The Occupational Stress Check and Assessment Questionnaire: development, validity, and reliability

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BACKGROUND: Existing occupational stress questionnaires are mostly based on Western work environments and were generally developed earlier, with insufficient cultural adaptation and incomplete coverage of emerging stressors in Chinese work environments. Their applicability has also been constrained by cultural differences and by the lack of validation in non-Western populations. This study aimed to develop and evaluate an instrument to measure the level of occupational stress among workers and the risk of occupational stress in the workplace. METHOD: The study was carried out in two stages: questionnaire development and item screening with subsequent questionnaire evaluation. The Occupational Stress Check and Assessment Questionnaire (OSCAQ) was developed based on three classical models: the NIOSH Model of Job Stress, the Job Demand-Control-Support (JDCS) Model, and the Effort-Reward Imbalance (ERI) Model. The initial questionnaire was developed through a comprehensive literature review, reference to existing scales, expert consultation, and a preliminary survey conducted among the target population. During July 2023 to November 2024, a valid sample of 13,019 respondents was collected in Beijing, China, through an online platform. Item analysis and exploratory factor analysis (EFA) were conducted on a sample of 6,453 workers to screen questionnaire items and investigate the factorial structure. Validity testing was conducted on a sample of 6,566 workers using confirmatory factor analysis (CFA) to assess the construct validity, convergent validity, and discriminant validity. Cronbach's α coefficients and Spearman-Brown coefficients were used to determine the questionnaire's internal consistency reliability. RESULTS: Through item analysis and EFA, a total of 10 items were removed from the OSCAQ, resulting in a final questionnaire consisting of 75 items. The retained items were categorized into three subscales: work stressors, social support factors, and stress reactions. The work stressors and social support factors were jointly analysed, explaining 66.99% of the total variance, while the stress reactions were analysed separately, accounting for 64.43% of the total variance. A good model fit was indicated by CFA, as evidenced by root mean square error of approximation (RMSEA) = 0.063, comparative fit index (CFI) = 0.908, tucker-lewis index (TLI) = 0.905, and standardized root mean square residual (SRMR) = 0.067. Convergent validity was demonstrated, with all latent constructs exceeding the combined reliability (CR) threshold (> 0.70), and most average variance extracted (AVE) values above 0.50, except for the work stressors subscale (AVE = 0.443). Discriminant validity was supported, as the square root of AVE for each dimension was greater than its correlations with other dimensions. The questionnaire demonstrated good internal consistency, with Cronbach's α coefficients ranging from 0.911 to 0.952 across subscales and from 0.770 to 0.927 across dimensions, and Spearman-Brown coefficients ranging from 0.850 to 0.895 and 0.671 to 0.919, respectively. CONCLUSION: The OSCAQ was demonstrated to possess satisfactory reliability and validity, and can be considered a suitable instrument for assessing the status of occupational stress.

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