Psychometric Evaluation of a Fear of COVID-19 Scale in China: Cross-sectional Study

Abstract

Background At the very beginning of the COVID-19 pandemic, information about fear of COVID-19 was very limited in Chinese populations, and there was no standardized and validated scale to measure the fear associated with the pandemic. Objective This cross-sectional study aimed to adapt and validate a fear scale to determine the levels of fear of COVID-19 among the general population in mainland China and Hong Kong. Methods A web-based questionnaire platform was developed for data collection; the study instruments were an adapted version of the 8-item Breast Cancer Fear Scale (“Fear Scale”) and the 4-item Patient Health Questionnaire. The internal construct validity, convergent validity, known group validity, and reliability of the adapted Fear Scale were assessed, and descriptive statistics were used to summarize the participants’ fear levels. Results A total of 2822 study participants aged 18 years or older were included in the analysis. The reliability of the adapted scale was satisfactory, with a Cronbach α coefficient of .93. The item-total correlations corrected for overlap were >0.4, confirming their internal construct validity. Regarding convergent validity, a small-to-moderate correlation between the Fear Scale and the 4-item Patient Health Questionnaire scores was found. Regarding known group validity, we found that the study participants who were recruited from Hong Kong had a higher level of fear than the study participants from mainland China. Older adults had a higher level of fear compared with younger adults. Furthermore, having hypertension, liver disease, heart disease, cancer, anxiety, and insomnia were associated with a higher fear level. The descriptive analysis found that more than 40% of the study participants reported that the thought of COVID-19 scared them. About one-third of the study participants reported that when they thought about COVID-19, they felt nervous, uneasy, and depressed. Conclusions The psychometric properties of the adapted Fear Scale are acceptable to measure the fear of COVID-19 among Chinese people. Our study stresses the need for more psychosocial support and care to help this population cope with their fears during the pandemic.

Psychometric evaluation of Korean version of COVID-19 fear scale (K-FS-8): A population based cross-sectional study

“…The BCFS was previously validated in Chinese for COVID-19 fear measurement [22]. Similar to this study, the validation study of Choi and colleagues confirmed their convergent validity of BCFS for COVID-19 fear with the PHQ-4; correlations between the level of fear and anxiety and depressive symptoms were validated [22].…”

“…reliability) [22]. Therefore, it can be confirmed that BCSF, which was modified for measuring COVID-19 fear both in Korean and Chinese, is valid and reliable.…”

“…Therefore, this study that included wider age groups of participants would have advantage. Moreover, this study and the Chinese validation study [22] conducted the psychometric evaluation of BCSF for COVID-19 fear with large samples(n = 2,235 and n = 2,822, respectively), comparing with the FCV-19 studies, which can be another advantage of this study.…”

“…The BCFS was developed on the robust theoretical frameworks-Extended Parallel Process Model (EPPM) [20] and Health Belief Model (HBM) [21], which establishes the definitions of fear, threat and barrier based on a profound understanding of their nature [19]. Even though the fear scale was originally developed to measure the fear of breast cancer, a study validated the scale to measure the fear of COVID-19 using BCFS in mainland China and Hong Kong [22]. Moreover, the theoretical framework of BCFS (i.e., EPPM and HBM) has been widely used for research addressing public health emergencies including COVID-19.…”

Covid-19 Korkusunu Etkileyen Faktörler

“…Furthermore, even though the Fear Scale was originally developed to measure fear of breast cancer, the question items are generic and comprehensive. The Fear Scale covers common responses to fear such as feeling scared, nervous, upset, depressed, jittery, uneasy, and anxious, as well as having heart palpitations (Choi et al, 2022). And finally, the 8-item Breast Cancer Fear Scale was one of the few instruments available to measure fear among the Turkish population (Secginli, 2012).…”