Is clinical experience associated with lower perceived resuscitation stress in emergency nurses? Psychometric validation of the Chinese Perceived Stress during Resuscitation Scale and comparison of novice, intermediate, and expert practitioners.

Authors

Haixia Zhao, Yiming Lu, Xuan Qiao, Chun Wang, Xinwei Zhang, Yujia Liu, Yue Ma, Chuang Li, Yang Zheng, Yanyan Lu

Published in

BMC nursing. Jul 11, 2026. Epub Jul 11, 2026.

Abstract

Resuscitation imposes substantial psychological stress on emergency nurses, potentially impairing clinical performance and patient outcomes. Whether cumulative clinical experience is associated with lower perceived resuscitation stress remains empirically unresolved, and no validated Chinese instrument exists to measure resuscitation-specific perceived stress. This study aimed to translate the Perceived Stress during Resuscitation Scale (PSDRS) into Chinese, psychometrically evaluate its properties, and test its known-groups validity by comparing scores across novice, intermediate, and expert emergency nurses.
A multicenter cross-sectional study was conducted across seven tertiary hospitals in Liaoning Province, China, from June 2025 to February 2026. Following the Brislin translation model, the original PSDRS was translated, back-translated, and culturally adapted through expert panel review and pilot testing. A convenience sample of 434 emergency nurses completed the Chinese PSDRS. Participants were stratified by clinical experience: novice (< 2 years, n = 52), intermediate (2-10 years, n = 202), and expert (≥ 10 years, n = 180). Psychometric evaluation included content validity (S-CVI), construct validity via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) on randomly split subsamples, internal consistency reliability (Cronbach's α), test-retest reliability (ICC), and known-groups validity tested through one-way ANOVA.
The Chinese PSDRS demonstrated robust psychometric properties. Content validity was excellent (S-CVI = 0.926). A randomly split subsample for EFA (n = 210) extracted a seven-factor structure explaining 75.17% of total variance. CFA on the validation subsample (n = 224) confirmed satisfactory model fit (χ²/df = 1.295, RMSEA = 0.036, CFI = 0.958, TLI = 0.951). Internal consistency was satisfactory (Cronbach's α = 0.815) and test-retest reliability was acceptable (ICC = 0.774). Known-groups validity was supported, with expert nurses reporting lower PSDRS scores (M = 2.31, SD = 0.42) than intermediate (M = 2.48, SD = 0.45) and novice nurses (M = 2.67, SD = 0.49; F = 24.36, P < 0.001, η²=0.102). Post-hoc analyses confirmed all pairwise comparisons were statistically significant (all P < 0.01).
The Chinese PSDRS is a reliable and valid instrument. A significant dose-response gradient was observed, with greater clinical experience associated with lower perceived resuscitation stress. This pattern is consistent with theoretical perspectives such as the stress-inoculation hypothesis and professional development frameworks; however, these mechanisms were not directly tested, and causal inferences cannot be drawn given the cross-sectional design. This tool can facilitate early identification of at-risk novice nurses and inform experience-tailored stress management interventions.
Not applicable.

PMID:
42436553
Bibliographic data and abstract were imported from PubMed on 12 Jul 2026.

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