Cross-cultural Adaptation Of The Body Image And Relationship Scale (BIRS) And Application In Chinese Breast Cancer Patients

Objective To crosss-cultural adapt the Body Image and Relationship Scale(BIRS)to Chinese breast cancer patients;To investigate the body image of breast cancer patients,and to explore the relationship between body image and illness perception.Methods After obtaining authorization and technical support of the developers,the Chinese version of BIRS was translated and culturally adapted from the English BIRS based on the standard guidelines which AAOS recommended,following 6 steps:forward translation and synthesis the translation,back translation and review,expert consultation,pilot trial,thus formulated the prefinal version of BIRS.A total of 323 breast cancer patients from 4 tertiary hospitals of two provinces were investigated with a self-designed demographic questionnaire,prefinal version of BIRS,BIS,BIPQ,SF-8by using convenience sampling method.Again convenient sampling method was used to select 30 breast cancer patients to repeat the prefinal version of BIRS so as to calculate the test-retest reliability.Critical Ratio,correlation coefficient method and Cronbach’s α method were used to select items.The validity of the Chinese version of BIRS was tested by content validity,face validity,construst validity,convergent validity,criterion-related validity,known-groups validity.Cronbach’s α and test-retest reliability(ICC)were used to evaluate reliability of Chinese version of BIRS;SPSS20.0 statistical analysis of data was used.Effective data is analyzed using the method of descriptive statics,correlation,univariate analysis and multiple hierarchical stepwise regression analysis.Results(1)Expert content validity evaluation result showed that I-CVI was 0.88~1,S-CVI/Ave was 0.99;With the item screening and exploratory factor analysis(EFA),item 21,item 22,item 30,item 31,item 32 were finally decided to be deleted;Use the remaining items for exploratory factor analysis,the results show that,KMO was 0.909,three factors explained 56.032% of the total variance;Convergent validity: The results revealed a moderate,negative correlation between scores on the BIRS-C and the SF-8(sr =-0.751~-0.422,p <0.01);Criterion-related validity: The results revealed a moderate,positive correlation between scores on the BIRS-C and the BIS(r = 0.368~0.658,p <0.01);Known-groups validity: BIRS-C was able to discriminate between breast cancer patients with respect to exercise and age,who reported currently keeping exercising was better in body image,strength and health,social barriers,appearance and sexuality,women younger than age 50 were more likely to score higher on appearance;The Cronbach’s α was 0.922 for all items and 0.896,0.865 and 0.829 for the domains of strength and health,social barriers,and appearance,respectively;Intra-class correlation for the three subscales of BIRS-C ranged between 0.891 to 0.913;(2)The average score of core body image was(86.41±13.97),the average score of core illness perception was(42.12±7.09);Among the dimension scores of BIRS-C,the score of the appearance dimension was highest,the score of the strength and health dimension was second,the score of the social barriers was lowest;The top ten items were item 3,item 20,item 12,item 19,item 11,item 15,item 14,item 24,item 9,item 17;Religious belief,the degree of attention to appearance,whether insist to take exercise,time after operation,different disease stages were the related factors of body image(p <0.05);Multiple hierarchical stepwise regression analysis showed that illness perception can explain 24.4% of the total variance of breast cancer patients’ body image independently.Conclusions BIRS-C consists 27 items and 3 dimensions.It was proved to be reliable and valid.It can be used to assess the status of body image among breast cancer patients in China mainland.In this research,breast cancer patients’ body image distress were in middle and high level.The influencing factors of breast cancer patients’ body image including religious belief,the degree of attention to appearance,whether insist to take exercise,time after operation,different disease stages and illness perception,illness perception can explain 24.4% of the total variance of breast cancer patients’ body image independently.The tips can be from the illness perception to improve body image distress of breast cancer patients in aspects such as cognitive behavioral intervention.