Development and psychometric testing of an observation-based assessment tool focusing on work-related stressors among health professionals: the STRAIN-External Observation of work Stressors

Karin A. Peter*, Esther Stadelmann, Jos M. G. A. Schols, Ruud J. G. Halfens, Sabine Hahn

*Corresponding author for this work

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Background Health professionals are especially affected by various stressors in their daily work, such as a high workload, physical and emotional challenges. The aim of this study was to develop and test the validity, reliability and usability of an observation-based instrument designed to assess work stressors in the healthcare sector. Methods Using a cross sectional design, 110 health professionals were observed during one entire shift by an external observer. Factor analysis was used to test construct validity, Cronbach's alpha to test internal consistency and correlations using Kendall's Tau were computed to test for convergent validity. Results For 9 out of 10 tested scales the results showed a one-factor solution for all observation scales (explained variance ranged from 55.5 to 80.2%), satisfactory reliability (Cronbach's alpha between .67 and .92), sufficient usability and satisfactory convergent validity. Conclusions The newly developed STRAIN-EOS, an observation-based assessment tool designed to assess stressors specifically in the healthcare sector, was shown to be potentially useful. However, further refinement and testing is necessary before it can be widely used.

Original languageEnglish
Article number27
Number of pages13
JournalJournal of Occupational Medicine and Toxicology
Issue number1
Publication statusPublished - 26 Aug 2020


  • Work stressors
  • Observation
  • Health professionals
  • Healthcare sector
  • Observation-based assessment

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