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      Development and criterion validity of the COVID-19 anxiety and fear assessment scale: a cross sectional study

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          Abstract

          Background:

          The emergence of the new severe acute respiratory syndrome coronavirus 2, which causes COVID-19 disease, has been a major public health challenge and an increase in the feeling of uncertainty of the population, who is also experiencing an increase in levels of anxiety and fear regarding the COVID-19 disease.

          Objective:

          The objective of the study was the construct and criterion validation of the Escala de evaluación de la Ansiedad y MIedo a COVID-19 (AMICO, for its acronym in Spanish) to measure both constructs in the general Spanish population

          Methods:

          Descriptive study of psychometric validation. A field study was carried out to execute univariate and bivariate analyses, in addition to the exploratory and confirmatory factorial analysis of the scale. For the criteria validity study, the State-Trait Anxiety Inventory ( STAI) and sensitivity and specificity values were calculated.

          Results:

          The study sample was composed of 1036 subjects over 18 years of age, who resided in Spain, where 56.3% were women with a mean age of 48.11 years (SD = 15.13). The study of construct validity reported two factors and 16 items, with a Cronbach's alpha value of 0.92. The scale was concurrently valid with the used gold standard and obtained sensitivity values of 90.48% and specificity values of 76%.

          Conclusions:

          The AMICO scale is valid and reliable for assessing the level of anxiety and fear of COVID-19 in the adult Spanish population and is highly sensitive.

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          Most cited references48

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          A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations

          The Coronavirus Disease 2019 (COVID-19) epidemic emerged in Wuhan, China, spread nationwide and then onto half a dozen other countries between December 2019 and early 2020. The implementation of unprecedented strict quarantine measures in China has kept a large number of people in isolation and affected many aspects of people’s lives. It has also triggered a wide variety of psychological problems, such as panic disorder, anxiety and depression. This study is the first nationwide large-scale survey of psychological distress in the general population of China during the COVID-19 epidemic.
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            The Fear of COVID-19 Scale: Development and Initial Validation

            Background The emergence of the COVID-19 and its consequences has led to fears, worries, and anxiety among individuals worldwide. The present study developed the Fear of COVID-19 Scale (FCV-19S) to complement the clinical efforts in preventing the spread and treating of COVID-19 cases. Methods The sample comprised 717 Iranian participants. The items of the FCV-19S were constructed based on extensive review of existing scales on fears, expert evaluations, and participant interviews. Several psychometric tests were conducted to ascertain its reliability and validity properties. Results After panel review and corrected item-total correlation testing, seven items with acceptable corrected item-total correlation (0.47 to 0.56) were retained and further confirmed by significant and strong factor loadings (0.66 to 0.74). Also, other properties evaluated using both classical test theory and Rasch model were satisfactory on the seven-item scale. More specifically, reliability values such as internal consistency (α = .82) and test–retest reliability (ICC = .72) were acceptable. Concurrent validity was supported by the Hospital Anxiety and Depression Scale (with depression, r = 0.425 and anxiety, r = 0.511) and the Perceived Vulnerability to Disease Scale (with perceived infectability, r = 0.483 and germ aversion, r = 0.459). Conclusion The Fear of COVID-19 Scale, a seven-item scale, has robust psychometric properties. It is reliable and valid in assessing fear of COVID-19 among the general population and will also be useful in allaying COVID-19 fears among individuals.
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              2019-nCoV epidemic: address mental health care to empower society

              A novel coronavirus (2019-nCoV) has been identified as originating in Wuhan, Hubei Province, China. It has widely and rapidly spread in China and several other countries, causing an outbreak of acute infectious pneumonia. According to the official website of the National Health Commission, 1 as of Feb 4, 2020, 24 324 people have been confirmed to have a 2019-nCoV infection and 490 deaths have resulted from 2019-nCoV in 31 provinces in mainland China. 1 16 678 confirmed cases were in Hubei province. 2 Nearly 160 cases of 2019-nCoV have been detected and confirmed in southeast Asia (Thailand, Singapore, Malaysia, Vietnam, Philippines, and Cambodia), east Asia (Japan and Korea), south Asia (India, Nepal, and Sri Lanka), western Asia (United Arab Emirates), Europe (Germany, France, Italy, UK, Russia, Finland, Spain, and Sweden), North America (USA and Canada), and Australia. 3 Approximately 13% of people with confirmed 2019-nCoV infection are reported to have severe respiratory symptoms, 2% have died, and 4% have been cured. 1 Human-to-human transmission is occurring, and WHO has recommended limiting human-to-human transmission by reducing secondary infections among close contacts and health-care workers, preventing transmission amplification events, and preventing further international spread.3, 4 The outbreak of 2019-nCoV in China has caused public panic and mental health stress. The increasing number of patients and suspected cases, and the increasing number of outbreak-affected provinces and countries have elicited public worry about becoming infected. The unpredictable future of this epidemic has been exacerbated by myths and misinformation, often driven by erroneous news reports and the public's misunderstanding of health messages, thus causing worry in the population. Further travel bans and some executive orders to quarantine travellers during the Spring Festival holiday might have generated public anxiety while trying to contain the outbreak. The medical health-care workers who are caring for individuals who are either severely ill, feel scared, or experiencing bereavement are themselves exposed to trauma. Health-care workers are also at risk of getting infected, and they carry a large burden in the clinical treatment and public prevention efforts in Chinese hospitals and community settings. The challenges and stress they experience could trigger common mental disorders, including anxiety and depressive disorders, and posttraumatic stress disorder, 5 which in turn could result in hazards that exceed the consequences of the 2019-nCoV epidemic itself. To efficiently cope with the 2019-nCoV outbreak, the Chinese Government has implemented rapid and comprehensive public health emergency interventions. To date, all of the 31 provincial-level regions in mainland China with confirmed 2019-nCoV cases have activated so-called level 1 public health emergency responses (ie, the highest level of emergency public health alerts and responses within the national public health management system). 6 The provincial governments are responsible for organising, coordinating, and handling all emergency public health treatments, disclosing information, and gathering emergency materials and facilities under the guidance of the State Council. For health-care sectors, in addition to public health interventions, dealing with public psychological barriers and performing psychological crisis intervention is included in the level 1 response. The National Health Commission has released guidelines for local authorities to promote psychological crisis intervention for patients, medical personnel, and people under medical observation during the 2019-nCoV outbreak. 7 Peking University is preparing a mental health handbook for the public that describes how to deal with stress and other psychological problems occurring due to the outbreak of 2019-nCoV. 8 The Chinese Government strives to improve the public's awareness of prevention and intervention strategies by providing daily updates about surveillance and active cases on websites and social media. Increasingly, psychologists and psychiatrists use the internet and social media (eg, WeChat, Weibo, etc) to share strategies for dealing with psychological stress. For example, experts from Peking University Sixth Hospital made six suggestions for the public to cope with mental stress. 9 These included assessing the accuracy of information disclosed, enhancing social support systems (eg, families and friends), eliminating stigma associated with the epidemic, maintaining a normal life under safe conditions, and using the psychosocial service system, particularly telephone-based and internet-based counselling for health-care staff, patients, family members, and the public. Numerous psychiatric hospitals, psychological counselling centres, and psychology departments within universities have launched specialised hotlines to provide psychological counselling services for people in need. 7 We believe that including mental health care in the national public health emergency system will empower China and the world during the campaign to contain and eradicate 2019-nCoV.
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                Author and article information

                Journal
                Sci Prog
                Sci Prog
                SCI
                spsci
                Science Progress
                SAGE Publications (Sage UK: London, England )
                0036-8504
                2047-7163
                26 October 2021
                Oct-Dec 2021
                : 104
                : 4
                : 00368504211050291
                Affiliations
                [1 ]Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, Ringgold 16743, universityUniversity of Huelva; , Spain
                [2 ]Safety and Health Postgraduate Programme, Ringgold 27890, universityUniversidad Espíritu Santo; , Ecuador
                [3 ]Department of Nursing, Ringgold 16778, universityUniversity of Seville; , Spain
                [4 ]Department of Psychology, Ringgold 376603, universityUniversidad Loyola Andalucía; , Spain
                [5 ]Andalusian Health Service, Juan Ramón Hospital in Huelva, Spain
                [6 ]Department of Nursing and Podiatry, Health Sciences School, Ringgold 16752, universityUniversity of Málaga; , Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
                Author notes
                [*]Regina Allande Cussó, Department of Nursing, University of Seville, 6 Avenzoar st 41009 Sevilla, Spain. Email: rallande@ 123456us.es
                [*]Juan Gómez-Salgado, Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva. Avenida Tres de marzo, s/n, 21007, Huelva, Spain. Email: salgado@ 123456uhu.es , jgsalgad@ 123456gmail.com
                Author information
                https://orcid.org/0000-0001-9053-7730
                https://orcid.org/0000-0001-8325-0838
                https://orcid.org/0000-0002-5666-1487
                https://orcid.org/0000-0003-3715-1382
                Article
                10.1177_00368504211050291
                10.1177/00368504211050291
                10306143
                34698544
                ac66d4cb-2864-4050-9666-125d57ba4a00
                © The Author(s) 2021

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Categories
                Original Manuscript
                Custom metadata
                ts19
                October-December 2021

                fear,anxiety,covid-19,public health,mental health,instrument development

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