engleski

Body image scale: psychometric validation on a sample of croatian breast cancer patients

Objectives/purpose: Breast cancer treatment often results in disfigurement which can vastly alter one’s body image and negatively impact quality of life. In this context, the Body Image Scale (BIS) was developed as a standardized self-report questionnaire to assess affective, behavioral, and cognitive body image changes in patients with cancer. Even though it is the most frequently used instrument for assessing body image, so far it has not been validated in Croatia. Therefore, this study aimed to examine its factor structure, reliability, and discriminant validity on a sample of Croatian breast cancer patients. Methods: Participants were 325 women (age range 31-83 years, mean age of 59 years, sd=10.95) recruited between 2009 and 2013 from two large tertiary institutions in a cross-sectional study at four points of adjuvant treatment (two weeks after primary surgery, during adjuvant chemotherapy, adjuvant radiotherapy, and at a 6- month follow- up). Basic socio-demographic and medical data were also collected (age, body mass index, surgery type). Results: A confirmatory factor analyses was conducted in the Mplus 8.3 software in order to examine the one factor structure of the scale. The CFA showed a good fit, confirming the original unidimensional structure of the BIS (χ2(df) = 96.67 (35), RMSEA = .07, CFI = .95, SRMR = .04). The internal consistency for the scale was high (α = .92). Next, it was negatively correlated with age (r = - .24, p < .01), and not correlated with body mass index (r = - .03, p > .05). Differences in BIS scores were also found between women who underwent a conserving and radical surgery, with latter having higher scores (F=3, 56, p<.01). In addition, there were some differences in BIS scores based on phase of treatment. At the point of adjuvant chemotherapy, the women showed a worse body image then those at adjuvant radiotherapy, and 6-months follow up (F=5, 62, p<.01). Conclusion and clinical implications: The obtained results provide support for the original unidimensional structure, reliability, and discriminant validity of the Body Image Scale on a sample of Croatian breast cancer patients. It was found to be negatively correlated with age, while there was no correlation with body mass index. Moreover, it was found to be sensitive to type of surgery and phase of treatment – radical surgery and adjuvant chemotherapy were associated with worst body image. These results demonstrate this instrument has overall good psychometric validity and can be useful in adjuvant care of women with breast cancer.

body image ; breast cancer ; mastectomy ; validation

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