The participants’ Fear of COVID-19 Scale mean score average was found 19.59 ± 6.98. Given that the scale scores range between 7 and 35, this result indicates that the participants in this study had an above-average level of fear of COVID-19. In their study conducted with patients with COPD, Gorpuz (2021) found the fear of COVID-19 scale mean score as 16,92 ± 6,36 [16]. The findings of this study are in line with the literature.
Women’s fear of COVID-19 Scale mean score was found to be higher in women than in men in this study. In a study conducted in Bangladesh, women received significantly higher fear of COVID-19 scores than men [17]. A study conducted in Cuba found that being female was an indicator of having a middle or high level of fear of COVID-19 [18]. The results of this study are in line with the literature.
In this study, the participants who had an education level of primary school had higher fear of COVID-19 scores compared to other groups. The literature findings including fear of COVID-19 indicated that education level was an important indicator affecting the level of fear of COVID-19 [15, 19]. The finding related to the fear of COVID-19 and the education level is similar to other studies in the literature.
This study found that participants with income less than expenses had higher levels of fear of COVID-19. Studies showed that the current economic condition had effects on psychological problems, and the decrease in economic condition was associated with increased psychological problem levels [20, 21]. Besides, a high monthly income level was known to be a protective factor against psychological problems during the pandemic process [20, 22, 23]. Individuals who have income less than expenses worry about their future, and due to having a low economic level, think that accessing good health services is not sufficient, which might have had effects on the increase in their fear of COVID-19 levels in the pandemic process.
This study detected no significant differences between the participants’ age and their fear of COVID-19, and the literature includes studies reporting similar findings [15, 17]. On the other hand, some studies reported a significant difference between age and the fear of COVID-19 [1, 24]. This difference could be associated with the differences in the number of samples and age groups in the sample.
No differences were detected between marital status and the fear of COVID-19 in this study. In a similar vein, while some studies in the literature reported similar findings [25, 26], some other studies reported opposite findings [1]. The different number of samples and different demographic characteristics of the sample group in the studies might have effects on these results.
The fear of COVID-19 was found to be higher in those who had a chronic disease in comparison to those who did not. Studies in the literature similarly reported that people who had a chronic disease had a significantly higher fear of COVID-19 in comparison to those who did not [16, 27]. Doctor check-ups, follow-ups, laboratory retests, and regulation of medication at certain times are of importance during the care of chronic diseases. When these measures are not taken, there is a potential risk of experiencing disruptions in the management of the disease, causing the development of new problems [28]. Fear of COVID-19 could also be caused by factors such as the disruption in the follow-up and treatment of patients’ current diseases, worsening in the quality of care, or worries about the course of their chronic diseases during the pandemic period [29]. The findings of this study are in line with the literature.
The fear of COVID-19 was found to be higher in individuals who were diagnosed with cancer in this study. This finding is in line with the literature [30–34]. Fear of COVID-19 in cancer patients might have increased due to factors such as patients’ thinking about the probability of disruptions in their treatment and having a higher risk of experiencing COVID-19 more severely. Participating individuals who had a relative diagnosed with cancer were found to have higher fear of COVID-19. Osborn et al. (2006) reported that around 50% of individuals who were diagnosed with an advanced level of cancer were affected psychologically [35]. First-degree relatives of individuals with a chronic disease such as cancer, due to their relatives’ current chronic diseases, are in a high-risk group, which might have affected their fear of COVID-19.
Individuals who had cancer screenings before the pandemic were found to have higher fear of COVID-19 in this study. Individuals who had cancer screenings before the pandemic period were probably more sensitive and had their cancer screenings. These participants’ fear of COVID-19 levels might have been higher because they are afraid of catching diseases.
Individuals who went to health institutions during the pandemic period had higher fear of COVID-19 in this study. In their study conducted with individuals who had a noncontagious disease diagnosis, Say and Cakır (2021) reported that the treatment processes of some of the participants (36.40%) were affected by the pandemic negatively, approximately 73% were afraid of going to health institutions, and the health condition of the 55% would worsen even more due to the delays experienced [36]. Another study reported that the fear of COVID-19 transmission (89.90%) was the greatest reason for failing to meet the participants’ health service needs [13]. The literature generally indicated a decrease in going to the health institution due to the fear of COVID-19 [13, 36]. In this study, the fear of COVID-19 was found to be higher in individuals who visited health institutions.
The fear of COVID-19 was found to be higher in participating individuals who refrained from going to the health institution during the pandemic period. A review of the literature indicated that patients avoided going to hospitals because they were afraid of being infected with COVID-19 [37]. A study conducted in the USA reported that applications to emergency services decreased by 50% during the fight against the COVID-19 pandemic, which was considered to be associated with patients’ fear of catching COVID-19 [38]. The decrease in the applications in health institutions seems to be associated with individuals’ fear of COVID-19.
This study found that those who thought about having cancer screening during the pandemic process had higher fear of COVID-19 (p < 0.05). Individuals who think about having their cancer screenings even in case of the continuation of the pandemic because of being more sensitive and more afraid of having cancer could also be individuals who are more afraid of catching COVID-19.
This study found that those who had cancer screenings during the pandemic process had higher fear of COVID-19 (p < 0.05). Unlike the present study, a study conducted in Korea detected that a significant part of the general population demonstrated a significant decrease in participating in regular medical check-ups, including cancer screenings, due to the fear of COVID-19 [39]. Bestari and Joewono found that the COVID-19 pandemic decreased participants’ willingness for having cancer screenings due to the fear of catching COVID-19 [12]. A study conducted in the USA also reported a significant decrease in participation in cancer screenings in the year 2020. Some of this decrease in cancer screenings are reported to be associated with canceled or postponed cancer screenings as well as the fear of catching COVID-19 during a doctor's examination or while at the hospital [40]. Studies show that cancer screenings decreased during the pandemic period due to the fear of COVID-19 [12, 39, 40]. Although the significance test results in this study showed high levels of fear of COVID-19 in individuals who participated in cancer screenings, regression analysis results showed that the fear of COVID-19 prevented the cancer screening behaviors by 0.923 times in the pandemic process. The results of the present study also showed that the fear of COVID-19 was higher in individuals who had cancer screenings during the pandemic process. This study conducted with 393 individuals found that only 60 participants had screenings during the pandemic process, and the fear of COVID-19 levels were found to be high. The remaining 333 individuals were found not to have done cancer screenings during the pandemic process.
Limitations and strengths
Since there were restrictions applied due to the pandemic at the time of the study, data were collected online from the participants. This may be a limitation. Despite this limitation, our study makes an important contribution to the literature that fear of COVID-19 is an effective factor on cancer screening.