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BACKGROUND At the very beginning of the COVID-19 pandemic, information about fear of COVID-19 was very limited in Chinese populations, and there was no standardized and validated scale to measure the fear associated with the pandemic. OBJECTIVE This cross-sectional study aimed to adapt and validate a fear scale to determine the levels of fear of COVID-19 among the general population in mainland China and Hong Kong. METHODS A web-based questionnaire platform was developed for data collection; the study instruments were an adapted version of the 8-item Breast Cancer Fear Scale (“Fear Scale”) and the 4-item Patient Health Questionnaire. The internal construct validity, convergent validity, known group validity, and reliability of the adapted Fear Scale were assessed, and descriptive statistics were used to summarize the participants’ fear levels. RESULTS A total of 2822 study participants aged 18 years or older were included in the analysis. The reliability of the adapted scale was satisfactory, with a Cronbach α coefficient of .93. The item-total correlations corrected for overlap were >0.4, confirming their internal construct validity. Regarding convergent validity, a small-to-moderate correlation between the Fear Scale and the 4-item Patient Health Questionnaire scores was found. Regarding known group validity, we found that the study participants who were recruited from Hong Kong had a higher level of fear than the study participants from mainland China. Older adults had a higher level of fear compared with younger adults. Furthermore, having hypertension, liver disease, heart disease, cancer, anxiety, and insomnia were associated with a higher fear level. The descriptive analysis found that more than 40% of the study participants reported that the thought of COVID-19 scared them. About one-third of the study participants reported that when they thought about COVID-19, they felt nervous, uneasy, and depressed. CONCLUSIONS The psychometric properties of the adapted Fear Scale are acceptable to measure the fear of COVID-19 among Chinese people. Our study stresses the need for more psychosocial support and care to help this population cope with their fears during the pandemic.

BACKGROUND At the very beginning of the COVID-19 pandemic, information about fear of COVID-19 was very limited in Chinese populations and there was no standardised and validated scale to measure the fear associated with the pandemic. OBJECTIVE Therefore, this cross-sectional study aimed to adapt and validate a fear scale to determine the levels of fear of COVID-19 among the general population in mainland China and Hong Kong. METHODS An online questionnaire platform was developed for data collection; the study instruments were an adapted version of the eight-item Breast Cancer Fear Scale (‘the Fear Scale’) and the four-item Patient Health Questionnaire (PHQ-4). The internal construct validity, concurrent validity, known-group validity, and reliability of the adapted Fear Scale were assessed, and descriptive statistics were used to summarise the participants’ fear levels. RESULTS A total of 2,822 study participants aged 18 or older were included in the analysis. The reliability of the adapted scale was satisfactory, with a Cronbach’s alpha coefficient of 0.93. The item-total correlations corrected for overlap were >0.4, confirming its internal construct validity. Regarding concurrent validity, a small to moderate correlation between the Fear Scale and the PHQ-4 scores was found. Regarding known-group validity, we found that study participants who were recruited from Hong Kong had a higher level of fear than the study participants from mainland China. Older adults had a higher level of fear than the younger adults. Study participants who were separated/divorced/widowed had a higher level of fear than those who were single or married. Furthermore, having hypertension, liver diseases, heart diseases, cancer, anxiety and insomnia were associated with a higher fear level. The descriptive analysis found that more than 40% of the study participants reported that the thought of COVID-19 scared them. About one-third of the study participants reported that when they thought about COVID-19, they felt nervous, uneasy and depressed. CONCLUSIONS To conclude, the adapted Fear Scale is a valid and reliable scale for measuring the fear of COVID-19 among Chinese people. Our study stresses the need for more psychosocial support and care to help this population cope with their fears during the pandemic.

Background At the very beginning of the COVID-19 pandemic, information about fear of COVID-19 was very limited in Chinese populations, and there was no standardized and validated scale to measure the fear associated with the pandemic. Objective This cross-sectional study aimed to adapt and validate a fear scale to determine the levels of fear of COVID-19 among the general population in mainland China and Hong Kong. Methods A web-based questionnaire platform was developed for data collection; the study instruments were an adapted version of the 8-item Breast Cancer Fear Scale (“Fear Scale”) and the 4-item Patient Health Questionnaire. The internal construct validity, convergent validity, known group validity, and reliability of the adapted Fear Scale were assessed, and descriptive statistics were used to summarize the participants’ fear levels. Results A total of 2822 study participants aged 18 years or older were included in the analysis. The reliability of the adapted scale was satisfactory, with a Cronbach α coefficient of .93. The item-total correlations corrected for overlap were >0.4, confirming their internal construct validity. Regarding convergent validity, a small-to-moderate correlation between the Fear Scale and the 4-item Patient Health Questionnaire scores was found. Regarding known group validity, we found that the study participants who were recruited from Hong Kong had a higher level of fear than the study participants from mainland China. Older adults had a higher level of fear compared with younger adults. Furthermore, having hypertension, liver disease, heart disease, cancer, anxiety, and insomnia were associated with a higher fear level. The descriptive analysis found that more than 40% of the study participants reported that the thought of COVID-19 scared them. About one-third of the study participants reported that when they thought about COVID-19, they felt nervous, uneasy, and depressed. Conclusions The psychometric properties of the adapted Fear Scale are acceptable to measure the fear of COVID-19 among Chinese people. Our study stresses the need for more psychosocial support and care to help this population cope with their fears during the pandemic.

Background Empirical research has linked psychological distress with fatigue. However, few studies have analyzed the factors (eg, stimuli from bedtime media use) that affect the relationship between psychological distress and fatigue. Objective The aim of this study was to examine whether visual stimuli from bedtime media use mediate the relationship between psychological distress and fatigue among college students. Methods The sample included 394 participants (92 males, 302 females) with a mean age of 19.98 years (SD 1.43 years), all of whom were Chinese college students at an occupational university in Sichuan Province, China. Data were collected using a paper-based questionnaire that addressed psychological distress, stimuli from bedtime media use, and fatigue. Mediation analysis was conducted using the PROCESS macro version 2.16.2 for SPSS 22, which provided the 95% CIs. Results Both psychological distress (r=.43, P Conclusions The findings imply that psychological distress has an indirect effect on fatigue via visual stimuli from bedtime media use. In contrast, auditory stimuli from bedtime media use did not have the same effect. We suggest that college students should reduce bedtime media use, and this could be achieved as part of an overall strategy to improve health. Mobile health apps could be an option to improving young students’ health in daily life.

BACKGROUND Empirical research has linked psychological distress with fatigue. However, few studies have analyzed the factors (eg, stimuli from bedtime media use) that affect the relationship between psychological distress and fatigue. OBJECTIVE The aim of this study was to examine whether visual stimuli from bedtime media use mediate the relationship between psychological distress and fatigue among college students. METHODS The sample included 394 participants (92 males, 302 females) with a mean age of 19.98 years (SD 1.43 years), all of whom were Chinese college students at an occupational university in Sichuan Province, China. Data were collected using a paper-based questionnaire that addressed psychological distress, stimuli from bedtime media use, and fatigue. Mediation analysis was conducted using the PROCESS macro version 2.16.2 for SPSS 22, which provided the 95% CIs. RESULTS Both psychological distress (r=.43, PPP=.08). The relationship between psychological distress and fatigue was partially mediated by visual stimuli from bedtime media use (beta=.01, SE 0.01, 95% CI 0.0023-0.0253). CONCLUSIONS The findings imply that psychological distress has an indirect effect on fatigue via visual stimuli from bedtime media use. In contrast, auditory stimuli from bedtime media use did not have the same effect. We suggest that college students should reduce bedtime media use, and this could be achieved as part of an overall strategy to improve health. Mobile health apps could be an option to improving young students’ health in daily life.