Adaptation and validation of the psychological tolerance questionnaire for second victims of adverse events(WITHSTAND-PSY)among neurosurgery nurses

CHEN Xiaoming; LI Qin; YIN Luxin; CHEN Lili; HUA Lei; HAN Ting; LIU Xue

doi:10.3969/j.issn.1671-2897.2026.03.015

Abstract：Objective To translate psychological tolerance questionnaire for second victims of adverse events(WS-PSY-Q)into Chinese,and analyze its reliability and validity so as to provide a reliable tool for assessing and intervening in neurosurgery nurses'psychological resilience.Methods The scale was literally adapted by following the translation-back-translation method and culturally adapted through two rounds of expert consultation(involving 7 neurosurgical nursing experts in clinical practice and management).A formal survey was then conducted among 250 neurosurgical nurses from six tertiary grade A hospitals in Jiangsu province,who were selected by stratified cluster sampling.Reliability and validity analyses were performed using SPSS 28.0 software.Results The Chinese version of the WS-PSY-Q comprised of two sub-questionnaires:the psychological distress questionnaire and the coping strategy questionnaire.The former included three dimensions(emotional response,cognitive dissonance,and somatization symptoms)with a total of 25 items.The latter included three dimensions(problem-focused strategies,emotion regulation strategies,and social support utilization)with a total of 27 items.Reliability analysis showed that Cronbach's alpha coefficient of the total scale was 0.941,a split-half reliability coefficient of 0.879,and a test-retest reliability of 0.845.Content validity analysis indicated that content validity index(CVI)for the total scale was 0.94,with item-level CVIs ranging from 0.86 to 1.00.Factor analysis revealed a KMO value of 0.891,and Bartlett's test of sphericity was significant(χ2=3246.75,P<0.05).The psychological distress questionnaire contained three factors,explaining 61.7%of the total variance.The coping strategy questionnaire contained three factors,explaining 68.3%of the total variance.Factor loadings of items on their respective common factors ranged from 0.52 to 0.86.Correlation analysis showed that the correlation coefficients between each item and its respective dimension ranged from 0.65 to 0.83,and the correlation coefficients between each item and the total scale ranged from 0.65 to 0.86(all P<0.05).Criterion-related validity analysis found that using the General Health Questionnaire(GHQ-12)as the criterion,the total score of the psychological distress questionnaire was significantly positively correlated with the GHQ-12(r=0.71,P<0.05),while the total score of the coping strategy questionnaire was significantly negatively correlated with the GHQ-12(r=-0.63,P<0.05).Conclusions The Chinese version of the WS-PSY-Q demonstrates good reliability and validity.It can serve as a standardized assessment tool in China to evaluate psychological resilience of the second victims of adverse nursing events.It can effectively identify neurosurgical nurses at high psychological risk,providing a basis for hospitals to conduct psychological resilience assessment and intervention for nurses.