Abstract
BackgroundThe assessment of fear of recurrence (FCR) is crucial for understanding an important psychological state in patients diagnosed and treated for cancer. The study aim was to determine psychometric details of a seven question self-report scale (FCR7) and a short form (FCR4) based upon items already used in various extensive measures of FCR.MethodsTwo consecutive samples of patients (breast and colorectal) were recruited from a single specialist cancer centre. The survey instrument contained the FCR7 items, Hospital Anxiety and Depression Scale (HADS), and demographic details. Clinical information was obtained from patient hospital records. Statistical analyses were performed using classical test and item response theory approaches, to demonstrate unidimensional factor structure and testing key parameters. Construct validity was inspected through nomological and theoretical prediction.ResultsInternal consistency was demonstrated by alpha coefficients (FCR4: 0.93 and FCR7: 0.92). Both scales (FCR7 & FCR4) were associated with the HADs subscales as predicted. Patients who experienced chemotherapy, minor aches/pains, thought avoidance of cancer and high cancer risk belief were more fearful. Detailed inspection of item responses profile provided some support for measurement properties of scales.ConclusionThe internal consistency, and pattern of key associations and discriminability indices provided positive psychometric evidence for these scales. The brief measures of FCR may be considered for audit, screening or routine use in clinical service and research investigations.
Highlights
The assessment of fear of recurrence (FCR) is crucial for understanding an important psychological state in patients diagnosed and treated for cancer
Multi-item scales have the benefit of assessing a variety of qualities or features of FCR [5]
This paper reports on the evaluation of a 7 item FCR scale (FCR7) and that has already been presented in a sample of head and neck cancer patients in the Northwest of England [9]
Summary
The assessment of fear of recurrence (FCR) is crucial for understanding an important psychological state in patients diagnosed and treated for cancer. Multi-item scales have the benefit of assessing a variety of qualities or features of FCR [5]. They can be burdensome to complete, timeconsuming and challenging to score and interpret. The rationale we believe that is being supported by Costa et al is to identify the key area to be accurately measured and follow up through further assessment with associated features. These areas can be assessed through, either specific packets of items in a further questionnaire, or a structured clinical interview. The short uni-dimensional measure can be considered initially as a screening instrument for additional follow-up and enquiry
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