Assessing stress in disability: developing and piloting the Disability Related Stress Scale.

BACKGROUND: Stress negatively influences health, but few scales capture unique stressors encountered by people with physical disability.

OBJECTIVE/HYPOTHESIS: Conduct a pilot study to develop and evaluate the factor structure of a stress measure targeting unique stressors facing people with physical limitations due to impaired movement of the upper and lower extremities.

METHODS: Development of the Disability Related Stress Scale (DRSS) included: (1) obtaining input regarding content and items from focus groups and outside experts and (2) piloting the instrument. Participants recruited from an independent living center attended a focus group or completed the pilot survey. The piloted measure was a 107 item two-part survey. Part 1 assessed stressors encountered over the past week and Part 2 assessed stressors encountered over the past six months. Participants included a convenience sample of 143 adults who experienced a physical limitation; 26 attended focus groups and 117 completed the instrument. Respondents were predominantly women (60%), Caucasian (58%), and unemployed (92%). Respondents were 50.51 ± 14.46 years old and had lived with their disability for 15.64 ± 13.04 years.

RESULTS: Exploratory factor analyses revealed a 4-factor solution for Part 1 and a 2-factor solution for Part 2 of the DRSS. Estimates of internal consistency (Part 1 Cronbach's α = .78-84; Part 2 Cronbach's α = .72) and factor loadings (.40-1.00 for Part 1; .43-.87 for Part 2) indicate adequate reliability for all subscales.

CONCLUSIONS: Preliminary results provide initial support for the instrument's reliability and factor structure although further validation studies are warranted.