Validation and Norming of the Body Acceptance Scale in Women with Breast Cancer (BAS-BC)

Soleymany, Esmaiel; Pakravan, Hanie

doi:10.30473/hpj.2025.73937.6213

Document Type : Scientific Research

Authors

Esmaiel soleymany ¹
hanie pakravan ²

¹ Associate Professor, Department of Psychology, Urmia University, Urmia, Iran.

² PhD student in psychology, Department of Psychology, Urmia University, Urmia, Iran

10.30473/hpj.2025.73937.6213

Abstract

Objective: Breast cancer is one of the most common malignancies affecting women globally, with significant physical, psychological, and social consequences. Treatments such as mastectomy, chemotherapy, and radiotherapy often lead to body image disturbances, reduced self-esteem, and lower quality of life. Among psychological coping strategies, body acceptance, defined as acknowledging, normalizing, and adapting to bodily changes, plays a key role in promoting mental well-being in breast cancer patients. This study aimed to validate and norm the Body Acceptance Scale for Women with Breast Cancer (BAS-BC), a newly developed instrument designed to assess body acceptance among breast cancer survivors. The research evaluated the psychometric properties of the BAS-BC in an Iranian population. Method: A descriptive validation design was employed. Participants included 457 Iranian women diagnosed with breast cancer, recruited via convenience sampling. Data were collected online through validated instruments: BAS-BC (Ahn & Suh, 2023), the Multidimensional Body-Self Relations Questionnaire (MBSRQ), and the SF-36 Health-Related Quality of Life Questionnaire. Statistical analyses, including confirmatory factor analysis (CFA), Pearson correlation, and Cronbach’s alpha, were conducted using SPSS-23 and AMOS-24. Results: CFA supported a six-factor structure of the BAS-BC (exposure, perception, adaptation, return to daily life, successful transition, and leap toward the future), consisting of 17 items. The scale demonstrated high internal consistency (Cronbach’s alpha = 0.84). Convergent validity was confirmed through significant correlations between BAS-BC scores and both MBSRQ and SF-36 measures. The six factors explained 82.5% of the total variance, indicating strong construct validity. Conclusion: The BAS-BC offers a robust tool for both research and clinical assessment of body acceptance among breast cancer patients. Its application can inform personalized therapeutic approaches aimed at improving psychosocial outcomes and quality of life. Future research should explore cultural influences on body acceptance and develop targeted interventions to support body image adjustment in this population.

Keywords

Main Subjects

References

Ahn, J., & Suh, E. E. (2023). Body acceptance scale for women with breast cancer: development and validation of a measurement. In Seminars in Oncology Nursing (Vol. 39, No. 5, p. 151486). WB Saunders.https://doi.org/10.1016/j.soncn.2023.151486

Ahn, J., & Suh, E. E. (2023). Body image alteration in women with breast cancer: a concept analysis using an evolutionary method. Asia-Pacific journal of oncology nursing, 10(5), 100214.https://doi.org/10.1016/j.apjon.2023.100214

Aizpurua-Perez, I., & Perez-Tejada, J. (2020). Resilience in women with breast cancer: A systematic review. European Journal of Oncology Nursing, 49, 101854.https://doi.org/10.1016/j.ejon.2020.101854

Annunziata, M. A., Giovannini, L., & Muzzatti, B. (2012). Assessing Body Image: Relevance, Application, and Instruments for Oncological Settings. Supportive Care in Cancer, 20, 901-907. https://doi.org/10.1007/s00520-011-1339-x

Bailey, K. A., & Gammage, K. L. (2020). Applying action research in a mixed-methods positive body image program assessment with older adults and people with physical disability and chronic illness. Journal of Mixed Methods Research, 14(2), 248-267.

https://doi.org/10.1177/1558689819871814

Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R. L., Soerjomataram, I., & Jemal, A. (2024). Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 74(3), 229-263.https://doi.org/10.3322/caac.21834

Buki, L. P., Reich, M., & Lehardy, E. N. (2016). “Our organs have a purpose”: body image acceptance in Latina breast cancer survivors. Psycho‐Oncology, 25(11), 1337-1342.https://doi.org/10.1002/pon.4270

Cash, T.F. (2017). Multidimensional Body–Self Relations Questionnaire (MBSRQ). In: Wade, T. (eds) Encyclopedia of Feeding and Eating Disorders. Springer, Singapore.https://doi.org/10.1007/978-981-287-104-6_3

Dinapoli, L., Colloca, G., Di Capua, B., & Valentini, V. (2021). Psychological aspects to consider in breast cancer diagnosis and treatment. Current oncology reports, 23, 1-7. https://doi.org/10.1007/s11912-021-01049-3

Esmaeili, Nikogoftar, Yaghoubi, & Nazari. (2024). The mediating role of coping strategies and resilience in the relationship between stressful life events and positive and negative emotions in women with breast cancer. Health Psychology, 13(51), 21-36. (in Persian).https://doi.org/10.30473/hpj.2024.68222.5834

Ettridge, K., Scharling-Gamba, K., Miller, C., Roder, D., & Prichard, I. (2022). Body image and quality of life in women with breast cancer: Appreciating the body and its functionality. Body Image, 40, 92-102.https://doi.org/10.1016/j.bodyim.2021.11.001

Faridi, Lotfi Kashani, Farah, & Vaziri. (2024). The role of culture in the lived experience of women with breast cancer in Iran: A phenomenological study. Iranian Journal of Breast Diseases, 16(4), 50-68. (In Persian) http://dx.doi.org/10.61186/ijbd.16.4.50

Hami Kargar, Nikkhah, & Ganji. (2024). Body identity in women with breast cancer. Payavard Salamat, 18(4), 347-360. (In Persian).http://payavard.tums.ac.ir/article-1-7697-fa.html

Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural equation modeling: a multidisciplinary journal, 6(1), 1-55. https://doi.org/10.1080/10705519909540118

Kasgri, K. A., Abazari, M., Badeleh, S. M., Badeleh, K. M., & Peyman, N. (2024). Comprehensive Review of Breast Cancer Consequences for the Patients and Their Coping Strategies: A Systematic Review. Cancer Control, 31, 10732748241249355.

https://doi.org/10.1177/10732748241249355

Kenny, D. A., Kaniskan, B., & McCoach, D. B. (2015). The performance of RMSEA in models with small degrees of freedom. Sociological Methods & Research, 44(3), 486-507.https://doi.org/10.1177/0049124114543236

Khan, M. A., Ali, S., & Khan, F. (2023). Factors associated with the psychological burden of breast cancer in women: A cross-sectional study in Morocco. BMC Psychiatry, 23(1), 1-10. https://doi.org/10.1186/s12888-023-04639-0

Koçan, S., & Gürsoy, A. (2016). Body image of women with breast cancer after mastectomy: qualitative research. The Journal of breast health, 12(4), 145. https://doi.org/10.5152/tjbh.2016.2913

Lewis-Smith, H., Diedrichs, P. C., & Harcourt, D. (2018). A pilot study of a body image intervention for breast cancer survivors. Body image, 27, 21-31.https://doi.org/10.1016/j.bodyim.2018.08.006

Li, Y., Zhang, J., Wang, M., & Liu, J. (2022). Global trends of research on depression in breast cancer: A bibliometric analysis. Frontiers in Psychology, 13, 96 96 79 .https://doi.org/10.3389/fpsyg.2022.969679

Mahmoudfakheh, Himen, & Rahimi Cham Heydari. (2024). The effectiveness of schema therapy on post-traumatic growth and psychological capital in women with breast cancer. Health Psychology, 13(50), 63-76. (in Persian)

https://doi.org/10.30473/hpj.2024.67379.5777

Markey, C. H., Dunaev, J. L., & August, K. J. (2020). Body image experiences in the context of chronic pain: An examination of associations among perceptions of pain, body dissatisfaction, and positive body image. Body Image, 32, 103-110.https://doi.org/10.1016/j.bodyim.2019.11.005

Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): Translation and validation study of the Iranian version. Qual Life Res. 2005; 14(3):875-82. https://DOI:10.1007/ s11136-004-1014-5

Moradi, Niazi, Azin, Hakami Shalamzari, & Kowsar. (2024). Examining the impact of educational-counseling interventions on sexual issues of Iranian women with breast cancer: A review study. Iranian Journal of Breast Diseases, 17(2), 102-122. (In Persian) http://dx.doi.org/10.61186/ijbd.17.2.102

Mozafari, F., Rashidzadeh, H., Ghaffarlou, M., Salehiabar, M., Ertas, Y. N., Ramazani, A., ... & Danafar, H. (2022). ROS-based cancer radiotherapy. In Harnessing Materials for X-ray Based Cancer Therapy and Imaging (pp. 265-309). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-031-04071-9_10

Paterson, C. L., Lengacher, C. A., Donovan, K. A., Kip, K. E., & Tofthagen, C. S. (2016). Body image in younger breast cancer survivors: a systematic review. Cancer Nursing, 39(1), E39-E58. 10.1097/NCC.0000000000000251

Ruan, J., Wu, L., & Zhou, Y. (2020). Experiences of body image changes in Chinese patients living with inflammatory bowel disease: a descriptive qualitative study. Asian Nursing Research, 14(4), 196-205.https://doi.org/10.1016/j.anr.2020.07.006

Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8(2), 23-74. http://www.mpr-online.de/

Sebri, V., Durosini, I., Triberti, S., & Pravettoni, G. (2021). The efficacy of psychological intervention on body image in breast cancer patients and survivors: a systematic review and meta-analysis. Frontiers in Psychology, 12, 611954. https://doi.org/10.3389/fpsyg.2021.611954

Whoqol Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological medicine, 28(3), 551-558.https://doi.org/10.1017/S0033291798006667

Yamani Ardakani, B., Tirgari, B., & Roudi Rashtabadi, O. (2020). Body image and its relationship with coping strategies: The views of Iranian breast cancer women following surgery. European journal of cancer care, 29(1), e13191. https://doi.org/10.1111/ecc.13191

Yun, Y., & Ahn, J. (2025). Exploring factors influencing body acceptance in women with breast cancer: A cross-sectional study. European Journal of Oncology Nursing, 102802. https://doi.org/10.1016/j.ejon.2025.102802

Validation and Norming of the Body Acceptance Scale in Women with Breast Cancer (BAS-BC)

References

References

Volume 14, Issue 55November 2025Pages 57-72

Volume 14, Issue 55
November 2025
Pages 57-72