The Body Image after Breast Cancer questionnaire: The design and testing of a disease-specific measure

Research has been impeded by the lack of a self-report measure of body image suitable for use in the breast cancer population. The objective of this thesis was to create such a measure, the Body Image after Breast Cancer (BIBC) questionnaire.;575 items were generated from a review of pre-existing measures, and interviews with 30 experts, 51 women with breast cancer and 4 spouses. The number of items was reduced to 216 by a judgemental review for acceptability by 26 women, and elimination of obviously redundant items. The 216 remaining items were formatted and administered to 360 women with breast cancer. Analysis of the 309 responses enabled further elimination of items. A sample of 164 women completed the remaining 111 items. Further item reduction to 53 items was achieved by factor analysis and statistical analysis. Six factors were identified (and thus a conceptualization of the aspects of body image salient to women with breast cancer proposed); Vulnerability; Body Stigma, Limitations; Body Concerns; Transparency; and Arm Concerns. Six scales were formed consisting of the items belonging to the 6 factors. Reliability was tested by administration of the questionnaire twice. Good reliability (both internal consistency and test-retest reliability) was found for the 6 scales (ranging from 0.75 to 0.86). The BIBC was reviewed by 20 women and found to be acceptable in terms of length, comprehensibility and suitability. An examination of the validity of the BIBC was undertaken. Scores on the BIBC were found to correlate with similar measures but not with a measure of social desirability. Scales of the BIBC were found to discriminate between women treated for breast cancer with lumpectomy and those treated with mastectomy, and between women with breast cancer and a control group, supporting the validity of the BIBC as a descriptive tool. A brief self-report measure of body image (the BIBC) has been developed, suitable for use in the breast cancer population. The BIBC has been found to be acceptable, reliable, and valid.