title: Index of sources of stress in nursing students: a confirmatory factor  analysis.
abstract: OBJECTIVE
  This paper is a report of a study to test the proposed factor structure of the Index of Sources of Stress in Nursing Students.
  
  
  BACKGROUND
  Research across many countries has identified a number of sources of distress in nursing students but little attempt has been made to understand and measure sources of eustress or those stressors likely to enhance performance and well-being. The Index of Sources of Stress in Nursing Students was developed to do this. Exploratory factor analysis suggested a three-factor structure, the factors being labelled: learning and teaching; placement-related and course organization. It is important, however, to subject the instrument to confirmatory factor analysis as a further test of construct validity.
  
  
  METHODS
  A convenience sample of final year nursing students (n = 176) was surveyed in one university in Northern Ireland in 2007. The Index of Sources of Stress in Nursing Students, which measures sources of stress likely to contribute to distress and eustress, was completed electronically. The LISREL programme was used to carry out the confirmatory factor analysis and test the factor structure suggested in the exploratory analysis.
  
  
  RESULTS
  The proposed factor structure for the items measuring 'Uplifts' proved to be a good fit to the data and the proposed factor structure for the items measuring 'Hassles' showed adequate fit.
  
  
  CONCLUSIONS
  In nursing programmes adopting the academic model and combining university-based learning with placement experience, this instrument can be used to help identify the sources of stress or course demands that students rate as distressing and those that help them to achieve. The validity of the ISSN could be further evaluated in other education settings.
authors.affiliation: School of Nursing, Queen's University Belfast, UK. c.gibbons@qub.ac.uk
authors.forename: Chris
authors.initials: C
authors.lastname: Gibbons
authors.forename: Martin
authors.initials: M
authors.lastname: Dempster
authors.forename: Marianne
authors.initials: M
authors.lastname: Moutray
mesh_terms: D004506:Education, Nursing; D005163:Factor Analysis, Statistical; D006801:Humans; D009660:Northern Ireland; D011594:Psychometrics; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000209:etiology*; D013338:Students, Nursing / Q000523:psychology*