Food-related Quality of Life in Inflammatory Bowel Disease: Development and Validation of a Questionnaire.
BACKGROUND
Psychosocial factors surrounding eating and drinking, such as enjoying food, managing restrictions, and maintaining social relationships, remain under-researched in inflammatory bowel disease [IBD]. This study aimed to develop and validate a food-related quality of life [FR-QoL] questionnaire to systematically measure these issues in the IBD population.


METHODS
Following semi-structured interviews with 28 IBD patients, 150 potential questionnaire items were generated. These were ranked by 100 IBD patients, and items were removed based on ceiling/floor effects and high inter-item correlations [> 0.7], with 41 items being retained. In total, 323 IBD patients, 100 asthma patients [chronic disease control], and 117 healthy controls completed the FR-QoL questionnaire, alongside generic and disease-specific QoL and food satisfaction questionnaires. Principal components analysis [PCA], construct and discriminant validity, and test-retest reliability were calculated.


RESULTS
Twelve items were removed following PCA. The reduced questionnaire [FR-QoL-29] explained 63.9% of the variance [Cronbach's α = 0.96]. FR-QoL-29 correlated significantly with generic QoL [r = 0.697], depression [r = -0.519], anxiety [r = -0.531], and food satisfaction [r = 0.701]. The FR-QoL-29 sumscores were significantly lower for IBD (89.5, standard deviation [SD] 28.6) than asthma [125.4, SD 24.1; p < 0.001] and healthy volunteers [123.0, SD 16.5; p<0.001]. Within IBD, worse food-related QoL was found in those with moderate/high disease activity [66.7, SD 22.1] compared with remission/low disease activity [92.5, SD 28.1]. Test-retest reliability was good (intra-class correlation [ICC] = 0.83, 95% confidence interval [CI] = 0.76:0.88).


CONCLUSIONS
The FR-QoL-29 shows good reliability and validity across a range of IBD characteristics. This easily administered questionnaire is a useful tool in identifying poor food-related QoL and in the future may identify areas for intervention.
King's College London, Department of Psychology, London, UK.
Lyndsay D
LD
Hughes
King's College London, Diabetes and Nutritional Sciences Division, London, UK.
Laura
L
King
King's College London, Health and Social Care Division, London, UK.
Myfanwy
M
Morgan
King's College London, Health and Social Care Division, London, UK.
Salma
S
Ayis
Frimley Park Hospital NHS Foundation Trust, Department of Gastroenterology, Frimley, UK.
Natalie
N
Direkze
King's College London, Diabetes and Nutritional Sciences Division, London, UK Guys and St Thomas' NHS Foundation Trust, Department of Nutrition & Dietetics, London, UK Guys and St Thomas' NHS Foundation Trust, Department of Gastroenterology, London, UK.
Miranda C
MC
Lomer
Barts and the London School of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, London, UK Digestive Diseases Unit, Barts Health NHS Trust, London, UK.
James O
JO
Lindsay
King's College London, Diabetes and Nutritional Sciences Division, London, UK kevin.whelan@kcl.ac.uk.
Kevin
K
Whelan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D063427:Food Quality; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D011594:Psychometrics / Q000379:methods*; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult
Inflammatory bowel disease; nutrition; quality of life; questionnaire; validation