Association between health anxiety dimensions and preventive behaviors during the COVID-19 pandemic among Japanese healthcare workers

Health anxiety (HA), defined as excessive worry about having a serious medical condition, may affect preventive behaviors during the coronavirus disease 2019 (COVID-19) pandemic. We examined the distinct role of two dimensions of HA—perceived likelihood (probability dimension) and awfulness of illness (awfulness dimension)—in self-protection, as reflected in preventive behaviors during the pandemic. Participants comprised 657 healthcare workers. Data were collected between February 24 and 26, 2021. The Short Health Anxiety Inventory determined the HA dimensions. Adherence to the government's recommendations for COVID-19 preventive behaviors was self-rated. An independent association between each HA dimension and participants' adherence to the recommendations was examined using multivariable regression. Within the analyzed sample of 560 subjects, severe HA was observed in 9.1 %. The more the participants felt awful, the less frequently they engaged in the recommended preventive behaviors (adjusted odds ratio = 0.993, 95 % confidence interval: 0.989, 0.998, p = 0.003) regardless of their profession, working position, psychological distress, sleep disturbance, and current physical diseases. However, the probability dimension was not associated with their preventive behaviors. The awfulness dimension of HA could be a more sensitive marker of preventive behaviors than the probability dimension. Paying particular attention to the awfulness dimension may help optimize self-protection strategies during the COVID-19 pandemic. A two-dimensional understanding of HA may be useful for the maintenance of the healthcare system and public health as well as healthcare workers’ own health. •The role of two health anxiety dimensions in COVID-19 prevention was examined.•Only the awfulness dimension was found to be associated with preventive behaviors.•The more participants felt awful, the less they followed recommended behaviors.•The awfulness dimension may be more important for self-protection during the pandemic.