Psychometric evaluation of the Hemodialysis Stressor Scale.

This report updates the psychometric information available on the Hemodialysis Stressor Scale. The tool is a 29-item scale that rates the incidence and severity of stressors associated with hemodialysis treatment of end-stage renal disease. Six items are classified as physiologic stressors and 23 as psychosocial stressors. Alpha homogeneity coefficients achieved acceptable standards for reliability. Content validity is demonstrated by the varied sources used to ascertain pertinent items for the scale. Construct validity of the scale was investigated by factor analysis (N = 174). A two-factor solution to evaluate the validity of the physiological-psychosocial dichotomy showed insufficient support for this simplistic dichotomous classification of hemodialysis stressors. A subsequent unrestricted factor solution to explore the multidimensionality of the scale yielded eight factors, but only three were significant, so a three-factor solution was subjected to rotation. The content of the 6 physiological and 9 psychosocial items loading significantly on Factor I characterized this factor as psychobiological; Factor II consisted of 12 psychological and social stressors; Factor III pertained to 8 dependency and restriction stressors. The three-factor solution was seen as the best-fitting solution with this particular data set because it was conceptually clear, informative, and parsimonious.