Fear of COVID-19 Scale (FCV-19S) across countries: Measurement invariance issues.
Chung-Ying Lin, Wen-Li Hou, Mohammed A Mamun and 15 others
PMID 33745219WHAT IT FOUND
The seven-item Fear of COVID-19 Scale measured fear similarly by gender and age, but not across countries.
Nurses may use it for patient fear assessment, but country-to-country score comparisons are not straightforward.
Key findings
01The scale's overall properties were satisfactory, including an internal consistency value of 0.87.
02Full measurement invariance was supported across gender and age groups, but only partial invariance was supported across countries.
03Iran had the highest average fear score (3.92) and New Zealand the lowest (2.02) on the 1 to 5 scale.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All samples were convenience samples, so they may not represent each country's population. The countries were sampled at different times and under different pandemic policies, case numbers and deaths, so score differences may reflect those circumstances rather than true fear differences. The country samples were not directly comparable: the New Zealand sample was very young and the Taiwan sample was much older. Italy had very few males (8.0%), so its score may reflect mainly females. No other validated instruments were used, so the scale's concurrent validity could not be assessed. Only 27 participants reported 'other' gender, so measurement invariance for that group could not be tested. The text says ten countries, but the tables also include a French sample (N=316). The country set is unclear.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not treat country score differences as definitive evidence of different fear levels. The scale showed only partial invariance across countries, and most items had substantial differential item functioning, so observed country differences may reflect how items were interpreted rather than true fear differences.