Validating the Medical Students' Stressor Questionnaire (MSSQ) from a Sri Lankan medical faculty

OBJECTIVES: The Medical Students' Stressor Questionnaire (MSSQ) is a specific tool to assess the degree of stress in medical students. However, this tool has not been validated in Sri Lanka. Therefore, this study contextually adapted the MSSQ and investigated its validity in the local context. METHODS: A total of 603 medical students, in various phases of their undergraduate training, from the Faculty of Medicine at the University of Colombo, participated in the study. Students who have completed their studies in the faculty for at least six months were included. The self-administered questionnaire was contextually adapted to the local setting and was approved by subject and language experts. Responses were analysed for construct validity (including exploratory factor analysis to estimate factor structure of the scale), sample adequacy, and internal consistency. Data were analysed using the SPSS statistical package. RESULTS: The mean age of the study cohort was 23.3 ± SD 2.0 years, while 258 (42.8%) were males. The MSSQ scale significantly correlated with the General Health Questionnaire (p<0.001), indicating a strong concurrent validity. The exploratory factor analysis showed that items were loaded appropriately on five new factors, and the Kaiser-Meyer-Olkin measure (0.954) and Bartlett's test of sphericity (p<0.001) showed excellent sample adequacy. The internal consistency of the MSSQ overall (α = 0.95), and each of the new factors: (α > 0.82 for the first four factors and α = 0.54 for the fifth) were satisfactory. The test-retest reliability was high (Pearson's r = 0.918, p<0.001). CONCLUSIONS: The contextually adapted MSSQ is a valid and reliable instrument that can be used in the assessment of stress among medical students.