Development of an Instrument to Measure Stress in Korean Nurses Performing End-of-Life Care for Children.

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.