BACKGROUND: Levels of fear have increased since the COVID-19 pandemic outbreak. The absence of a safe and effective vaccine for mass-vaccination deteriorates this situation, which has a significant impact on mental health. This study aimed to assess the feelings of fear among nurses and nursing students in five European countries. METHODS: A multicenter cross-sectional study was conducted in five European countries (Greece, Albania, Cyprus, Spain, and Kosovo) before the start of mass vaccination in Europe. Data collection was conducted in December 2020-January 2021 using an online questionnaire for nursing students and professional nurses. Fear of COVID-19 Scale (FCV-19S) was used for measuring levels of fear. IBM SPSS version 21.0 was used for statistical analysis. RESULTS: The study population included 1135 nurses and 1920 nursing students from Kosovo (n = 1085), Spain (n = 663), Greece (n = 534), Albania (n = 529), and Cyprus (n = 244). According to multivariable analysis, females (OR = 2.53, 95% CI = 1.89-3.15), married (OR = 0.86, 95% CI = 0.24-1.48), nurses (OR = 0.87, 95% CI = 0.28-1.45) and those with a chronic disease (OR = 0.86, 95% CI = 0.11-1.62) were more fearful of COVID-19. CONCLUSIONS: It is important to decrease fear in the population of nurses who are at the frontlines of the pandemic. The provision of appropriate education and training activities for nurses and students to manage their stress levels is of high importance. Future studies should focus on levels of fear after the administration of several safe and effective vaccines worldwide.

Clinic of Social and Family Medicine School of Medicine University of Crete 700 13 Crete Greece

Clinical Epidemiology Laboratory Department of Nursing National and Kapodistrian University of Athens 157 72 Athens Greece

Degree Course in Nursing Azienda USL IRCCS di Reggio Emilia 41121 Reggio Emilia Italy

Department of Healthcare Faculty of Health University of Vlora 9401 Vlora Albania

Department of Nursing and Midwifery Faculty of Medicine University of Ostrava 701 03 Ostrava Czech Republic

Department of Nursing Frederick University Nicosia 3080 Cyprus

Department of Nursing School of Health Sciences Hellenic Mediterranean University 714 10 Crete Greece

Department of Psychology and Social Sciences Frederick University Nicosia 3080 Cyprus

Department of Surgery Medicine Dentistry and Morphological Sciences University of Modena and Reggio Emilia 41121 Reggio Emilia Italy

Faculty of Nursing AAB College P O Box 10000 Pristina Kosovo

IMCU Group Faculty of Physiotherapy and Nursing University of Castilla La Mancha 45004 Toledo Spain

Research Centre of Public Health Faculty of Health University of Vlora 9401 Vlora Albania

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