Factor structure of the Persian version of general, social, and negative self-consciousness of appearance domains of Derriford Appearance Scale 59: an application in the field of burn injuries

BACKGROUND The Derriford Appearance Scale 59 (DAS59) is a widely used measure of the spectrum of psychological distress and dysfunction that is characteristic of disfigurement. Also, disfigurement due to burn injury leads to feeling guilty or less socially competent, avoiding social situations, suicide, poor self-esteem, sexual difficulties, and depression. Therefore, the purpose of this study was to translate and culturally adapt three subscales of DAS59 into Persian language and to investigate its factor structure for Iranian burned patients. METHOD Translation-back translation of the scale into Persian was done. The internal consistency of the translated scale was evaluated by Cronbach's alpha. Next, construct validity of the translated instrument was assessed by exploratory factor analysis using principal components and rotation of varimax methods. This research involved a convenience sample of 189 adult burned patients with disfigurement in their face, head, ears, neck, hands, and legs. RESULT The Cronbach's alpha for overall scale, subscales 1, 2, and 3 were 0.93, 0.93, 0.89, and 0.80, respectively. The best solution from the principal components analysis of the 40 items of the DAS59 revealed three factors corresponding to the three subscales with 20 items: factor 1 (general self-consciousness of appearance) consisted of 9 statements accounting for 33.23% of the variance (eigenvalue =9.23); factor 2 (social self-consciousness of appearance) consisted of 7 statements accounting for 22.91% of the variance (eigenvalue =1.53); and factor 3 (negative self-concept) consisted of 4 statements accounting for 14.98% of the variance (eigenvalue =1.13). CONCLUSION The factor structure of the three subscales of DAS59 provides a widely acceptable, psychometrically robust, factorial self-report scale to assess distress and dysfunction in problems of appearance among Iranian burned patients, and facilitates further research into the efficacy of treatment approaches for problems of appearance and early investigation of therapeutic outcome.