The Difficult Patient Stress Scale: a new instrument to measure interpersonal stress in nursing

This study describes the development of the Difficult Patient Stress Scale, an instrument designed to investigate the stress that nurses experience when they are involved in interpersonal conflict with patients. The DPSS is based on the theoretical conceptualization of stress proposed by DeLongis, Lazarus and Folkman and on the personality theory of Individual Psychology. The DPSS utilises visual analog scales to measure nurses' responses to hypothetical scenarios that present typical, difficult nurse-patient situations. The DPSS has been tested over a period of two years with 228 nurses and the results to date indicate that it is valid, reliable and suitable for use in the clinical environment. It is proposed that it may provide a useful instrument for exploring the impact and frequency of interpersonal stressors in nursing and may assist in the development of educational programs to better equip nurses to deal with interpersonal nurse-patient conflict.