Evaluation of the validity and screening performance of a revised single‐item fear of cancer recurrence screening measure (FCR‐1r)

Smith, Allan Ben; Gao, Manxin; Tran, Mei Jun; Ftanou, Maria; Jegathees, Sharuja; Wu, Verena S.; Jefford, Michael; Lynch, Fiona; Dhillon, Haryana M.; Shaw, Joanne; McDowell, Lachlan; White, Alan; Halloran, Clare; Wiesenfeld, D.; Bamgboje‐Ayodele, Adeola

doi:10.1002/pon.6139

Cited by 12 publications

(8 citation statements)

References 53 publications

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“…The tools were also pilot tested for face validity and acceptability among cancer survivors with mixed diagnoses, a critical step that is often neglected. 4,21 Indeed, during the development of the FCRI, a single round of pilot testing was used to establish the face T A B L E 1 Ottawa fear of recurrence-Screener (OCFR-S).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, there is currently only one single-item tool designed to rapidly screen for FCR in clinical practice, the FCR-1. 3 Although a complementary study by Smith et al 4 provided preliminary insight into the screener's psychometric properties, this study and its future phases will allow for additional validation with a larger sample to further support integration into clinical practice and research.…”

Section: Introductionmentioning

confidence: 94%

“…However, the screener's psychometric properties have been preliminarily investigated by Smith et al. 4 They found that the OCFR-S (reported as the FCR-1r)…”

Section: Itemmentioning

confidence: 99%

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The Ottawa clinical fear of recurrence instruments: A screener, self‐report, and clinical interview

Giguère,

Mutsaers,

Harris

et al. 2024

Psycho-Oncology

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ObjectiveClinical fear of cancer recurrence (FCR) was recently defined by a group of experts during a Delphi study. Five criteria were agreed upon, namely: (a) high levels of preoccupation, (b) high levels of worry, (c) that are persistent, (d) hypervigilance and hypersensitivity to physical sensations that e) may result in functional impairment. No existing instruments comprehensively capture all these criteria for clinical FCR.MethodsTo remedy this gap, a set of three patient‐reported outcome instruments including a one‐item screener, self‐report questionnaire, and semi‐structured clinical interview, named the Ottawa Clinical Fear of Recurrence instruments, were developed. To do so, the research team first conducted a literature review of potential items. Additional FCR experts discussed the content of the screener and interview. The self‐report's items were assessed for content validity by the same expert panel using Likert ratings and the Content Validity Index to narrow down the number of items. The three instruments were piloted with a group of cancer survivors to assess face validity following the European Organization for Research and Treatment of Cancer recommendations.ResultsThe literature review and content validity assessment led to a final draft pre‐pilot of 23 potential items for the self‐report questionnaire. The instruments were piloted. Pilot study participants suggested changing wording and response options (particularly for the self‐report) for greater clarity.ConclusionsBased on the feedback received, minor modifications were made, mostly for the self‐report. In general, content and face validity for the three instruments were good for both experts and cancer survivors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

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The Ottawa clinical fear of recurrence instruments: A screener, self‐report, and clinical interview

Giguère,

Mutsaers,

Harris

et al. 2024

Psycho-Oncology

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“…Furthermore, investigations are underway to test screening FCR as part of routine clinic follow‐up alongside other patient‐reported outcome measures, given that FCR correlates poorly with clinicopathological factors associated with risk of recurrence, and patients are reluctant to raise FCR with treating physicians 5 . Single‐item FCR screening instruments showing high sensitivity and specificity and can be readily incorporated into patient reported outcome measures utilised in the clinic 18,19 . An implementation study of a melanoma stepped care FCR programme involving usual care for patients with low FCR, psychoeducational booklet for intermediate FCR and 3–5 psychotherapeutic telehealth sessions for those with high FCR is underway, 20 but results are not yet reported.…”

Section: Discussionmentioning

confidence: 99%

A novel clinician‐delivered intervention to reduce fear of recurrence in breast cancer survivors: Results from a Phase I/II implementation study (CIFeR_2)

Liu,

He,

Butow

et al. 2023

Psycho-Oncology

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ObjectiveFear of cancer recurrence (FCR) is highly prevalent, however there is no formal training for clinicians to address FCR. A novel brief clinician intervention to help patients manage FCR (Clinician Intervention to Reduce Fear of Recurrence (CIFeR)) was shown to be feasible, acceptable, and reduced FCR in breast cancer patients in a pilot study. We now aim to explore the barriers and facilitators of implementing CIFeR within routine oncology practice in Australia.MethodsThis multicentre, single‐arm Phase I/II implementation study recruited surgical, medical and radiation oncologists who treat women with early breast cancer. Participating clinicians completed online CIFeR training and were asked to use CIFeR for the next 6 months. Questionnaires were administered before (T0), immediately after (T1), then 3 (T2) and 6 months (T3) after training to assess confidence in addressing FCR and Proctor Implementation outcomes. The primary outcome was adoption at T2. Secondary outcomes were self‐efficacy in FCR management, acceptability, feasibility, costs, barriers and facilitators of implementation.ResultsFifty‐two clinicians consented of whom 37 completed the CIFeR intervention training. Median age of participants was 41.5 (range 29–61), 73% were female and 51% were medical oncologists. The primary endpoint was met, with CIFeR adopted by 82%. Clinician intervention delivery took 7.4 min on average and was deemed acceptable, appropriate and feasible. Self‐efficacy in managing FCR improved significantly across all domains (p < 0.001). Lack of time was the greatest barrier to routine CIFeR_2 implementation.ConclusionsA structured brief, low‐cost clinician intervention to reduce FCR is useful, acceptable and improved self‐efficacy with FCR management. Fear of cancer recurrence training should be incorporated into communication skills training of oncologists and surgeons.Trial RegistrationProspectively registered with the Australian New Zealand Clinical Trials Registry, ACTRN12621001697875.Trial SponsorChris O’Brien Lifehouse.

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“…Precise detection and surveillance of cancer patients with high levels of FoP is important for preventing or reducing negative consequences of exaggerated FoP. Therefore, several instruments have been developed to assess FoP in cancer [25], ranging from ultra-short 1-item instruments [26,27] to the 43-item Fear of Progression Questionnaire (FoP-Q) [28]. A frequently used and validated instrument for assessing FoP in cancer patients is a short form of the FoP-Q, the FoP-Q-12 [29].…”

Section: Introductionmentioning

confidence: 99%

Fear of Cancer Progression: A Comparison between the Fear of Progression Questionnaire (FoP-Q-12) and the Concerns about Recurrence Questionnaire (CARQ-4)

Hinz,

Schulte,

Mehnert-Theuerkauf

et al. 2024

Healthcare

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As cancer patients often suffer from fear of cancer progression (FoP), valid screening for FoP is of high relevance. The aims of this study were to test psychometric properties of two FoP questionnaires, to determine their relationship to other anxiety-related constructs, and to analyze the impact of sociodemographic and clinical factors on the FoP. Our sample consisted of n = 1733 patients with mixed cancer diagnoses. For measuring FoP, the Fear of Progression questionnaire (FoP-Q-12) and the Concerns About Cancer Recurrence Questionnaire (CARQ-4) were used. The mean scores of the FoP-Q-12 and the CARQ-4 were 30.0 ± 10.4 and 16.1 ± 10.8, respectively, indicating relatively high levels of FoP. Both questionnaires showed excellent internal consistency coefficients, α = 0.895 and α = 0.915, respectively. The correlation between the two FoP questionnaires was r = 0.72. Female patients reported more FoP than male patients (d = 0.84 and d = 0.54, respectively). There was a nonlinear age dependency of FoP, with an increase found in the age range from 18 to 50 years and a decrease in the older age range. Radiation, chemotherapy, and antibody therapy, but not surgery, lead to an increase in FoP. Both questionnaires show good psychometric properties and can be recommended for use in an oncological routine. Female patients and patients in the middle-age range deserve special attention from healthcare providers.

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Evaluation of the validity and screening performance of a revised single‐item fear of cancer recurrence screening measure (FCR‐1r)

Cited by 12 publications

References 53 publications

The Ottawa clinical fear of recurrence instruments: A screener, self‐report, and clinical interview

The Ottawa clinical fear of recurrence instruments: A screener, self‐report, and clinical interview

A novel clinician‐delivered intervention to reduce fear of recurrence in breast cancer survivors: Results from a Phase I/II implementation study (CIFeR_2)

Fear of Cancer Progression: A Comparison between the Fear of Progression Questionnaire (FoP-Q-12) and the Concerns about Recurrence Questionnaire (CARQ-4)

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