Work

Validation and reliability testing of the Swedish version of the BREAST-Q reconstruction

Year: 2025

Type: article

Abstract: PURPOSE: This study validates and assesses the reliability of the Swedish version of the BREAST-Q Reconstruction Module, a patient-reported outcome measure (PROM) designed to evaluate satisfaction and health-related quality of life (HRQoL) before and after breast reconstruction. METHODS: This observational study included 300 patients undergoing breast reconstruction at Sahlgrenska University Hospital. The psychometric evaluation involved content validity through cognitive interviews, internal consistency (Cronbach's α), test-retest reliability, convergent validity (comparison with the EORTC QLQ-BRECON 23), responsiveness (Wilcoxon rank test), and analysis of floor and ceiling effects. BREAST-Q version 1.0 was used to maintain item richness and comparability with historical data. RESULTS: Content validity was confirmed through interviews. Internal consistency was acceptable across all domains (Cronbach's α = 0.70-0.95). Test-retest reliability showed good agreement on the group level. Moderate correlations with BRECON-23 supported convergent validity. Responsiveness was demonstrated with significant improvements across all domains postoperatively (mean difference = 20.3, p < 0.001). Ceiling effects were observed preoperatively in Physical Well-being abdomen (40.1%) and postoperatively in four domains, notably Physical Well-being chest (45.5%). These effects may reflect true clinical success but also suggest limited sensitivity in high-functioning populations. CONCLUSION: The Swedish BREAST-Q Reconstruction Module demonstrates good validity, reliability, and responsiveness. However, ceiling effects in several domains highlight limitations in detecting subtle differences among patients with high levels of satisfaction, suggesting a need for stratified analysis and potential refinement of the scale. PREREGISTRATION: ClinicalTrials.gov Identifier: NCT05233891 and NCT04714463.

Source: Scandinavian Journal of Surgery

DOI: 10.1177/14574969251387498

Authors: Christian Jepsen, Anna Paganini, Emma Hansson

Institutions: Sahlgrenska University Hospital, University of Gothenburg

Language: English

Topic: Breast Implant and Reconstruction

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $2,000