An Arabic version of the Perceived Stress Scale: Translation and validation study

Abstract

Background

The Perceived Stress Scale has been designed to measure the degree to which situations in a person's life are perceived as stressful.

Objective

The paper describes the development of an Arabic version of the Perceived Stress Scale.

Design

A translation process with cross-cultural considerations was employed to produce an Arabic version of the Perceived Stress Scale.

Settings

Participants were asked to complete the Arabic version Perceived Stress Scale twice in their homes.

Participants

The Jordanian study population for the Arabic version Perceived Stress Scale validation consisted of 126 volunteers (74 male, 52 female). Ninety participants completed the scale twice (55 male, 35 female), of whom 58 were high schools teachers and 32 technical workers. Arabic was the first language of all participants and all gave informed consent.

Results

The Arabic version Perceived Stress Scale reliability and validity were evaluated. Prior to an exploratory factor analysis, the suitability of data for factor analysis was assessed with acceptable results. The exploratory factor analysis showed two factors with eigenvalues greater than 1.0 (45.0% of variance). The Cronbach's alpha coefficients were 0.74 (Factor 1), 0.77 (Factor 2) and 0.80 for the Arabic version Perceived Stress Scale overall. The test–retest reliability had an intra-correlation coefficient of 0.90.

Conclusions

The Arabic version Perceived Stress Scale showed an adequate reliability and validity. Therefore, the Arabic Perceived Stress Scale is considered a suitable instrument to assess perceived stress in Arabic people.

Introduction

Stress may be considered a stimulus, a response or an interaction process between the individual and his environment (Brantley and Thomason, 1995). Lazarus (1999) and Lazarus and Folkman (1984) take the latter view that psychological stress is a dynamic interaction between the individual and his environment, and they proposed that stress is neither an environmental stimulus nor a psychological response, but rather a relationship between environmental demands and the ability to deal with them. Thus, stress is seen as a transaction between individual and environment. In other words, the environment provides the initial stimulus, but the key determinants of stress are the way the individual perceives the environment and his ability to cope with the stress. Based on this transactional definition of stress, Cohen et al. (1983) designed the Perceived Stress Scale (PSS) and later Levenstein et al. (1993) published the Perceived Stress Questionnaire (PSQ), which are self-reported measures of the degree to which situations in an individual's life are perceived as stressful. Both the PSS and PSQ have been translated into many languages and applied in different settings. Due to the length of the PSQ (30 items), we chose the shorter PSS (14 items) to be translated and validated. PSS items were designed to assess the degree to which individuals found their life unpredictable, uncontrollable, and overloaded. These issues have been repeatedly found to be central components of the experience of stress (Cohen et al., 1983). The PSS has been applied in a variety of studies including those linking stress to psychological or physiological disorders and depression symptoms (Chang, 1998); detecting the stress level of schizophrenia caregivers (Dyck et al., 1999); assessing the stress level of HIV-infected patients (Cruess et al., 1999); correlation between stress and increased susceptibility to respiratory diseases (Cohen et al., 1993); and also to the anti-inflammatory response (Song et al., 1999).

The PSS assesses the level of perceived stress experienced over the previous month, and has three versions: the PSS-14 (Appendix B), PSS-10 and PSS-4 with 14 and 10 and 4 items respectively. The PSS-14 has seven positive and seven negative items. The tool has demonstrated good reliability coefficients with Cronbach's alpha ranging from 0.75 to 0.91 (Cohen et al., 1983, Cohen and Williamson, 1988, Cole, 1999). The PSS has been translated into several languages including Spanish (Remor, 2006), Swedish (Eskin and Parr, 1996), Chinese (Lee and Crockett, 1994), and Japanese (Mimura and Griffiths, 2008). Thus, its application has particular value in cross-cultural studies, since it has been used in a wide range of cultures. While there has been one validation study of an Arabic version of the PSS-10 (Chaaya et al., 2010), there is no evaluated Arabic version of the PSS-14. This paper reports the development of a translated Arabic version of the PSS-14 together with testing for reliability and validity.