Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
BMJ Open. 2023 Nov 30;13(11):e076372. doi: 10.1136/bmjopen-2023-076372.
The 10-item Perceived Stress Scale (PSS-10) is a widely used measure of perceived stress that has been validated in various populations, yet with inconsistent results on its factor structure. The present study examines the reliability and validity of the PSS-10 in a population not previously examined: Chinese family caregivers of persons with schizophrenia, with a focus on factor analysis.
A sample of 449 family caregivers of persons with schizophrenia was recruited for psychometric testing of the scale. The factor structure of PSS-10 was tested by randomly dividing the sample into two groups for both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The scale was further tested for internal consistency, test-retest reliability, convergent validity, discriminant validity and concurrent validity.
EFA extracted two factors: perceived helplessness with six negative phrasing items and perceived efficacy with four positive phrasing items. CFA confirmed the structure of two factors with satisfactory model fit indices. Convergent validity was supported by high standard regression weight (0.78-0.92), average variance extracted (AVE=0.79-0.81) and composite reliability (0.88-0.94), while discriminant validity was confirmed by higher AVE estimates than the squared interconstruct correlations. The PSS-10 showed good internal consistency and test-retest reliability, with Cronbach's alpha of 0.79 and intraclass correlation coefficient of 0.91, respectively. Concurrent validity was demonstrated by its significant positive correlations with stigma, depression and anxiety, as well as significant negative correlations with social support, family functioning and positive caregiving experiences.
The two-factor PSS-10 has good psychometric characteristics assessing the perceived stress of family caregivers of people with schizophrenia. The findings indicate that the PSS-10 can be used to measure perceived stress in future research and practice among caregivers of people with schizophrenia, and potentially, other caregiving samples.
10 项感知压力量表（PSS-10）是一种广泛使用的感知压力测量工具，已在各种人群中得到验证，但在其因子结构方面的结果不一致。本研究在以前未研究过的人群中，即中国精神分裂症患者家属中，检验了 PSS-10 的信度和效度，重点是因子分析。
招募了 449 名精神分裂症患者家属作为量表的心理测量学测试样本。通过将样本随机分为两组，分别进行探索性因子分析（EFA）和验证性因子分析（CFA），检验 PSS-10 的因子结构。进一步对量表进行内部一致性、重测信度、聚合效度、区别效度和同时效度检验。
EFA 提取出两个因子：包含 6 个消极表述项目的感知无助感和包含 4 个积极表述项目的感知效能感。CFA 验证了具有满意模型拟合指数的两个因子结构。高标准回归权重（0.78-0.92）、平均方差提取值（AVE=0.79-0.81）和综合可靠性（0.88-0.94）支持聚合效度，而区别效度通过高于交叉构念相关的 AVE 估计得到确认。PSS-10 具有良好的内部一致性和重测信度，Cronbach's alpha 为 0.79，组内相关系数为 0.91。与耻辱感、抑郁和焦虑呈显著正相关，与社会支持、家庭功能和积极的照顾体验呈显著负相关，表明具有同时效度。
两因素 PSS-10 具有良好的心理计量学特征，可评估精神分裂症患者家属的感知压力。研究结果表明，PSS-10 可用于未来精神分裂症患者家属的研究和实践中测量感知压力，也可能用于其他照顾者样本。
