1544 - "SUFFERING FROM CARING": PSYCHOMETRIC PROPERTIES OF THE SECONDARY TRAUMATIC STRESS SCALE AMONG HONG KONG NURSES CARING FOR TRAUMA-EXPOSED PATIENTS

Session: D02S007 - Measurement Theory and Modeling 2
AUTHORS:
Yeung Nelson (The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong ~ Hong Kong ~ Hong Kong) , Tam Victor (The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong ~ Hong Kong ~ Hong Kong) , Pan Lihua (The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong ~ Hong Kong ~ Hong Kong) , Lau Stephanie (The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong ~ Hong Kong ~ Hong Kong) , Yang Jessie (The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong ~ Hong Kong ~ Hong Kong) , Wong Eliza (The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong ~ Hong Kong ~ Hong Kong) , Vujanovic Anka (Texas A&M University ~ College Station ~ United States of America) , Hung Kevin (The Accident and Emergency Medicine Unit, The Chinese University of Hong Kong ~ Hong Kong ~ Hong Kong) , Tang So-Kum Catherine (Department of Counseling and Psychology, Hong Kong Shue Yan University ~ Hong Kong ~ Hong Kong)
Abstract text:
Introduction. Caring for trauma-exposed patients could trigger secondary traumatic stress(STS) symptoms(behaviors/emotions when indirectly exposed to others' traumas) among frontline nurses. The addition of indirect trauma exposure into the definition of DSM-5 PTSD criterion A event further highlighted the importance of measuring STS among trauma-prone helping professionals. Despite the high prevalence and negative health impacts of STS found in Western nurses, the development/validation of measures for STS among Asian nurses are still limited.


Purpose. The psychometric properties of the Secondary Traumatic Stress Scale(STSS) and its factor structures were examined among Hong Kong nurses.


Methods. Nurses(N=689, 85% female) caring for trauma-exposed patients in hospitals/community settings(e.g., accidents, terminal illnesses, mental health problems) during the past year were recruited through Hong Kong nursing associations between December 2024-September 2025. They completed online surveys measuring their sociodemographic characteristics, secondary traumatic stress, and other psychosocial variables.

Results. Confirmatory factor analysis showed the 7-factor hybrid model(including intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, dysphoric arousal) provided an excellent fit(χ2(149)=515.24, CFI=0.94, TLI=0.93, RMSEA=0.06). Compared to other DSM-5-based models with 4-6 factors, the 7-factor model also demonstrated the best fit. The correlations among the 7 factors were in medium-to-high effect-sizes(rs from .41 to .69, ps<.001). Regarding construct validity, the total score on STSS was associated with lower work dedication, colleague support, and life satisfaction(rs from -.35 to -.27, ps<.001), plus higher perceived stress, depression/anxiety, work interference, and insomnia symptoms(rs from .23 to .52, ps<.001). Test-retest reliability of the STSS at 2-week follow-up(n=193) was satisfactory(r=.77, p<.001).


Conclusions. This study validated the STSS among Hong Kong nurses exposed to patients' traumas, demonstrating satisfactory psychometric properties and interpretable factor structure based on the revised DSM-5 criteria. As STS is increasingly common among healthcare workers, our findings supported the future use of the scale to quantify STS symptoms in clinical settings/mental health interventions.