| Objective:1.To translate the Stress and Anxiety to Viral Epidemics-9 items Scale(SAVE-9)into Chinese and to verify its reliability and validity among Chinese medical personnel.The optimal cut-off scores of the scale were determined to provide a reliable measurement tool for the assessment and screening of the psychological status of Chinese medical personnel when they are faced with a viral epidemic.2.To apply the Chinese version of SAVE-9 scale among medical staff to investigate the mental health status of medical staff after the release of the epidemic and to analyze the main factors that affect their psychological health.It is a reference and scientific basis for efficiently improving the mental health status and interventions of medical staff.Methods:This study includes two parts:the first part is to translate the SAVE-9 scale into Chinese and test its reliability and validity,and the second part is the application of the Chinese version of SAVE-9 scale among medical staff to investigate the mental health status of medical staff and the influence factors after the release of the epidemic control.1.The Brislin translation model was used to translate,back-translate,and cross-culturally adapt the SAVE-9 scale in order to develop the Chinese version of SAVE-9 scale.A convenience sampling method was used to select 238 medical staff from Taiyuan hospitals for an online questionnaire survey in November-December 2021,using a self-made general information questionnaire,the Chinese version of the SAVE-9scale,Generalized Anxiety Disorder-7(GAD-7),and the Patient Health Questionnaire-9(PHQ-9)as survey instruments,applying SPSS26.0 and Amos24.0 statistical software for data analysis,the Critical Ration and Item Analysis methods were used for item selection of the scales,the content validity,structural validity,and criterion validity were used for validity testing,the internal consistency test,split-half reliability,and re-test reliability were used for reliability testing,and the GAD-7(≥5 points)was used as a standard of reference,and the sensitivity,specificity,and ROC curve were used to determine the best critical values.2.An online survey was conducted on 348 hospital medical staff by questionnaire star from January 28-31,2023,using a self-made general information questionnaire,the Chinese version of SAVE-9 scale,GAD-7,and PHQ-9 to measure the anxiety and depression status of medical staff after the release of the epidemic control.Statistical analysis was performed by SPSS26.0 software for uni-variate and multi-variate analysis.Independent samples t-test was used for comparison between two groups,single factor analysis of variance(ANOVA)was used between three or more groups,and multi-factor analysis was conducted to analyze the influencing factors by using multiple linear regression with the response variable of the total score of the Chinese version of SAVE-9scale.Results:1.The Chinese version of the SAVE-9 scale includes 9 items with 2 dimensions,dimension 1:anxiety about the epidemic(5 items)and dimension 2:work-related stress about the epidemic(4 items).The scale was consistent with our cultural context,with no deleted items,and item 5 was divided from dimension 1 to dimension 2.2.Validity examination results:(1)Content validity:the Item-level Content Validity Index was 0.80 to 1.00,the Scale-level Content Validity Index/UA was 0.89,and the Scale-level Content Validity Index/Ave was 0.97.(2)Structural validity:exploratory factor analysis showed KMO value=0.917,Bartlett’s spherical test chi-square value of 1554.444(P<0.05),and two common factors were extracted,with factor loading coefficients of0.615～0.873 for each entry and cumulative variance contribution of 73.76%.The validation factor analysis showed thatχ~2/df<5,RM-SEA<0.1,GFI>0.9,TLI>0.9,IFI>0.9,CFI>0.9,and the model fit was good.(3)Criterion validity:The correlation coefficients of the Chinese version of the SAVE-9 scale and the GAD-7 and PHQ-9scales were 0.719 and 0.666,respectively.3.Reliability test results:(1)Internal consistency:Cronbach’sαfor the total scale was 0.919,Cronbach’sαfor dimension 1 was 0.904,and Cronbach’sαfor dimension 2was 0.829.(2)Split-half reliability:The split-half reliability coefficient of the total scale was 0.842.(3)Retest reliability:The intra-class correlation coefficient(ICC)for the total scale score was 0.848,the intra-class correlation coefficient for dimension 1 was 0.902,and the intra-class correlation coefficient for dimension 2 was 0.856.4.The best cut-off value for the Chinese version of the SAVE-9 was 15 points,with a sensitivity of 0.631-0.664,a specificity of 0.828-0.858,and AUC=0.882[P<0.01,95%CI(0.830-0.934)].The consistency coefficient Kappa value with the GAD-7 scale was 0.460,P<0.01.5.Medical personnel scored(14.39±8.46),(6.67±5.64),and(7.90±6.57)on the Chinese version of SAVE-9 scale,the GAD-7 scale,and the PHQ-9 scale,respectively,and the detection rates of anxiety and depression were 47.4%,61.5%,and 62.1%,respectively.Multiple linear regression results showed that sleep quality,living with or without family members,and self-assessed psychological stress caused by the epidemic were influential factors in the mental health of medical staff.Conclusion:The Chinese version of Stress and Anxiety to Viral Epidemics-9 items scale has good reliability and validity,and a suitable cutoff scores,and can be used to assess and screen the anxiety and stress status of Chinese medical personnel faced with a viral epidemic.The mental health status of medical staff is still not ideal after the release of epidemic control,and good sleep,family health,and a positive attitude can help alleviate the anxiety and stress of medical staff.Therefore,the hospital and its managers should pay more attention to the psychological condition of medical staff and take specific measures to promote their mental health. |
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