title: Development of a breast reconstruction satisfaction questionnaire (BRECON-31): principal components analysis and clinimetric properties.
abstract: BACKGROUND
  A reliable, valid questionnaire is essential to assess patient satisfaction with breast reconstruction.
  
  
  METHODS
  A 105-item pilot BRECON questionnaire was previously developed. One hundred eighty-one women with breast reconstruction were mailed the pilot BRECON, BREAST-Q, and EQ-5D questionnaires. Fifty women were re-mailed the BRECON. Based on the responses, the BRECON was refined using statistical means and principal components analysis (PCA). Reliability was assessed using the intraclass correlation coefficient (ICC) and Cronbach's alpha. Validity was assessed by comparing subscales of the BRECON to the BREAST-Q and comparing a summary score of the BRECON-31 to the EQ-5D using the Pearson's correlation coefficient (PCC).
  
  
  RESULTS
  A total of 71% (128/181) of women completed the three questionnaires, and 86% (43/50) of women responded to the re-mailed BRECON. Statistical methods and PCA maintained 31 items covering eight components including self-image, arm concerns, intimacy, satisfaction, recovery, self-consciousness, expectations, and breast appearance. A 4-item "nipple" subscale and a 10-item "abdominal" subscale were developed for use where applicable. Measures of reliability and validity were high: Cronbach's alpha ranged from 0.67 to 0.91, ICC ranged from 0.55 to 0.85, and PCC ranged from 0.42 to 0.76.
  
  
  CONCLUSIONS
  A reliable, valid 31-item breast reconstruction satisfaction questionnaire was developed.
authors.affiliation: Division of Plastic Surgery, University of Calgary, Calgary, Alberta, Canada. ctemple4@uwo.ca
authors.forename: Claire F
authors.initials: CF
authors.lastname: Temple-Oberle
authors.forename: E Francis
authors.initials: EF
authors.lastname: Cook
authors.forename: Margo
authors.initials: M
authors.lastname: Bettger-Hahn
authors.forename: Nadia
authors.initials: N
authors.lastname: Mychailyshyn
authors.forename: Hina
authors.initials: H
authors.lastname: Naeem
authors.forename: Joy
authors.initials: J
authors.lastname: Macdermid
mesh_terms: D000367:Age Factors; D001828:Body Image; D001941:Breast Diseases / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D002979:Climacteric; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000523:psychology*; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D025341:Principal Component Analysis; D011594:Psychometrics; D015203:Reproducibility of Results; D012649:Self Concept; D011795:Surveys and Questionnaires