Aims: Fear of cancer recurring or progressing (FCR) is a key concern for cancer caregivers, with 48% experiencing FCR at levels considered clinically significant among survivors. A recent systematic review investigating the utility of caregiver FCR measures found low adherence to measure development and psychometric validation best practice as outlined by the COSMIN taxonomy. This study aimed to develop and evaluate the psychometric properties of a caregiver specific measure of FCR (CARE-FCR).
Methods: Item generation was guided by results from a qualitative systematic review and qualitative interview study. 438 caregivers (56% female, Mage= 50.53 years, SD= 17.38) were recruited through cancer organisations, Register4 an Australian online registry where people diagnosed with cancer and caregivers can indicate their interest in participating in research studies and Prolific paid study participation. An exploratory factor analysis, in a split sample of 220 resulted in a 24 item, three factor scale. We then performed confirmatory factor analysis on these 24 items in the remaining sample. Convergent validity was assessed using pre-existing measures of fear of recurrence and progression, depression, anxiety, death anxiety and meta-cognitions. The extraversion dimension of the Big Five Personality Trait questionnaire was used to assess divergent validity.
Results: the 24-item scale demonstrated good convergent, divergent validity internal consistency (overall Cronbach’s α= .96, progression= 0.93, recurrence= .92 and behaviours= .78) and test- retest reliability (r (377) = .81, p = <.001).
Conclusions: The CARE-FCR is a theoretically informed and psychometrically robust measure of caregiver FCR. Further research to determine clinical cut-offs for the measure are required.