Psychometric properties of the Japanese version of the Concerns About Recurrence Scale (CARS-J)

Kanae Momino, Tatuo Akechi, Toshinari Yamashita, Takashi Fujita, Hironori Hayahi, Nobuyuki Tsunoda, Mitsunori Miyashita, Hiroji Iwata
Japanese Journal of Clinical Oncology 2014, 44 (5): 456-62

OBJECTIVE: Although the fear of recurrence is a major concern among breast cancer survivors after their surgery, there are no instruments to evaluate their distress in Japan. This study examines the psychometric properties of the Japanese version of the concerns about recurrence scale, which was originally developed in the USA.

METHODS: The forward and backward translation method was used to develop Concerns About Recurrence Scale. Randomly selected ambulatory female patients with breast cancer participated in this study. They were asked to complete Japanese version of the concerns about recurrence scale and Hospital Anxiety and Depression Scale. The validity and reliability of Japanese version of the concerns about recurrence scale were evaluated statistically.

RESULTS: Data were obtained from 375 patients. A novel four-factor solution was found (Health and Death Worries, Womanhood Worries, Self-valued Worries and Role Worries) that accounted for 59.2% of the total variance. Correlation coefficients between the Japanese version of the concerns about recurrence scale subscale scores and the anxiety score measured by Hospital anxiety and depression scale ranged from 0.39 to 0.60. Cronbach's alpha coefficients, which are measures of the internal consistency of the subscales, ranged from 0.86 to 0.94.

CONCLUSIONS: The results suggest that Japanese version of the concerns about recurrence scale is a reliable and valid clinical research tool to evaluate the fear of recurrence among patients with breast cancer in Japan, although there may be cross-cultural differences regarding factor structures between Western and Japanese breast cancer patients.

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