Psychometric Evaluation and Cross-Cultural Adaptation of the Persian Version of the Relocation Stress Syndrome Scale – Short Form (Rsss-Sf) in Patients Transferred From Intensive Care Units to General Wards Publisher



Soofi S ; Zakerimoghadam M ; Zoroufchi M ; Gorgulu O ; Shafahi A ; Khoshkesht S
Source: BMC Nursing Published:2026

Abstract

Background and aims: The transition from intensive care units to general wards is a critical and stressful phase in patient recovery, often associated with adverse psychological and clinical outcomes. Relocation Stress Syndrome (RSS) is a recognized condition resulting from this transition, highlighting the need for valid and culturally adapted assessment tools to accurately measure patient stress and guide nursing interventions. Methods: This methodological study was conducted to adapt and validate the Persian version of the Relocation Stress Syndrome Scale–Short Form (RSSS-SF). The final Persian version was administered to 155 patients who had been transferred from intensive care units (ICUs) to general wards in Tehran hospitals. Data were analyzed using IBM SPSS 29 and AMOS 24.Item–total correlations, Cronbach’s alpha coefficients, and exploratory factor analysis (EFA) were conducted to examine internal consistency and factor structure. Confirmatory factor analysis (CFA) was subsequently performed to test the goodness-of-fit of the model. Model fit indices (χ²/df, CFI, GFI, AGFI, IFI, and RMSEA) and reliability coefficients were evaluated according to standard psychometric criteria. Results: Exploratory factor analysis supported a three-factor structure for the Persian version of the RSSS-SF, explaining 57.97% of the total variance. The Kaiser–Meyer–Olkin value (0.74) and Bartlett’s test of sphericity (χ² = 419.33, p <.001) confirmed sampling adequacy. Confirmatory factor analysis demonstrated acceptable model fit (χ²/df = 2.13, CFI = 0.91, RMSEA = 0.07). The overall internal consistency of the scale was acceptable. (Cronbach’s α = 0.83). Conclusion: In summary, the Persian version of the RSSS-SF demonstrated satisfactory validity and reliability, generally supporting the factorial structure of the original instrument. The scale is a practical and culturally appropriate tool for assessing relocation stress among Iranian ICU patients and can facilitate the development of patient-centered, family-integrated nursing strategies to improve post-transfer adaptation and recovery. Ethics and dissemination: This study was approved by the Research Ethics Committee of the Tehran University of Medical Sciences, School of Nursing and Midwifery (Ethics Code: IR.TUMS.FNM.REC.1404.026). All participants were fully informed regarding the study objectives and procedures, and written informed consent was obtained prior to participation. Participation was voluntary, and confidentiality and anonymity of the collected data were assured. The study adhered to the principles of the Declaration of Helsinki. Clinical trial number: Not applicable. Trial status: Data collection for this study was conducted between June 2025 and November 2025. All 155 participants completed the Persian short-form RSSS during the study period. © The Author(s) 2026.