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Validation of the Surgical Fear Questionnaire in Adult Patients Waiting for Elective Surgery
Open accessAbstract
OBJECTIVES: Because existing instruments for assessing surgical fear seem either too general or too limited, the Surgical Fear Questionnaire (SFQ) was developed. The aim of this study is to assess the validity and reliability of the SFQ. METHODS: Based on existing literature and expert consultation the ten-item SFQ was composed. Data on the SFQ were obtained from 5 prospective studies (N = 3233) in inpatient or day surgery patients. These data were used for exploratory factor analysis (EFA), confirmatory factor analysis (CFA), reliability analysis and validity analysis. RESULTS: EFA in Study 1 and 2 revealed a two-factor structure with one factor associated with fear of the short-term consequences of surgery (SFQ-s, item 1-4) and the other factor with fear of the long-term consequences of surgery (SFQ-l, item 5-10). However, in both studies two items of the SFQ-l had low factor loadings. Therefore in Study 3 and 4 the 2-factor structure was tested and confirmed by CFA in an eight-item version of the SFQ. Across all studies significant correlations of the SFQ with pain catastrophizing, state anxiety, and preoperative pain intensity indicated good convergent validity. Internal consistency (Cronbach's alpha) was between 0.765-0.920 (SFQ-total), 0.766-0.877 (SFQ-s), and 0.628-0.899 (SFQ-l). The SFQ proved to be sensitive to detect differences based on age, sex, education level, employment status and preoperative pain intensity. DISCUSSION: The SFQ is a valid and reliable eight-item index of surgical fear consisting of two subscales: fear of the short-term consequences of surgery and fear of the long-term consequences.
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“The SFQ is a reliable and valid self-report instrument designed to assess fear of surgery, and it consists of 8 items which is scored on an 11-point scale ranging from 0 (not at all afraid) to 10 (very afraid) [90].”
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Hoofwijk, D. M. N., Fiddelers, A. A. A., Peters, M. L., Stessel, B., Kessels, A. G. H., Joosten, E. A., Gramke, H.-F., & Marcus, M. A. E. (2015) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000207 · Cited by 116
Self-citationValidation of the Turkish Version of the Surgical Fear Questionnaire
Bağdigen, M., & Özlü, Z. K. (2017) · Journal of PeriAnesthesia Nursing · doi:10.1016/j.jopan.2017.05.007 · Cited by 92
The relationship between fear of surgery and affecting factors in surgical patients
Akutay, S., & Ceyhan, Ö. (2023) · Perioperative Medicine · doi:10.1186/s13741-023-00316-0 · Cited by 81
Recovery 3 and 12 months after hysterectomy
Theunissen, M., Peters, M. L., Schepers, J., Maas, J. W. M., Tournois, F., van Suijlekom, H. A., Gramke, H., & Marcus, M. A. E. (2016) · Medicine · doi:10.1097/md.0000000000003980 · Cited by 66
Self-citationPrevalence and Predictors of Quality of Recovery at Home After Day Surgery
Stessel, B., Fiddelers, A. A. A., Joosten, E. A. J., Hoofwijk, D. M. N., Gramke, H., & Bühre, W. (2015) · Medicine · doi:10.1097/md.0000000000001553 · Cited by 54
Metadata
- Authors
- Theunissen, M., Peters, M. L., Schouten, E. G. W., Fiddelers, A. A. A., Willemsen, M. G. A., Pinto, P. R., Gramke, H.-F., & Marcus, M. A. E.
- Affiliations
- Maastricht University Medical Centre (NL)
- Maastricht University (NL)
- University of Minho (PT)
- Corresponding author
- Theunissen, Maurice
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-06-24
- Volume
- 9
- Issue
- 6
- Pages
- e100225
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4069058
- OpenAlex
- W2152421797
- Cited by
- 176
- References
- 41
- Citations by year
- 2026: 25 · 2025: 24 · 2024: 25 · 2023: 24 · 2022: 18 · 2021: 9 · 2020: 8 · 2019: 6 · 2018: 10 · 2017: 10 · 2016: 11 · 2015: 5
- FWCI
- 12.03
- Type
- journal article
- Language
- en
- Update notices
- correction (2016-09-09)
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by-nc-nd)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- ZonMw (110000007)
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Nursing › Research and Theory › Health Education and Validation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
- Keywords
- surgical fear, preoperative anxiety, psychometric validation, factor structure, pain catastrophizing, state anxiety, elective surgery, questionnaire reliability
- MeSH terms
- Adult, Aged, Aged, 80 and over, Factor Analysis, Statistical, Fear, Female, Humans, Male, Middle Aged, Psychometrics, Surveys and Questionnaires, Risk Factors, Surgical Procedures, Operative, Reproducibility of Results, Self Report
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