Development and Validation of the Japanese Version of a Job Stressor Scale for Triage Nurses in Emergency Departments

Abstract

Background: With an increasing number of patients who visit emergency outpatient units, a shortage of physicians and nurses in emergency units has become an issue in Japan. Triage nurses who interview patients and their families before medical examinations feel stressed to determine the triage level in a limited time, necessitating the measures to alleviate stressors. Objective: To develop a triage nurse job stressor scale (TNJSS) for Japanese triage nurses in emergency outpatient units and to verify the reliability and validity of this scale. Methods: Anonymous, self-administered questionnaires were sent to nursing directors of 180 emergency and critical care centers randomly selected from 251 centers throughout Japan, requesting to distribute the questionnaire to nurses. Results: Based on the responses obtained from 363 nurses, the construct validity, internal consistency, and criterion-related validity were verified. A factor analysis of 44 items yielded five factors: “Lack of triage ability”, “Busy triage work”, “Patients without understanding of explanations”, “Complaints from patients waiting for treatment”, and “Lack of support to improve triage ability”. Cronbach’s α was 0.93 for the full scale and significant correlations were observed between the nurses’ stressor scores and scores for the Stress Response Scale-18 (r = 0.409; p r = 0.410; p < 0.01). Conclusions: The TNJSS with a five-factor structure containing 44 items was determined to be a reliable and valid tool for evaluating Japanese triage nurse job stressors. The findings suggest the necessity to continuously educate and support triage nurses.