1. Introduction
According to Worldometers [
1], COVID-19 is present in at least 230 countries worldwide, with more than 688 million confirmed cases and approximately 6.9 million deaths associated with the disease. Several preventive measures have been introduced in Czechia since March 2020, when the first patients with COVID-19 were diagnosed. One of the most widely implemented strategies to reduce social interactions and prevent the spread of the disease has been the imposition of various measures such as curfews, quarantines, and bans on large gatherings. These measures aimed to limit the human-to-human transmission of the virus, which is crucial in slowing down an outbreak. In addition to these measures, it has been widely recognized that wearing masks or respirators can reduce the spread of the virus. The use of face masks has been required in many countries as a protective measure against the virus. Regular and frequent hand sanitation has also been recommended as another essential measure to prevent the virus from spreading. The introduction of appropriate interventions has been accompanied by extensive information campaigns aimed at raising awareness about these measures and strengthening compliance. Since the spring of 2020, in many countries, including Czechia, COVID-19, its spread, and its impact on society have dominated the media [
2,
3].
The COVID-19 pandemic has intensified people’s uncertainty in terms of their outlook on life, increased any perceived vulnerability, and strengthened concerns about the health or even life of loved ones. The sudden onset of the pandemic brought about a new situation with unexpected impacts, such as a pervasive feeling of lacking control or altered mental health [
4]. Some researchers pointed out that one of the negative side effects of the implemented interventions and their publicity might be an increased risk of mental disorders in the general population and especially within vulnerable sub-populations [
5]. The disease itself, the consequent anti-epidemic interventions, and media coverage of the issues related to the spread of COVID-19 have created a growing fear in many people’s lives. COVID-19 thus represents a considerable stress factor that deserves significant research attention [
6].
Examining the level of fear is particularly important, as high levels of fear might carry increased risks of maladaptive and negative behaviors or other forms of inappropriate psychological responses; it may also contribute to the development of depression, anxiety, or nervousness [
7,
8,
9]. For decision-makers, it is important to adequately understand the nature of the population’s fear when planning and implementing effective interventions aimed at reducing the transmission of the disease [
10].
In response to this challenge, Ahorsu et al. [
11] developed the “Fear of COVID-19” scale (FCV-19S). Over a short period of time, it has been used and validated by many researchers throughout the world, appearing in several translations (e.g., Italian, Romanian, Arabic, Spanish, Turkish, and many others). The proposed scale has already been tested in varying socio-cultural settings including Israel [
12], Turkey [
13], Japan [
14], Cuba [
15], and India [
16]. The FCV-19S has also been tested on different populations, especially the medical workforce [
17] and university students [
18,
19]. Many published studies have been conducted within populations that were (relatively) easy to access—residents of a single city (e.g., Lima, Peru, as reported by Huarcaya-Vichoria [
20]) or a sample gathered via convenience sampling techniques [
21,
22,
23]. Such a research design is appropriate for validating the scale psychometric characteristics; however, the authors of these studies admit that such findings can hardly be extrapolated to the general public or to the whole population of the given countries, i.e., the theoretical population.
As a response to these limitations, the presented research is based on a robust nationwide representative sample of the entire population. Moreover, the FCV-19S has not been used in Czechia before; therefore, the presented research is the very first use of the newly developed scale within the adult Czech population. The data from Czechia serve as an important case study since the country not only experienced rigid measures imposed on the population (lockdown) during the so-called “first wave” of the outbreak during the spring of 2020 but also demonstrated a high degree of individual solidarity and a strong adherence to restrictions among the population. The impact of the disease, measured by the number of infected people and deaths, was at that time significantly lower than in other countries [
24]. The level of fear embedded in the context of the time, therefore, provides useful knowledge about the scale. Furthermore, the study expands the current knowledge via a concurrent validity assessment, which used the health consciousness scale (HCS) introduced by Gould [
25] as a reference. Validation of the FCV-19S, conducted with the use of health consciousness, represents a novel approach as the constructs of fear and consciousness have not previously been used for such a purpose. Meanwhile, the constructs of the fear of COVID-19 and health consciousness are interrelated for several other reasons:
- (a)
The fear of COVID-19 can lead to increased health consciousness. When people are afraid of contracting the virus, they may become more aware of their health, they might have a greater understanding of the importance of maintaining good health practices, and they can be more willing to adopt healthy habits [
25]. From another perspective, health consciousness can also lead to a fear of COVID-19, as people who are health-conscious may be more concerned about their susceptibility to the virus and its potential impact on their health. Such concerns can result in fear and anxiety [
26].
- (b)
The fear of COVID-19 and health consciousness both involve an awareness of the risks associated with the virus and the importance of taking measures to mitigate those risks. People who are health-conscious may be more likely to perceive the risks associated with COVID-19 and take the appropriate precautions to protect themselves and others [
27].
- (c)
The fear of COVID-19 and health consciousness can impact an individual’s sense of self-efficacy, i.e., a belief in their own ability to accomplish a task or act in a given situation [
25]. Fear can make people feel helpless and overwhelmed, while health consciousness can give them a sense of control over their health and their ability to protect themselves from the virus [
28].
The main objective of this study is to validate the FCV-19S using Czech data, i.e., to test the internal consistency of the scale, confirm its unidimensional structure, analyze its psychometric characteristics, and compare the achieved results with the original scale that was introduced and initially validated by Ahorsu et al. [
11]. The research objectives are aimed at proving the normal distribution of the scale, its internal consistency, and its uni-dimensional structure. Moreover, the aim is to confirm whether the Czech data support the proposed single-factor model, if the seven items purport to reflect a construct of fear, if the scale shows concurrent validity, based on the correlation with HCS, and if the scale discriminates among the levels of fear between males and females and among different age groups. Finally, an additional aim of the study is to analyze the levels of fear within the different sub-populations, i.e., to analyze the mean difference in FCV-19S scores according to selected sociodemographic characteristics (especially gender and age).
4. Discussion
The current study aimed to translate and validate the FCV-19S in Czechia. In this respect, the whole range of relevant tests was performed, especially the univariate statistics test, the uni-dimensionality of the scale, and its psychometric performance when the EFA and CFA confirmed the one-factor structure of the scale. A series of validation attempts, including convergent validity, concurrent validity, and discriminant validity, indicates that the scale measured the intended construct, i.e., fears regarding COVID-19.
The following descriptive statistics are based on a sample of 1357 cases; the grand mean of the scale is 18.29, and the standard deviation is 7.278. For comparison, in India, the score reached 18.00; SD = 5.68 [
16], in Romania 14.11, SD = 5.62 [
35], in Russia 17.4, SD = 4.7 [
58], in Belarus 16.6, SD = 4.5 [
58], in Iran 27.39 [
11], or in Japan 16.67, SD = 4.85 [
59].
Previous research has indicated a significant correlation between fear and the various aspects of psychological well-being, such as anxiety and despair [
12,
19,
60,
61]. Fear is typically defined as a negative emotional response to a perceived threat or stressful situation [
4], which involves both a subjective emotional response and an actual experience. The available studies suggest that fear is a complex emotional response that can impact an individual’s psychological health in various ways. Some researchers suggest that fear is associated with an overestimation of the probability of experiencing a dangerous, life-threatening event [
62].
Additionally, several studies have evaluated the internal consistency of the Fear of COVID-19 scale (FCV-19S), with researchers reporting high levels of reliability. For example, Alyami et al. [
34] reported an internal consistency coefficient of 0.88, while Satici et al. [
13] reported a coefficient of 0.85. Reznik et al. [
58] reported 0.81, while Midorikawa et al. [
59] reported 0.83, Sakib et al. [
9] reported 0.871, and Ping et al. [
63] reported 0.893. Moreover, Perz [
19] conducted a factor analysis and reported that the scale demonstrated 66% uni-dimensionality.
Sakib et al. [
9] reported χ
2 = 554.75; Midorikawa et al. [
59] reported χ
2 = 386.25;
p < 0.001; Perz et al. [
19] reported a KMO = 0.88. For comparison, the CR in the original scale reported by Ahorsu et al. [
11] was 0.88 and the AVE was 0.51. Sakib et al. declared values of CR = 0.89 and AVE = 0.58 [
9], whereas Ping et al. achieved a CR = 0.799 and AVE = 0.411 [
63].Based on the high intercorrelations of AVE and CR, the Czech version of the FCV-19S might be considered to have items that are interrelated and are converging into a common construct.
Statistically significant differences in the FSC-19S scores between females and males were identified in this study, similar to some other studies, e.g., Stanculescu [
35]. As Broche-Pérez et al. [
15] reported, in Cuba, the subsample of males reached 17.9 (SD = 8.05), whereas female scores reached 21.9 (SD = 6.90); similarly, Sakib et al. [
9] found that males reached 22.75 (SD = 5.65) and females 20.29 (SD = 5.90). Such a finding is not unique, as many other studies have already mentioned that females are more sensitive to external stressors, and a higher level of fear is a typical reaction [
12,
60,
64].
A verbal report on experiences with COVID-19 may not be accurate, as there may be a risk of social desirability bias, especially in the case of males, who are avoidant of expressing their fear. All indicators were self-reported, with no cross-checks.
Some studies indicate that the two-factorial model performs better than a single-factor model (e.g., in China [
38]). However, this is not the case in Czechia, where the results are comparable with findings that confirm the single-factor model.
The cross-sectional design of the study precludes the determination of causality between the FCV-19S and HCS. It is not clear whether heightened health consciousness leads to a greater fear of COVID-19 or whether the increased fear of COVID-19 motivates greater health consciousness. Both explanations are plausible, but further research is needed to establish a causal relationship. A longitudinal study, such as a panel survey, would enable the monitoring of changes in the level of fear over time as the pandemic evolves or in response to specific interventions. Such a design would allow for repeated interviews with the same participants and provide an opportunity to analyze changes in their attitudes and fear. This would provide valuable insights into the dynamics of fear and health consciousness and help establish causality.
Sharing the results of this research supplements the body of resources on the performance of the FCV-19S in different parts of the world. It might also help other researchers in the future to perform a meta-analysis that is either focused on the findings as such or on the methodologies used.
5. Conclusions
The primary goal of the presented paper was to evaluate the key psychometric characteristics of the FCV-19S instrument. To reach this goal, several methods and indices were used, especially Cronbach’s alpha, EFA, and CFA. The very first data from Czechia show that the FCV-19S, as it was translated into the Czech language, performs well; the results indicate that the scale has a unidimensional structure, satisfactory concurrent validity, and good discriminant validity (see its correlations with direct stimuli, gender, and age). The scale also has high internal consistency and acceptable construct validity, based on the fit indices between the data and the proposed model. Concurrent validity is supported by the significant correlation with the HCS (the study showed that the FCS is highly correlated with the HCS). Similar findings were reported by other studies that tested the association of the scale with other relevant constructs. These studies claim that FCV-19S scores well with: GAD-7 [
19]; PHQ-9 [
9]; HADS [
11]; DASS-21 [
12]; SCS-SP [
38]; PVDS [
65]. The FCV-19S might, therefore, be considered a sound scale with robust psychometric properties.
Based on the findings, it can be concluded that the Fear of COVID-19 scale (FCV-19S) is a reliable tool for measuring the fear of COVID-19 among the general population. Furthermore, this study contributes to the growing body of research on the impact of the pandemic on various subgroups by identifying vulnerable populations at risk of experiencing high levels of fear. Specifically, the results of the ANOVA analysis indicate that females and the elderly are more likely to experience high levels of fear related to COVID-19. While the FCV-19S may also be capable of identifying other vulnerable subgroups, further research is needed to explore this possibility.