Development and Application of Global Health Events-Mental Stress Scale for Assessment of Medical Staff's Acute Mental Stress Responses

Xin-Ying Cai,1 Shao-Yan Zheng,2 Zhen-Su Lin,2 Su-Zhi Chen,2 Wei-Yi Zhu,2 Jia-Jia Huang,2 Ze-Li Zheng,2 Yu-Hua Zhou2 1Clinical Research Center, Shantou Central Hospital, Shantou City, People’s Republic of China; 2Nursing Department, Shantou Central Hospital, Shantou City, People’s Republic of ChinaCorrespondence: Yu-Hua Zhou, Nursing Department, Shantou Central Hospital, Wai-ma Road 114, Shantou City, People’s Republic of China, Tel +86 0754-88903584, Fax +86 0754-88548117, Email zhouyuhua1023@163.comBackground: Medical workers have been increasingly involved in emergent public health events, which can lead to severe stress. However, no standardized, officially recognized, unified tool exists for mental distress measurement in medical workers who experienced the public health events.Purpose: In the present study, we propose the Global Health Events-Mental Stress Scale (GHE-MSS), as a revised version of the Impact of Event Scale-Revision (IES-R), for assessment of medical workers’ acute mental stress responses within one month and their chronic mental stress responses within six months after major health events.Patients and methods: The IES-R was slightly modified, developed, and its reliability and validity were tested using the Delphi survey, primary survey with 115 participants, formal survey with 300 participants, and clinical evaluation with 566 participants.Results: Exploratory factor analysis and confirmatory factor analysis confirmed a promising validity of the scale. The values of Cronbach’s alpha coefficient, the Spearman-Brown coefficient, and the retested Cronbach’s alpha coefficient of the scale applied for the clinical evaluation were 0.88, 0.87, and 0.98, respectively, which confirmed a good internal consistency and stability. The results of the goodness-of-fit test indicated a good adaptation of the model. A correlation analysis was conducted to assess the correlation between the GHE-MSS and the PCL-C, which had a correlation coefficient of 0.68 (P< 0.01).Conclusion: GHE-MSS can be applied with a promising reliability and validity for the assessment of the acute mental stress response of medical workers experiencing public health events. This method can also be used for the screening of mental stress-associated disorders.Keywords: IES-R, global health events, mental stress scale, medical workers, mental disorders, mental stress responses