Validation of the Italian version of the Secondary Traumatic Stress Scale (STSS-I) within midwifery students

Aim: to evaluate the psychometric properties of the Italian version of the Secondary Traumatic Stress Scale (STSS-I) specifically for midwifery students. Background: midwives are at risk of developing Secondary Traumatic Stress (STS) which arises from witnessing or hearing about the trauma of others. Midwifery students are particularly vulnerable to STS due to the emotionally intense situations they encounter during their clinical training. This stress impacts their emotional well-being and their professional development. Despite the significant impact of STS on midwifery students, it remains underexplored in academic settings. Methods: An observational study was conducted enrolling midwifery bachelor students of University of Milano Bicocca and Verona. Reliability and structural validity of STSS-I were studied using Confirmatory Factor Analysis and Cronbach's alpha. Moreover, the criterion concurrent validity was tested using the GHQ-12 as criterion standard through the ROC curve's study. Analysis was performed using Stata/MP18.0 and R (version 4.3.2). Results: confirming the two-dimension structure, within midwifery students the STSS-I had a good structural validity (RMSEA=0.079, CFI=0.992 and TLI=0.991) and reliability (Arousal subscale's and Intrusion's Cronbach alpha were respectively 0.90 and 0.84). The criterion validity demonstrated a moderate level of accuracy (AUC 0.75 ± 0.06). The total average STSS-I score was 24.44 (DS=9.91), ranging from 15 to 68. The average of Arousal and Intrusion subscales were respectively 17.70 and 9.73. Conclusions: the STSS-I has good psychometric properties, representing a valid and reliable measure for assessing STS within midwifery students.