Background: The objective of this study was to investigate anxiety symptoms and preventive measures being taken against COVID-19. The study also aimed to compare the association between preventive measures and anxiety symptoms during the week immediately preceding the study and those symptoms and measures at the beginning of the outbreak. Methods: : A cross-sectional population survey using an online questionnaire commenced on 14 February 2020. The study participants were residents of Taiwan and were aged between 20 and 70 years. The 6-item state version of the State–Trait Anxiety Inventory (STAI-6) was used to assess anxiety symptoms. The questions about preventive measures asked participants about their personal protection, cough etiquette, contact precautions, voluntary quarantine, and prompt reporting. Results: : Of a total of 3,555 completed responses, a total of 52.1% (95% Confidence Interval [CI] 50.4–53.7) of the respondents reported having moderate to severe levels of anxiety symptoms in the past week, whereas 48.8% (95%CI 47.2–50.5) reported that they had had moderate to severe levels of anxiety symptoms at the beginning of the outbreak. The median scores for anxiety symptoms in the past week and at the beginning of the outbreak were 46.7 (IQR [Interquartile Range] 36.7-53.3) and 43.3 (IQR 36.7-53.3), respectively. The median scores for the preventive measures taken in the past week and at the beginning of the outbreak were 26.0 (IQR 21.0–30.0) and 24.0 (IQR 19.0–28.0), respectively, out of a maximum score of 36. In the multivariate analysis, having an increased anxiety symptom score from the beginning of the outbreak to the past week (adjusted OR = 7.38, 95%CI 6.28–8.66) was a strongly significant determinant of having an increased preventive measures score in the past week compared with score at the beginning of the outbreak. Conclusions: : The study reveals the need to reduce levels of public anxiety and to maintain appropriate levels of infection prevention against COVID-19. The psychological effects and psychobehavioural responses to the outbreak found in this study provide important information about developing and implementing effective preventive and emotional regulation control strategies.
Investigation into public anxiety symptoms and preventive measures during the COVID-19 outbreak in Taiwan