Cross-cultural adaptation and psychometric refinement of the Thai Work-Related Stress Questionnaire (T-WRSQ) for registered nurses

Abstract

Background & Aim: Work-related stress can adversely affect nurses’ well-being, workforce stability, and quality of care. However, a culturally appropriate and psychometrically validated instrument for assessing psychosocial work-related stress among Thai nurses is needed. This study aimed to translate, culturally adapt, and psychometrically refine the Work-Related Stress Questionnaire (WRSQ) for Thai registered nurses.

Methods & Materials: This two-phase methodological study translated and culturally adapted the WRSQ following international guidelines. The instrument was evaluated by five experts and pilot-tested with 30 nurses. Psychometric evaluation was conducted among 276 registered nurses from Ministry of Public Health hospitals, randomly allocated to exploratory and confirmatory samples. Exploratory factor analysis (EFA) examined factor structure and item performance, followed by confirmatory factor analysis (CFA) of competing models. Convergent validity, discriminant validity, and internal consistency were assessed.

Results: The Thai WRSQ demonstrated excellent content validity (I-CVI and S-CVI/Ave = 1.00). EFA initially identified four factors broadly corresponding to the original WRSQ; however, the Job Demand domain lacked structural coherence. A revised 10-item, three-factor model excluding this domain showed the best CFA fit (χ²/df=1.66, CFI = 0.96, TLI= 0.94, RMSEA= 0.07, SRMR= 0.05). The retained domains demonstrated satisfactory convergent validity (CR= 0.79–0.85; AVE= 0.56-0.66), discriminant validity (AVE>MSV; HTMT= 0.09–0.79), and internal consistency (overall α = 0.82; ω = 0.85).

Conclusions: The revised 10-item Thai WRSQ is a valid and reliable instrument for assessing psychosocial work-related stress among Thai registered nurses.