This questionnaire was designed in 1970 to measure state and trait anxiety [35]. This inventory consists of 40 questions, 20 of which are related to state anxiety (expressing personal feelings) and the remaining 20 questions measure the trait anxiety (general and common emotions). This scale is scored based on a 4-point Likert scale, ranging from 1 (lowest level of anxiety) to 4 (highest level of anxiety). Items 1, 2, 5, 8, 10, 11, 15, 16, 19, 20 (state anxiety scale) and items 21, 23, 26, 27, 30, 33, 34, 36, 39 (trait anxiety scale) are scored in reverse. The possible score range is from 20 to 80 for each scale, with scores 20–31,32–42, 43–53,54–64, 65–75, and 76 and above indicating mild, moderate to low, and moderate to high, and relatively severe, severe, and very severe anxiety, respectively. The reliability of this questionnaire was confirmed based on previous studies in Iran with Cronbach’s alpha coefficient of 0.84 and content validity [9].
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