Development and validation of the Healthcare Worker Stress Scale-Vietnamese: a culturally grounded instrument to assess work-related stress

초록

BackgroundReliable measurement of occupational stress is essential for designing effective interventions for healthcare workers; however, Vietnam currently lacks culturally validated assessment tools.ObjectivesTo develop and validate the Healthcare Worker Stress Scale - Vietnam (HWSS-V), a profession-inclusive, culturally grounded instrument that extends the Health Professions Stress Inventory (HPSI) and the Nursing Stress Scale (NSS) by adding Vietnam-salient domains and crisis-monitoring utility.MethodsWe conducted a cross-sectional survey of 520 physicians, nurses, and medical technicians at two university hospitals (June-December 2021). Fifty items adapted from HPSI/NSS underwent forward - backward translation and expert review. Psychometric evaluation included item-level content validity index (I-CVI), scale-level content validity index (S-CVI), exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability testing (Cronbach's alpha).ResultsAll fifty items showed strong content validity (I-CVI >= 0.80; kappa 0.67-0.97; S-CVI = 0.90). EFA supported a five-factor structure. After removing six low-loading items, forty-four items explained 87.1% of variance with excellent reliability (overall Cronbach's alpha = 0.96; subscales 0.85-0.95). CFA indicated acceptable fit (Root Mean Square Error of Approximation = 0.077; Standardized Root Mean Squared Residual = 0.060; Tucker - Lewis Index = 0.827; Comparative Fit Index = 0.816).ConclusionsHWSS-V enables practical hospital-level stress surveillance and quality improvement. Hospitals can: (i) embed HWSS-V into biannual staff health checks to benchmark units and triage high-risk groups; (ii) integrate scores into dashboards to trigger tailored responses; and (iii) deploy rapid assessments during crises (e.g. outbreaks, patient surges) to guide resource allocation. By addressing culturally specific stressors across major clinical professions, HWSS-V provides actionable capabilities beyond HPSI/NSS for Vietnam's hospitals.

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