Translation and psychometric properties of the Chinese version of the inventory to measure and assess image disturbance in head and neck cancer (IMAGE-HN).

Authors

Wenjie Xu, Shuman Wang, Yu Zhu, Kelsey A Duckett, Jing Yang, Yukun Zhang, Lina Xiang, Rong Ge, Yumei Dai, Mimi Zheng, Evan M Graboyes, Hongwei Wan

Published in

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. Volume 35. Issue 8. Jun 15, 2026. Epub Jun 15, 2026.

Abstract

Head and neck cancer and its treatments often lead to significant functional and cosmetic changes, resulting in body image disturbance (BID), which is a prevalent and distressing psychosocial issue affecting up to 75% of patients. To address the clinical limitations of existing tools for assessing BID in Chinese patients, this study culturally adapted the English-language IMAGE-HN into Mandarin Chinese and evaluated its psychometric properties.
Following the 2017 EORTC Translation Procedure Manual, a forward translation, reconciliation, backward translation, reporting, expert panel review, and cognitive debriefing were conducted to develop a culturally adapted Chinese version. The translated instrument was administered to 387 patients from two tertiary medical centers. Psychometric evaluation included classical test theory and item response theory, with confirmatory factor analysis to examine unidimensionality and local independence, and Rasch analysis to assess model fit, monotonicity, reliability, and separation indices.
Confirmatory factor analysis confirmed the unidimensionality and local independence of the four hypothesized domains and the overall scale. Rasch analysis indicated acceptable model fit (infit and outfit mean squares < 2.0) and monotonicity across all rating scale categories. Person reliability ranged from 0.85 to 0.92, separation indices from 2.43 to 3.34, and item reliability from 0.71 to 0.95. All 24 items and subscales were retained without modification.
The Chinese version of IMAGE-HN demonstrates satisfactory psychometric properties, supporting its reliability and validity for assessing body image disturbance in head and neck cancer patients in China. It is recommended for use in future clinical research and practice with this population.

PMID:
42295549
Bibliographic data and abstract were imported from PubMed on 15 Jun 2026.

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