability of an observation-based instrument designed to assess work stressors in the healthcare sector.

Methods

Using a cross sectional design, 110 health professionals were observed during one entire shift by an external observer. Factor analysis was used to test construct validity, Cronbach’s alpha to test internal consistency and correlations using Kendall’s Tau were computed to test for convergent validity.

Results

For 9 out of 10 tested scales the results showed a one-factor solution for all observation scales (explained variance ranged from 55.5 to 80.2%), satisfactory reliability (Cronbach’s alpha between .67 and .92), sufficient usability and satisfactory convergent validity.

Conclusions

The newly developed STRAIN-EOS, an observation-based assessment tool designed to assess stressors specifically in the healthcare sector, was shown to be potentially useful. However, further refinement and testing is necessary before it can be widely used.
Literature
1.
go back to reference Eurofound: Working conditions and workers’ health. Luxembourg: Publications Office of the European Union; 2019. Eurofound: Working conditions and workers’ health. Luxembourg: Publications Office of the European Union; 2019.
2.
go back to reference Lim J, Bogossian F, Ahern K. Stress and coping in Australian nurses: a systematic review. Int Nurs Rev. 2010;57(1):22–31.CrossRef Lim J, Bogossian F, Ahern K. Stress and coping in Australian nurses: a systematic review. Int Nurs Rev. 2010;57(1):22–31.CrossRef
3.
go back to reference Fuss I, Nubling M, Hasselhorn HM, Schwappach D, Rieger MA. Working conditions and work-family conflict in German hospital physicians: psychosocial and organisational predictors and consequences. BMC Public Health. 2008;8(1):353–70.CrossRef Fuss I, Nubling M, Hasselhorn HM, Schwappach D, Rieger MA. Working conditions and work-family conflict in German hospital physicians: psychosocial and organisational predictors and consequences. BMC Public Health. 2008;8(1):353–70.CrossRef
4.
go back to reference Hämmig O. Explaining burnout and the intention to leave the profession among health professionals - a cross-sectional study in a hospital setting in Switzerland. BMC Health Serv Res. 2018;18(1):785.CrossRef Hämmig O. Explaining burnout and the intention to leave the profession among health professionals - a cross-sectional study in a hospital setting in Switzerland. BMC Health Serv Res. 2018;18(1):785.CrossRef
5.
go back to reference Leka S, Jain A. Health impact of psychosocial hazards at work: an overview. Geneva: World Health Organization; 2010. Leka S, Jain A. Health impact of psychosocial hazards at work: an overview. Geneva: World Health Organization; 2010.
6.
go back to reference Long MH, Johnston V, Bogossian F. Work-related upper quadrant musculoskeletal disorders in midwives, nurses and physicians: a systematic review of risk factors and functional consequences. Appl Ergon. 2012;43(3):455–67.CrossRef Long MH, Johnston V, Bogossian F. Work-related upper quadrant musculoskeletal disorders in midwives, nurses and physicians: a systematic review of risk factors and functional consequences. Appl Ergon. 2012;43(3):455–67.CrossRef
7.
go back to reference Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. J Am Med Assoc. 2002;288(16):1987–93.CrossRef Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. J Am Med Assoc. 2002;288(16):1987–93.CrossRef
8.
9.
go back to reference Lee R, Seo B, Hladkyj S, Lovell BL, Schwartzmann L. Correlates of physician burnout across regions and specialties: a meta-analysis. Hum Resour Health. 2013;11(1):48.CrossRef Lee R, Seo B, Hladkyj S, Lovell BL, Schwartzmann L. Correlates of physician burnout across regions and specialties: a meta-analysis. Hum Resour Health. 2013;11(1):48.CrossRef
10.
go back to reference Semmer NK, Grebner S, Elfering A. Beyond self-report: Using observational, physiological, and situation-based measures in research on occupational stress. In: Perrewe PL, Ganster DC, editors. Research in Occupational Stress and Well Being. 3rd ed. Amsterdam: Emerald Group Publishing Limited; 2004. p. 205–63. Semmer NK, Grebner S, Elfering A. Beyond self-report: Using observational, physiological, and situation-based measures in research on occupational stress. In: Perrewe PL, Ganster DC, editors. Research in Occupational Stress and Well Being. 3rd ed. Amsterdam: Emerald Group Publishing Limited; 2004. p. 205–63.
11.
go back to reference Kompier M. Assessing the psychosocial work environment—“subjective” versus “objective” measurement. Scand J Work Environ Health. 2005;31(6):405–8.CrossRef Kompier M. Assessing the psychosocial work environment—“subjective” versus “objective” measurement. Scand J Work Environ Health. 2005;31(6):405–8.CrossRef
12.
go back to reference Connell P, Lee VB, Spector PE. Job stress assessment methods. In: Thomas JC, Hersen M, editors. Comprehensive handbook of psychological assessment: Industrial and organizational assessment; 2004. p. 455–69. Connell P, Lee VB, Spector PE. Job stress assessment methods. In: Thomas JC, Hersen M, editors. Comprehensive handbook of psychological assessment: Industrial and organizational assessment; 2004. p. 455–69.
13.
go back to reference Corradini I, Marano A, Nardelli E. Work-related stress risk assessment: a methodological analysis based on psychometric principles of an objective tool. SAGE Open. 2016;6(3):1–9.CrossRef Corradini I, Marano A, Nardelli E. Work-related stress risk assessment: a methodological analysis based on psychometric principles of an objective tool. SAGE Open. 2016;6(3):1–9.CrossRef
14.
go back to reference Frese M, Zapf D. Methodological issues in the study of work stress: Objective vs. subjective measurement of work stress and the question of longitudinal studies. In: Cooper CL, Payne R, editors. Causes, coping and consequences of stress at work. Chichester: Wiley; 1988. p. 375–411. Frese M, Zapf D. Methodological issues in the study of work stress: Objective vs. subjective measurement of work stress and the question of longitudinal studies. In: Cooper CL, Payne R, editors. Causes, coping and consequences of stress at work. Chichester: Wiley; 1988. p. 375–411.
15.
go back to reference Foster P. Observational Research. In: Sapsford R, Jupp V, editors. Data Collection and Analysis. Volume 2. London: SAGE; 2006. p. 57–92. Foster P. Observational Research. In: Sapsford R, Jupp V, editors. Data Collection and Analysis. Volume 2. London: SAGE; 2006. p. 57–92.
16.
go back to reference Monahan T, Fisher JA. Benefits of “observer effects”: lessons from the field. Qual Res. 2010;10(3):357–76.CrossRef Monahan T, Fisher JA. Benefits of “observer effects”: lessons from the field. Qual Res. 2010;10(3):357–76.CrossRef
17.
go back to reference Hull L, Arora S, Kassab E, Kneebone R, Sevdalis N. Assessment of stress and teamwork in the operating room: an exploratory study. Am J Surg. 2011;201(1):24–30.CrossRef Hull L, Arora S, Kassab E, Kneebone R, Sevdalis N. Assessment of stress and teamwork in the operating room: an exploratory study. Am J Surg. 2011;201(1):24–30.CrossRef
18.
go back to reference Syed I, Daly T, Armstrong P, Lowndes R, Chadoin M, Naidoo V. How do work hierarchies and strict divisions of labour impact care workers’ experiences of health and safety? Case studies of long term care in Toronto. J Nurs Home Res. 2016;2(1):41–9. Syed I, Daly T, Armstrong P, Lowndes R, Chadoin M, Naidoo V. How do work hierarchies and strict divisions of labour impact care workers’ experiences of health and safety? Case studies of long term care in Toronto. J Nurs Home Res. 2016;2(1):41–9.
19.
go back to reference Stab N, Hacker W, Weigl M. Work organization in hospital wards and nurses’ emotional exhaustion: a multi-method study of observation-based assessment and nurses’ self-reports. Int J Nurs Stud. 2016;61:52–62.CrossRef Stab N, Hacker W, Weigl M. Work organization in hospital wards and nurses’ emotional exhaustion: a multi-method study of observation-based assessment and nurses’ self-reports. Int J Nurs Stud. 2016;61:52–62.CrossRef
20.
go back to reference Wheelock A, Suliman A, Wharton R, Babu ED, Hull L, Vincent C, Sevdalis N, Arora S. The impact of operating room distractions on stress, workload, and teamwork. Ann Surg. 2015;261(6):1079–84.CrossRef Wheelock A, Suliman A, Wharton R, Babu ED, Hull L, Vincent C, Sevdalis N, Arora S. The impact of operating room distractions on stress, workload, and teamwork. Ann Surg. 2015;261(6):1079–84.CrossRef
21.
go back to reference Büssing A, Glaser J. Das Tätigkeits-und Arbeitsanalyseverfahren für das Krankenhaus-Selbstbeobachtungsversion (TAA-KH-S): Hogrefe; 2002. Büssing A, Glaser J. Das Tätigkeits-und Arbeitsanalyseverfahren für das Krankenhaus-Selbstbeobachtungsversion (TAA-KH-S): Hogrefe; 2002.
22.
go back to reference Weigl M, Muller A, Zupanc A, Angerer P. Participant observation of time allocation, direct patient contact and simultaneous activities in hospital physicians. BMC Health Serv Res. 2009;9(1):110.CrossRef Weigl M, Muller A, Zupanc A, Angerer P. Participant observation of time allocation, direct patient contact and simultaneous activities in hospital physicians. BMC Health Serv Res. 2009;9(1):110.CrossRef
23.
go back to reference Golz C, Peter KA, Hahn S. Cognitive pretesting and pretest of the STRAIN questionnaire to elaborate work-related stress of health care staff in Switzerland. Int J Health Professions. 2018;5(1):109–20.CrossRef Golz C, Peter KA, Hahn S. Cognitive pretesting and pretest of the STRAIN questionnaire to elaborate work-related stress of health care staff in Switzerland. Int J Health Professions. 2018;5(1):109–20.CrossRef
24.
go back to reference Peter KA, Schols JMGA, Halfens RJG, Hahn S. Investigating work-related stress among health professionals at different hierarchical levels: a cross-sectional study. Nurs Open. 2020;00:1–11. Peter KA, Schols JMGA, Halfens RJG, Hahn S. Investigating work-related stress among health professionals at different hierarchical levels: a cross-sectional study. Nurs Open. 2020;00:1–11.
25.
go back to reference Spector PE, Dwyer DJ, Jex SM. Relation of job stressors to affective, health, and performance outcomes: a comparison of multiple data sources. J Appl Psychol. 1988;73(1):11–9.CrossRef Spector PE, Dwyer DJ, Jex SM. Relation of job stressors to affective, health, and performance outcomes: a comparison of multiple data sources. J Appl Psychol. 1988;73(1):11–9.CrossRef
26.
go back to reference Kristensen TS. A new tool for assessing psychosocial factors at work: the Copenhagen psychosocial questionnaire. Copenhagen: National Institute of Health; 2000. Kristensen TS. A new tool for assessing psychosocial factors at work: the Copenhagen psychosocial questionnaire. Copenhagen: National Institute of Health; 2000.
27.
go back to reference Nübling M, Stössel U, Hasselhorn HM, Michaelis M, Hofmann F. Measuring psychological stress and strain at work: evaluation of the COPSOQ questionnaire in Germany. GMS Psycho-Social-Medicine. 2006;3:1–14. Nübling M, Stössel U, Hasselhorn HM, Michaelis M, Hofmann F. Measuring psychological stress and strain at work: evaluation of the COPSOQ questionnaire in Germany. GMS Psycho-Social-Medicine. 2006;3:1–14.
28.
go back to reference Nübling M, Vomstein M, Nolle I, Lindner A, Haug A, Lincke HJ. Deutsche Standard-Version des COPSOQ 2017. Freiburg: FFAW-Freiburger Forschungsstelle für Arbeitswissenschaften GmbH; 2017. Nübling M, Vomstein M, Nolle I, Lindner A, Haug A, Lincke HJ. Deutsche Standard-Version des COPSOQ 2017. Freiburg: FFAW-Freiburger Forschungsstelle für Arbeitswissenschaften GmbH; 2017.
29.
go back to reference Nübling M, Stößel U, Hasselhorn HM, Michaelis M, Hofmann F. Methoden zur Erfassung psychischer Belastungen: Erprobung eines Messinstruments (COPSOQ). Dortmund: Bundesanstalt für Arbeitsschutz und Arbeitsmedizin; 2005. Nübling M, Stößel U, Hasselhorn HM, Michaelis M, Hofmann F. Methoden zur Erfassung psychischer Belastungen: Erprobung eines Messinstruments (COPSOQ). Dortmund: Bundesanstalt für Arbeitsschutz und Arbeitsmedizin; 2005.
30.
go back to reference Eurofound. Sixth European Working Conditions Survey - Questionnaire. Luxembourg: Publications Office of the European Union; 2015. Eurofound. Sixth European Working Conditions Survey - Questionnaire. Luxembourg: Publications Office of the European Union; 2015.
31.
go back to reference Parent-Thirion A, Fernández Macías E, Hurley J, Vermeylen G. Fourth European working conditions survey. Luxembourg: European Foundation for the Improvement of Living and Working Conditions; 2007. Parent-Thirion A, Fernández Macías E, Hurley J, Vermeylen G. Fourth European working conditions survey. Luxembourg: European Foundation for the Improvement of Living and Working Conditions; 2007.
32.
go back to reference LEP-AG. Methode zur Dokumentation und Auswertung von Leistungen im Gesundheitswesen. St. Gallen: LEP AG; 2017. LEP-AG. Methode zur Dokumentation und Auswertung von Leistungen im Gesundheitswesen. St. Gallen: LEP AG; 2017.
33.
go back to reference Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420–8.CrossRef Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420–8.CrossRef
34.
go back to reference Peter KA, Hahn S, Stadelmann E, Halfens R, Schols J. Assessing work stressors in the health care sector by combining external observation and health professionals’ self-report in a cross-sectional study design. Occup Med Health Affairs. 2020;8(1):303–9. Peter KA, Hahn S, Stadelmann E, Halfens R, Schols J. Assessing work stressors in the health care sector by combining external observation and health professionals’ self-report in a cross-sectional study design. Occup Med Health Affairs. 2020;8(1):303–9.
Metadata
Title
Development and psychometric testing of an observation-based assessment tool focusing on work-related stressors among health professionals: the STRAIN-External Observation of work Stressors
Authors
Karin A. Peter
Esther Stadelmann
Jos M. G. A. Schols
Ruud J. G. Halfens
Sabine Hahn
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Journal of Occupational Medicine and Toxicology / Issue 1/2020
Electronic ISSN: 1745-6673
DOI
https://doi.org/10.1186/s12995-020-00275-y

Other articles of this Issue 1/2020

Journal of Occupational Medicine and Toxicology 1/2020 Go to the issue