title: Instrument translation and initial psychometric evaluation of the Danish Body Image Quality of Life Inventory.
abstract: OBJECTIVE
  Negative body perception has been reported in a number of patient populations. No instrument in Danish for measuring body image-related concerns has been available. Without such an instrument, understanding of the phenomenon in Danish-speaking populations is limited. The purpose of the study was thus to translate and validate a Danish version of the Body Image Quality of Life Inventory (BIQLI), in order to obtain a valid instrument applicable for healthcare research.
  
  
  METHODS
  The study consisted of two phases: (i) instrument adaptation, including forward and back translation, expert committee comparisons and cognitive interviewing, and (ii) empirical testing of the Danish version (BIQLI-DA) with subsequent psychometric evaluation. Hypothesised correlations to other measures, including body mass index (BMI), Medical Outcome Short Form-8 (SF-8), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 and Symptom Check List-90-Revised (SCL-90-R®) were tested. In addition, exploratory factor structure analysis (EFA) and internal consistency on item and scale level were performed.
  The adapted instrument was found to be semantically sound, yet concerns about face validity did arise through cognitive interviews. Danish college students (n = 189, 65 men, Mage= 21.1 years) participated in the piloting of the BIQLI-DA. Convergent construct validity was demonstrated through associations to related constructs. Exploratory factor analysis revealed a potential subscale structure. Finally, results showed a high internal consistency (Cronbach's alpha = 0.92). Support for the validity of the BIQLI-DA might have been strengthened by repeating cognitive interviews after layout alterations, by piloting the instrument on a larger sample.
  
  
  CONCLUSIONS
  This study demonstrated tentative support for the validity of the Danish Body Image Quality of Life (BIQLI-DA) and found the measure to be reliable in terms of internal consistency. Further exploration of response processes and construct validity is needed.
authors.affiliation: The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.|Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark.
authors.forename: Trine Bernholdt
authors.identifier: http://orcid.org/0000-0002-4733-8119
authors.initials: TB
authors.lastname: Rasmussen
authors.affiliation: The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.|Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark.
authors.forename: Selina Kikkenborg
authors.initials: SK
authors.lastname: Berg
authors.affiliation: Yale University School of Nursing, Orange, CT, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Dixon
authors.affiliation: The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.|Centre for Health Services and Nursing Research, University of Leuven, Leuven, Belgium.|Institute of Health and Care Science, University of Gothenburg, Göteborg, Sweden.
authors.forename: Philip
authors.initials: P
authors.lastname: Moons
authors.affiliation: Research Unit, Gentofte University Hospital, Hellerup, Denmark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Konradsen
mesh_terms: D001828:Body Image; D003718:Denmark; D006801:Humans; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results
keywords: Body Image Quality of Life Inventory; body image (MeSH); measures; psychometrics (MeSH); translations (MeSH); validation studies (MeSH)