Introducing the Ottawa Clinical Fear of Recurrence-Self-Report; A New Assessment Tool for Clinical Fear of Cancer Recurrence.

Abstract

The Ottawa Clinical Fear of Recurrence-Self-Report (OCFR-SR) was developed to enable brief assessment of clinically significant fear of cancer recurrence (FCR) according to recently updated criteria based on expert consensus: a) high levels of worry, b) high levels of preoccupation, c) hypervigilance of bodily symptoms, and d) that last for more than 3 months. The study evaluated the OCFR-SR item pool with the goal of optimizing its brevity and psychometric properties. The OCFR-SR's 23 candidate items were administered to mixed cancer survivors recruited from The Ottawa Hospital along with other assessment measures within the questionnaire package. Eligible participants had to have been diagnosed with any cancer, stages I-III, and have completed primary treatment. Exploratory factor analysis, item response theory, and internal reliability were used to optimize the number of items. Internal (MacDonald's omega and Cronbach's alpha) and test-retest reliability (intra-class correlation) were assessed. Finally, convergent and discriminant validity were explored (Pearson correlations and z-tests). A total of N = 296 survivors completed the questionnaire package. Seven items were selected for the final version of the OCFR-SR. All items performed similarly on psychometric assessments. Theoretical considerations were decisive in selecting the final items. The final OCFR-SR demonstrated satisfactory convergent and discriminant validity, and internal and test-retest reliability. This study introduces the final seven-item OCFR-SR, enabling clinicians and researchers to assess the clinical significance of FCR according to the recently updated criteria. It is the first brief self-report tool aimed at assessing clinical FCR.