1. Introduction
sychology has never scrutinized the body as an independent phenomenon. Individuals’ psychological organization and personality structure play an undeniable role in their behavior and lifestyle. Today, social, cultural, and media pressures on the beauty and control of the body lead to a person’s desire to manipulate his body, in which the individual’s satisfaction with his physical image and the distance between the real self and the ideal self would be necessary [1, 2, 3].
Kash (2004) argues that body image is a multidimensional and complex psychological construct that includes body-related self-perceptions and self-attitudes such as thoughts, beliefs, feelings, and behaviors [4]. In other words, body image refers to a person’s perceptions, feelings, and ideas related to his/her body. It is usually conceptualized as a structure consisting of estimating body size, assessing body attractiveness, and feelings related to body size and shape [5, 6]. Accordingly, Cash (2000) presented the Multidimensional Body-Self Relations Questionnaire (MBSRQ) to measure body image. This questionnaire contains 69 questions and 9 components. Therefore, the minimum score is, 69 and the maximum is 345. The questionnaire’s scoring is such that people who have a more appropriate mental image of themselves get higher scores [4]. 
Kash (2000, 2002) reported the components’ validity and reliability with 95% confidence limits for men from 0.77 to 0.91 and women from 0.73 to 0.89, respectively. Kash (2002, 2000) reported the components’ validity and reliability with 95% confidence limits for men from 0.77 to 0.91 and women from 0.73 to 0.89, respectively. The reliability of this questionnaire and its subscales have been confirmed in various studies [4]. 
A review of the studies shows that the Persian version of this questionnaire has not been psychometric in the elderly. Internal research has only expressed its reliability in the elderly samples. Several studies have provided reliable evidence of the validity and reliability of the MBSRQ; however, this information has been obtained in samples outside the Iranian society. According to psychologists, the questionnaire’s validity and reliability are specific to the communities in which they were developed. This study aimed to evaluate the psychometrics of the Persian version of the MBSRQ in the Iranian elderly.
2. Methods & Materials 
The method of this study is non-experimental. Among the psychometric research tools, the necessary information was collected to determine the validity and reliability of the Persian version of the MBSRQ. The statistical population of this study consisted of all elderly aged over 60 years old in Tehran City. For each question in this study, 15 people, and 1035 people as a whole, were selected as a statistical sample. Of them, 300 people were selected to determine the reliability of the test-retest method.
The MBSRQ consists of 69 questions, 9 components, and 3 dimensions. The physical dimension includes 54 questions. The satisfaction dimension from different parts of the body consists of 9 questions. The individual’s attitude about weight also consists of 6 questions on a 5-point Likert scale from 1 (completely dissatisfied) to 5 (completely satisfied). Therefore, the minimum score is, 69 and the maximum is 345. The scoring is such that those who have a more appropriate mental image get higher scores [4]. Components of the MBSRQ Questionnaire include Appearance Evaluation(AE), Appearance Orientation (AO), Fitness Evaluation (FE), Proportion Orientation (FO), Health Evaluation (HE), Health Orientation (HO), Body Areas Satisfaction Scale (BASS), Over Weight Preoccupation (OWP), and their Self-Classified Weight (SCW) [4, 5, 6, 7].
To begin the work process, permission to use the MBSRQ was obtained by sending an email from the principal researcher. Then, the MBSRQ was translated into Persian by two colleagues of the project. After coordination and standardization, it was translated into English by a person fluent in English; then was compared with the original version. This process was performed according to the IQOLA protocol. In the next part of this stage, during a session with translators 1 and 2 and the study researchers, the original versions translated by two translators were reviewed and discussed. Evaluating the questionnaire’s face validity, five elderly people similar to the target community were asked about the questionnaire’s clarity and comprehensibility and ten experts about the general form and comprehensibility of the questionnaire. Then, in the presence of the facilitator and colleagues, the opinions of these people were reviewed, and the Persian version of the MBSRQ was extracted.
The Lawshe method was used to determine the content validity, which uses Content Validity Ratio (CVR) and Content Validity Index (CVI). The SocioCultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) was used to determine the concurrent validity of the MBSRQ. This questionnaire is a 30-item self-assessment scale with 4 components that scored as a 5-point Likert scale. Validity evaluation of MBSRQ scores was determined using confirmatory factor analysis and principal components analysis using IMOS software. To evaluate the reliability of the test-retest, 300 people completed the MBSRQ two weeks apart. The internal consistency coefficient of the MBSRQ and its subscales were also calculated using Cronbach’s alpha coefficient.
3. Results
The content validity Results showed that each question and component’s Content Validity Index (CVR) was calculated equal to 0.89-0.81. Also, the content validity index was 0.84, which indicates the validity of the acceptable content of the MBSRQ in the elderly. Using the first-order analysis method, the construct validity Results showed that the model for measuring the Persian version of the MBSRQ is appropriate. All numbers and parameters of the model were significant:
The Goodness Fit Index (GFI) was 0.941, which indicates this rate’s acceptability for the optimal fit of the model. The second Root Mean Squared Residual (RMSR) error was 0.086, which was less than the absolute value of 4; so, the model was validated. The value and Parsimonious Normed Fit Index (PNFI) was 0.075, which was more than 0.05, and the RMSEA was 0.042, which was less than 0.05, which is acceptable and indicates the approval of the research model. 
The Tucker-Lewis Index (TLI) was 0.978, the Comparative Fit Index (CFI) was 0.903, and the Bentler-Bonett Fit Index (BBI) was 0.926, which is higher than 0.9, which all indicate the desired fit and approval of the research model. The data’s concurrent validity Results show a high and significant correlation coefficient, which means the overall questionnaire set or the MBSRQ. Therefore, the Persian version of the MBSRQ and its components have concurrent validity. 
The time reliability Results of the MBSRQ and its components using the intra-class correlation coefficient showed that the values varied from 0.78 to 0.89, and the values of all subscales were higher than the acceptable value (0.75), which indicates the sufficient temporal reliability or reproducibility of MBSRQ components. 
The value of the correlation coefficient within the entire categories of the questionnaire with 0.83 and in the confidence interval of 0.95 confirms the time reliability of the whole questionnaire. Cronbach’s alpha coefficient was used to determine the internal consistency of the MBSRQ and its components. The Results showed that the internal consistency (Cronbach’s alpha coefficient) of the whole questionnaire with 69 questions, was 0.981 and the internal consistency of the components of the questionnaire is at the desired level (α> 0.75).
4. Conclusion
This study aimed to investigate the psychometric properties (validity and reliability) of the MBSRQ in the Iranian elderly. In general, the Results obtained in this study showed that the Results of confirmatory factor analysis, Cronbach’s alpha coefficients, and correlation within the Persian version of the MBSRQ supported the nine-factor structure (component) and 69 questions and confirmed the factor validity, internal consistency, and temporal validity of the questionnaire. As a result, the Persian version of the MBSRQ can be used as a valid and reliable tool to study and evaluate the individual attitudes about the body in the elderly. This tool, along with other psychological assessment tools, also provides a good platform for psychologists, physicians, and researchers related to geriatrics for more research and applied activities.
Ethical Considerations
Compliance with ethical guidelines
All ethical principles are considered in this article. The participants were informed of the purpose of the research and its implementation stages. They were also assured about the confidentiality of their information and were free to leave the study whenever they wished, and if desired, the research results would be available to them. The study approved by the Research Committee of the University of Social Welfare and Rehabilitation Sciences.
Funding
This Paper is based on a research project sponsored by the University of Social Welfare and Rehabilitation Sciences and Sabzevar University of Medical Sciences.
Authors' contributions
Conceptualization: Hashem Shemshadi, Robab Sahaf, Parvaneh Shamsipour Dehkordi, and Amir Shams; Methodology: Robab Sahaf, Amir Shams, Parvaneh Shamsipour Dehkordi; Validation: Parvaneh Shamsipour Dehkordi, Robab Sahaf, Amir Shams, Hossain Zareian; Formal Analysis: Amir Shams, Hossain Zareian; Investigation: Parvaneh Shamsipour Dehkordi, Amir Shams, Hashem Shemshadi; Writing – original draft, and Writing – review & editing: Amir Shams, Robab sahaf; Visualization, Supervision, Project Administration: Alireza Moslem, Amir Shams; Funding: Shemshadi, Moslem.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgments 
The authors thank the Vice-Chancellor for Research of Sabzevar University of Social Welfare and Rehabilitation Sciences and Sabzevar University of Medical Sciences.


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