The German version of the body image scale: Validation and item response analysis in cancer patients

Tim J Hartung; Michael Friedrich; Peter Esser; Anja Mehnert-Theuerkauf; Antje Lehmann-Laue; Anne Letsch; Matthias Rose; Uta Fendel

doi:10.1016/j.jpsychores.2022.111129

The German version of the body image scale: Validation and item response analysis in cancer patients

J Psychosom Res. 2023 Feb:165:111129. doi: 10.1016/j.jpsychores.2022.111129. Epub 2022 Dec 23.

Authors

Tim J Hartung¹, Michael Friedrich², Peter Esser², Anja Mehnert-Theuerkauf², Antje Lehmann-Laue², Anne Letsch³, Matthias Rose⁴, Uta Fendel⁵

Affiliations

¹ Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany; Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany. Electronic address: tim.hartung@charite.de.
² Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
³ Department of Hematology and Oncology, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Medicine II, Hematology and Oncology, University Hospital Schleswig-Holstein, Kiel, Germany.
⁴ Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Quantitative Health Sciences, Medical School, University of Massachusetts, Amherst, MA, USA.
⁵ Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.

PMID: 36608510
DOI: 10.1016/j.jpsychores.2022.111129

Abstract

Objective: To translate the cancer-specific Body Image Scale (BIS) into German and assess its psychometric properties.

Methods: The BIS was translated in accordance with current guidelines. In a prospective, cross-sectional two center study (psychosocial counselling center for cancer patients Leipzig, oncological inpatient ward Berlin), we assessed composite reliability and factor structure using confirmatory factor analysis. Additional item response theory (IRT) modelling was performed. Convergent validity was assessed via correlation with the Body Appreciation Scale (BAS) as well as psychological symptom burden (PHQ-9, GAD-2 and Distress Thermometer). Discriminant validity was assessed via demographic and clinical group comparisons.

Results: 677 patients participated (response rate 78%). Composite reliability was 0.95 and the one-factor structure was confirmed (standardized root mean square residual = 0.051, average variance extracted ≥50%, no indications of local dependence). In IRT models, all items had a discriminating power above the established threshold of b = 0.5 and relatively high "difficulty" parameters (b = 0.89-2.06). The BIS was negatively correlated with the BAS (rho = -0.62, p < 0.001) and positively with psychological symptom burden (e.g. PHQ-9: rho = 0.49, p < 0.001). Patients who were younger, female, had undergone chemotherapy, radiotherapy or surgery and those who were distressed by fatigue, their appearance or sexual problems had significantly higher BIS scores.

Conclusion: The German version of the BIS is a valid tool to assess BID in patients with cancer that is now available for clinical or research contexts.

Keywords: Body image; Factor analysis; Neoplasms; Psychometrics; Statistical; Translations.

MeSH terms

Body Image*
Cross-Sectional Studies
Factor Analysis, Statistical
Female
Humans
Neoplasms*
Prospective Studies
Psychometrics / methods
Reproducibility of Results
Surveys and Questionnaires
Translations