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. 2024 Sep 25;30(6):e13304. doi: 10.1111/ijn.13304

Turkish adaptation of the state–trait anxiety inventory short version (STAIS‐5, STAIT‐5)

Seher Döner 1, Yağmur Sezer Efe 2,✉, Ferhan Elmalı 3
PMCID: PMC11608918  PMID: 39323115

Abstract

Aim

This study examines the validity and reliability of a Turkish version of the State–Trait Anxiety Inventory Short Version.

Methods

The sample consisted of 306 people between the ages of 18–59 who agreed to participate in the study and met the inclusion criteria. Data were collected with the demographic questionnaire, State–Trait Anxiety Inventory Short Version, State–Trait Anxiety Inventory and Brief Fear of Negative Evaluation Scale.

Results

All factor loadings of the State Anxiety Inventory Short Version were between 0.706 and 0.835, and those of the Trait Anxiety Inventory Short Version were between 0.694 and 0.810. The Cronbach alpha coefficients of the State and Trait Anxiety Inventory Short Version were calculated as 0.838 and 0.837, respectively. There was a significant difference between the first‐test and retest values of the State Anxiety Inventory Short Version (p = 0.033) and no difference in the Trait Anxiety Inventory Short Version (p = 0.145).

Conclusions

The Turkish‐adapted State–Trait Anxiety Inventory Short Version is a valid and reliable measurement tool to determine the anxiety levels of individuals aged 18–59.

Keywords: anxiety, nursing, reliability, scale adaptation, state–trait anxiety inventory, validity

Summary statement

What is known on the subject?

  • Early detection and prevention of anxiety is very important because it causes some mental and physical problems.

  • There are different measurement tools that have been tested for validity and reliability and used to evaluate the presence and severity of anxiety.

What the paper adds to existing knowledge?

  • It was thought that the short version of a scale would be useful in cases where the measurement tool is desired to be used repeatedly/more than once.

  • It could be said that with this scale, anxiety level assessments in different samples could be made more easily and in less time.

  • The Turkish validity and reliability study of the 10‐item short version of STAI was conducted and introduced to the literature.

What are the implications for practice?

  • STAIS‐5 and STAIT‐5 are brief, age‐appropriate, self‐reported, easily applicable, valid, and reliable tools, useful in situations where repeated or multiple assessments are desired.

  • In studies where a multitude of questionnaires are required to be used at the same time, this scale may be preferred due to its shortness.

  • With this scale, anxiety levels can be assessed more easily and in less time across different samples.

1. INTRODUCTION

Anxiety is a normal response to situations perceived as threats to biological integrity or individualism, arising from the internal and external environment and experienced by everyone at different intensities throughout his/her life (Spielberger, 1972). Anxiety can be felt in many situations, such as getting an important exam, attending a job interview, waiting for a medical test result or encountering a new situation (Clark & Beck, 2012; Öner & Le Compte, 1985). If the severity and duration of the anxiety is proportional to the threat, it is considered normal. However, when the anxiety is disproportionate and excessive to the threat, it is considered abnormal or pathological because it negatively affects the functionality of the person (Bradley, 2016; Clark & Beck, 2012).

Anxiety is called ‘state anxiety’ when it is temporary and is felt depending on a stressful situation, but it is called ‘trait anxiety’ when it is permanent (Spielberger, 1972). State anxiety is a temporary emotional state characterized by subjective feelings of tension and anxiety consciously perceived and experienced in a particular stressful situation. However, trait anxiety indicates the tendency of the person to perceive and interpret stressful situations as threatening, that is, to experience anxiety in general. Trait anxiety is the intensified and sustained state of state anxiety (Barlow, 2002; Bradley, 2016; Öner & Le Compte, 1985; Spielberger, 1972). Spielberger et al. (1970) developed the State–Trait Anxiety Inventory (STAI) to measure two different types of anxiety based on their theory (Öner & Le Compte, 1985).

Mild to moderate anxiety serves to activate individuals, prompting them to navigate challenges, solve problems and pursue goals. Additionally, it facilitates adaptation to new conditions, fosters spiritual development and contributes to overall maturation. However, severe and panic‐level anxiety negatively affects the life and functionality of individuals and could prevent their spiritual development (Aşık et al., 2017; Clark & Beck, 2012; Macleod & Mathews, 2012; McNally, 2019). Early detection and prevention of anxiety, which is one of the important mental health problems, is very important because it causes some mental and physical problems (American Psychiatric Association, 2016).

Different measurement tools have been tested for validity and reliability and used to evaluate the presence and severity of anxiety. One of the self‐report scales frequently used in the assessment of anxiety is the STAI, which was developed by Spielberger in 1970 (Balsamo et al., 2018; Zsido et al., 2020). The STAI, conducted by Öner and Le Compte in 1974–1977 for the Turkish validity and reliability study, has been translated and adapted into 70 languages and dialects since its publication (Öner & Le Compte, 1985; Zsido et al., 2020). STAI can also be applied in clinical settings in various cultures (du Rocher & Pickering, 2022; Mielimąka et al., 2017). Due to the large number of items in the STAI, it may take time to evaluate and fill out the form. However, measuring anxiety is very important for scientific research and application activities to be carried out in Turkey.

For this reason, when choosing a measurement tool, it should be careful that it is easy to apply (i.e., short and easy to understand) and can be scored easily (Aydemir, 2007). In addition, too many items could cause fatigue by boring readers (Şencan, 2005). Especially in the elderly, it is important to develop self‐report tools that measure anxiety with a limited number of items without reverse scoring and considering age‐related factors (Balsamo et al., 2018). Therefore, using the short 10‐item version of the STAI (STAIS‐5 and STAIT‐5) developed by Zsido et al. (2020) may be useful. In addition, it was thought that the short version of the STAI would be useful in cases where the measurement tool is desired to be used repeatedly/more than once. It could be said that with this scale, anxiety level assessments in different samples could be made more easily and in less time.

The study aimed to translate and cross‐culturally adapt the STAIS‐5 and STAIT‐5 to Turkish and test the validity and reliability of the Turkish version.

2. METHODS

2.1. Design

The descriptive, cross‐sectional study was performed in two phases. The first phase involved translation and cultural adaptation of the original version of STAIS‐5 and STAIT‐5 into Turkish, and the second phase included psychometric tests of the Turkish version. To provide the quality and transparency of the current study, the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) checklist was used (Kottner et al., 2011).

2.2. Phase I: Translation and cultural adaptation of STAIS‐5 and STAIT‐5

The original versions of STAIS‐5 and STAIT‐5 were translated into Turkish using the forward‐backward translation method. For the translation of the STAIS‐5 and STAIT‐5, the guide proposed by the World Health Organization was used (https://terrance.who.int/mediacentre/data/WHODAS/Guidelines/WHODAS%202.0%20Translation%20guidelines.pdf). The process was developed in four steps. First, an English‐speaking nurse researcher and two translators with excellent English language proficiency independently translated the STAIS‐5 and STAIT‐5 into Turkish. The two versions were then compared and consolidated into one version. Then, this preliminary Turkish version of the STAIS‐5 and STAIT‐5 was independently back‐translated by two professional translators and a native‐speaking nurse researcher with excellent Turkish language proficiency. The nurse researchers then compared and contrasted the original English version, the preliminary Turkish, with the back‐translated English version. Thus, the language validity of the STAIS‐5 and STAIT‐5 was ensured. After translation and cultural adaptation of STAIS‐5 and STAIT‐5, a pilot study was conducted with 49 people not included in the sample to evaluate the linguistic intelligibility of the scales. As a result of the pilot study, it was determined that the questionnaires were understandable, and no changes were made.

2.3. Phase II: Psychometric test of the Turkish version of STAIS‐5 and STAIT‐5

A cross‐sectional study was conducted to test the psychometric properties (validity‐reliability) of the Turkish version of STAIS‐5 and STAIT‐5. Data were collected on the internet via Google Forms.

2.4. Sample and setting

The research was conducted with faculty, college students, vocational school students and staff working in all academic/administrative units in the central campus of a university in the Central Anatolia Region. The number of students and personnel to be recruited from the units in the university was selected by stratified sampling method, and the people who would participate in the research from the units were determined by the simple random sampling method. The number of samples could be determined to be 5–10 times the number of adapted scale items (Esin, 2015). In addition, for factor analysis, 100 observations are low, 200 observations are moderate, and 300 observations are good (Alpar, 2014). Since the number of items in the scales adapted was low (5 + 5 items = 10 items), 306 people who agreed to participate in the research were included in the study. In the current study, the STAIT‐5 and STAIS‐5 were applied a second time to 63 people 2 weeks after the data were collected (test–retest). Individuals who were 18 years of age or older, had no mental and physical disabilities, could speak, read and write Turkish, did not have any mental illness and agreed to participate in the research were included.

2.5. Measures

Data were collected with the Demographic Questionnaire, the Short Version of the State–Trait Anxiety Inventory (STAIS‐5, STAIT‐5), the State–Trait Anxiety Inventory (STAI) and the Brief Fear of Negative Evaluation Scale (BFNE).

  • Demographic Questionnaire: This form consisted of questions about the age, gender, educational status, and marital status of the individuals.

  • The Short Version of the State–Trait Anxiety Inventory (STAIS‐5, STAIT‐5): The 10‐item short version of the 40‐item form of the State–Trait Anxiety Inventory (STAI) was developed by Zsido et al. (2020). In the process of shortening the STAI, Zsido et al. (2020) first removed the reverse‐scored items from the scale and then reduced these inventories to their short 5‐item forms by performing confirmatory factor analysis (CFA), item response theory analysis, and ROC analysis in order to preserve the items that could best discriminate (STAIS‐5 and STAIT‐5). The scales in the 4‐point Likert type consist of 5 items. Emotions and behaviours specified in the STAIS‐5 are marked according to the degree of severity as 1 = Not at all, 2 = Somewhat, 3 = Moderately so, 4 = Very much so; and STAIT‐5 items are marked as 1 = Not at all, 2 = Sometimes, 3 = Moderately so, 4 = Very much so. Individuals who score 10 and above on the STAIS‐5 and 14 and above on the STAIT‐5 are considered clinically anxious (Zsido et al., 2020). The Cronbach alpha values of the STAIS‐5 and STAIT‐5 were calculated as 0.86 and 0.91, respectively (Zsido et al., 2020). This study calculated Cronbach's alpha coefficients of STAIS‐5 and STAIT‐5 as 0.838 and 0.837, respectively.

  • State–Trait Anxiety Inventory (STAI): The STAI, developed by Spielberger et al. (1970) to measure state and trait anxiety levels separately, was adapted into Turkish by Öner & Le Compte between 1974 and 1977. The STAI in a 4‐point Likert‐type scale consists of 20 items. Emotions and behaviours specified in the State Anxiety Inventory are marked according to the degree of severity as ranging from 1 = Not at all to 4 = Very much so; and Trait Anxiety Inventory items are marked as ranging from 1 = Almost never to 4 = Almost Always. In the State Anxiety Inventory, the person evaluates ‘how he/she is feeling right now’ (at a certain moment and under certain conditions). In the Trait Anxiety Inventory, the person evaluates ‘how he/she feels in general’. The total score obtained from each scale is between 20 and 80 (Öner & Le Compte, 1985). Zsido et al. (2020) found the correlation coefficients between the STAI and STAIS‐5, STAIT‐5 as 0.86 and 0.88, respectively (Zsido et al., 2020). Therefore, The STAI was used to test the external validity of the STAIS‐5 and STAIT‐5. In this study, Cronbach's alpha coefficient was found to be 0.92 for state anxiety and 0.87 for trait anxiety.

  • The BFNE: This scale was used to test the external validity of the STAIS‐5 and STAIT‐5. The BFNE was developed by Leary in 1983, and its Turkish validity and reliability were done by Çetin et al. (2010). This scale is a 5‐point Likert‐type scale consisting of 12 items, which aim to determine the tolerance of individuals to negative or hostile evaluations by others. This scale is a 5‐point Likert‐type scale scored (1 = Absolutely inappropriate, 5 = Absolutely appropriate). However, one item was removed because it was unsuitable for adapting to Turkish, and its 11‐item form was used. The internal consistency coefficient of the BFNE was found to be 0.84 and the reliability coefficient to be 0.83 (Çetin et al., 2010). In this study, the Cronbach alpha coefficient was calculated as 0.80.

2.6. Data analyses

Data were evaluated using IBM SPSS Statistics Standard Concurrent User V 25 (IBM Corp., Armonk, New York, USA), Statistica v.12 (StatSoft Inc., Tulsa, Oklahoma, USA) and IBM SPSS AMOS statistical package programmes. Descriptive statistics are given as number (n), percent (%), mean ± standard deviation (x̄ ± sd), median, minimum and maximum. The normal distribution of numerical variables was evaluated with the Shapiro–Wilk test of normality and Q‐Q graphs. The Content Validity Index (CVI) was calculated for the content validity of the STAIS‐5 and STAIT‐5. The appropriateness of the Turkish forms of STAIS‐5 and STAIT‐5 was evaluated primarily with CFA, and its factorial structure was evaluated with explanatory factor analysis (EFA). Fit indices were calculated with CFA and compared with reference values for the model's fit. Chi‐squared/degrees of freedom (χ 2/df) (good fit ≤2), standardized root mean squared residual (SRMR) (good fit <0.05), root mean square error of approximation (RMSEA) (good fit <0.05), comparative fit index (CFI) (good fit ≥0.95), goodness of fit index (GFI) (good fit ≥0.95), adjusted goodness of fit index (AGFI) (good fit ≥0.90), Bentler‐Bonett Normed Fit Index (NFI) (good fit ≥0.95), Bentler‐Bonett non‐normed fit index (NNFI) (good fit ≥0.95) (Hu & Bentler, 1999; Schermelleh‐Engel et al., 2003; Esin, 2015; Skinner, 2018). EFA was performed with principal component analysis. The sample adequacy was evaluated with the Kaiser‐Meyer‐Olkin test, and factorability was evaluated with Bartlett's sphericity test. Test–retest, intraclass correlation coefficient (ICC) and paired t‐tests were used for scale reliability, and Pearson or Spearman correlation analyses were used for external validity. In addition, Cronbach's alpha reliability coefficient was calculated to evaluate internal consistency.

2.7. Ethics

The STAIS‐5 and STAIT‐5 were used with the permission of the author Zsido et al. (2020). Approval was obtained from the Social and Humanities Ethics Committee (No: 146), and the institution where the study was conducted (No: 99219772‐044‐E.26205). Before starting the study, the purpose of the research was explained to the individuals, and their consent was obtained from those who wanted to participate in the study.

3. RESULTS

3.1. Characteristics of participants

Of the participants, 52.3% were women, 90.2% were single, 57.8% had undergraduate education, and 52.0% had middle income. The participants participating in the study were between the ages of 18–59, and the mean age was 23.13 ± 6.81 years (Table 1).

TABLE 1.

Descriptive characteristics of participants (n = 306).

Descriptive characteristics N %
Gender
Male 146 47.7
Female 160 52.3
Marital status
Single (not married) 276 90.2
Married 30 9.8
Educational status
Secondary education 2 0.7
Associate degree 101 33.0
Undergraduate 177 57.8
Graduate 26 8.5
Income rate
Income less than expenses 120 39.2
Income equals expense 159 52.0
Income more than expenses 27 8.8
Mean ± SD Median (min‐max)
Age (year) 23.13 ± 6.81 21.00 (18–59)
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Abbreviations: max, maximum; min, minimum; SD, standard deviation.

3.2. Validity analysis

3.2.1. Content validity

For the content validity of the STAIS‐5 and STAIT‐5, opinions were taken from 12 researchers being experts in their fields. Expert opinions were evaluated using the Davis technique, and the CVI of each item was calculated (Davis, 1992). CVI of all items of the STAIS‐5 and STAIT‐5 was ≥0.9166. CVI for both scales is at the desired level (CVI ≥0.80) (Esin, 2015).

3.2.2. Criterion‐related validity

To examine the criterion‐related validity of the STAIS‐5 and STAIT‐5, the relationship between the total scores of the STAIS‐5 and STAIT‐5 and the total scores of the STAI and BFNE were examined with Spearman correlation analysis and correlation coefficients were calculated. It was determined that there was a high level of positive correlation between the STAIS‐5 total score and the STAI‐State total score (r = 0.733, p < 0.001), while a weak significant correlation between the STAIS‐5 and BFNE total scores (r = 0.241, p < 0.001). It was identified that there was a high level of positive correlation between the STAIT‐5 and STAI‐Trait total score (r = 0.753, p < 0.001) and a moderately significant positive correlation between the STAIT‐5 and BFNE (r = 0.391, p < 0.001) (Table 3).

TABLE 3.

Correlation between the Short Version of the State‐Trait Anxiety Inventory (STAIS‐5, STAIT‐5) and state–trait anxiety inventory (STAI‐state, STAI‐trait) and the Brief Fear of Negative Evaluation Scale (BFNE) (Spearman).

State anxiety inventory (STAI‐state) Trait anxiety inventory (STAI‐trait) The Brief Fear of Negative Evaluation Scale (BFNE)
r r r
The short version of the state anxiety inventory (STAIS‐5) 0.733 * ‐ 0.241*
The short version of the trait anxiety inventory (STAIT‐5) ‐ 0.753 * 0.391*
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Abbreviations: p, significance level; r, correlation coefficient.

*

p < 0.001.

3.2.3. Construct validity

CFA was performed to evaluate the construct validity of the STAIS‐5 and STAIT‐5, and fit indices were calculated. The fit indices of the STAIS‐5 and STAIT‐5 were quite good (χ2/sd = 2.60 and 3.038, SRMR<0.001 and <0.001, RMSEA = 0.072 and 0.082, CFI = 0.986 and 0.981, GFI = 0.984 and 0.981, AGFI = 0.951 and 0.944, NFI = 0.977 and 0.973, NNFI = 0.986 and 0.981, respectively). The factor loadings of the models are shown in the PATH Diagram in Figure 1.

FIGURE 1.

FIGURE 1

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PATH diagram of the Short Version of the State‐Trait Anxiety Inventory (STAIS‐5 and STAIT‐5) (standardized coefficients).

EFA was performed to determine the factor structure of the STAIS‐5 and STAIT‐5. The suitability of the data for factor analysis was evaluated with BTS (560.449 and 549.298, p < 0.001, respectively), and the sample adequacy was analysed by the KMO test (KMO coefficient 0.841 and 0.839, respectively), and it was found that the data were suitable for factor analysis (Table 2). As a result of the EFA, it was determined that the STAIS‐5 explained 60.82% and the STAIT‐5 explained 60.59% of the total variance, and a single‐factor structure was obtained because there was one eigenvalue greater than 1 in both scales. In the study, factor loads of the STAIS‐5 and STAIT‐5 items were found to be between 0.706–0.835 and 0.694–0.810, respectively (Table 2). The single‐factor and theoretical structure of the STAIS‐5 and STAIT‐5 were confirmed, and it was determined that the scales consisting of five items could effectively measure the structure they aimed to measure.

TABLE 2.

Explanatory factor analysis results of the Short Version of the State‐Trait Anxiety Inventory (STAIS‐5 and STAIT‐5).

Scales Item Factor loadings
STAIS‐5

  1. I feel upset.

  2. I feel frightened.

  3. I feel nervous.

  4. I am jittery.

  5. I feel confused.

0.832

0.706

0.835

0.770

0.748
STAIT‐5

  1. I feel that difficulties are piling up so that I cannot overcome them.

  2. I worry too much over something that really does not matter.

  3. Some unimportant thoughts run through my mind and bothers me.

  4. I take disappointments so keenly that I cannot put them out of my mind.

  5. I get in a state of tension or turmoil as I think over my recent concerns and interests.

0.694

0.781

0.796

0.810

0.805
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3.3. Reliability analysis

Based on the paired t‐test results, it was determined that there was a significant difference between the first‐test and posttest values of the STAIS‐5 (p = 0.033), while there was no difference for the STAIT‐5 (p = 0.145). ICC were found to be 0.816 and 0.855, respectively (p < 0.001).

In addition, the adjusted item‐total correlation coefficients of the STAIS‐5 and STAIT‐5 varied between 0.554–0.714 and 0.543–0.680, respectively. The Cronbach's alpha coefficient, which measures the internal consistency (homogeneity) of the items in the scale, was found to be 0.838 and 0.837 for the STAIS‐5 and STAIT‐5, respectively.

4. DISCUSSION

In this study, based on the need for a measurement tool to determine the anxiety levels of individuals in less time and to be used in repeated measurements, STAIS‐5 and STAIT‐5 developed by Zsido et al. (2020) have been adapted to Turkish culture. In the study, first of all, the scale items were translated into Turkish; language and content validity were examined; then, the psychometric properties of the Turkish scales were evaluated with internal consistency, test–retest, item reliability, criterion‐related validity and construct validity methods.

The scale was first translated into Turkish and then into English; expert opinions were taken, and a pilot study was made. The CVIs (≥0.916 for STAIS‐5 and STAIT‐5), which evaluate the agreement of expert opinions, showed that there was high agreement among experts and that the content validity criteria were met (Esin, 2015). As a result, it can be said that the STAIS‐5 and STAIT‐5 have an understandable language structure and content.

The correlation coefficient between the scores obtained from the old and new scales was calculated by applying one or more scales measuring the same conceptual structure, together with the scale whose validity was tested in concurrent validity to the same group (Alpar, 2014; Esin, 2015). If the correlation coefficient (validity coefficient) is close to 1, it is interpreted that the scales are similar (strong) and close to 0 means that the validity is weak (Alpar, 2014). In this study, it was found that there was a high level of positive correlation (r = 0.733, p < 0.001) between the STAIS‐5 and STAI‐state and a weakly significant relationship (r = 0.241, p < 0.001) with the BFNE (Table 3) (Alpar, 2014; Şencan, 2005). Zsido et al. (2020) determined that there was a moderate negative correlation (r = −0.621, p < 0.01) between the STAIS‐5, BFNE and a high positive correlation (r = 0.86, p < 0.01) with the STAI‐State. In the current study, as the anxiety increases, the fear of negative evaluation increases was an expected situation and was found to be compatible with the literature (Bilge & Kelecioğlu, 2008; Çetin et al., 2010; Ganesh Kumar et al., 2015). It was found that there was a high level of positive correlation (r = 0.753, p < 0.001) between the STAIT‐5 and STAI‐Trait and a moderately significant positive correlation (r = 0.391, p < 0.001) with the BFNE (Table 3) (Alpar, 2014; Şencan, 2005). Zsido et al. (2020) calculated the correlation between the STAIT‐5, BFNE and STAI‐Trait as −0.596 and 0.88 (p < 0.01), respectively. Zsido et al. (2020) stated that both scales and their original long forms were highly correlated. As a result of this study, both scales showed a high positive correlation with their long forms. According to the calculated correlation coefficient results, it could be said that the STAIS‐5 and STAIT‐5 have criterion‐related validity.

In this study, factor analysis (EFA and CFA) was used to test the construct validity of the scales. The fit of the sample included in the current study for factor analysis was evaluated with KMO and BTS. The Bartlett test was significant; the KMO value was greater than 0.60, which indicated that the data were appropriate for factor analysis and that the sample size was adequate (DeVellis, 2016; Hair et al., 2010; Tabachnick & Fidell, 2013). According to the KMO values calculated from EFA, the study has a good sample size (Table 2). This study found BTS at a p < 0.001 significance level (Table 2). As a result, it was seen that the data was suitable for factor analysis.

In the first stage of factor analysis, CFA was performed to test the accuracy of the model, and fit indices were calculated, providing information about whether the model and theory were compatible. The calculated fit indices showed that the original single‐factor structure of the STAIS‐5 and STAIT‐5, which were adapted into Turkish, have a good fit and can validly measure the structure it aims to measure (Esin, 2015; Hu & Bentler, 1999; Lattin et al., 2003; Rindskopf, 1992; Schermelleh‐Engel et al., 2003; Skinner, 2018). Zsido et al. (2020) also concluded that the single‐factor model provided an acceptable fit in CFA.

In determining the factorial structure of the scale, the percentage of variance was explained and calculated by EFA, the number of eigenvalues greater than 1, and the scree plot was considered. One‐dimensional scales should explain at least 40% of the total variance and have an eigenvalue greater than 1 (Alpar, 2014; Şencan, 2005). In this study, it was seen that the STAIS‐5 explained 60.82% of the total variance, and the STAIT‐5 explained 60.59% of the total variance due to the EFA performed with principal component analysis (Table 2). In addition, when the factor load obtained from the EFA is 0.50 and above, it is interpreted as the load has application significance, and when it has a value of 0.70 and above, it is interpreted as the load that could explain the structure well (Almén et al., 2018; Alpar, 2014; Hair et al., 2010; Posch et al., 2019; Pretorius & Padmanabhanunni, 2023). In the current study, it was seen that each item explained the scale structure well according to the calculated factor loadings (Table 2) (Alpar, 2014). In other words, the calculated EFA results revealed that the STAIS‐5 and STAIT‐5 were valid measurement tools with a strong one‐dimensional structure. As a result, based on the results of CFA and EFA, it was concluded that the single factor structure of the STAIS‐5 and STAIT‐5, consisting of five items, was suitable, and the construct validity of the scales was ensured.

In this study, the test–retest method was used to test the reliability of the STAIS‐5 and STAIT‐5 and internal consistency reliability coefficients were calculated (Esin, 2015; Şencan, 2005). It was concluded that there was a significant difference (t = −2.131, p = 0.033) between the first‐test and posttest values of the STAIS‐5, but there was no difference (t = −1.458, p = 0.145) in the STAIT‐5. The difference between the first and posttest scores in the STAIS‐5 is because the state of anxiety fluctuates over time, according to the conditions (Spielberger, 1972). Similarly, Öner and Le Compte (1985) determined that the test–retest reliability coefficients ranged between 0.26 and 0.68 in the STAI‐State and 0.71 and 0.86 in the STAI‐Trait. They also stated that trait anxiety scores did not change much between 10 days and 1 year, while state anxiety scores showed remarkable variability (Öner & Le Compte, 1985). The results obtained from the current study also displayed that Spielberger (1966)'s ‘Two‐Factor Anxiety Theory’ was compatible. Therefore, the scales were reliable and supported the conceptual/theoretical structure, the construct validity.

To test the reliability of the test–retest method, ICC was also calculated (Alpar, 2014). According to the ICC values in this study, there is an acceptable relationship between the first and posttest of both scales; similar results were found in both measurements (Alpar, 2014). The test–retest analysis results show that the STAIS‐5 and STAIT‐5 are reliable measurement tools.

The Cronbach alpha coefficient is a measure of the internal consistency (homogeneity) of the scale items; that is, it is an indicator of whether the scale items form a whole (Alpar, 2014; Şencan, 2005). The alpha coefficient should be at least 0.70 (Heale & Twycross, 2015), and a value of 0.80 and above indicates that the scale has high reliability (Alpar, 2014). Zsido et al. (2020) found Cronbach's alpha values in the original forms of the scales to be 0.91 and 0.86, respectively. This study calculated the Cronbach's alpha coefficients of the STAIS‐5 and STAIT‐5 as 0.838 and 0.837, respectively. These values showed that the scales were highly reliable, as in their original form (Alpar, 2014).

Item‐total correlations >0.50 provide evidence of construct validity as it demonstrates that all items contribute to the latent construct (DeVon et al., 2007). In this study, it was identified that each item of the STAIS‐5 and STAIT‐5 showed a desired level of correlation with the total score. In addition, when the Cronbach alpha coefficients occur when the relevant item is removed, it was observed that the reliability coefficient of both scales decreased slightly when any item was removed. Each item contributed positively to the reliability of the scale. According to all these results, it was found that the STAIS‐5 and STAIT‐5 have a high level of internal consistency.

4.1. Limitations

The research population consisted of the students of faculties, colleges, vocational schools and personnel from all administrative/academic units in the central and district campuses of a university located in the Central Anatolia Region. However, the limitations of this study are that the data were collected from institutions located in the central campus due to transportation facilities and pandemic conditions, the study was conducted only online, the education level of the individuals participating in the study was secondary or above, a clinical sample was not included in the study, and the sample was not homogeneous.

5. CONCLUSIONS

In this study, STAIS‐5 and STAIT‐5 were adapted to Turkish, and it was concluded that they are valid and reliable measurement tools. It could be recommended that these one‐dimensional scales, which measure the state and trait anxiety levels of individuals easily and in less time, could be used as an assessment tool in new studies to determine the anxiety levels of individuals between the ages of 18 and 59 and to test the scales in larger samples with mental health problems, and in studies with different aims. Moreover, the clinical applicability of the STAI short form was performed in different clinical populations and with various cultural adaptations can be evaluated in future studies.

5.1. Implications for psychiatric and mental health nursing

The current study is the first to adapt the STAIS‐5 and STAIT‐5 to another culture. Measuring anxiety is very important for scientific research and application activities to be carried out. For this reason, when choosing a measurement tool to be used, it should be taken to ensure that it is easily applicable (i.e., short and understandable) and easily scored, and that it does not tire the reader. STAIS‐5 and STAIT‐5 are is a brief, age‐appropriate, self‐reported, easily applicable, valid and reliable tool. In addition, it was thought that STAIS‐5 and STAIT‐5 would be useful in cases where it is desired to be used repeatedly/more than once. It can be said that with this scale, anxiety level assessments in different samples can be made more easily and in a shorter time.

AUTHORSHIP STATEMENT

Seher Döner: The conception and design of the study; acquisition of data; analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; final approval of the version to be submitted. Yağmur Sezer Efe: The conception and design of the study; interpretation of data; drafting the article or revising it critically for important intellectual content; final approval of the version to be submitted. Ferhan Elmalı: The conception and design of the study; analysis and interpretation of data; drafting the article.

CONFLICT OF INTEREST STATEMENT

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

ETHICAL CONSIDERATIONS

Ethical approval was obtained from the Social Sciences Ethics Committee of a university. 2020/146.

ACKNOWLEDGEMENTS

The authors thank the participants who participated in this study.

Döner, S. , Efe, Y. S. , & Elmalı, F. (2024). Turkish adaptation of the state–trait anxiety inventory short version (STAIS‐5, STAIT‐5). International Journal of Nursing Practice, 30(6), e13304. 10.1111/ijn.13304

Funding information No funding.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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