Validation of the Chinese version of the perceived medical school stress (PMSS) scale and analysis of the associated factors

Abstract Background In recent decades, mental health and stress among medical students have become a global concern. Currently, China lacks a scale specifically designed to assess stress levels in medical school settings. This study aims to cross-culturally translate and adapt the Perceived Medical...

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Main Authors: Chunyan Zhang, Chunguang Liang, Fan Zhang, Qian Zhang, Kaiyan Xu
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Psychology
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Online Access:https://doi.org/10.1186/s40359-025-02604-4
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author Chunyan Zhang
Chunguang Liang
Fan Zhang
Qian Zhang
Kaiyan Xu
author_facet Chunyan Zhang
Chunguang Liang
Fan Zhang
Qian Zhang
Kaiyan Xu
author_sort Chunyan Zhang
collection DOAJ
description Abstract Background In recent decades, mental health and stress among medical students have become a global concern. Currently, China lacks a scale specifically designed to assess stress levels in medical school settings. This study aims to cross-culturally translate and adapt the Perceived Medical School Stress (PMSS) Scale into Chinese, evaluate its psychometric properties in medical schools, and analyze the associated factors of medical students’ stress levels. Methods Data collection for the Chinese version of the PMSS was conducted from October to November 2023, among medical students from selected medical schools in North and East China. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the underlying factor structure. Content validity was assessed using the Content Validity Index (CVI). Criterion validity was evaluated with the Chinese version of the Perceived Stress Scale (PSS). Internal consistency was assessed by calculating Cronbach’s alpha coefficient, McDonald’s Omega coefficient, and test-retest reliability. Additionally, relationships between medical school stress and general demographic characteristics, insomnia severity, and self-efficacy were examined. Results The final Chinese version of the PMSS supports a two-factor structure with 13 items, defined as “psychological stress and environment” and “resilience and expectations.” The scale’s Content Validity Index (CVI) was 0.980, with a criterion validity of 0.767. The Cronbach’s alpha coefficient was 0.911, McDonald’s Omega coefficient was 0.914, and the test-retest reliability was 0.794. Medical school stress levels showed significant differences based on gender and educational background (P < 0.05). Stress levels were positively correlated with insomnia severity and negatively correlated with self-efficacy. Conclusions The Chinese version of the PMSS is a reliable and valid tool for assessing stress levels among medical students in Chinese medical schools. Female students and those pursuing graduate degrees report higher levels of medical stress. Insomnia severity and self-efficacy significantly influence stress levels among medical students.
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spelling doaj-art-5c33fac6ba194d84b71dd2be47e487672025-08-20T03:01:39ZengBMCBMC Psychology2050-72832025-03-0113111010.1186/s40359-025-02604-4Validation of the Chinese version of the perceived medical school stress (PMSS) scale and analysis of the associated factorsChunyan Zhang0Chunguang Liang1Fan Zhang2Qian Zhang3Kaiyan Xu4School of Nursing, Jinzhou Medical UniversitySchool of Nursing, Jinzhou Medical UniversitySchool of Nursing, Jinzhou Medical UniversitySchool of Nursing, Jinzhou Medical UniversitySchool of Nursing, Jinzhou Medical UniversityAbstract Background In recent decades, mental health and stress among medical students have become a global concern. Currently, China lacks a scale specifically designed to assess stress levels in medical school settings. This study aims to cross-culturally translate and adapt the Perceived Medical School Stress (PMSS) Scale into Chinese, evaluate its psychometric properties in medical schools, and analyze the associated factors of medical students’ stress levels. Methods Data collection for the Chinese version of the PMSS was conducted from October to November 2023, among medical students from selected medical schools in North and East China. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the underlying factor structure. Content validity was assessed using the Content Validity Index (CVI). Criterion validity was evaluated with the Chinese version of the Perceived Stress Scale (PSS). Internal consistency was assessed by calculating Cronbach’s alpha coefficient, McDonald’s Omega coefficient, and test-retest reliability. Additionally, relationships between medical school stress and general demographic characteristics, insomnia severity, and self-efficacy were examined. Results The final Chinese version of the PMSS supports a two-factor structure with 13 items, defined as “psychological stress and environment” and “resilience and expectations.” The scale’s Content Validity Index (CVI) was 0.980, with a criterion validity of 0.767. The Cronbach’s alpha coefficient was 0.911, McDonald’s Omega coefficient was 0.914, and the test-retest reliability was 0.794. Medical school stress levels showed significant differences based on gender and educational background (P < 0.05). Stress levels were positively correlated with insomnia severity and negatively correlated with self-efficacy. Conclusions The Chinese version of the PMSS is a reliable and valid tool for assessing stress levels among medical students in Chinese medical schools. Female students and those pursuing graduate degrees report higher levels of medical stress. Insomnia severity and self-efficacy significantly influence stress levels among medical students.https://doi.org/10.1186/s40359-025-02604-4Chinese medical studentPerceived stressReliabilityValidityInsomniaSelf-efficacy
spellingShingle Chunyan Zhang
Chunguang Liang
Fan Zhang
Qian Zhang
Kaiyan Xu
Validation of the Chinese version of the perceived medical school stress (PMSS) scale and analysis of the associated factors
BMC Psychology
Chinese medical student
Perceived stress
Reliability
Validity
Insomnia
Self-efficacy
title Validation of the Chinese version of the perceived medical school stress (PMSS) scale and analysis of the associated factors
title_full Validation of the Chinese version of the perceived medical school stress (PMSS) scale and analysis of the associated factors
title_fullStr Validation of the Chinese version of the perceived medical school stress (PMSS) scale and analysis of the associated factors
title_full_unstemmed Validation of the Chinese version of the perceived medical school stress (PMSS) scale and analysis of the associated factors
title_short Validation of the Chinese version of the perceived medical school stress (PMSS) scale and analysis of the associated factors
title_sort validation of the chinese version of the perceived medical school stress pmss scale and analysis of the associated factors
topic Chinese medical student
Perceived stress
Reliability
Validity
Insomnia
Self-efficacy
url https://doi.org/10.1186/s40359-025-02604-4
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