Assessing Perceived Stress in Medical Personnel: In Search of an Appropriate Scale for the Bengali Population

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Byline: Amrita. Chakraborti, Prasenjit. Ray, Debasish. Sanyal, Rajarshi. Thakurta, Amit. Bhattacharayya, Asim. Mallick, Ranjan. Das, Syed. Ali

Background: The occurrence of stress and stress related anxiety and depression in medical personnel are being increasingly reported in literature. The perceived stress scale (PSS) is the most widely used psychological instrument for measuring the perception of stress. It is needed to assess perceived stress in our population using appropriately translated version of PSS. The objectives of study were to prepare a Bengali version of PSS-10 and to establish its psychometric properties in the study population. Materials and Methods: The study was conducted in a teaching hospital among medical students and interns ( N=37). The translated Bengali version and the original English version of PSS-10 were separately handed over to the individual subjects. The scores were compared across different subgroups and psychometric properties of the translated version were assessed using SPSS 16. Results: Internal consistency of PSS English (a=0.79) and Bengali (a=0.80) was satisfactory. Intra-rater reliability was adequate (?>0.5) for most of the items, but showed an inadequate value (?<0.5) for four items on the scale. After deleting these four items from the Bengali version, a new six-item PSS in Bengali was derived that showed good internal consistency (a=0.699). Conclusion: This new version needs to be validated in a larger study population. Perceived stress score using PSS-10 was considerably high in our study population, although there was no significant difference between the subgroups (male/female, intern/student).


The concept of stress has been around for centuries, but only recently has it been systematically conceptualized and has become a subject of research, indicating its reciprocal relation with body physiology. The relevance of psychological stress in research leads to the need for valid and reliable instruments to measure it. The perceived stress scale (PSS) is one of the most widely used psychological instrument for measuring the perception of stress. [sup][1] It is a measure of the degree to which situations in one's life are appraised as stressful. Items were designed to tap how unpredictable, uncontrollable, and overloaded respondents find their lives. [sup][1]

The occurrence of stress and stress-related anxiety and depression in medical students, trainees, and qualified physicians are being increasingly reported in literature. Stress is not only a risk factor for several chronic diseases including hypertension, diabetes, and coronary artery disease and precipitates several mental ailments, the impact on stress in the medical work environment affects healthcare delivery as well. [sup][2] The ability to measure stress reliably would be useful to further characterize the link between stress and health. More importantly, it would help evaluate interventions that may decrease stress levels. To the best of our knowledge, no study has been conducted so far using PSS in a Bengali-speaking population, neither has its validity and reliability been tested in this language.

A number of studies [sup][3],[4],[5] in recent years focused on the incidence of stress and stress-related illnesses such as anxiety and depression among students, trainees, and qualified physicians. Indeed, some research indicate the unique academic challenges of medical studies, rigor of the educational program, and emotionally tense experiences, such as dealing with illness, disease, and dying that make medical students more vulnerable to stress and anxiety than students of other disciplines. [sup][2],[6]

A study conducted in UAE among medical students, trainees, and university faculties using a questionnaire based on Cohen's Perceived Stress Scale (English), showed that 65% of the students perceived stress (PS) levels too high. Relationship between stress scores and students' opinions regarding whether stress perceived was too high or not was significant. …


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