Measuring Positive Stress Appraisal Among Nursing Students: Development and Psychometric Evaluation of the Nursing Student Positive Stress Scale (NSPSS)
- 1The University of Waikato
Abstract
BackgroundStress research in nursing education has largely focused on distress, stressors, and negative outcomes, although challenging experiences may also support motivation, confidence, learning, and growth when appraised positively.
ObjectiveTo develop and evaluate the psychometric properties of the Nursing Student Positive Stress Scale (NSPSS).
DesignA methodological instrument development and psychometric evaluation study.
MethodsThe NSPSS was developed using a deductive, theory-driven approach informed by the transactional theory of stress and coping and positive psychology perspectives. Content validity was assessed by an international nursing expert panel. Psychometric evaluation used national survey data from nursing students in New Zealand. Of 539 responses, 507 were analysed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted using separate subsamples. Internal consistency was assessed using Cronbachs alpha and McDonalds omega, and convergent validity through correlation with Perceived Stress Scale-10 scores.
ResultsContent validity was strong (I-CVI = .88-1.00; S-CVI/Ave = .975; S-CVI/UA = .800). EFA identified a dominant factor explaining 41.38% of variance (loadings = .528-.735). CFA supported a two-context Academic and Clinical Positive Stress model with correlated residuals between five parallel item pairs, {chi}{superscript 2}(29) = 60.49, CFI = .970, TLI = .954, RMSEA = .063, SRMR = .065. Internal consistency was good ( = .839; {omega} = .843). NSPSS scores correlated negatively with PSS-10 scores (r = -.298, p < .001).
ConclusionThe NSPSS demonstrated strong content validity, preliminary evidence of structural and convergent validity, and good internal consistency reliability for assessing positive stress appraisal among nursing students. Further validation in independent samples is warranted.
Impact statementThe NSPSS provides a theory-driven measure of positive stress appraisal across academic and clinical nursing education contexts, enabling more comprehensive investigation of how nursing students respond adaptively to stress.
Plain language statementStress is common in nursing education and is often studied in terms of its negative effects. However, stressful experiences may also be viewed positively and contribute to motivation, confidence, learning, and personal growth. Few measures have been designed to capture this positive side of stress among nursing students.
We developed the Nursing Student Positive Stress Scale (NSPSS) to measure how nursing students positively appraise stressful experiences in both academic and clinical learning settings. The scale was informed by established stress theory and positive psychology. An international panel of nursing experts first reviewed the scale. It was then tested using responses from nursing students participating in a national survey in New Zealand.
The findings showed that the NSPSS performed well overall. The results supported related academic and clinical aspects of positive stress appraisal, and the scale showed good consistency across its items. Students who reported greater positive stress appraisal also tended to report lower levels of perceived stress.
The NSPSS provides a new way to examine positive responses to stress alongside existing measures that focus mainly on distress. It may help researchers and nursing educators develop a more balanced understanding of how students respond to challenging academic and clinical experiences. Further testing with nursing students in other settings is needed.
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BibTeX
@misc{yan2026measuring,
title = {{Measuring Positive Stress Appraisal Among Nursing Students: Development and Psychometric Evaluation of the Nursing Student Positive Stress Scale (NSPSS)}},
author = {H. Yan and A. J. O'Brien and S. H. Yoon and V. Shaw and k. vakavosaki},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.30.26361779},
url = {https://www.medrxiv.org/content/10.64898/2026.08.30.26361779v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Measuring Positive Stress Appraisal Among Nursing Students: Development and Psychometric Evaluation of the Nursing Student Positive Stress Scale (NSPSS)
AU - H. Yan
AU - A. J. O'Brien
AU - S. H. Yoon
AU - V. Shaw
AU - k. vakavosaki
PY - 2026
DA - 2026/08/30
PB - medRxiv
DO - 10.64898/2026.08.30.26361779
UR - https://www.medrxiv.org/content/10.64898/2026.08.30.26361779v1
AB - BackgroundStress research in nursing education has largely focused on distress, stressors, and negative outcomes, although challenging experiences may also support motivation, confidence, learning, and growth when appraised positively. ObjectiveTo develop and evaluate the psychometric properties of the Nursing Student Positive Stress Scale (NSPSS). DesignA methodological instrument development and psychometric evaluation study. MethodsThe NSPSS was developed using a deductive, theory-driven approach informed by the transactional theory of stress and coping and positive psychology perspectives. Content validity was assessed by an international nursing expert panel. Psychometric evaluation used national survey data from nursing students in New Zealand. Of 539 responses, 507 were analysed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted using separate subsamples. Internal consistency was assessed using Cronbachs alpha and McDonalds omega, and convergent validity through correlation with Perceived Stress Scale-10 scores. ResultsContent validity was strong (I-CVI = .88-1.00; S-CVI/Ave = .975; S-CVI/UA = .800). EFA identified a dominant factor explaining 41.38% of variance (loadings = .528-.735). CFA supported a two-context Academic and Clinical Positive Stress model with correlated residuals between five parallel item pairs, {chi}{superscript 2}(29) = 60.49, CFI = .970, TLI = .954, RMSEA = .063, SRMR = .065. Internal consistency was good ( = .839; {omega} = .843). NSPSS scores correlated negatively with PSS-10 scores (r = -.298, p < .001). ConclusionThe NSPSS demonstrated strong content validity, preliminary evidence of structural and convergent validity, and good internal consistency reliability for assessing positive stress appraisal among nursing students. Further validation in independent samples is warranted. Impact statementThe NSPSS provides a theory-driven measure of positive stress appraisal across academic and clinical nursing education contexts, enabling more comprehensive investigation of how nursing students respond adaptively to stress. Plain language statementStress is common in nursing education and is often studied in terms of its negative effects. However, stressful experiences may also be viewed positively and contribute to motivation, confidence, learning, and personal growth. Few measures have been designed to capture this positive side of stress among nursing students. We developed the Nursing Student Positive Stress Scale (NSPSS) to measure how nursing students positively appraise stressful experiences in both academic and clinical learning settings. The scale was informed by established stress theory and positive psychology. An international panel of nursing experts first reviewed the scale. It was then tested using responses from nursing students participating in a national survey in New Zealand. The findings showed that the NSPSS performed well overall. The results supported related academic and clinical aspects of positive stress appraisal, and the scale showed good consistency across its items. Students who reported greater positive stress appraisal also tended to report lower levels of perceived stress. The NSPSS provides a new way to examine positive responses to stress alongside existing measures that focus mainly on distress. It may help researchers and nursing educators develop a more balanced understanding of how students respond to challenging academic and clinical experiences. Further testing with nursing students in other settings is needed.
ER -