Psychometric evaluation of the Fear of Cancer Recurrence Inventory (FCRI) and development of a short version in patients with follicular lymphoma

Purpose: To evaluate the psychometric properties of the Chinese Fear of Cancer Recurrence Inventory (FCRI-C) in follicular lymphoma (FL) survivors. Materials and methods: A nationwide cross-sectional study was conducted online between July and September 2020. The following psychometric properties of the FCRI-C were evaluated: construct, convergent, and discriminant validity, and reliability. Item variance was assessed using differential item functioning (DIF). A short version of the FCRI-C was developed using a two-parameter item response theory (IRT) model. The patterns of response scale, item fit, and item information were assessed. The receiver operating characteristic (ROC) curve was used to determine the clinical cut-off point for the FCRI-C. Results: A total of 326 FL survivors completed the questionnaire. The confirmatory factor analysis supported the bi-factor structure of the FCRI-C. The IRT analysis confirmed a 10-item short version of the FCRI-C. Satisfactory convergent and discriminant validity were underpinned by a priori hypotheses. Cronbach’s alpha of 0.95 and intraclass correlation coefficient of 0.82 indicated good internal consistency and test–retest reliability. The ROC curve determined a cut-off point of 83 and 20 for the full and short versions, respectively. Conclusions: The FCRI-C used to measure and screen the levels of FCR in Chinese FL survivors was found to be valid and reliable.Implications for Rehabilitation The Chinese Fear of Cancer Recurrence Inventory (FCRI-C) is a reliable and valid measure to evaluate the fear of cancer recurrence (FCR) in follicular lymphoma survivors. The short version of the FCRI-C provides a rapid screening tool for the clinical detection of FCR in patients. The cut-off point of the FCRI-C could differentiate patients between “high” and “low” levels of FCR in clinical practice.