Validation of the Chinese version of the Perceived Stress Scale-10 integrating exploratory graph analysis and confirmatory factor analysis

The study aimed to initially assess the measurement properties of the 10-item simplified Chinese version of the Perceived Stress Scale (PSS-C-10) and as a first, assess a longitudinal measurement invariance (LMI). A longitudinal survey was conducted with a convenient sample of healthcare students using the PSS-C-10. We assessed the PSS-C-10 mainly using composite analytical approaches, including exploratory graph analysis (EGA) and confirmatory factor analysis (CFA) to suggest the best-fit factor structure and assess measurement invariance. The EGA identified a two-factor structural solution with an accuracy of 98.6% at baseline and 100% at a 7-day follow-up. The CFA subsequently confirmed this structure, with a comparative fit index of 0.963 at baseline and 0.987 at follow-up, Tucker-Lewis index of 0.951 at baseline and 0.982 at follow-up, and root mean square error of approximation of 0.111 at baseline and 0.089 at follow-up. The LMI was supported by the goodness-of-fit indices, and their changes fell within the recommended cut-off range. Additionally, Cronbach's alpha (0.885 at baseline and 0.904 at follow-up), McDonald's omega (0.885 at baseline and 0.902 at follow-up), and an ICC value of 0.816 for 7 days demonstrated the robust reliability of the PSS-C-10. The PSS-C-10 exhibited a stable two-factor structure with promising LMI and measurement properties.