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

Kim Changnam,Ahmed Oli,Park C. Hyung Keun,Chung Seockhoon 대한신경정신의학회 2022 PSYCHIATRY INVESTIGATION Vol.19 No.6

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.

Psychometric Properties of the Insomnia Severity Index and Its Comparison With the Shortened Versions Among the General Population

Seockhoon Chung,Oli Ahmed,Eulah Cho,Young Rong Bang,Junseok Ahn,Hayun Choi,Yoo Hyun Um,Jae-Won Choi,Seong Jae Kim,Hong Jun Jeon 대한신경정신의학회 2024 PSYCHIATRY INVESTIGATION Vol.21 No.1

Objective The aim of this study was to explore the psychometric properties of the Insomnia Severity Index (ISI) based on modern test theory, such as item response theory (IRT) and Rasch analysis, with shortened versions of the ISI among the general population.Methods We conducted two studies to evaluate the reliability and validity of the shortened versions of the ISI in a Korean population. In Study I, conducted via online survey, we performed an exploratory factor analysis (n=400). In Study II, confirmatory factor analysis (CFA) was conducted (n=400). IRT and Rasch analysis were performed on all samples. Participants symptoms were rated using the ISI, Dysfunctional Beliefs and Attitudes about Sleep–16 items, Dysfunctional Beliefs about Sleep–2 items, Patient Health Questionnaire–9 items, and discrepancy between desired time in bed and desired total sleep time.Results CFA showed a good fit for the 2-factor model of the ISI (comparative fit index=0.994, Tucker–Lewis index=0.990, root-meansquare-error of approximation=0.039, and standardized root-mean-square residual=0.046). The 3-item versions also showed a good fit for the model. All scales showed good internal consistency reliability. The scale information curve of the 2-item scale was similar to that of the full-scale ISI. The Rasch analysis outputs suggested a good model fit.Conclusion The shortened 2-factor ISI is a reliable and valid model for assessing the severity of insomnia in the Korean population. The results are needed to be explored further among the clinical sample of insomnia.

Adherence to Physical Distancing and Health Beliefs About COVID-19 Among Patients With Cancer

Hammoudi Sajida Fawaz,Ahmed Oli,An Hoyoung,Hong Youjin,Ahn Myung Hee,Chung Seockhoon 대한의학회 2023 Journal of Korean medical science Vol.38 No.43

Background: This study aimed to validate questionnaires on adherence to physical distancing and health beliefs about coronavirus disease 2019 (COVID-19) among patients with cancer and explore their interaction with depression or viral anxiety among them. Methods: Through an online survey, data from 154 cancer patients (female: 82.5%, breast cancer: 66.2%, current cancer treatment, presence: 65.6%) were collected from March to June 2022. The survey gathered responses to questionnaires on adherence to physical distancing, health beliefs about COVID-19, perceived social norms, Stress and Anxiety to Viral Epidemics-6 items, and Patient Health Questionnaire-2. Confirmatory factor analysis (CFA) for construct validity and structural equation model (SEM) were performed. Results: The CFA showed a good model fit for adherence to physical distancing (comparative fit index [CFI] = 1.000, Tucker–Lewis index [TLI] = 0.930, root-mean-square-error of approximation [RMSEA] = 0.000, and standardized root-mean-square residual [SRMR] = 0.050) and a satisfactory model fit for health beliefs about COVID-19 (CFI = 0.978, TLI = 0.971, RMSEA = 0.061, and SRMR = 0.089). Through SEM, we found that personal injunctive norms were the main mediators linking health beliefs with physical distancing in patients with cancer. Depression also mediated the effects of viral anxiety and perceived severity on physical distancing (χ2 = 20.073, df = 15, P = 0.169; CFI = 0.984; RMSEA = 0.047). Conclusion: The questionnaires are reliable and valid. Patients with cancer may be able to adhere to physical distancing by addressing perceived severity, viral anxiety, perceived benefits, self-efficacy, perceived barriers, as well as personal injunctive norms.

Mediating Role of Viral Anxiety and Insomnia in Relationship Between Work-Related Stress and Depression Among Cold Chain Workers During COVID-19 Pandemic

Xinjie Du,Runlian He,Ahmed Oli,Cho Eulah,Chung Seockhoon 대한의학회 2023 Journal of Korean medical science Vol.38 No.43

Background: Here we investigated whether cold chain workers’ insomnia, work-related stress, and viral anxiety contributed to their depression. Furthermore, we investigated the role of viral anxiety in mediating the association between work-related stress and depressive symptoms. Methods: All 200 invited cold chain workers voluntarily responded to an online survey. All were working at a market in Taiyuan, Shanxi Province, China, and responsible for testing nucleic acids in imported cold chain foods and disinfecting outer packaging at government request. We collected their demographic variables and rated their symptoms using the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6), Patient Health Questionnaire-9, Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), and Maslach Burnout Inventory - General Survey (MBI-GS). Results: Cold chain workers’ depression was significantly correlated with higher SAVE-6 (r = 0.450, P < 0.01), ISI (r = 0.603, P < 0.01), MBI-GS (r = 0.481, P < 0.01), and PSS (r = 0.390, P < 0.01) scores. SAVE-6 score was significantly correlated with ISI (r = 0.462, P < 0.01), MBI-GS (r = 0.305, P < 0.01), and PSS (r = 0.268, P < 0.01) scores. Linear regression revealed that their depression was predicted by SAVE-6 (β = 0.183, P = 0.003), ISI (β = 0.409, P < 0.001), and MBI-GS (β = 0.236, P = 0.002, adjusted R2 = 0.440, F = 40.04, P < 0.001) scores. Mediation analysis showed that their burnout directly influenced their depression, while viral anxiety or insomnia severity mediated the influence of burnout on depression. Conclusion: The study showed that burnout was a direct cause of depression and that viral anxiety and insomnia severity mediated the relationship between burnout and depression.

Intolerance of Uncertainty Mediates the Influence of Viral Anxiety on Social Distancing Phobia Among the General Korean Population During the Coronavirus Disease 2019 Pandemic

Cho Inn-Kyu,Ahmed Oli,Lee Dongin,Cho Eulah,Chung Seockhoon,Günlü Aykut 대한신경정신의학회 2022 PSYCHIATRY INVESTIGATION Vol.19 No.9

Objective We aimed to examined the reliability and validity of Korean version of Social Distancing Phobia scale, and whether intolerance of uncertainty mediates the association of the general population’s social distancing phobia with viral anxiety and depression.Methods Through this anonymous online survey, we collected responses from 400 individuals in the general Korean population. Participants’ demographic information and rating scales scores, including the Social Distancing Phobia scale, Stress and Anxiety to Viral Epidemics-6 items, Patient Health Questionnaire-9, and Intolerance of Uncertainty-12 items.Results Confirmatory factor analysis showed a good model fit, and the Korean version of Social Distancing Phobia scale showed good internal consistency. Social distancing phobia was significantly correlated with age (r=0.213, p<0.001), viral anxiety (r=0.390, p<0.001), depression (r=0.244, p<0.001), and intolerance of uncertainty (r=0.323, p<0.001). A linear regression analysis showed that age (β=0.235, p<0.001), viral anxiety (β=0.281, p<0.001), depression (β=0.121, p=0.009), and intolerance of uncertainty (β=0.200, p<0.001; adjusted R²=0.246, F=33.6, p<0.001) predicted social distancing phobia. Mediation analysis revealed that viral anxiety directly influenced social distancing phobia (z=6.48, p<0.001), and intolerance of uncertainty partially mediated this association (z=2.92, p=0.003).Conclusion Social distancing phobia may cause psychological stress but may also increase adherence to physical distancing measures and prevent the spread of viruses.

Application of Stress and Anxiety to Viral Epidemics-6 to Measure the Anxiety Response of Cold Chain Practitioners During the COVID-19 Post-Pandemic Era in China

Runlian He,Xinjie Du,Ahmed Oli,Cho Eulah,Chung Seockhoon 대한신경정신의학회 2023 PSYCHIATRY INVESTIGATION Vol.20 No.2

Objective This study explored the psychometric properties of the Chinese version of the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6) scale for cold chain practitioners exposed to moderate-to-high risk of infection.Methods A total of 233 cold chain practitioners participated in an anonymous online survey, conducted from October to November 2021. The questionnaire comprised participant demographic characteristics, the Chinese version of SAVE-6, the Generalized Anxiety Disorders-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9) scales.Results Based on the results of the parallel analysis, the single-structure model of the Chinese version of SAVE-6 was adopted. The scale showed satisfactory internal consistency (Cronbach’s alpha=0.930) and good convergent validity based on Spearman’s correlation coefficient with the GAD-7 (rho=0.616, p<0.001) and PHQ-9 (rho=0.540, p<0.001) scale scores. The optimal cutoff score for Chinese Stress and Anxiety to Viral Epidemics-9 Items was identified as ≥12 (area under the curve=0.797, Sensitivity=0.76, Specificity=0.66) for cold chain practitioners.Conclusion The Chinese version of the SAVE-6 scale has good psychometric properties and can be applied as a reliable and valid rating scale to assess the anxiety response of cold chain practitioners in the post-pandemic era.

Validation of the Pandemic Grief Risk Factors and Its Relationship With Work-Related Stress and Grief Reaction Among Healthcare Workers Who Witnessed Patient Deaths

Park C. Hyung Keun,Yoo Soyoung,Ahmed Oli,Chung Seockhoon,Lee Sherman A. 대한의학회 2024 Journal of Korean medical science Vol.39 No.11

Background: The Pandemic Grief Risk Factors (PGRFs) was developed as a self-report tool to compile a comprehensive list of unique risk factors related to grief when experiencing a coronavirus disease 2019 (COVID-19) loss. We explored the reliability and validity of the PGRF among healthcare workers who witnessed their patients’ deaths during the COVID-19 pandemic. Further, we examined whether the general severity of PGRF may have been associated with work-related stress and pandemic grief reactions. Methods: An online survey was conducted among tertiary hospital healthcare workers (doctors and nursing professionals) who had witnessed the deaths of patients they cared for. Pandemic Grief Scale for healthcare workers, the Stress and Anxiety to Viral Epidemics-3 items, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7 responses were collected. Results: In total, 267 responses were analyzed. The single-factor structure of the Korean version of the PGRF showed a good fit for the model. The scale demonstrated good internal consistency and convergent validity with other depression and anxiety rating scales. The mediation analysis revealed that work-related stress directly influenced pandemic grief reactions positively, and depression, anxiety, and general severity of grief risk factors partially mediated the association positively. Conclusion: Among healthcare workers who witnessed the deaths of their patients due to COVID-19, the Korean version of the PGRF was valid and reliable for measuring the overall severity of PGRF. The PGRF can be used to identify individuals at risk for dysfunctional grief.

Validation of the Stress and Anxiety to Viral Epidemics-9 (SAVE-9) Scale and Relationship With Insomnia or Depression Among Healthcare Workers Who Witnessed Patient’s Death in COVID-19 Pandemic

Lee Dongin,Kamaleddine Issa,Cho Inn-Kyu,Ahmed Oli,Cho Eulah 대한수면학회 2022 sleep medicine research Vol.13 No.3

Background and Objective We tested the psychometric properties of the Stress and Anxiety to Viral Epidemics-9 (SAVE-9) scale among healthcare workers who experienced patients’ deaths.Methods From June 2nd to 10th, 2022, an anonymous, online survey was administered to medical doctors and nursing professionals who witnessed the deaths of patients they cared for during the last two years. Participants demographic characteristics and responses to the SAVE-9, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI) were collected.Results A total of 267 responses were collected in this survey. The two-factor model of the SAVE-9 fits well among healthcare workers who witnessed patients’ death (CFI = 1.000, GFI = 0.996, RMSEA = 0.000, RSMR = 0.040). The SAVE-9 scale showed good reliability of internal consistency and convergent validity with the GAD-7 (r = 0.429, p = 0.001), PHQ-9 score (r = 0.414, p = 0.001), and ISI (r = 0.368, p = 0.001).Conclusions We observed that the SAVE-9 and its two subscales were valid and reliable tools for measuring work-related stress and viral anxiety among healthcare workers who witnessed the death of their patients.

Validity and Psychometric Properties of the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6) Scale Among Nursing Students During COVID-19

( Jeong Hye Kim ),( Mi-kyeong Jeon ),( Oli Ahmed ),( Seockhoon Chung ),( Seong Yoon Kim ) 한국정신병리진단분류학회 2022 精神病理學 Vol.26 No.1

Background During the coronavirus disease 2019 (COVID-19) pandemic, nursing students have suffered moderate levels of stress, higher than that of students in other academic majors. Purpose This study explores the validity and reliability of the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6) scale as a measurement tool for anxiety responses of nursing students to the COVID-19 pandemic. Methods An online survey was conducted from 8-10 December, 2021 in South Korea. A total of 227 nursing students participated in the survey, which included the rating scales SAVE-6, 9-question Patients Health Questionnaire (PHQ-9), and Generalized Anxiety Disorders-7 (GAD-7). Results A confirmatory factor analysis showed a good fit for the single factor structure model of SAVE-6 (χ2/df = 2.86, CFI = 1.00, TLI = 1.013, RMSEA = 0.000, and SRMR = 0.036). SAVE-6 showed good internal consistency and reliability based on Cronbach’s alpha (0.833) and McDonald’s Omega (0.838). Furthermore, it revealed good convergent validity with the GAD-7 (r = 0.518, p < 0.001) and PHQ-9 scores (r = 0.261, p < 0.001). The appropriate cut-off score of the SAVE-6 in accordance with the mild degree of GAD-7 (≥ 5) was 15 (area under the curve = 0.783, sensitivity = 0.82, specificity = 0.61). Conclusions SAVE-6 can measure nursing students’ virus-related anxiety during the COVID-19 pandemic with good reliability and validity.

Assessing Stress and Anxiety in Firefighters During the Coronavirus Disease-2019 Pandemic: A Comparative Adaptation of the Stress and Anxiety in the Viral Epidemic–9 Items and Stress and Anxiety in the Viral Epidemics–6 Items Scales

Inn-Kyu Cho,Han Sung Lee,Kayoung Song,Oli Ahmed,Dongin Lee,Jiyoung Kim,Eulah Cho,Soomin Jang,Jeong-Hyun Kim,Seockhoon Chung 대한신경정신의학회 2023 PSYCHIATRY INVESTIGATION Vol.20 No.11

Objective This study assessed the reliability and validity of the Stress and Anxiety to Viral Epidemics–9 items (SAVE-9) and Stress and Anxiety to Viral Epidemics–6 items (SAVE-6) scales for measuring viral anxiety among firefighters during the coronavirus disease-2019 pandemic.Methods An online survey was conducted among 304 firefighters assigned in Gyeonggi-do. The SAVE-9 scale, initially developed for healthcare workers, was adapted for firefighters. We compared it with the SAVE-6 scale designed for the general population among the firefighters sample. The confirmatory factor analysis (CFA) was conducted to explore the factor structure of both scales. Internal consistency reliability was checked using Cronbach’s alpha and McDonald’s omega. Convergent validity was assessed in accordance with the Patient Health Questionnaire–9 and Generalized Anxiety Disorder–7 scales.Results The SAVE-9 scale demonstrated a Cronbach alpha of 0.880, while the SAVE-6 scale yielded an alpha of 0.874. CFA indicated good model fits for both SAVE-9 and SAVE-6 scales among firefighters sample. The SAVE-9 and SAVE-6 comparably measures viral anxiety of firefighters.Conclusion Both of the SAVE-9 and SAVE-6 scales are reliable and valid instruments for assessing viral anxiety among firefighters during the pandemic.