Development of the Stress and Anxiety to Viral Epidemics-9 (SAVE-9) scale for assessing work-related stress and anxiety in healthcare workers in response to COVID-19

Abstract

The coronavirus disease 2019 (COVID-19) has had psychological impacts on healthcare workers. However, very few scales are available to specifically assess healthcare workers’ work-related stress and anxiety in response to viral epidemics. This study developed a new rating scale, the Stress and Anxiety to Viral Epidemics-9 (SAVE-9), and validated it among healthcare workers directly affected by COVID-19 in Korea. A total of 1,019 healthcare workers responded through anonymous questionnaires during April 20-30, 2020. Internal consistency of the SAVE-9 was measured through Cronbach’s alpha, and principal component analysis with varimax rotation was used to determine its component structure. It was also compared with the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 scales. Its most appropriate cut-off point was determined by conducting receiver operating characteristic analysis. The nine-item scale had satisfactory internal consistency (Cronbach’s α=0.795). It adopted a two-factor structure: (1) anxiety about viral epidemics and (2) work-related stress associated with viral epidemics (Bartlett’s test of sphericity, p < 0.001; Kaiser-Meyer-Olkin=0.85). Correlations between SAVE-9 and the other scales were statistically significant. The cut-off points of the SAVE-9 and its anxiety subcategory were 22 and 15, respectively, compared with a GAD-7 score of 5. The results suggest that the SAVE-9 is a useful, reliable, and valid tool to evaluate stress and anxiety responses in healthcare workers during viral epidemics.

Application of the Stress and Anxiety to Viral Epidemics-6 (SAVE-6) and Coronavirus Anxiety Scale (CAS) to Measure Anxiety in Cancer Patient in Response to COVID-19

“…Among 221 cancer patients, 110 (49.8%) had SAVE-6 scores ≥ 15 (Chung et al, 2020), while only 21 (9.5%) had CAS scores ≥ 5 (Lee, 2020b). A total of 104 (47.1%) subjects had WSAS scores ≥ 11 (moderate to severe dysfunction) and 29 (13.1%) had WSAS ≥ 21 (severe dysfunction) (Mundt et al, 2002).…”

“…Previous study (Chung et al, 2020) used a cut-off score of the SAVE-6 was 15 based on the least mild degree (≥5 points) of the General Anxiety Scale-7 (GAD-7).…”

“…The six-item Stress and Anxiety to Viral Epidemics (SAVE-6) (Chung et al, 2020), one of scales that measure the anxiety related to viral epidemics, is a self-report questionnaire. SAVE-6 was shown to sensitively detect people with non-pathological psychological problems and stresses (Ahn et al, 2020).…”

The Attitudes of Medical Students for Their Roles and Social Accountability in the COVID-19 Pandemic Era

“…The SAVE-6 scale is the anxiety response to a viral epidemic, and a subcategory of the SAVE-9 scale [11], that was initially developed for assessing work-related stress and anxiety responses of healthcare workers to viral epidemics in COVID-19 [12]. The SAVE-9 was clustered into the following two factors: 1) anxiety response to viral epidemics and 2) work-related stress.…”

“…In Korea, since the first reported case on January 20, 2020, the COVID-19 crisis level has remained at the 'severe' level. Around the world, 12,322,395 patients have tested positive for COVID-19. Korea has reported 13,440 cases, with 298 deaths due to COVID-19-related causes.…”