The Effect of Perceived Risk of COVID-19 on Anxiety: Developing a Scale


Perceived Risk

How to Cite

Ari E, Yilmaz V, Arikan İnci. The Effect of Perceived Risk of COVID-19 on Anxiety: Developing a Scale. Integr J Med Sci [Internet]. 2020Aug.4 [cited 2020Oct.30];7. Available from:


Background: The emergence of COVID-19 and its pandemic nature have increased fears and anxieties that have led to stigmatization worldwide. This fear and anxiety are directly related to the rate of transmission of the disease, its invisible presence in the environment, its spread, morbidity and mortality. The aim of this study is to develop a data collection tool (a scale) which will evaluate perceived risk and anxiety of people living in Turkey regarding COVID-19, to propose a research model to describe the relationship between perception of risk and anxiety, and to form hypotheses.
Methods: The number of participants from each province of Turkey was determined by considering the number of COVID-19 positive cases in the provinces and their populations. The study was conducted between April 2020 with the participation of 661 individuals through a link created on the internet.
Results:The fit of the proposed model and the test of hypotheses were performed by using structural equation modelling. As a result of the study, it was determined that one unit increase in perceived health risk related to COVID-19 would lead to a 0.47 unit increase in anxiety, and one unit increase in perceived economic risk and inability to socialize would cause an increase of 0.18 and 0.15 units in anxiety, respectively.
Conclusions: As a result of the study, it was determined that the variable that most affects people's anxiety is perceived health risk. COVID-19 scale can be used as a valid and reliable scale. It should be applied in larger and different sample groups.


Wu Z, McGoogan JM. Characteristics of and important lessons from the coronvirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese center for disease control and prevention. JAMA. 2020 Feb 24. doi: 10.1001/jama.2020.2648

WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. Erişim: https:// remarks-at-the-media-briefing-on-covid-19 - 11- march-2020.Access date: 4.4.2020.

World Health Organization (WHO). Global research on coronavirus disease, 2020. Access Adress: Access date:6.4.2020.

Republic of Turkey Ministry of Health, COVID-19, 2020. Access Adress: Access date:6.4.2020.

Garfin DR, Silver RC, Holman EA. The novel coronavirus (COVID-2019) outbreak: Amplification of public health consequences by media exposure. Health Psychol. 2020;39(5):355-357.

Jung S. Exploratory factor analysis with small sample sizes: a comparison of three approaches. Behav Processe 2013; 97:90-95.

Kline, R. B. Principle and practice of structural equation modelling. (Third Edition). New York: The Guilford Press, 2011.

Schermelleh- Engel, K., & Moosbrugger, H. Evaluating The Fit Of Structural Equation Models: Test Of Significance And Descriptive Goodness Of-Fit Measures. Methods of Psychological Research- Online 2003; 8(2): 23-74.

Akan H, Gürol Y, İzbıra G, et al. Knowledge and attitudes of university students toward pandemic influenza: a cross-sectional study from Turkey. BMC Public Health 2010; 10:413.

Brug J, Aro AR, Oenema A, et al. SARS Risk Perception, Knowledge,Precautions, and Information Sources, the Netherlands. DISPATCHES 2004; 10(8), 1486-1489.

Bults M, Beaujean-Desirée, JMA. et al. Perceived risk, anxiety, and behavioural responses of the general public during the early phase ofthe Influenza A (H1N1) pandemic in theNetherlands: results of three consecutive onlinesurveys. BMC Public Health 2011; 11:2

Liao Q, Cowling BJ, Lam WW, Ng DM, Fielding R. Anxiety, worry and cognitive risk estimate in relation to protective behaviors during the 2009 influenza A/H1N1 pandemic in Hong Kong: ten cross-sectional surveys. BMC Infect Dis 2014 Mar 27;14:169. doi: 10.1186/1471-2334-14-169.

Lohiniva AL, Sane J, Sibenberg K, Puumalainen T, Salminen M. Understanding coronavirus disease (COVID-19) risk perceptions among the public to enhance risk communication efforts: a practical approach for outbreaks, Finland, February 2020.Euro Surveill. 2020 Apr;25(13). doi: 10.2807/1560-7917.ES.2020.25.13.2000317.

Taghrir MH, Borazjani R, Shiraly R.COVID-19 and Iranian Medical Students; A Survey on Their Related-Knowledge, Preventive Behaviors and Risk Perception. Arch Iran Med 2020; Apr 1;23(4):249-254. doi: 10.34172/aim.2020.06.

Kim EY, Lio Q, Yu ES, et al. Middle East respiratory syndrome in South Korea during 2015: Risk-related perceptions and quarantine attitudes, Am J Infect Control 2016; 44, 1414-1416.

Mak KK, Lai CM. Knowledge, risk perceptions, and preventive precautions among Hong Kong students during the 2009 influenza A (H1N1) pandemic. Am J Infect Control 2012; 40, 273-275.

Ibuka Y, Chapman GB, Meyers LA, Li M, Galvani AP. The dynamics of risk perceptions and precautionary behavior in response to 2009(H1N1) pandemic influenza. BMC Infect Dis 2009; 10:296.

Smith RD. Responding to global infectious disease outbreaks: Lessons from SARS on the role of risk perception, communication and management. Social Science & Medicine 2006; 63: 3113–3123.

Wu JT, Leung K, Leung GM. Nowcasting and forecastingthe potential domestic and intirnational spread ofthe 2019-nCoV outbreak originating in Wuhan, China:a modelling study. Lancet 2020; 395: 689-697.

Lin CY. Social reaction toward the 2019 novel coronavirus (COVID-19). Soc Health Behav 2020;3:1-2.

Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The Fear of COVID-19 Scale: Development and Initial Validation. Int J Ment Health Addict 2020;27:1-9.doi: 10.1007/s11469-020-00270-8.

Meng R, Li J, Wang Z, Zhang D, Liu B, Luo Y, Hu Y, Yu C. The Chinese version of the Perceived Stress Questionnaire: development and validation amongst medical students and workers. Health Qual Life Outcomes 2020; 13;18(1):70. doi: 10.1186/s12955-020-01307-1.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2020 Erkan Ari et al.