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 Viral Epidemics

Abstract

Background The coronavirus disease 2019, or COVID-19, has had a major psychological impact on healthcare workers. However, very few scales are available to specifically assess work-related stress and anxiety in healthcare workers responding to a viral epidemic. This study developed a new assessment tool, the Stress and Anxiety to Viral Epidemics-9 (SAVE-9) and aimed to validate it among healthcare workers directly affected by COVID-19 in Korea. Methods A total of 1,019 healthcare workers responded through anonymous questionnaires during April 20–30, 2020. Exploratory factor analysis (EFA) was conducted to explore the construct validity, and the reliability was assessed using internal consistency measures of Cronbach's alpha coefficients. Receiver operating characteristic analysis was conducted to define the most appropriate cut-off point of SAVE-9 using the Generalized Anxiety Disorder-7 scale (GAD-7; ≥ 5). Second, Spearman's rank correlation coefficient was used to establish convergent validity for the SAVE-9 questionnaire with GAD-7 and the Patient Health Questionnaire-9. Results The nine-item scale had satisfactory internal consistency (Cronbach's α = 0.795). It adopted a two-factor structure: 1) anxiety regarding viral epidemics and 2) work-related stress associated with viral epidemics. A cut-off score of 22 for the SAVE-9 ascertained levels of stress and anxiety in response to a viral epidemic in healthcare workers that warranted clinical attention. Correlations between the SAVE-9 and the other scales were statistically significant ( P < 0.05). Conclusion 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.

Healthcare Workers' Resilience Mediates the Influence of Organizational Commitment and Anxiety Response to Viral Epidemic on Their Quality of Life in the COVID-19 Pandemic

“…In this study, the mean score of SAVE-9 was 23.0. Considering that our previous study describing the SAVE-9 proposed a cut-off score of 22 points ( 44 ), we observed that 241 (62%) of healthcare workers showed work-related stress and anxiety during the pandemic. This finding is consistent with previous studies confirming a substantial proportion of mental health issues among healthcare workers ( 12 , 13 , 16 , 51 ).…”

“…Therefore, early detection, screening, and interventions are crucial. The SAVE-9 is a virus-related anxiety and work stress scale developed by Chung ( 44 ) to directly reflect the psychological stress in relation to the viral epidemic during COVID-19. Traditional assessment scales such as the Generalized Anxiety Disorder-seven items (GAD-7) ( 45 ), Zung's Self-rating Anxiety Scale (SAS) ( 46 ), and the Depression Anxiety and Stress Scale ( 47 ) are general scales to evaluate the anxiety of an individual.…”

Mediation Effect of Self-Efficacy and Resilience on the Psychological Well-Being of Lebanese People During the Crises of the COVID-19 Pandemic and the Beirut Explosion

“…The SAVE-6 scale is a self-reporting rating scale which was developed to measure the respondent's anxiety response to the COVID-19 pandemic ( 28 ). It was derived from the original SAVE-9 scale, in order to measure the work-related stress and anxiety of healthcare workers in response to the COVID-19 pandemic ( 29 ). The SAVE-6 scale was validated among the general population in various languages, including Korean ( 28 ), Arabic ( 30 ), and English ( 31 ).…”

Validity and Reliability of the Stress and Anxiety to Viral Epidemics-6 (SAVE-6) Scale to Measure Viral Anxiety of Healthcare Workers in Spain During the COVID-19 Pandemic

“…Therefore, specifically assessing healthcare workers' anxiety responses to the viral epidemic to manage their mental health should be considered important. For that, Chung et al (11) developed the Stress and Anxiety to Viral Epidemics-9 items (SAVE-9) scale to measure healthcare workers' work-related stress and anxiety responses during the pandemic. It is a 9item self-rating scale and validated in Korean (11), Russian (12), Italian (13), Japanese (14), Turkish (15), and German (16).…”

“…For that, Chung et al (11) developed the Stress and Anxiety to Viral Epidemics-9 items (SAVE-9) scale to measure healthcare workers' work-related stress and anxiety responses during the pandemic. It is a 9item self-rating scale and validated in Korean (11), Russian (12), Italian (13), Japanese (14), Turkish (15), and German (16). The SAVE-6 scale, derived from the SAVE-9 scale, used to assess the anxiety response of the general population, was validated in Korean (17), Lebanese (18), and American samples (19).…”