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Updated: Jan 11, 2026
Validation of a Psychosocial Intervention on Body Image in Older People: An Experimental Design
Published on: May 31, 2021
Development and reliability and validity test of the body image and social function scale for patients after thyroid
Qingqing Diao1, Jieyu Lu2, Sailei Shi3
1Department of Thyroid Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Objective:
This study aimed to develop and validate a thyroid cancer-specific instrument to assess body image and social functioning in patients after thyroidectomy.
Methods:
Using a multi-stage approach guided by Cash's Body Image Disturbance Theory and Leary's Social Avoidance-Distress Model, we developed the Thyroid Cancer Body Image and Social Impact Scale (TC-BISIS). Item generation involved literature review, semi-structured interviews with 18 thyroid cancer survivors, expert consultation (n = 15), and preliminary testing (n = 30). Psychometric properties were evaluated in 686 thyroid cancer patients with a mean age of 39.397 ± 12.278 years and approximately 73.40% female divided into two samples: Sample 1 (n = 321) for item analysis and exploratory factor analysis (EFA), and Sample 2 (n = 365) for confirmatory factor analysis (CFA) and longitudinal measurement assessment at one, two, and three months post-surgery. Measurement invariance across gender was also assessed.
Results:
EFA identified a five-factor structure explaining 62.43% of variance: Scar Cognition and Emotional Response, Voice Change Experience, Social Avoidance Behavior, Social Role Function Impact, and Intimate Relationship Impact. CFA confirmed excellent model fit (CFI = 0.987, TLI = 0.986, RMSEA = 0.018, SRMR = 0.039). The 30-item TC-BISIS demonstrated good internal consistency (α = 0.866-0.886), strong criterion validity with the Body Image Scale (r = 0.809), and measurement invariance across three time points and between male and female patients.
Conclusions:
The TC-BISIS is the first validated instrument specifically addressing body image and social functioning in thyroid cancer survivors. Its strong psychometric properties support its utility in clinical practice for identifying patients requiring targeted psychosocial interventions and in research for evaluating intervention effectiveness. The scale enables comprehensive assessment of thyroid-specific concerns that are often overlooked in this population frequently labeled as having a "good cancer."
