Academic journal article Journal of Nursing Measurement

Support for the Reliability and Validity of a Six-Item State Anxiety Scale Derived from the State-Trait Anxiety Inventory

Academic journal article Journal of Nursing Measurement

Support for the Reliability and Validity of a Six-Item State Anxiety Scale Derived from the State-Trait Anxiety Inventory

Article excerpt

Identifying the most efficient and theoretically appropriate methods to assess patient anxiety in fast-paced medical environments may be beneficial for clinical purposes as well as for research. The purpose of this study was to examine the reliability and validity of two previously published six-item versions of the State form of the State-Trait Anxiety Inventory (STAI) and to identify the version that would be most appropriate to use with a sample of parents who had infants with normal or abnormal newborn screens. In the current study, confirmatory factor analyses were conducted to evaluate the fit of the two six-item forms with STAI data collected at three time points from 288 parents of 150 infants. Study groups of parents were based upon infant newborn screens and subsequent diagnostic testing to include cystic fibrosis (CF; n = 26), congenital hypothyroidism (CH; n = 39), CF Carriers (CF-C; n = 45), and healthy infants (H; n = 40). The results showed the version containing items 1, 3, 6, 15, 16, and 17 of the State form of the STAI to be a better fitting model across all three time points, and it had better internal consistency than the version containing items 5, 9, 10, 12, 17, and 20. Both short forms were highly correlated with the 20-item STAI score, and all internal consistency reliabilities were greater than .90. It was concluded that the version containing items 1, 3, 6, 15, 16, and 17 of the State Anxiety scale was a reliable and valid instrument for this study sample.

Keywords: measurement; psychometric properties; validity; reliability; state anxiety; State-Trait Anxiety Inventory

A plethora of health-related research identifies anxiety as an important construct in the study of the human experience of health and illness. The State-Trait Anxiety Inventory (STAI; Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983; STAI Web site, 2007) is one of the most widely used subjective measures of anxiety in health research. It contains two 20-item self-report scales designed to measure how much worry, tension, or apprehension the subject experiences in his or her present circumstances (state anxiety) and how much anxiety represents a personality characteristic (trait anxiety). Items emphasize the frequency of particular symptoms (ranging from 1 = not at all to 4 = very much so). Although the STAI is a useful instrument, the fast-paced health care environment at times may preclude study participants from completing a 20-item scale, especially when the instrument is combined with other assessments. Furthermore, any steps that decrease the burden of research for potential participants may have a favorable impact upon sample size and therefore the quality of the findings. An example of a potentially high anxiety situation with limited time for completing paper and pencil assessments is during outpatient appointments for which parents bring their newborns in need of diagnostic testing following abnormal newborn screens. During these brief health encounters, potentially worried parents are bombarded with complicated information about their infant's health. Therefore, the purpose of this study was to evaluate the psychometric properties of a shorter six-item version of the State form of the STAI for future use in our research assessing the relationship between parental anxiety and cognitive understanding of infant medical test results.

BACKGROUND AND CONCEPTUAL FRAMEWORK

The STAI (Spielberger et al., 1983) was based upon the theoretical conception of anxiety as having two facets. The State scale was designed to measure the transient state of arousal subjectively experienced as anxiety while the Trait scale was developed to assess the more enduring characteristic presence of this emotion. Items in each scale were based upon a 2-factor model of anxiety present or anxiety absent. This instrument has excellent psychometric properties. The median alpha reliability coefficients for the State and Trait scales (Form Y) are . …

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