Developing the modified 4-item version of perceived stress scale for functional dyspepsia

Area of Science:

• Psychometrics
• Gastroenterology
• Mental Health

Background:

• Functional dyspepsia (FD) is a common gastrointestinal disorder often associated with psychological distress.
• Existing measures of psychological stress, such as the 4-item Perceived Stress Scale (PSS-4), may lack optimal reliability and validity in FD populations.
• There is a need for a refined tool to accurately assess psychological stress and its impact on FD patients' well-being.

Purpose of the Study:

• To develop and validate a modified 4-item Perceived Stress Scale (PSS-4) for use in patients with functional dyspepsia (FD).
• To compare the reliability and validity of the modified PSS-4 against the original PSS-4.
• To explore the correlations between psychological stress, dyspepsia symptom severity (DSS), anxiety, depression, somatization, and quality of life (QoL) in FD patients.

Main Methods:

• A cohort of 389 FD patients meeting Roman IV criteria participated in the study.
• The 10-item Perceived Stress Scale (PSS-10) was administered, and 4 items were selected using psychometric methods (Cronbach's coefficient, EFA, item analysis) to create the modified PSS-4.
• Reliability and validity were assessed using internal consistency, EFA, and CFA. Correlations were analyzed using Pearson's correlation and multiple linear regression.

Main Results:

• The modified PSS-4 exhibited higher Cronbach's alpha (0.855) than the PSS-4 (0.848), indicating improved internal consistency.
• Exploratory and confirmatory factor analyses supported a well-fitting single-factor model for the modified PSS-4.
• Psychological stress, as measured by the modified PSS-4, was significantly correlated with DSS, anxiety, depression, somatization, and QoL, with a stronger association observed for somatization and QoL compared to the PSS-4.

Conclusions:

• The modified PSS-4 demonstrates superior reliability and validity for assessing psychological stress in FD patients compared to the original PSS-4.
• Psychological stress, particularly as measured by the modified PSS-4, significantly impacts somatization and quality of life in individuals with FD.
• The modified PSS-4 is a promising tool for clinical application and further research in the management of functional dyspepsia.