Factorial Validity of the Arabic Version of the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6) Scale among the General Population in Lebanon

Abstract

This study explored the psychometric properties of the Arabic version of the Stress and Anxiety to Viral Epidemics-6 items (SAVE-6) scale for assessing people's anxiety in response to the viral epidemic in Lebanon. The 406 participants responded voluntarily to the online survey that included the SAVE-6, Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) tools. The single-structure SAVE-6 model showed good internal consistency (Cronbach's α = 0.773). The SAVE-6 scale also showed good convergent validity with the GAD-7 (Spearman's ρ = 0.42, P < 0.001) and PHQ-9 (ρ = 0.38, P < 0.001). Receiver operating characteristic (ROC) analysis revealed an Arabic SAVE-6 cut-off score of 12 points (area under the curve [AUC] = 0.753; sensitivity = 62.74%; specificity = 78.26%) for an at least mild degree of anxiety (GAD-7 score ≥ 5). The Arabic version of the SAVE-6 was a reliable, valid, and solely usable scale for measuring the anxiety response of the general population to the viral epidemic.

Stress and Anxiety to Viral Epidemics-6 for Medical Students: Psychometric Properties of the Anxiety Measure for the COVID-19 Pandemic

“…In this study, a single-structure model of SAVE-6 was confirmed to be valid and in line with previous studies ( 8 , 9 ). However, we observed a relatively low factor loading value of 0.446 for item 1, “Are you afraid that the virus outbreak will continue indefinitely?” The survey was conducted during the summer of 2020, when people were worried that the COVID-19 pandemic would be difficult to control, which may have contributed to the high proportion of answers of “often” (53.8%) and “always” (17.0%) among medical students.…”

“…In this study, a single-structure model of SAVE-6 was confirmed to be valid and in line with previous studies (8,9). However, we observed a relatively low factor loading value of 0.446 for item 1, "Are you afraid that the virus outbreak will continue indefinitely?"…”

“…The Stress and Anxiety to Viral Epidemics-6 items (SAVE-6) scale is a version extracted from the original SAVE-9 scale ( 7 ) which was developed to assess work-related stress and anxiety of healthcare workers in response to the viral epidemic. The utility of SAVE-6 among the general population has been studied in Korea ( 8 ) and Lebanon ( 9 ). The items are rated on a 5-point Likert scale: 0 (never), 1 (rarely), 2 (sometimes), 3 (often), and 4 (always) 2 .…”

“…Since medical students are not healthcare workers, it is not appropriate to apply the SAVE-9 scale to them. We observed that the SAVE-9 scale was clustered into two factors: factor I—“anxiety about the viral epidemic” and factor II—“work-related stress associated with the viral epidemic.” We previously explored the validity of factor I (namely, SAVE-6) for measuring anxiety of the general population in Korea ( 8 ) and Lebanon ( 9 ). Several rating scales such as Coronavirus Anxiety Scale (CAS) ( 10 ), COVID-19-Anxiety Questionnaire ( 11 ), Fear of COVID-19 Scale ( 12 ), Obsession with COVID-19 Scale ( 13 ), Coronavirus Pandemic Anxiety Scale ( 14 ), COVID-19 Anxiety Syndrome Scale ( 15 ), and COVID-19 Anxiety Scale ( 16 ) were also developed and applied to assess the anxiety response of the general population to the viral epidemic.…”

“…Several rating scales such as Coronavirus Anxiety Scale (CAS) ( 10 ), COVID-19-Anxiety Questionnaire ( 11 ), Fear of COVID-19 Scale ( 12 ), Obsession with COVID-19 Scale ( 13 ), Coronavirus Pandemic Anxiety Scale ( 14 ), COVID-19 Anxiety Syndrome Scale ( 15 ), and COVID-19 Anxiety Scale ( 16 ) were also developed and applied to assess the anxiety response of the general population to the viral epidemic. SAVE-6 included items inquiring about the apprehension of an individual during the current pandemic situation, worry about avoidance behavior of others, and concern about their own health and that of their family members ( 8 , 9 ). In this study, we hypothesized that the SAVE-6 scale can be applied usefully to measure the anxiety response of medical students to the viral epidemic.…”