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Gac Sanit. 2003 Jan-Feb;17(1):37-51.

[KEZKAK: a new bilingual questionnaire to measure nursing students' stressors in clinical practice].

[Article in Spanish]

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Departamento Enfermería II. Escuela Universitaria de Enfermería de Donostia-San Sebastián. Euskal Herriko Unibertsitatea/Universidad del País Vasco. San Sebastián. España.



To develop a bilingual questionnaire (Basque-Spanish) to measure nursing students' stressors in clinical practice.


Ideas were gathered from nursing students in group discussions. Initially, 287 nursing students from the School of Nursing in San Sebastián (Spain) completed the State-Trait Anxiety Inventory (STAI) and the 55-item version of our questionnaire. After analyzing the items, we selected 41 items for the final version. Some of the subjects completed this final version two (198 = 198) and six months (n = 211) later.


The questionnaire presented high internal consistency (Cronbach's alpha: 0.95), considerable reliability (Spearman's correlation: 0.72 at two months and 0.68 at six months), and acceptable concurrent validity (Spearman's correlation with anxiety: 0.39). Factor analysis produced nine factors, with high internal consistency, which explained 64.4% of the variance. Based on these factors, the main stressors for nursing students in the workplace were produced by lack of competence (11.2%), contact with suffering (9.1%), relationships with tutors, workmates and classmates (8.9%), uncertainty and impotence (7.7%), lack of control in relationships with patients (7.6%), emotional involvement (5.8%), relationships with patients [being harmed by the relationship (5.2%) and patients seeking a close relationship (4.6%)], and overwork (4.3%). Methodological and practice aspects of the questionnaire are discussed, as well as its utility in planning the training of future nurses.


The KEZKAK questionnaire is a useful instrument for measuring nursing students' stressors in clinical practice.

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