Inventory of Stressful Events

Abstract

The Inventory of Stressful Events (ISE) is a psychological instrument consisting of 45 items designed to quantify the frequency of stressful occurrences encountered in an occupational setting. Developed and validated by Motowidlo, Packard, and Manning in 1986, the scale was initially created to assess stressors specific to the nursing profession. The items were derived from extensive interviews conducted across various clinical areas within multiple hospitals, resulting in content highly relevant to the hospital context. Respondents use a Likert-type scale to report how often these potentially stressful events occur while performing their job duties, providing a measure of objective occupational stress exposure.

Keywords

Occupational stress, nursing stress, job demands, stressful events, workload, job satisfaction, job performance, psychological distress, Motowidlo.

Authors

S. J. Motowidlo, J. S. Packard, M. R. Manning.

Purpose

The primary purpose of the ISE is to provide a quantitative measure of the frequency of specific, discrete stressful events that occur within a job environment. By focusing on frequency rather than subjective appraisal of stress intensity (though a secondary scale for intensity is available), the instrument helps researchers and practitioners identify specific environmental or organizational factors contributing to occupational strain.

Initially tailored for nurses, the scale aims to capture the unique interpersonal, organizational, and patient-care related stressors prevalent in high-demand, clinical settings. The resulting scores can be used to predict outcomes such as burnout, psychological distress, and changes in job performance.

Construct

The ISE measures the construct of Occupational Stressors Frequency, defined as the objective rate at which potentially negative or demanding events occur within the work environment. Although stress is often conceptualized subjectively, the ISE focuses on objective event occurrence, allowing for the distinction between the presence of stressors and an individual’s psychological response to them (stress/strain).

The 45 items cover a range of workplace challenges, including interpersonal conflict (with doctors, nurses, patients), organizational constraints (lack of supplies, short-staffing), and role ambiguity or overload (extra work, inability to complete duties).

Validity

Validation studies (e.g., Fox & Dwyer, 1995; Fox et al., 1993) support the construct validity of the ISE through its correlation pattern with established psychological and performance measures. The frequency of stressful events demonstrated significant positive correlations with several negative outcomes:

• Psychological distress and somatic complaints (indicating strain).
• Indicators of heavy workload, specifically quantitative workload and qualitative workload.
• The personality trait of self-monitoring.

Conversely, the ISE showed significant negative correlations with desirable job outcomes, confirming its predictive utility for organizational health:

• Job satisfaction.
• Job performance.
• Perceived job control.

Reliability

Internal consistency for the Inventory of Stressful Events is robust. Research conducted by Fox and Dwyer (1995) and Fox, Dwyer, and Ganster (1993) reported a high Coefficient alpha value of .88. This value suggests that the 45 items consistently measure the underlying construct of stressful event frequency, providing high confidence in the scale’s internal homogeneity.

Factor Analysis

The source material does not explicitly detail the original factor structure of the 45-item scale as developed by Motowidlo et al. (1986). Subsequent research utilizing the ISE often treats it as a unidimensional measure of overall stressful event frequency, particularly in studies focused on predicting general job strain. However, the diverse nature of the items (e.g., doctor conflict, organizational issues, patient refusal) suggests that subfactors related to specific categories of occupational stressors may exist and have been explored in later adaptations or analyses of the scale.

Instrument

Test Type: Self-report frequency inventory.

Format: 45 items scored using a Likert-type scale. Two potential response formats: Frequency (4-point) and Stressfulness (5-point).

Language Available: English (Original research).

Population Group: Occupational/Clinical staff.

Age Group: Adult working population.

Population Details: Originally validated on registered nurses working in hospital settings. The item wording is specific to the hospital context (e.g., referencing doctors, patients, and head nurses).

Test Methodology: Respondents indicate the frequency of occurrence (1 = never to 4 = fairly often) for each item, answering the question: “How often do these things generally happen to you in your job?” Responses can also be obtained using a separate 5-point scale for perceived stressfulness (1 = not at all stressful to 5 = extremely stressful).

Keywords

Nursing administration, healthcare workload, job control, psychological measurement, internal consistency, occupational stress, hospital staff.

Authors

Author ORCID Identifier: Not provided in source.

Affiliation Email addresses: Not provided in source.

Correspondence Address: Not provided in source.

Permissions & Fee and Test Year

Test Year: 1986.

Permissions: The items were originally published in the appendix of the article in the Journal of Applied Psychology (1986) and are explicitly noted as reprinted with permission from the American Psychological Association (APA). Researchers should contact the APA or the primary author for current usage permissions.

Fee: Information regarding commercial fees is not available in the source material, but academic use typically follows APA permissions guidelines.

Reference’s

• Motowidlo, S. J., Packard, J. S., & Manning, M. R. (1986). Occupational stress: Its causes and consequences for job performance. Journal of Applied Psychology, 71, 618-629. Items were taken from the appendix, p. 629. Copyright © 1986 by the American Psychological Association.
• Fox, S., & Dwyer, D. J. (1995). The Inventory of Stressful Events: Further evidence regarding its reliability and validity.
• Fox, S., Dwyer, D. J., & Ganster, D. C. (1993). Causal modeling of stress and performance in nurses.

Items of the Inventory of Stressful Events

Respondents are asked, How often does this generally happen to you? Responses are obtained on a 4-point Likert-type scale where 1 = never and 4 = fairly often. Responses can also be obtained for the same 45 items asking the question How stressful is or would this be for you? and obtaining responses from 1 = not at all stressful to 5 = extremely stressful.

How often do these things generally happen to you in your job?

1. You fall behind in your regular duties because you have extra work that is not part of your daily routine
2. You are so busy you have to pass up a chance to talk to a patient and give him or her some emotional support
3. Another nurse calls you away from important work for a trivial matter
4. A patient complains to you about the food or other things not under your control
5. Your head nurse or supervisor disagrees with your judgment about a patient’s treatment or condition
6. A doctor is verbally abusive toward you
7. You perform work that should have been done by your head nurse
8. Your regular head nurse is temporarily absent from the unit when you need help
9. A doctor becomes angry at you for something that is not your fault
10. Your work is interrupted by delays caused by other units or departments
11. You have so much to do that you have to leave some things undone
12. You are unable to contact a doctor in an emergency
13. You have to make an extra trip for special supplies because a doctor changed his or her mind about a medical procedure
14. A doctor wastes your time by having you perform non-nursing tasks
15. A doctor becomes upset with you for taking too long to do something
16. Your unit is short-staffed because someone called in sick
17. A doctor does not accept your suggestions regarding a patient’s condition or treatment
18. Your head nurse or supervisor assigns a lighter workload to a co-worker
19. A doctor contradicts hospital rules or standard nursing procedures which you were following with a patient
20. A patient under your care refuses to accept medication or other treatment
21. You have to explain the behavior of a doctor to a patient or the patient’s family
22. A patient criticizes your nursing care
23. You have to do extra work because another unit or department did not do their own work properly
24. A patient becomes verbally abusive with you
25. Another nurse is angry or rude with you
26. You disagree with the patient care ordered by a doctor
27. You see a doctor act rudely or inconsiderately toward a patient
28. You see another nurse relaxing and taking it easy while you are very busy
29. A patient under your care refuses to eat a meal
30. Another nurse’s negligence makes it difficult for you to perform your own work properly
31. Visitors are verbally abusive or rude toward a patient under your care
32. Your head nurse or supervisor gives you incorrect information pertaining to patient care
33. Another nurse will not fill in for you so you can take a day off
34. Your head nurse or supervisor refuses your request for time off or a change in your schedule
35. A patient under your care refuses to stay in bed
36. A patient under your care purposely removes his or her dressings
37. You have so much to do that you have to work overtime
38. You need medical equipment or supplies that are not available in your unit
39. A doctor publicly criticizes your nursing care
40. A patient tries to harm himself or herself while under your care
41. You hear another nurse complaining about the workload
42. Another nurse criticizes your nursing care
43. You have to use a piece of equipment or perform a nursing procedure that is new to you
44. A patient’s family or visitors criticize your nursing care
45. A patient reports you to a doctor or a nursing supervisor