Reliability and validity of the student stress inventory-stress manifestations; questionnaire and its association with personal and academic factors in university students

Background: Stress affects us in every environment and it is also present in the educational sphere. Previous studies have reported a high prevalence of stress in university students. The Student Stress Inventory-Stress Manifestations (SSI-SM), identify stressors and evaluate stress manifestations in adolescents but its validity in university students remains uncertain. Objectives: We aimed to determine the internal consistency and validity of an adapted version of the Student Stress Inventory-Stress Manifestations (SSI-SM) for university students and to investigate if high stress levels are associated with personal and academic factors. Design and Methods: In this quantitative, descriptive, cross-sectional study, we included 115 university students of the Nursing Degree during the second semester of the 2014/2015 academic year. Information about personal issues, lifestyle and academic performance was recorded and the stress was evaluated with the SSI-SM questionnaire. The internal consistency and homogeneity of the SSI-SM questionnaire was tested and a factorial analysis was performed. Results: After the homogeneity analysis, the final version of the SSI-SM questionnaire included 19 items, with a Cronbach's alpha of 0.924. In the factorial analysis, 4 factors were found ('Self-concept', 'Uncertainty' and 'Somatization'; all Cronbach's alpha > 0.700). Students with higher values on the SSI-SM were, in overall, women (41.0 +/- 12.7 vs. 33.2 +/- 9.5; p = 0.001) and had significantly more family conflicts (47.6 +/- 13.8 vs. 35.2 +/- 9.6; p < 0.001), consumed less alcohol (R = 0.184, p = 0.048), slept less hours (R = -0.193, p = 0.038) and had worse academic performance in Clinical Nursing (36.3 +/- 10.4 vs. 41.2 +/- 13.3, p = 0.039). Conclusions: After exclude three items of the original SSI-SM, higher scores in the SSI-SM are correlated with stress level in a cohort of university students of the Nursing Degree. Family conflicts, female gender, absence of alcohol consumption, few sleep hours and poor academic performance are associated with higher stress levels.