Document Type : Research articles


1 Spiritual Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.

2 Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Faculty of Amol Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran

4 Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

5 Patient Safety Research Center, Clinical Research Institute, Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran


Background: Self-care during Coronavirus Disease 2019 (COVID-19) helps people follow self-care strategies to reduce the spread of the virus. To control the disease, people need to engage in self-care behaviors, which should be investigated by a valid and reliable instrument to yield valid and credible results.
Objectives: This study aimed to validate the Persian version of the Self-Care in COVID-19 Scale (SCOVID Scale).
Methods: The sample included 582 participants from Tehrans general population, selected through convenience sampling in 2021. They were divided into two groups, one for exploratory factor analysis (EFA) and the other for confirmatory factor analysis (CFA). Cronbachs alpha coefficient and McDonalds omega were used to assess the internal consistency. Standard error of measurement and the interclass correlation coefficient were also employed to examine absolute and relative stability, respectively.
Results: In the EFA, three factors, including Precaution, Routine Activities, and Lifestyle, were extracted, explaining 32.31% of the total variance in COVID-19 self-care. Internal consistency of the whole scale using both Cronbachs alpha coefficient and McDonalds omega was above 0.7. The goodness of fit indices of the second-order CFA were in the acceptable range (x2=262.365, df=82, P<0.001, RMSEA=0.062, PCFI=0.725, PNFI=0.703, IFI=0.930, and the CFI=0.929).
Conclusion: The Persian version of the SCOVID Scale is a valid and reliable instrument that can be used in studies on COVID-19.


  1. Chew NW, Lee GK, Tan BY, Jing M, Goh Y, Ngiam NJ, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun 2020;88:559-65. 10.1016/j.bbi.2020.04.049
  2. Zhang Y, Ma ZF. Impact of the COVID-19 pandemic on mental health and quality of life among local residents in Liaoning Province, China: A cross-sectional study. Int J Environ Res Public Health 2020;17(7):2381. 10.3390/ijerph17072381
  3. Organisation WH. Coronavirus Disease (COVID-19) Advice for the Public. 2019. Available online: (accessed on 29 April 2020).
  4. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382(8):727-33. 10.1056/NEJMoa2001017
  5. Mehraeen E, Hayati B, Saeidi S, Heydari M, Seyedalinaghi S. Self-care instructions for people not requiring hospitalization for coronavirus disease 2019 (COVID-19). Archives of Clinical Infectious Diseases 2020;15(COVID-19):e102978. 10.5812/archcid.102978
  6. Control. CfD. Coronavirus disease 2019 (COVID-19)., [cited 2020 Mar 09]. . 2020. Available from: (accessed on 10 July 2020).
  7. Riegel B, Jaarsma T, Strömberg A. A middle-range theory of self-care of chronic illness. Advances in Nursing Science 2012;35(3):194-204. 10.1097/ANS.0b013e318261b1ba
  8. De Maria M, Ferro F, Ausili D, Alvaro R, De Marinis MG, Di Mauro S, et al. Development and psychometric testing of the self-care in COVID-19 (SCOVID) scale, an instrument for measuring self-care in the COVID-19 pandemic. Int J Environ Res Public Health 2020;17(21):7834. 10.3390/ijerph17217834.
  9. Mayers A. Introduction to statistics and SPSS in psychology. London, UK.: Pearson Higher Ed; 2013.
  10. Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 1993;46(12):1417-32. 10.1016/0895-4356(93)90142-n
  11. Vergunst F, Jenkinson C, Burns T, Anand P, Gray A, Rugkåsa J, et al. Psychometric validation of a multi-dimensional capability instrument for outcome measurement in mental health research (OxCAP-MH). Health and quality of life outcomes 2017;15(1):1-11. 10.1186/s12955-017-0825-3
  12. Browne MW, Cudeck R. Alternative ways of assessing model fit. Sociological methods & research 1992;21(2):230-58.
  13. Soleimani M, Zarabadi Pour S, Yaghoobzadeh Y, Pahlevan Sharif S, Sharif Nia H. Factor Structure of McGill Quality of Life Questionnaire in Patients with Heart Disease: Second-order Confirmatory Factor Analysis. Iranian Journal of Epidemiology 2018;14(1):83-94.
  14. Henseler J, Ringle CM, Sarstedt M. A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the academy of marketing science 2015;43(1):115-35.
  15. Hair JF, Anderson R, Tatham R, W B. Multivariate data analysis (pp. 326–386). Delhi, India: Pearson Education; 1998.
  16. Hancock GR. Rethinking construct reliability within latent variable systems. Structural equation modeling: Present and future 2001:195-216.
  17. Ebadi A, Zarshenas L, Rakhshan M, Zareiyan A, Sharifnia S, Mojahedi M. Principles of scale development in health science. Tehran: Jame-e-negar 2017.
  18. Ahmadizadeh MJ, Ebadi A. Development and psychometric evaluation of the treatment adherence questionnaire for patients with combat post-traumatic stress disorder. Patient preference and adherence 2019;13:419-30. 10.2147/PPA.S175353.
  19. Lotfi M, Hamblin MR, Rezaei N. COVID-19: Transmission, prevention, and potential therapeutic opportunities. Clin Chim Acta 2020;508:254-66. 10.1016/j.cca.2020.05.044.
  20. Jiang Y, Zhao B, Li X, Yang X, Zhang Z, Zhang Y, editors. Investigating a safe ventilation rate for the prevention of indoor SARS transmission: An attempt based on a simulation approach. Building Simulation; 2009: Springer.
  21. Kampf G. Potential role of inanimate surfaces for the spread of coronaviruses and their inactivation with disinfectant agents. Infection Prevention in Practice 2020;2(2):100044. 10.1016/j.infpip.2020.100044
  22. Sarfaraz S, Shabbir J, Mudasser MA, Khurshid Z, Al-Quraini AAA, Abbasi MS, et al., editors. Knowledge and attitude of dental practitioners related to disinfection during the COVID-19 pandemic. Healthcare; 2020: Multidisciplinary Digital Publishing Institute.
  23. Khubchandani J, Saiki D, Kandiah J. Masks, gloves, and the COVID-19 pandemic: Rapid assessment of public behaviors in the United States. Epidemiologia 2020;1(1):16-22. 10.3390/epidemiologia1010004
  24. Galli F, Reglero G, Bartolini D, Visioli F. Better prepare for the next one. Lifestyle lessons from the COVID-19 pandemic. PharmaNutrition 2020;12:100193. 10.1016/j.phanu.2020.100193
  25. Altena E, Baglioni C, Espie CA, Ellis J, Gavriloff D, Holzinger B, et al. Dealing with sleep problems during home confinement due to the COVID‐19 outbreak: Practical recommendations from a task force of the European CBT‐I Academy. J Sleep Res 2020;29(4):e13052. 10.1111/jsr.13052
  26. Shigemura J, Ursano RJ, Morganstein JC, Kurosawa M, Benedek DM. Public responses to the novel 2019 coronavirus (2019‐nCoV) in Japan: Mental health consequences and target populations. Psychiatry Clin Neurosci 2020;74(4):281-2. 10.1111/pcn.12988
  27. Clemente-Suarez VJ, Fuentes-Garcia JP, de la Vega Marcos R, Martinez Patiño MJ. Modulators of the personal and professional threat perception of olympic athletes in the actual COVID-19 crisis. Front Psychol 2020;11:1985. 10.3389/fpsyg.2020.01985
  28. Fu W, Wang C, Zou L, Guo Y, Lu Z, Yan S, et al. Psychological health, sleep quality, and coping styles to stress facing the COVID-19 in Wuhan, China. Translational psychiatry 2020;10(1):1-9. 10.1038/s41398-020-00913-3
  29. Maugeri G, Castrogiovanni P, Battaglia G, Pippi R, D'Agata V, Palma A, et al. The impact of physical activity on psychological health during Covid-19 pandemic in Italy. Heliyon 2020;6(6):e04315.
  30. Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med 2020;18(1):229.
  31. Gupta R, Grover S, Basu A, Krishnan V, Tripathi A, Subramanyam A, et al. Changes in sleep pattern and sleep quality during COVID-19 lockdown. Indian J Psychiatry 2020;62(4):370-8. 10.4103/psychiatry.IndianJPsychiatry_523_20
  32. Balanza–Martinez V, Atienza–Carbonell B, Kapczinski F, De Boni RB. Lifestyle behaviours during the COVID‐19–time to connect. Acta Psychiatr Scand 2020;141(5):399-400. 10.1111/acps.13177.
  33. Wahid A, Manek N, Nichols M, Kelly P, Foster C, Webster P, et al. Quantifying the association between physical activity and cardiovascular disease and diabetes: a systematic review and meta‐analysis. Journal of the American Heart Association 2016;5(9):e002495. 10.1161/JAHA.115.002495.
  34. Slimani M, Paravlic A, Mbarek F, Bragazzi NL, Tod D. The relationship between physical activity and quality of life during the confinement induced by COVID-19 outbreak: a pilot study in Tunisia. Front Psychol 2020;11:1882. 10.3389/fpsyg.2020.01882.