Development of the fear scale in hospitalized patients in health care organizations

Fear is a natural emotion that arises in the presence or expectation of danger. In patients with high levels of fear, avoidance, denial and reactive behaviors may be observed instead of coping with the existing health threat and taking protective measures. Therefore, it is important to determine the level of fear in patients and to plan and implement interventions accordingly. The aim of the study was to develop a valid and reliable measurement tool to determine the level of fear by self-assessment of patients. The sample of the principal components analysis of the study consisted of 345 patients hospitalized in a public hospital in Bayburt city center, while the confirmatory factor analysis sample consisted of 300 different patients hospitalized in the same hospital. As for test-retest, it was performed with a total of 40 patients. Data were collected through Personal Information Form and Fear in Patients Scale. In study, the face validity of the draft scale was ensured and the content validity index was determined as 0.88. For principal component analysis, Kaiser-Meyer-Olkin value is 0.93, Barlett test X2=5935.391 (p<0.05), anti-image correlation values are between 0.87 and 0.95. In the principal component analysis, it was determined that the Fear in Patients Scale was shaped by 23 items and four sub-dimensions, and the factor loadings of the items were between 0.835-0.676. For confirmatory factor analysis, the adjusted Χ2/Sd value is 2.26, RMSEA value is 0.07, CFI value is 0.91, and NFI value is 0.90. These fit indices are good and confirm the structure of the Fear in Patients Scale determined by principal component analysis. As for the convergent validity analyses, the average explained variance of the sub-dimensions is between 0.47-0.69 and the construct reliability values are between 0.81-0.92. Spearman- Brown=0.93, Guttman Split-Half=0.87 and Cronbach Alpha value of the scale was determined as 0.94. Item total correlation values were 0.55-0.81, r= 0.95 (p<0.001) and t=1.422 (p>0.05) in the test-retest analysis. However, the mean total scale score of the patients was 2.91±1.07. In addition, sociodemographic characteristics including gender, age, marital and educational status, employment status and presence of chronic diseases affected the level of fear (p<0.05). As a result, the Fear in Patients Scale, which was developed to determine the fear level of patients hospitalized in health care institutions through the evaluation of patients, can be used as a valid and reliable measurement tool.