Confirmatory Factor Analysis of the Sexual Adjustment and Body Image Scale in Women with Gynecologic Cancer

Background: There is evidence that treatment of gynecologic cancer (GC) negatively affects body image and sexuality. The Sexual Adjustment and Body Image Scale (SABIS-G) was developed to assess disturbances after diagnosis of GC. The objective of this study was to confirm the factor structure using a confirmatory factor analysis (CFA).

Methods: Women with a history of GC completed the SABIS-G, a 9-item self-report measure. Ninety randomly selected participants were used for the exploratory factor analysis (EFA). CFA was performed on the remaining participants (n = 204) to confirm the factor structure developed in the EFA against a one-factor model. Test-retest reliability between baseline and follow-up scores was assessed using the intraclass correlation coefficient.

Results: A total of 614 eligible patients were approached to participate: 398 (65%) consented to the study and 294 (74%) completed the SABIS-G. The median age was 53 years (range, 27-80 years) and the primary site of disease was: 120 (41%) uterine, 85 (29%) ovary, 82 (28%) cervix, and 7 (2%) other. A 2-factor structure was favored in the EFA, and the CFA fit indices indicated an excellent fit for the 2-factor measurement model (standardized root-mean-square residual = 0.05, non-normed fit index = 0.97, comparative fit index = 0.98). Internal consistency reliability was high for the Body Image (0.88) and Sexual Adjustment (0.91) subscales, as was test-retest reliability (0.89).

Conclusions: These results confirm the 2-factor structure of the SABIS-G and provide evidence that this is a valid and reliable instrument to measure changes in body image and sexuality in women after a diagnosis of GC.