Ford Daniel M, Lawton Rebecca, Travis Elizabeth, Teale Elizabeth A, O'Connor Daryl B
School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK.
Health Psychol Behav Med. 2024 Aug 28;12(1):2396135. doi: 10.1080/21642850.2024.2396135. eCollection 2024.
Hospitalisation can be a traumatic experience, where inpatients are exposed to an abundance of physical and psychological stressors. Evidence suggests that these hospital-related stressors negatively impact health: a phenomenon known as post-hospital syndrome. The current study aimed to identify hospital-related stressors, and to develop and provide initial validation for a new measure of in-hospital stress.
Measure development occurred in three stages: (i) semi-structured interviews, (ii) item generation, and (iii) pilot testing. Twenty-one patients were interviewed regarding their recent hospital experiences, and a list of hospital-related stressors was produced. These stressors were compiled into a questionnaire and piloted on 200 recent inpatients to provide initial evidence of internal consistency and construct validity.
Stressors identified from the interviews captured all relevant questions from three previous hospital stress measures, plus 12 more. The most reported stressor was 'poor sleep'. These hospital-related stressors were developed into 67 questions, forming the Hospital Stress Questionnaire (HSQ). The HSQ showed excellent internal consistency and construct validity, and correlated with feelings of vulnerability and being unprepared to go home.
The HSQ is a promising self-report tool for measuring in-hospital stress. Future research ought to investigate its psychometric properties further in larger and more diverse samples. The measure has potential to be used to monitor patient risk of post-hospital syndrome.
住院可能是一段痛苦的经历，住院患者会面临大量身体和心理压力源。有证据表明，这些与医院相关的压力源会对健康产生负面影响：这一现象被称为出院后综合征。本研究旨在识别与医院相关的压力源，并开发一种新的住院压力测量方法并进行初步验证。
测量方法的开发分三个阶段进行：（i）半结构化访谈，（ii）项目生成，以及（iii）试点测试。对21名患者就其近期住院经历进行了访谈，并列出了一份与医院相关的压力源清单。这些压力源被编制成一份问卷，并在200名近期住院患者中进行了试点测试，以提供内部一致性和结构效度的初步证据。
从访谈中识别出的压力源涵盖了之前三种医院压力测量方法中的所有相关问题，另外还有12个问题。报告最多的压力源是“睡眠不佳”。这些与医院相关的压力源被编制成67个问题，形成了医院压力问卷（HSQ）。HSQ显示出了出色的内部一致性和结构效度，并且与易受伤害感以及对回家毫无准备的感觉相关。
HSQ是一种很有前景的用于测量住院压力的自我报告工具。未来的研究应该在更大、更多样化的样本中进一步研究其心理测量特性。该测量方法有可能用于监测患者出院后综合征的风险。
