Reliability and Preliminary Validation of a Body Image Scale Survey for Use in Bladder Cancer Patients

Introduction Extirpative bladder surgery for bladder cancer requires urinary diversion which causes cosmetic and functional changes that affect a patient’s body image and quality of life. Current health-related quality of life (HRQOL) surveys validated for use in bladder cancer patients have no dedicated domain evaluating body image. We sought to validate the ten-item Body Image Scale (BIS) for use in bladder cancer patients. The BIS is scored on a 4-point Likert scale with a maximum score of 30. Higher scores represent increasing distress. Methods With Institutional Review Board approval, native English or Spanish speaking patients who had undergone radical cystectomy and urinary diversion with either ileal conduit formation or orthotopic neobladder creation within the past 5 years for muscle-invasive bladder cancer were identified. The survey was conducted via telephone or e-mail. Surveys were scored and analyzed for reliability and validity. Results 32 patients were identified (22 men, 10 women). 25 patients had ileal conduits and 7 had orthotopic neobladders. Cronbach’s alpha reliability coefficient measuring internal consistency for the BIS instrument in this group was 0.926. All ten items met the response criteria (score of >0 by >30% respondents) in our study population. Though the ileal conduit group mean (17.4) and median (16) scores were lower than the neobladder (mean=19.1 and median=22), there was no statistically significant difference in BIS scores between the two cohorts (p=0.755). Conclusions We present a validation study for use of BIS in bladder cancer patients to be utilized in future clinical trials or psycho-oncology research.