Cancer Recurrence Fear Questionnaire (CRFQ)

Abstract

The Cuestionario de Miedo a la Recurrencia del Cáncer (CMRC), or the Fear of Cancer Recurrence Questionnaire, is an 8-item psychometric instrument developed specifically for the Spanish population to measure the intensity of Fear of Cancer Recurrence (FCR) among cancer survivors.

The development of the CMRC addressed a critical need for validated FCR measures in Spanish-speaking contexts. The initial process began with a comprehensive literature review and selection of 22 items from existing FCR scales, which were then adapted and subjected to expert review to establish Content Validity, reducing the pool to 10 items.

The final 8-item version was derived after administering the measure to gynecological cancer survivors in Spain. Subsequent psychometric analysis confirmed the scale’s strong internal consistency (Cronbach’s Alpha = 0.851) and established satisfactory Predictive Validity through correlations with measures of emotional functioning and anxiety.

Keywords

Cancer Recurrence, Cancer Survivors, Fear of Cancer Recurrence, Gynecological Cancer Survivors, Client Attitudes, Fear, Illness Behavior, Neoplasms, Health Attitude Measures.

Authors

del Prado, Celia Ibáñez; Aleksandrovna, Volha Zontava; Cruzado, Juan Antonio; Ospina, Gloria Marquina; Santos, Javier García; Nodal, Inés Rodríguez; del Amo, Mónica Bellón; Fernández, Aránzazu Manzano; Herráez, Antonio Casado.

Purpose

The primary purpose of the Cuestionario de Miedo a la Recurrencia del Cáncer (CMRC) is to provide a reliable and validated assessment tool to quantify the level of Fear of Cancer Recurrence (FCR) experienced by individuals who have completed primary cancer treatment.

This instrument is designed for use in clinical and research settings within the Spanish-speaking population, enabling clinicians and researchers to identify survivors experiencing clinically significant levels of FCR, which is essential for targeted psychological intervention.

Construct

The CMRC specifically measures the psychological construct of Fear of Cancer Recurrence (FCR). FCR is defined as the fear, worry, or concern that cancer will return or progress, often persisting long after treatment completion.

The 8 items of the scale focus on behavioral and cognitive manifestations of FCR, including excessive worry, avoidance behaviors, interference with daily enjoyment, difficulty planning for the future, and anxiety related to medical check-ups.

Validity

Predictive Validity: The CMRC demonstrated significant positive correlation with anxiety symptoms, as assessed by the Hospital Anxiety and Depression Scale (HADS). Specifically, FCR measured by the CMRC correlated significantly with the HADS anxiety subscale (Zigmond & Snaith, 1983). While there was no significant correlation with overall quality of life or depressive symptomatology, a meaningful association was found with the emotional function subscale of the area of functioning (r= -0.313; p=0.05). Furthermore, the CMRC exhibited a strong positive relationship (r=0.841, p<0.01) with the single-item Escala General del Miedo a la Recurrencia del Cáncer (EGMRC; del Prado et al., 2023).

Content Validity: Content validity was rigorously established through expert evaluation. The experts assessed the appropriateness of the items, resulting in Aiken’s V values greater than 0.76 for each item retained in the final scale, indicating high relevance and representativeness of the construct.

Reliability

Internal Consistency: The Cuestionario de Miedo a la Recurrencia del Cáncer (CMRC) showed good homogeneity among its items. The measure achieved a strong level of internal consistency, with a Cronbach’s Alpha coefficient reported at 0.851. This value suggests that the 8 items reliably measure the same underlying construct (FCR).

Factor Analysis

Data regarding the factor structure or dimensional analysis of the Cuestionario de Miedo a la Recurrencia del Cáncer (CMRC) is currently not available in the source documentation.

Instrument

Test Type: Original

Format: The measure utilizes an 8-item, 5-point Likert scale. The response options range from 0 to 4, where 0 represents “Not at all” (No en absoluto) and 4 represents “Totally agree” (Totalmente de acuerdo).

Language Available: Spanish

Population Group: Human, Female

Age Group: Adulthood (18 yrs & older), encompassing Young Adulthood (18-29 yrs), Thirties (30-39 yrs), Middle Age (40-64 yrs), and Aged (65 yrs & older).

Population Details: The validation study was conducted in Spain, focusing specifically on gynecological cancer survivors.

Test Methodology: Test Validity, Content Validity, Predictive Validity, Test Reliability, Internal Consistency.

Keywords

CMRC, Fear of Cancer Recurrence, Gynecological Cancer, Psychological Assessment, Spain, Oncopsychology, Cronbach’s Alpha.

Authors

Author ORCID Identifier: Not provided in source documentation.

Affiliation Email addresses:

• del Prado, Celia Ibáñez: [email protected] (Universidad Complutense de Madrid Facultad Psicología)

• Aleksandrovna, Volha Zontava: [email protected] (Universidad Complutense de Madrid Facultad Psicología)

• Cruzado, Juan Antonio: [email protected] (Universidad Complutense de Madrid Facultad Psicología)

• Ospina, Gloria Marquina: [email protected] (Hospital Universitario Clínico San Carlos Servicio de Oncología Médica)

• Santos, Javier García: [email protected] (Instituto de Salud de la Mujer del Hospital Clínico San Carlos)

• Nodal, Inés Rodríguez: [email protected] (Universidad Complutense de Madrid Facultad Psicología)

• del Amo, Mónica Bellón: [email protected] (Instituto de Salud de la Mujer del Hospital Clínico San Carlos)

• Herráez, Antonio Casado: [email protected] (Hospital Universitario Clínico San Carlos Oncología Médica)

Correspondence Address:

del Prado, Celia Ibáñez: Universidad Complutense de Madrid, Facultad Psicología, Ciudad Universitaria, Campus de Somosaguas, Madrid, Spain, 28223, [email protected]

Permissions & Fee and Test Year

Permissions: The instrument may be utilized for Research and Teaching purposes.

Fee: No fee is required for use.

Commercial Use: Commercial use is prohibited.

Test Year: 2023

Website: The scale is governed by the Creative Commons License: https://creativecommons.org/licenses/by/4.0/

Reference’s

del Prado, C. I., Aleksandrovna, V. Z., Cruzado, J. A., Ospina, G. M., Santos, J. G., Nodal, I. R., del Amo, M. B., Fernández, A. M., & Herráez, A. C. (2023). Evaluación del miedo a la recurrencia del cáncer en español: El Cuestionario de Miedo a la Recurrencia del Cáncer y Escala General del Miedo a la Recurrencia del Cáncer: un estudio piloto [Assessment of fear of cancer recurrence in Spanish: Fear of Recurrence Questionnaire and the General Scale of Fear of Cancer Recurrence: A pilot study]. Psicooncología, 20(1), 155–173. https://doi.org/10.1007/s10549-023-07085-0

Items of the Cuestionario de Miedo a la Recurrencia del Cáncer (CMRC)

This measure consists of 8 items. The specific items are available in the source reference: del Prado, C. I. et al. (2023). Psicooncología, 20(1), Table 7, Page 167.

Items

1. Estoy preocupado/a o ansioso/a por la posibilidad de volver a tener cáncer

2. La preocupación sobre la vuelta del cáncer supone un gran problema para mí

3. Pensar en la posibilidad de que el cáncer vuelva me impide disfrutar de las cosas como lo hacía antes de la enfermedad

4. Las personas cercanas a mí consideran que me preocupo excesivamente porque vuelva el cáncer

5. Las revisiones médicas me hacen sentir miedo por la posible vuelta del cáncer

6. Cuando me asaltan los pensamientos sobre la vuelta del cáncer trato de evitarlos

7. Mi temor a que el cáncer vuelva me dificulta hacer planes de futuro

8. Evito situaciones o cosas que me hacen pensar en la posibilidad de que el cáncer reaparezca

Note. Items are rated on a 5-point Likert scale: 0) No en absoluto; 1) Poco; 2) Medianamente 3) Mucho; 4) Totalmente de acuerdo.