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

The coronavirus disease 2019 (COVID-19) has had psychological impacts on healthcare workers. However, very few scales are available to specifically assess healthcare workers’ work-related stress and anxiety in response to viral epidemics. This study developed a new rating scale, the Stress and Anxiety to Viral Epidemics-9 (SAVE-9), and validated it among healthcare workers directly affected by COVID-19 in Korea. A total of 1,019 healthcare workers responded through anonymous questionnaires during April 20-30, 2020. Internal consistency of the SAVE-9 was measured through Cronbach’s alpha, and principal component analysis with varimax rotation was used to determine its component structure. It was also compared with the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 scales. Its most appropriate cut-off point was determined by conducting receiver operating characteristic analysis. The nine-item scale had satisfactory internal consistency (Cronbach’s α=0.795). It adopted a two-factor structure: (1) anxiety about viral epidemics and (2) work-related stress associated with viral epidemics (Bartlett’s test of sphericity, p < 0.001; Kaiser-Meyer-Olkin=0.85). Correlations between SAVE-9 and the other scales were statistically significant. The cut-off points of the SAVE-9 and its anxiety subcategory were 22 and 15, respectively, compared with a GAD-7 score of 5. 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.
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