Factor structure of the Persian version of general, social, and negative self-consciousness of appearance domains of Derriford Appearance Scale 59: an application in the field of burn injuries

Abstract

BackgroundThe Derriford Appearance Scale 59 (DAS59) is a widely used measure of the spectrum of psychological distress and dysfunction that is characteristic of disfigurement. Also, disfigurement due to burn injury leads to feeling guilty or less socially competent, avoiding social situations, suicide, poor self-esteem, sexual difficulties, and depression. Therefore, the purpose of this study was to translate and culturally adapt three subscales of DAS59 into Persian language and to investigate its factor structure for Iranian burned patients.MethodTranslation–back translation of the scale into Persian was done. The internal consistency of the translated scale was evaluated by Cronbach’s alpha. Next, construct validity of the translated instrument was assessed by exploratory factor analysis using principal components and rotation of varimax methods. This research involved a convenience sample of 189 adult burned patients with disfigurement in their face, head, ears, neck, hands, and legs.ResultThe Cronbach’s alpha for overall scale, subscales 1, 2, and 3 were 0.93, 0.93, 0.89, and 0.80, respectively. The best solution from the principal components analysis of the 40 items of the DAS59 revealed three factors corresponding to the three subscales with 20 items: factor 1 (general self-consciousness of appearance) consisted of 9 statements accounting for 33.23% of the variance (eigenvalue =9.23); factor 2 (social self-consciousness of appearance) consisted of 7 statements accounting for 22.91% of the variance (eigenvalue =1.53); and factor 3 (negative self-concept) consisted of 4 statements accounting for 14.98% of the variance (eigenvalue =1.13).ConclusionThe factor structure of the three subscales of DAS59 provides a widely acceptable, psychometrically robust, factorial self-report scale to assess distress and dysfunction in problems of appearance among Iranian burned patients, and facilitates further research into the efficacy of treatment approaches for problems of appearance and early investigation of therapeutic outcome.

Reliability and Validity Testing of the Persian Version of the Derriford Appearance Scale 24 in a Sample of Individuals With Craniofacial Irregularity and Amputation

“…Our results were similar to that of the Persian DAS59 which revealed excellent internal consistency (Cronbach's alpha = 0.93). 9 In that study, participants had suffered a burn injury in the face, head, ear, neck, hand and legs, however, the individuals in our study had disfigurements due to amputation. Regarding the item-total correlation, the statistical analysis revealed that items 8, 10, and 15 of the P-DAS24 were less than the cut-off value of 0.3.…”

“…Facially or physically disfigured individuals encounter more psychosocial problems in their daily lives than individuals deemed attractive. 9 Social stereotypes have led to the general assumption that physically attractive adults have more socially appealing personalities and live more fulfilling lives than those of lesser attractiveness. 10 Furthermore, they receive more attention and social support in childhood and adulthood.…”

“… 20 The questionnaire has also been widely used to assess general population facial concerns. 20 Although the Persian version of DAS59 was made available by Sadeghi-Bazargani et al, 9 the lengthy nature of the DAS59 has made its use time-consuming. Routine data collection in clinical practice and measurement of distress when there is a severe lack of time necessitates validation of its short form with the same sensitivity and improved time efficiency.…”

Psychological evaluation of adult burn survivors: a pilot study

“…based on two overlapping perspectives -"view from the outside" and "view from the inside". 3 The key concepts in attitudinal body image include overall satisfaction and dissatisfaction with one's external appearance, emotions like anxiety, discomfort or distress related to the appearance of self, excessive concerns of one's external appearances, faulty cognitions and schemas concerning body appearance and avoiding social situations due to body image disturbances. [4][5][6] For burns patients, coping with their new body image is often a traumatic task.…”