The Validation Study of the Stress and Anxiety to Viral Epidemics-6 Scale Among Patients With Cancer in the COVID-19 Pandemic

Catastrophizing Maladaptive Coping Affects the Association Between Viral Anxiety and Fear of Progression in Cancer Patients During COVID-19 Pandemic

OBJECTIVE

The aim of the present study was to explore whether or not cancer patients' viral anxiety and depression during the coronavirus-2019 (COVID-19) pandemic were associated with a fear of cancer progression. We also assessed whether coping strategies affected the relationship.

METHODS

The present cross-sectional survey included cancer patients who visited Ulsan University Hospital in Ulsan, Korea. The participants' demographic information and responses to the following symptoms rating scales were collected: Stress and Anxiety to Viral Epidemic-6; Patient Health Questionnaire-9; Cognitive Emotion Regulation Questionnaire-short version; or Fear of Progression Questionnaire-short version.

RESULTS

Of the 558 cancer patients surveyed, 25 (4.5%) reported that their treatment schedule was delayed during the COVID-19 pandemic. The patients' fear of progression was found to be related to age (β=-0.08; p=0.011), viral anxiety (β=0.40; p<0.001), depression (β=0.26; p<0.001), and catastrophizing coping strategies (β=0.15; p=0.004), for an overall adjusted R2 of 0.46 (F=66.8; p<0.001). Mediation analysis showed that viral anxiety and depression were directly associated with fear of progression, while catastrophizing mediated this relationship.

CONCLUSION

Fear of progression in cancer patients was associated with viral anxiety, depression, and maladaptive coping techniques, such as catastrophizing, during the COVID-19 pandemic.

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

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.

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

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.

Central Symptoms of Insomnia in Relation to Depression and COVID-19 Anxiety in General Population: A Network Analysis

BACKGROUND

Insomnia is prevalent among the general population, and studies have shown an increase in insomnia symptoms during the novel coronavirus (COVID-19) pandemic. Despite numerous studies of insomnia, few studies have investigated insomnia symptoms in detail. In this study, we used network analysis to investigate interactions between insomnia symptoms in the general population. Furthermore, given the effect of COVID-19 on mental health, we also investigated how anxiety response to COVID-19 and depression related to insomnia symptoms.

METHODS

Data from 785 non-infected participants were used. The Insomnia Severity Index (ISI), Stress and Anxiety to Viral Epidemics-6 Scale (SAVE-6), and Patient Health Questionnaire-9 (PHQ-9) were used to measure insomnia symptoms, anxiety response to COVID-19, and depression, respectively. Network analysis was performed using R Studio. Centrality indices and edge weights were obtained, and each index was evaluated using bootstrapping methods.

RESULTS

The network revealed ISI7 (worry about current sleep pattern) to be the most central insomnia symptom. ISI7 was strongly connected to SAVE-6 total score, and ISI2 (difficulty staying asleep) was strongly connected to PHQ-9 total score.

CONCLUSION

High centrality of ISI7 supports the role of dysfunctional cognitions in etiological models of insomnia and thus the cognitive behavioral therapy for insomnia. The relationship between ISI7 and SAVE-6 is explained by transposition of worry and fear of contracting COVID-19 to worry about sleep patterns. The link between ISI2 and PHQ-9 necessitate further investigations of whether specific symptoms of insomnia are more associated with depression.