Validation of the healthcare workers' version of the Pandemic Grief Scale among frontline nursing professionals during the COVID-19 pandemic in Korea.

Introduction: Nurses have been repeatedly exposed to unexpected death and grief during COVID-19 pandemic, and it is necessary to provide grief support for the nurses who have experienced the loss of patients to COVID-19. We aimed to explore the reliability and validity of the Pandemic Grief Scale (PGS) for Healthcare Workers among frontline nursing professionals working in COVID-19 inpatient wards whose patients may have died. Methods: An anonymous online survey was performed among frontline nursing professionals working in COVID-19 wards in three tertiary-level general hospitals in Korea between April 7 and 26, 2021. In total, 229 from participants who confirmed they had witnessed death of patients were employed for the statistical analysis. The survey included demographic characteristics and rating scales, including the Korean version of the PGS for Healthcare Workers, the Fear of COVID-19 scale, the Generalized Anxiety Disorder-7 items, and the Patient Health Questionnaire-9 items. Results: The single-factor structure of the Korean version of the PGS for Healthcare Workers showed good fits for the model. The scale had good internal consistency and convergent validity with other anxiety and depression scales. Conclusion: The Korean version of the PGS of Healthcare Workers was valid and reliable for measuring grief reactions among nursing professionals facing the pandemic. It will be helpful in evaluating the grief reaction of the healthcare workers and providing them with a psychological support system.

Grief Response of Nursing Professionals Is Associated With Their Depression, Loneliness, Insomnia, and Work-Related Stress While Working in COVID-19 Inpatients Wards.

OBJECTIVE: We aimed to explore whether nursing professionals' psychological states affect their grief response for a patient's death in the coronavirus disease-2019 (COVID-19) inpatients' ward. METHODS: Survey was conducted among frontline nursing professionals working in COVID-19 inpatients wards at three tertiary-level affiliated hospitals of the University of Ulsan during April 7-26, 2022. Participants' information such as age, years of employment, or marital status were collected, and their responses to rating scales including Pandemic Grief Scale (PGS) for healthcare workers, Stress and Anxiety to Viral Epidemics-9 items (SAVE-9), Patient Health Questionnaire-9 (PHQ-9), Loneliness and Social Isolation Scale, and Insomnia Severity Scale (ISI) were collected. RESULTS: All 251 responses were analyzed. We observed that 34% reportedly suffered from depression. The linear regression analysis showed that a high PGS score was expected by high SAVE-9 (ß=0.12, p=0.040), high PHQ-9 (ß=0.25, p<0.001), high loneliness (ß=0.17, p=0.006), and high ISI score (ß=0.16, p=0.006, F=20.05, p<0.001). The mediation analysis showed that the depression of nursing professionals directly influenced their pandemic grief reaction, and their work-related stress and viral anxiety, insomnia severity, and loneliness partially mediated the association. CONCLUSION: We confirm that frontline nursing professionals' depression directly influenced their grief reaction, and their work-related stress and viral anxiety, insomnia severity, and loneliness partially mediated the association. We hope to establish a psychological and social support system for the mental health of nurses working in the COVID-19 wards.

Effect of Cancer-Related Dysfunctional Beliefs About Sleep on Fear of Cancer Progression in the Coronavirus Pandemic.

BACKGROUND: This study aimed to explore clinical correlates of fear of progression (FoP) among patients with cancer during the coronavirus disease 2019 (COVID-19) pandemic and examine the mediation effect of cancer-related dysfunctional beliefs about sleep (C-DBS). METHODS: Medical charts of patients with cancer who visited a psycho-oncology clinic between July and November 2021 were reviewed. Baseline socio-demographic and cancer-related variables were collected. Patients' self-report questionnaires, regarding FoP, depression (Patient Health Questionnaire-9 items; PHQ-9), viral anxiety (Stress and Anxiety to Viral Epidemics-6 items; SAVE-6), C-DBS, and other distress, were investigated. Pearson's correlation and linear regression were performed to examine the risk factors of FoP. Mediation effect analysis with the bootstrap method with 2,000 resamples was implemented. RESULTS: A total of 231 patients were included in the analysis. Linear regression revealed that FoP was predicted by age (ß = -0.14, P = 0.003), PHQ-9 (ß = 0.48, P < 0.001), SAVE-6 (ß = 0.34, P < 0.001), and C-DBS (ß = 0.15, P = 0.005). FoP was directly influenced by SAVE-6 and mediated by C-DBS, while it was directly influenced by PHQ-9 with no mediation effect. CONCLUSION: During the COVID-19 pandemic, the FoP of patients with cancer was associated with younger age, depression, viral anxiety, and C-DBS. Depression and viral anxiety directly influenced FoP, while C-DBS mediated the association between viral anxiety and FoP. Therefore, oncology healthcare professionals are recommended to assess C-DBS of their patients when they are highly distressed from FoP.

Applicability and Psychometric Comparison of the General-Population Viral Anxiety Rating Scales among Healthcare Workers in the COVID-19 Pandemic.

We aimed to explore the reliability and validity of viral anxiety rating scales (developed for the general population) among healthcare workers. In addition, we compared the psychometric properties of rating scales in accordance with the Generalized Anxiety Scale-7 items (GAD-7) during this COVID-19 pandemic. The viral anxiety of 330 healthcare workers was measured with Stress and Anxiety to Viral Epidemics-9 items (SAVE-9), SAVE-6, Coronavirus Anxiety Scale (CAS), Fear of COVID-19 Scale (FCV-19S), and COVID-19 Anxiety Scale (CAS-7). Factor analyses, item response theory, and Rasch model analyses were conducted to confirm the construct validities of the scales and compare the psychometric properties of rating scales. The receiver operating curve (ROC) analysis examined the cutoff scores of rating scales in accordance with a mild degree of generalized anxiety. The SAVE-9, SAVE-6, CAS, FCV-19S, and CAS-7 scales showed good reliability of internal consistency among healthcare workers. Their construct validity and convergent validity of each scale were similarly good. Furthermore, in comparing the psychometric properties of rating scales, we observed that the CAS scale was the most discriminating and difficult among the scales. The CAS and FCV-19S provided more information and were more efficient than the SAVE-9, SAVE-6, and CAS-7 scales when they were used to measure healthcare workers' viral anxiety. Viral anxiety rating scales can be applied to healthcare workers with good reliability and validity.

Validation of the Korean Version of the Coronavirus Reassurance-Seeking Behaviors Scale During the COVID-19 Pandemic.

OBJECTIVE: In this study, we aimed to develop a Korean version of the Coronavirus Reassurance-Seeking Behaviors Scale (CRBS) and to explore its reliability and validity among the general population in South Korea. METHODS: Using an online survey conducted during November 9-15, 2021, we collected the demographic data of 400 individuals and their responses to rating scales such as the CRBS, the Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), the Generalized Anxiety Disorder-7 items (GAD-7), and the Patient Health Questionnaire-9 items (PHQ-9). We conducted factor analyses and utilized item response theory to confirm the validity and reliability of the Korean version of the CRBS. RESULTS: Factor analyses revealed that the single factor model of the Korean version of the CRBS showed a good fit with the CRBS (χ2=5.475, df=5, p value=0.361, χ2/df=1.095, CFI=0.999, TLI=0.998, RMSEA=0.015). Multigroup CFA results indicated that the CRBS measures reassurance-seeking behaviors consistently across variables of sex, depression, general anxiety, and viral anxiety. The CRBS also exhibited good convergent validity with the SAVE-6 (r=0.431, p<0.001), GAD-7 (r=0.574, p<0.001), and PHQ-9 (r=0.575, p<0.001). CONCLUSION: The CRBS is a reliable and valid rating scale that measures reassurance-seeking behavior in relation to viral epidemics.

Mediating Effect of Viral Anxiety and Perceived Benefits of Physical Distancing on Adherence to Distancing Among High School Students Amid COVID-19.

BACKGROUND: The aim of this study is to explore whether high school students' adherence to physical distancing was associated with health beliefs, social norms, and psychological factors during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Overall, 300 high school students participated in this anonymous online survey conducted from October 18-24, 2021. The survey included rating scales such as attitude toward physical distancing during the pandemic, Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), Patient Health Questionnaire-9 items, Satisfaction with Life Scale, and Connor Davidson Resilience Scale 2-items. RESULTS: The results revealed that perceived susceptibility or severity (ß = -0.13, P = 0.038), perceived benefit (ß = 0.32, P < 0.001), descriptive social norms (ß = 0.10, P = 0.041), social injunctive norms (ß = 0.19, P < 0.001), and SAVE-6 (ß = 0.24, P < 0.001) predicted students' adherence to physical distancing (adjusted R² = 0.42, F = 19.2, P < 0.001). Social injunctive norms and personal injunctive norms directly influenced adherence to physical distancing. Viral anxiety, measured by SAVE-6, mediated the association between social injunctive norms and adherence to physical distancing, and perceived benefits mediated the relationship between personal injunctive norms and adherence to physical distancing. The influence of perceived susceptibility or severity on adherence to physical distancing was entirely mediated by perceived benefits or viral anxiety. CONCLUSION: Explaining the rationale or benefits of physical distancing may be important in increasing adherence to physical distancing among high school students.

The Psychometric Properties of the French-Canadian Stress and Anxiety to Viral Epidemics-6 Scale for Measuring the Viral Anxiety of the General Population During the COVID-19 Pandemic.

Objective: This study examined the psychometric properties of the French-Canadian version of the Stress and Anxiety to Viral Epidemics-6 items (SAVE-6) scale for assessing the anxiety response to the viral epidemic among the general population in Quebec, Canada. Methods: A total of 590 participants responded to a confidential online survey between September 28 and October 18, 2020. Confirmatory Factor Analysis (CFA) was conducted to explore the factor structure of the scale. Psychometric properties were assessed using the Item Response Theory (IRT) approach. To explore the convergent validity, a Pearson correlation analysis between the SAVE-6 scale and the depression (Patient Health Questionnaire-2, PHQ-2) or anxiety subscale (Generalized Anxiety Disorder-2, GAD-2) of the Patient Health Questionnaire-4 items scale was conducted. Findings: The French-Canadian version of the SAVE-6 scale was clustered into a single factor. The CFA of the SAVE-6 scale showed a good model fit (CFI = 0.985, TLI = 0.976, RMSEA = 0.051, RSMR = 0.048), and the multi-group CFA revealed that the SAVE-6 scale can measure anxiety response in the same way across gender or the presence of elevated depressive and anxiety symptoms. It showed good internal consistency (Cronbach's alpha = 0.76, McDonald's Omega = 0.77) and significant correlation with the PHQ-2 score and GAD-2 score. The IRT model suggested the efficiency in discrimination among individuals in this latent trait. Conclusion: The French-Canadian version of the SAVE-6 scale is a valid and reliable rating scale, which can measure the general population's anxiety response to the viral epidemic.

Application of Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6) to Public Workers for Measuring Their Anxiety Response During the COVID-19 Pandemic.

Objective: This study aimed to compare the adaptability of the adapted version of Stress and Anxiety to Viral Epidemics-9 (SAVE-9) for public workers and the SAVE-6 scale and to validate them among public workers who are on the frontline of the coronavirus disease 2019 pandemic. Methods: A total of 300 public workers responded to the anonymous online survey during April 1-12, 2021. Principal component analysis was conducted with varimax rotation to explore the factor structure of this scale. Confirmatory factor analysis was also used to explore construct validity. Spearman correlation analysis of the scale with the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9) was performed to explore the convergent validity. The cut-off score in accordance with the mild degree of generalized anxiety symptoms (GAD-7 score of 5) was defined using the receiver operating characteristic (ROC) analysis. Findings: The single-structure model of each scale (the adapted version of SAVE-9 and SAVE-6) was adopted based on the results of the parallel analysis. Because SAVE-6 showed good construct validity, but the adapted version of SAVE-9 did not, we adopted to apply the SAVE-6 scale to assess the anxiety response of public workers in response to the viral epidemic. SAVE-6 showed good internal consistency (Cronbach's alpha = 0.817; McDonald's Omega = 0.818) and good convergent validity with GAD-7 (rho = 0.417, p < 0.001) and PHQ-9 (rho = 0.317, p < 0.001) scale scores. The appropriate cut-off score for SAVE-6 was determined to be ≥ 16. Conclusion: The SAVE-6 scale, as compared to the public workers' version of SAVE-9, is a reliable and valid rating scale to assess the work-related stress and anxiety of public workers due to the viral epidemic.