The psychometric properties of the Persian version of the body image after breast Cancer questionnaire: A second- order confirmatory factor analysis

The Body Image after Breast Cancer Questionnaire (BIBCQ) is a breast cancer specific tool for body image assessment which measures the long-term effects of breast cancer on different aspects of body image in breast cancer survivors. Culturally-appropriate instruments are needed for body image after breast cancer assessment. This study was conducted to assess the psychometric properties of the Persian version of BIBCQ. In this methodological study, BIBCQ was translated into Persian through forward-backward translation. In totally, 400 breast cancer survivors in north of Iran completed the BIBCQ. The content validity was assessed by twelve experts. 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 and McDonald's omega. In exploratory factor analysis, five factors were identified. Second-order factor analysis showed an overarching concept that labeled "Body image stigma". The questionnaire had acceptable content and convergent validity and composite reliability. This scale can be used in future studies to assess body image in Iranian breast cancer survivors. Healthcare policy makers can use the findings of the present study to develop care plans for improving body image and mental health among breast cancer survivors.