Body Image after Breast Cancer Questionnaire: psychometric properties of the Persian version

Abstract

Background: Assessing body image among breast cancer survivors is essential to the development of good treatment and rehabilitation plans. Culturally-appropriate methods and instruments are needed for body image assessment. The aim of this study was to assess the psychometric properties of the Persian version of Body Image after Breast Cancer Questionnaire. Methods: In this methodological study, the Body Image after Breast Cancer Questionnaire was translated into Persian through forward-backward translation. Then, its content validity was assessed by twelve experts, and 400 women with breast cancer completed the questionnaire. The construct validity of the questionnaire was evaluated through exploratory and confirmatory factor analyses and its convergent and discriminant validity were evaluated using Fornell and Larcker’s approach. The reliability of the questionnaire was also evaluated through Cronbach’s alpha, McDonald’s omega, and composite reliability. Results: In exploratory factor analysis, five factors were extracted, namely vulnerability, body stigma, body-related shame, body satisfaction, and physical disability stigma. Confirmatory factor analysis also confirmed the fit of the five-factor model (χ2 = 466.95; N = 241; P < 0.001; PCFI = 0.728; PNFI = 0.624; CMIN/DF = 1.938; RMSEA = 0.068; AGFI = 0.808; IFI = 0.838). Second-order factor analysis also revealed that the subscales of the questionnaire measured an overarching concept which was labeled “Body image stigma”. The questionnaire had acceptable content and convergent validity and composite reliability. Conclusion: The Persian version of Body Image after Breast Cancer Questionnaire measures the broad concept of “Body image stigma”. The Persian BIBCQ has acceptable validity and reliability and hence, can be used for assessing body image among breast cancer survivors. Keyword: Body image, Breast cancer, Psychometric evaluation, Validity, Reliability