{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:27:04Z","timestamp":1753892824040,"version":"3.41.2"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Peru is a country that has a high incidence of viral outbreaks and epidemics, which is why it is necessary to validate a scale that measures anxiety and stress in professionals who are on the front lines of these events. Therefore, our objective was to validate the Peruvian-Spanish version of the Stress and Anxiety to Viral Epidemics-9 items (SAVE-9) scale and to concurrently compare its validity and internal consistency with the SAVE-6 scale among healthcare workers (HCWs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>We conducted a cross-sectional study based on data collected from a self-reported survey in paper-and-pencil format between April and July 2023. A total of 203 HCWs participated in the research. We developed a confirmatory factor analysis (CFA) and item response theory (IRT). We calculated Cronbach\u2019s <jats:italic>\u03b1<\/jats:italic> coefficient and McDonald\u2019s <jats:italic>\u03c9<\/jats:italic> to assess the internal consistency of the scales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The results show that SAVE-9 (a two-factor model) and SAVE-6 (a one-factor model) provided an excellent fit in the confirmatory factor analysis. Both scales demonstrated strong internal consistency (Cronbach\u2019s <jats:italic>\u03b1<\/jats:italic> 0.85 and 0.86, respectively). Significant correlations were found between the SAVE-9 and SAVE-6 scales and Generalized Anxiety Disorder-7 items scale (<jats:italic>r<\/jats:italic> = 0.44 and <jats:italic>r<\/jats:italic> = 0.38, respectively, <jats:italic>p<\/jats:italic> &amp;lt; 0.001) as well as the Patient Health Questionnaire-9 items (<jats:italic>r<\/jats:italic> = 0.39 and <jats:italic>r<\/jats:italic> = 0.35, respectively, <jats:italic>p<\/jats:italic> &amp;lt; 0.001). The optimal cutoff points for SAVE-9 and SAVE-6 were identified for assessing anxiety, aligned with a GAD-7 score \u22655 points.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The Peruvian-Spanish SAVE-9 and SAVE-6 scales are reliable and valid rating scales to assess the anxiety response of HCWs in response to viral epidemics. Though COVID-19 is diminished, these scales will be useful for other viral epidemics in the future.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2024.1352896","type":"journal-article","created":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T04:47:12Z","timestamp":1714538832000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of the Stress and Anxiety to Viral Epidemic-9 and SAVE-6 scales among healthcare workers in Peru"],"prefix":"10.3389","volume":"15","author":[{"given":"Bryan","family":"Gamonal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rogelio","family":"Quispe-Lizano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nair","family":"Javier-Murillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Lapeyre-Rivera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Perea-Fl\u00f3rez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V\u00edctor","family":"Vel\u00e1squez-Rimachi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Alva-Diaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilberth","family":"Velazco-Gonzales","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oli","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seockhoon","family":"Chung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_2071_20","article-title":"Viral pandemics in the past two decades: an\u00a0overview","volume":"10","author":"Bhadoria","year":"2021","journal-title":"J Fam Med Prim Care"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.15381\/rpb.v16i2.212","article-title":"Los virus Influenza y la nueva pandemia A\/H1N1","volume":"16","author":"Talledo","year":"2009","journal-title":"Rev\u00a0Peru Biol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.35663\/amp.2016.332.69","article-title":"Brotes epid\u00e9micos de Zika en Per\u00fa: \u00bfestamos en condiciones de controlarlo","volume":"33","author":"Chavez-Cruzado","year":"2016","journal-title":"Acta M\u00e9dica Peru"},{"key":"B4","unstructured":"Repositorio \u00danico Nacional de Informaci\u00f3n en Salud: Tablero Vacuna COVID"},{"key":"B5","unstructured":"Casos positivos por COVID-19 - Plataforma Nacional de Datos Abiertos"},{"key":"B6","unstructured":"Sala situacional de viruela del mono"},{"key":"B7","unstructured":"Situaci\u00f3n del dengue en el Per\u00fa"},{"key":"B8","unstructured":"S\u00edndrome de Guillain-Barr\u00e9 - Per\u00fa"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18136695","article-title":"The impact of epidemics and\u00a0pandemics on the mental health of healthcare workers: A systematic review","volume":"18","author":"Chigwedere","year":"2021","journal-title":"Int\u00a0J\u00a0Environ Res Public Health"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.804525","article-title":"COVID-19 pandemic and overall mental health of healthcare professionals globally: A meta-review of systematic reviews","volume":"12","author":"Chutiyami","year":"2022","journal-title":"Front Psychiatry"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1097\/00063110-200502000-00005","article-title":"The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope","volume":"12","author":"Wong","year":"2005","journal-title":"Eur J Emerg Med Off J Eur Soc Emerg Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.5498\/wjp.v12.i5.739","article-title":"Mental health impact of the Middle East respiratory syndrome, SARS, and COVID-19: A comparative systematic review and meta-analysis","volume":"12","author":"Delanerolle","year":"2022","journal-title":"World J Psychiatry"},{"key":"B13","unstructured":"Study warns of high levels of depression and suicidal thoughts in Latin American health workers during pandemic"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2021.36.e319","article-title":"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","volume":"36","author":"Chung","year":"2021","journal-title":"J Korean Med Sci"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.24869\/psyd.2020.549","article-title":"Stress and anxiety among healthcare workers associated with COVID-19 pandemic in Russia","volume":"32","author":"Mosolova","year":"2020","journal-title":"Psychiatr Danub"},{"key":"B16","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.sleep.2021.06.035","article-title":"Validation of the Japanese version of Stress and Anxiety to Viral Epidemics-9 (SAVE-9) and relationship among stress, insomnia, anxiety, and depression in healthcare workers exposed to coronavirus disease 2019","volume":"84","author":"Okajima","year":"2021","journal-title":"Sleep Med"},{"key":"B17","first-page":"5","article-title":"A new rating scale (SAVE-9) to demonstrate the stress and anxiety in the healthcare workers during the COVID-19 viral epidemic","volume":"32","author":"Tavormina","year":"2020","journal-title":"Psychiatr Danub"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18179377","article-title":"The german translation of the stress and anxiety to viral epidemics-9 (SAVE-9) scale: results from healthcare workers during the second wave of COVID-19","volume":"18","author":"K\u00f6nig","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B19","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1002\/jcop.22680","article-title":"The validity and reliability of the Stress and Anxiety to Viral Epidemics-9 items Scale in Turkish health care professionals","volume":"50","author":"Uzun","year":"2022","journal-title":"J Community Psychol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191710673","article-title":"Adaptation and validation of the Malay version of the SAVE-9 viral epidemic anxiety scale for healthcare workers","volume":"19","author":"Wasimin","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.746244","article-title":"The psychometric properties of the stress and anxiety to viral epidemics-6 items: A test in the U.S","volume":"12","author":"Lee","year":"2021","journal-title":"Gen Popul Front Psychiatry"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2021.36.e168","article-title":"Factorial validity of the Arabic version of the stress and anxiety to viral epidemics-6 items (SAVE-6) scale among the general population in Lebanon","volume":"36","author":"Hong","year":"2021","journal-title":"J Korean Med Sci"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.908825","article-title":"Adaptation and validation of the Malay version of the stress and anxiety to viral epidemics-6 items scale among the general population","volume":"13","author":"Pang","year":"2022","journal-title":"Front Psychiatry"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.669606","article-title":"The stress and anxiety to viral epidemics-6 items (SAVE-6) scale: A new instrument for assessing the anxiety response of general population to the viral epidemic during the COVID-19 pandemic","volume":"12","author":"Chung","year":"2021","journal-title":"Front Psychol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.796225","article-title":"Validity and reliability of the stress and anxiety to viral epidemics-6 (SAVE-6) scale to measure viral anxiety of healthcare workers in Spain during the COVID-19 pandemic","volume":"12","author":"Moraleda-Cibri\u00e1n","year":"2022","journal-title":"Front Psychiatry"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.876379","article-title":"Validation of the Peruvian Spanish version of the stress and anxiety to viral epidemics-6 scale to measure viral anxiety of medical students during COVID-19","volume":"13","author":"Lapeyre-Rivera","year":"2022","journal-title":"Front Psychiatry"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.705805","article-title":"Stress and anxiety to viral epidemics-6 for medical students: psychometric properties of the anxiety measure for the COVID-19 pandemic","volume":"12","author":"Ahn","year":"2021","journal-title":"Front Psychiatry"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.701543","article-title":"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","volume":"12","author":"Park","year":"2021","journal-title":"Front Psychiatry"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.604441","article-title":"Application of the stress and anxiety to viral epidemics-6 (SAVE-6) and coronavirus anxiety scale (CAS) to measure anxiety in cancer patient in response to COVID-19","volume":"11","author":"Ahn","year":"2020","journal-title":"Front Psychol"},{"key":"B30","unstructured":"RM No 546-2011\/MINSA: NTS No 021-MINSA\/DGSP-V03 Norma T\u00e9cnica de Salud: \u201cCategor\u00edas de Establecimientos del Sector Salud\u201d2020"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"61","author":"von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.4236\/psych.2018.98126","article-title":"Applied psychometrics: sample size and sample power considerations in factor analysis (EFA, CFA) and SEM in general","volume":"9","author":"Kyriazos","year":"2018","journal-title":"Psychology"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.17241\/smr.2021.01025","article-title":"Utility of the stress and anxiety to viral epidemic-3 items as a tool for assessing work-related stress, and relationship with insomnia and burnout of healthcare workers during the COVID-19 pandemic","volume":"12","author":"Son","year":"2021","journal-title":"Sleep Med Res"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcp.2021.06.003","article-title":"Escala de ansiedad generalizada GAD-7 en profesionales m\u00e9dicos Colombianos durante pandemia de COVID-19: validez de constructo y confiabilidad","author":"Camargo","year":"2021","journal-title":"Rev Colomb Psiquiatr"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0221717","article-title":"Valid group comparisons can be made with the Patient Health Questionnaire (PHQ-9): A measurement invariance study across groups by demographic characteristics","volume":"14","author":"Villarreal-Zegarra","year":"2019","journal-title":"PloS One"},{"key":"B38","doi-asserted-by":"publisher","first-page":"67","DOI":"10.4103\/aca.ACA_157_18","article-title":"Descriptive statistics and normality tests for statistical data","volume":"22","author":"Mishra","year":"2019","journal-title":"Ann Card Anaesth"},{"key":"B39","article-title":"Introducci\u00f3n a las escalas de medici\u00f3n de la salud","volume-title":"Health Measurement Scales: A practical guide to their development and use, 5 edn","author":"Streiner","year":"2014"},{"key":"B40","first-page":"211","article-title":"Reliability and validity in the scales","volume":"30","author":"Ercan","year":"2004","journal-title":"Uludag Univ J Coll  Med"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1080\/10705511.2014.915373","article-title":"A comparison of diagonal weighted least squares robust estimation techniques for ordinal data","volume":"21","author":"DiStefano","year":"2014","journal-title":"Struct Equ Model Multidiscip J"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.3758\/s13428-015-0619-7","article-title":"Confirmatory factor analysis with ordinal data: Comparing robust maximum likelihood and diagonally weighted least squares","volume":"48","author":"Li","year":"2016","journal-title":"Behav Res Methods"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2016.00941","article-title":"Evidence of factorial validity of parental knowledge, control and solicitation, and adolescent disclosure scales: when the ordered nature of likert scales matters","volume":"7","author":"Lionetti","year":"2016","journal-title":"Front Psychol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v048.i02","article-title":"lavaan: an R package for structural equation modeling","volume":"48","author":"Rosseel","year":"2012","journal-title":"J Stat Softw"},{"key":"B45","doi-asserted-by":"crossref","DOI":"10.1016\/B978-012691360-6\/50002-1","article-title":"Multivariate Statistics and Mathematical Modeling","volume-title":"Handbook of Applied Multivariate Statistics and Mathematical Modeling","author":"Tinsley","year":"2000"},{"volume-title":"Multivariate Data Analysis: A Global Perspective","year":"2010","author":"Hair","key":"B46"},{"volume-title":"Principles and practice of structural equation modeling","year":"2015","author":"Kline","key":"B47"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.3758\/s13428-018-1055-2","article-title":"RMSEA, CFI, and TLI in structural equation modeling with ordered categorical data: The story they tell depends on the estimation methods","volume":"51","author":"Xia","year":"2019","journal-title":"Behav Res Methods"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.01507","article-title":"A primer to (Cross-cultural) multi-group invariance testing possibilities in R","volume":"10","author":"Fischer","year":"2019","journal-title":"Front Psychol"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1007\/BF02296192","article-title":"A scaled difference chi-square test statistic for moment structure analysis","volume":"66","author":"Satorra","year":"2001","journal-title":"Psychometrika"},{"key":"B51","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1080\/10705510701301834","article-title":"Sensitivity of goodness of fit indexes to lack of measurement invariance","volume":"14","author":"Chen","year":"2007","journal-title":"Struct Equ Model Multidiscip J"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnsa.2022.100066","article-title":"Women healthcare workers\u2019 experiences during COVID-19 and other crises: A scoping review","volume":"4","author":"Morgan","year":"2022","journal-title":"Int J Nurs Stud Adv"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1186\/s41155-016-0040-x","article-title":"An application of item response theory to psychological test development","volume":"29","author":"Zanon","year":"2016","journal-title":"Psicol Reflex E Cr\u00edtica"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000250483.85507.04","article-title":"Psychometric evaluation and calibration of health-related quality of life item banks: plans for the Patient-Reported Outcomes Measurement Information System (PROMIS)","volume":"45","author":"Reeve","year":"2007","journal-title":"Med Care"},{"key":"B55","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1111\/j.1745-3984.2008.00071.x","article-title":"Performance of the generalizedS-X2Item fit index for polytomous IRT models","volume":"45","author":"Kang","year":"2008","journal-title":"J Educ Meas"},{"key":"B56","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-54205-8","volume-title":"The Basics of Item Response Theory Using R","author":"Baker","year":"2017"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1007\/s11165-016-9602-2","article-title":"The use of Cronbach\u2019s alpha when developing and reporting research instruments in science education","volume":"48","author":"Taber","year":"2018","journal-title":"Res Sci Educ"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.6018\/analesps.33.3.268401","article-title":"Un viaje alrededor de alfa y omega para estimar la fiabilidad de consistencia interna","volume":"33","author":"Viladrich","year":"2017","journal-title":"Psicol Ann Psychol"},{"key":"B59","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s40271-013-0041-0","article-title":"An introduction to item response theory for patient-reported outcome measurement","volume":"7","author":"Nguyen","year":"2014","journal-title":"Patient"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-014-0450-3","article-title":"Cross-cultural aspects of anxiety disorders","volume":"16","author":"Hofmann","year":"2014","journal-title":"Curr Psychiatry Rep"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.3201\/eid1010.031037","article-title":"Nosocomial acquisition of dengue","volume":"10","author":"Wagner","year":"2004","journal-title":"Emerg Infect Dis"},{"key":"B62","doi-asserted-by":"publisher","first-page":"775","DOI":"10.3201\/eid1105.040934","article-title":"Nosocomial dengue by mucocutaneous transmission","volume":"11","author":"Chen","year":"2005","journal-title":"Emerg Infect Dis"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2024.1352896\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T04:47:21Z","timestamp":1714538841000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2024.1352896\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,1]]},"references-count":62,"alternative-id":["10.3389\/fpsyt.2024.1352896"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2024.1352896","relation":{},"ISSN":["1664-0640"],"issn-type":[{"type":"electronic","value":"1664-0640"}],"subject":[],"published":{"date-parts":[[2024,5,1]]},"article-number":"1352896"}}