2.3. Body image questionnaire (BIQ)

The body image questionnaire (BIQ) was previously described and applied by Dunker in 1998.^[13] Donors completed the BIQ, which has been demonstrated on factor analysis to produce two scales: the body image scale (BIS) and the cosmetic scale (CS). The BIS (items 1–5) investigates the patient's perception of and satisfaction with their own body and assesses the patient's attitudes toward their bodily appearance. It has five questions answered on a Likert scale ranging from 1 (no, not at all) to 4 (yes, extremely). The total BIS has a minimum of 5 and a maximum of 20. The CS (items 6–8) evaluates the donor's satisfaction with the physical appearance of their scar. The CS has 3 questions answered on a Likert scale: 2 questions ranging from 1 (very unsatisfied) to 7 (very satisfied) and a third question ranging from 1 (very unsatisfied) to 10 (very satisfied). The total CS score has a minimum of 3 and a maximum of 24. Note that on the BIQ a higher score indicates greater satisfaction on both scales. The reliability coefficients (values of Cronbach alpha) for BIS and CS were 0.81 and 0.74, respectively.^[14] Two items (9, 10) about the patient's self-confidence before and after surgery have been added to the final version of the BIQ; they are answered on a Likert scale ranging from 1 (not confident) to 10 (very confident). Predonation confidence ratings were subtracted from postdonation confidence ratings to determine the donors who felt their confidence decreased after donation. This questionnaire has been used and tested in two studies involving living donor nephrectomy and living donor hepatectomy.^[2,4]