Validation of a questionnaire for measuring morbidity in breast hypertrophy.
BACKGROUND
There is a growing body of evidence suggesting that body mass index and predicted breast resection weight may not be appropriate criteria for determining insurance eligibility for breast reduction surgery. Eligibility should ideally be based on need. However, no method for determining need in patients seeking reduction surgery currently exists. The purpose of this investigation was to develop a validated questionnaire for measuring the burden of breast hypertrophy.


METHODS
Forty-five symptoms specific to breast hypertrophy were incorporated into a questionnaire that was subsequently administered to a sample of 101 women. Reliability and validity testing was performed according to established psychometric criteria.


RESULTS
Three items were omitted based on low item remainder coefficients (Cronbach's alpha) and three were eliminated because of excessive skew. Intraclass correlation coefficients of 0.85 indicated favorable test-retest reliability. Content validity was achieved through the study design and then confirmed by a group of 11 plastic surgeons. The questionnaire showed reasonable criterion validity when compared with corresponding domains in the Short Form-36. Construct validity was excellent. Exploratory factor analysis revealed five questionnaire subdomains: (1) physical implications, (2) poor self-concept, (3) body pain, (4) negative social interactions, and (5) physical appearance.


CONCLUSIONS
The authors have developed an evaluative tool termed the Breast Reduction Assessed Severity Scale Questionnaire for measuring the burden of breast hypertrophy. The questionnaire produces subdomain scores and an overall measurement of the burden of breast hypertrophy that may be useful in the assessment of patients.
Sigurdson
Leif
L
Halifax, Nova Scotia, Canada From the Division of Plastic Surgery and Department of Community Health and Epidemiology, Dalhousie University.
Kirkland
Susan A
SA
Mykhalovskiy
Eric
E
D000293:Adolescent; D000328:Adult; D001828:Body Image; D015992:Body Mass Index; D001940:Breast / Q000473:pathology*; D017281:Cost of Illness; D005163:Factor Analysis, Statistical; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D006984:Hypertrophy; D016462:Mammaplasty / Q000191:economics; D008875:Middle Aged; D009674:Nova Scotia; D011594:Psychometrics; D011795:Surveys and Questionnaires