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. 2025 Jun 27;16(1):140.
doi: 10.1186/s13244-025-02018-1.

Development and psychometric evaluation of the fear of medical imaging radiation scale (FOMIRS): insights from multimethod analysis

Lin-Sen Feng #  1   2   3 , Si-Rong She #  4 , Yuan-Yuan Zhang  4 , Jia-Qi Xie  5 , Zheng-Jiao Dong  6   7 , Ai Tang  7 , Yin-Zhu Li  8 , Xiao-Qian Wu  6   7 , Qing Yang  9 , Hao-Yu Wang  5 , San-Bin Wang  10
Affiliations

Development and psychometric evaluation of the fear of medical imaging radiation scale (FOMIRS): insights from multimethod analysis

Lin-Sen Feng et al. Insights Imaging. .

Abstract

Objective: Fear of medical imaging radiation (FOMIR) may influence disease screening willingness; however, no validated tool currently exists to assess FOMIR. This study aimed to develop and validate the Fear of Medical Imaging Radiation Scale (FOMIRS) and explore its psychological mechanisms.

Methods: Based on classical test theory, the FOMIRS was developed through semi-structured interviews, grounded theory, and Delphi consultation. A cross-sectional survey with 1509 participants was conducted in Yunnan Province from September to December 2024. Psychometric properties were evaluated using construct validity, convergent validity, discriminant validity, criterion-related validity, content validity, and internal consistency. ROC curve analysis was used to determine the critical thresholds. Logistic regression analysis, network analysis, and structural equation modeling were employed to examine the relationships between the FOMIRS and related variables.

Results: The FOMIRS consisted of 18 items organized into a two-dimensional structure. It demonstrated good model fit (Goodness-of-fit index = 0.909, Comparative fit index = 0.949), convergent validity (AVE > 0.45, CR > 0.80), discriminant validity (HTMT = 0.574), criterion-related validity (γ = 0.441), and content validity (S-CVI = 0.889). The FOMIRS also showed excellent internal consistency (Cronbach's α = 0.926 and McDonald's ω = 0.935). Cost-induced refusal of imaging examinations, cancer screening willingness, online learning, imaging radiation cognition, and fear of cancer were identified as influencing factors of FOMIR (p < 0.05). FOMIR serves as a core node in the network, and imaging radiation cognition may affect cancer screening willingness through this mechanism (p < 0.05).

Conclusion: FOMIRS accurately measures individual FOMIR levels. It captures the psychological characteristics and behavioral tendencies associated with FOMIR and indicates potential mechanisms.

Critical relevance statement: We developed the Fear of Medical Imaging Radiation Scale (FOMIRS), a psychometric tool measuring individuals' fear of medical imaging radiation (FOMIR), demonstrating good reliability, validity, and practical application potential.

Key points: Evaluating individuals' FOMIR improves compliance with imaging exams and reduces related cognitive biases. FOMIRS is a reliable and valid tool for measuring FOMIR levels, capturing psychological and behavioral traits, and revealing interactions with external features. FOMIR is a complex phenomenon involving psychological traits, behavioral tendencies, and cognitive biases that affect people's willingness to undergo cancer screening.

Keywords: Fear of medical imaging radiation; Mechanisms; Reliability; Scale; Validity.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study protocol received approval from the Ethics Committee of the Sixth Affiliated Hospital of Kunming Medical University (Approval No. 2024 kmykdx6f014). This investigation was executed fully with the Declaration of Helsinki and within the authorization’s validity period. Participants were not offered any form of compensation to encourage their involvement in the study. The questionnaire design meticulously avoided questions perceived as discriminatory or offensive, ensuring it did not provoke physical discomfort or psychological stress among respondents. Consent for publication: At the beginning of the survey, participants were presented with an informed consent document, and they had to electronically sign a consent form before proceeding with the questionnaire. Individuals had the right to withdraw from the research without any penalty. No personal data such as names, contact information, residential or employment addresses were collected to protect participant anonymity and confidentiality. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Percentage of correct radiation cognition responses for medical imaging examinations. b Percentage of respondents with item score ≥ 3 points in FOMIRS
Fig. 2
Fig. 2
Structural equation model for two-dimensional FOMIRS
Fig. 3
Fig. 3
Spearman correlation matrix of FOMIRS, psychological dimension, behavioral dimension and items
Fig. 4
Fig. 4
Network analysis topological graph of the FOMIR external structures
Fig. 5
Fig. 5
Structural equation modeling of the mechanisms underlying FOMIR
See this image and copyright information in PMC

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References

    1. Smith-Bindman R, Chu PW, Azman Firdaus H et al (2025) Projected lifetime cancer risks from current computed tomography imaging. JAMA Intern Med. 10.1001/jamainternmed.2025.0505 - PMC - PubMed
    1. Bosch de Basea M, Thierry-Chef I, Harbron R et al (2023) Risk of hematological malignancies from CT radiation exposure in children, adolescents and young adults. Nat Med 29:3111–3119 - PMC - PubMed
    1. Hauptmann M, Byrnes G, Cardis E et al (2023) Brain cancer after radiation exposure from CT examinations of children and young adults: results from the EPI-CT cohort study. Lancet Oncol 24:45–53 - PubMed
    1. Angelidis G, Tsougos I, Valotassiou V, Georgoulias P (2020) Low-dose radiation cancer risk hypothesis may lead to ‘radiophobia’-driven imaging avoidance. J Nucl Cardiol 27:1050 - PubMed
    1. Lindberg JCH (2021) ‘J’accuse.!’: the continuous failure to address radiophobia and placing radiation in perspective. J Radiol Prot. 10.1088/1361-6498/abf9e2 - PubMed

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