Food-related Quality of Life in patients with Inflammatory Bowel Disease: Translation and Validation of the German version of FR-QoL-29

Abstract

Background and aims

The psychosocial effects of eating and drinking – summarized as food-related quality of life (FR-QoL) – are underexplored in inflammatory bowel disease (IBD). Currently, there is no German instrument to assess FR-QoL in IBD patients. This study aimed to translate the validated English FR-QoL-29 questionnaire into German and evaluate its validity and reliability.

Methods

A monocentric, cross-sectional study was conducted at a tertiary referral center with IBD patients and healthy controls. Participants completed questionnaires on sociodemographics, disease history, the Malnutrition Universal Screening Tool (MUST), the German Short Health Scale (SHS), and the FR-QoL-29-German. The FR-QoL-29 was translated into German using a forward-backward method. Its reliability and validity was assessed using Pearson correlation coefficients, intraclass correlation coefficients, and Cronbach’s α.

Results

N=200 IBD patients (Crohn’s disease: 61.8%; women: 50.8%; remission: 56.2%) and n=10 healthy controls completed the questionnaires. Overall, 113 IBD patients repeated the questionnaires after an average of six weeks. Significant differences in FR-QoL-29-German sum scores were found between all levels of IBD disease activity, except for remission – mild disease (p = 0.423) and moderate – severe disease (p = 0.999). FR-QoL-29-German scores significantly correlated with age (p = 0.041), disease activity (p < 0.001), MUST (p = 0.015), fecal Calprotectin (p = 0.011) and SHS (p < 0.001). Overall, the FR-QoL-29-German showed excellent internal consistency (Cronbach’s α = 0.965) and good test-retest reliability (ICC = 0.85 [95% CI: 0.78–0.89]).

Conclusion

The FR-QoL-29-German is a valid and reliable tool for assessing food-related quality of life in German-speaking individuals with IBD.

Zusammenfassung

Einleitung

Die psychosozialen Auswirkungen des Essens und Trinkens – zusammengefasst als ernährungsbezogene Lebensqualität (FR-QoL) – sind bei chronisch entzündlichen Darmerkrankungen (CED) noch wenig erforscht. Derzeit gibt es kein deutsches Instrument zur Bewertung der FR-QoL bei CED-Patienten. Ziel dieser Studie war es, den validierten englischen Fragebogen FR-QoL-29 ins Deutsche zu übersetzen und seine Validität und Reliabilität zu bewerten.

Methodik

Eine monozentrische Querschnittsstudie wurde an einem tertiären Referenzzentrum mit CED-Patienten und gesunden Kontrollpersonen durchgeführt. Die Teilnehmer füllten Fragebögen zu soziodemografischen Daten, zur Krankheitsgeschichte, zum Malnutrition Universal Screening Tool (MUST), zur deutschen Short Health Scale (SHS) und zum FR-QoL-29-German aus. Der FR-QoL-29 wurde mithilfe einer Vorwärts-Rückwärts-Methode ins Deutsche übersetzt. Seine Reliabilität und Validität wurde anhand von Pearson-Korrelationskoeffizienten, Intraklassen-Korrelationskoeffizienten und Cronbachs α bewertet.

Ergebnisse

N=200 CED-Patienten (Morbus Crohn: 61,8%; Frauen: 50,8%; Remission: 56,2%) und n=10 gesunde Kontrollpersonen füllten die Fragebögen aus. Insgesamt 113 CED-Patienten wiederholten die Fragebögen nach durchschnittlich sechs Wochen. Signifikante Unterschiede in den FR-QoL-29-German-Summenwerten wurden zwischen allen Stufen der CED-Krankheitsaktivitäten gefunden, mit Ausnahme von Remission – milde Erkrankung (p = 0,423) und moderate – schwere Erkrankung (p = 0,999). Die FR-QoL-29-German-Summenwerte korrelierten signifikant mit dem Alter (p = 0,041), der Krankheitsaktivität (p < 0,001), MUST (p = 0,015), fäkalem Calprotectin (p = 0,011) und SHS (p < 0,001). Insgesamt zeigte der FR-QoL-29-German eine ausgezeichnete interne Konsistenz (Cronbachs α = 0,965) und eine gute Test-Retest-Reliabilität (ICC = 0,85 [95% CI: 0,78–0,89]).

Schlussfolgerung

Der FR-QoL-29-German ist ein valides und zuverlässiges Instrument zur Erfassung der ernährungsbezogenen Lebensqualität bei deutschsprachigen CED-Patienten.

Keywords

IBD - Nutrition and metabolism - patient-reported outcome measures (PROMS) - Inflammatory bowel disease - Quality of life

Schlüsselwörter

CED - Ernährung und Stoffwechsel - Patient Reported Outcomes (PRO) - Chronisch entzündliche Darmerkrankungen - Lebensqualität

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