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Abdullah N, Kueh YC, Kuan G, Yahaya FH, Lee YY, Lee YY. A Theory Planned Behaviour of Study on Improving Abdominal Bloating among the Malays Population: A Qualitative Study. Malays J Med Sci 2022; 29:77-88. [PMID: 36818903 PMCID: PMC9910364 DOI: 10.21315/mjms2022.29.6.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/18/2022] [Indexed: 12/25/2022] Open
Abstract
Background Abdominal bloating (AB) is a common medical complaint known to diminish patients' quality of life. However, lifestyle and behavioural changes could mitigate its expression and severity. This study sought to explore the health beliefs, intentions and health-promoting behaviours among people with AB in Kelantan, Malaysia. Methods The theory of planned behaviour (TPB) was employed to explore the factors that influence the management of adults with AB, namely health beliefs and intentions. An interview guide was developed by adapting the TPB and the findings of prior studies concerning the factors associated with AB management. All eligible participants took part in in-depth interviews. Results The mean age of the participants was 32.5 years old (standard deviation [SD] = 14.19 years old) and the majority of participants were female (58.3%). The themes and sub-themes that emerged following the application of the TPB framework represented the qualitative results of this study, which indicated that the health beliefs, intentions and health-promoting behaviours observed among people with AB were closely related. Conclusion The findings of this study suggest that the adoption of a healthy lifestyle could be an effective means of improving AB. Thus, it is vital to implement a health education programme that promotes health-related beliefs and intentions in order to trigger health-promoting behaviour among people with AB.
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Affiliation(s)
- Nurzulaikha Abdullah
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Yee Cheng Kueh
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Garry Kuan
- Exercise and Sports Science, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,Department of Life Sciences, Brunel University, London, United Kingdom
| | | | - Yeong Yeh Lee
- Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,GI and Motility Unit, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
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Abdullah N, Kueh YC, Kuan G, Wong MS, Yahaya FH, Abd Samat NA, Zulkifli KK, Lee YY. Development and validation of the Health Promoting Behaviour for Bloating (HPB-Bloat) scale. PeerJ 2021; 9:e11444. [PMID: 34141467 PMCID: PMC8183425 DOI: 10.7717/peerj.11444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/21/2021] [Indexed: 12/04/2022] Open
Abstract
Background Health management strategies may help patients with abdominal bloating (AB), but there are currently no tools that measure behaviour and awareness. This study aimed to validate and verify the dimensionality of the newly-developed Health Promoting Behaviour for Bloating (HPB-Bloat) scale. Methods Based on previous literature, expert input, and in-depth interviews, we generated new items for the HPB-Bloat. Its content validity was assessed by experts and pre-tested across 30 individuals with AB. Construct validity and dimensionality were first determined using exploratory factor analysis (EFA) and Promax rotation analysis, and then using confirmatory factor analysis (CFA). Results During the development stage, 35 items were generated for the HPB-Bloat, and were maintained following content validity assessment and pre-testing. One hundred and fifty-two participants (mean age of 31.27 years, 68.3% female) and 323 participants (mean age of 27.69 years, 59.4% male) completed the scale for EFA and CFA, respectively. Using EFA, we identified 20 items that we divided into five factors: diet (five items), health awareness (four items), physical activity (three items), stress management (four items), and treatment (four items). The total variance explained by the EFA model was 56.7%. The Cronbach alpha values of the five factors ranged between 0.52 and 0.81. In the CFA model, one problematic latent variable (treatment) was identified and three items were removed. In the final measurement model, four factors and 17 items fit the data well based on several fit indices (root mean square error of approximation (RMSEA) = 0.044 and standardized root mean squared residual (SRMR) = 0.052). The composite reliability of all factors in the final measurement model was above 0.60, indicating acceptable construct reliability. Conclusion The newly developed HPB-Bloat scale is valid and reliable when assessing the awareness of health-promoting behaviours across patients with AB. Further validation is needed across different languages and populations.
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Affiliation(s)
- Nurzulaikha Abdullah
- Biostatistics & Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Yee Cheng Kueh
- Biostatistics & Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Garry Kuan
- Exercise and Sport Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Life Sciences, Brunel University, London, United Kingdom
| | - Mung Seong Wong
- Department of Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,GI Function & Motility Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | | | - Nor Aslina Abd Samat
- Department of Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,GI Function & Motility Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Khairil Khuzaini Zulkifli
- GI Function & Motility Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Yeong Yeh Lee
- Department of Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,GI Function & Motility Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Mahd-Ab.lah N, Kueh YC, Kuan G, Yahaya FH, Wong MS, Abd Samat NA, Hamid N, Mohamad Nor N, Whitehead WE, Thiwan SI, Lee YY. Validity and Reliability of the Malay Versions of Bloating Severity (BSQ-M) and Quality of Life (BLQoL-M) Questionnaires. Int J Environ Res Public Health 2021; 18:2487. [PMID: 33802426 PMCID: PMC7967615 DOI: 10.3390/ijerph18052487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 02/22/2021] [Indexed: 12/12/2022]
Abstract
Abdominal bloating (AB) is a prevalent and bothersome symptom, but there are no specific measures for severity and quality of life (QoL) other than the Bloating Severity Questionnaire (BSQ) and Bloating Quality of Life (BLQoL). We aimed to translate the BSQ and BLQoL into the Malay language and to validate them using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) approaches. The 12-item BSQ has two components, seven-item severity in general (SevGen) and five-item severity in the past 24 h (Sev24), and BLQOL has five items. Translation to the Malay language (BSQ-M and BLQoL-M) was performed using standard forward and backward processes. EFA followed by CFA were performed in participants with AB due to functional bowel disorders, with the purpose of examining the validity and reliability of the questionnaires translated into Malay. After EFA with 152 participants, all the items of BSQ-M remained in the model. Total variance extracted was 53.26% for BSQ-M and 58.79% for BLQoL-M. The internal consistency based on Cronbach's alpha values was 0.52 for SevGen, 0.86 for Sev24, and 0.81 for BLQoL-M. After performing CFA with another 323 participants, the final measurement model for BSQ-M and BLQoL-M fit the data well in terms of several fit indices (BSQ-M: root mean square error of approximation (RMSEA) = 0.050, Comparative Fit Index (CFI) = 0.966, Tucker-Lewis Fit Index (TLI) = 0.956, and standardized root mean squared residual (SRMR) = 0.051; BLQoL-M: RMSEA = 0.071, CFI = 0.985, TLI = 0.962, SRMR = 0.021). The composite reliability for BSQ-M and BLQoL-M were satisfactory (SevGen = 0.83, Sev24 = 0.89, BLQoL = 0.80). The intraclass correlation (ICC) results showed excellent stability for BSQ-M and BLQoL-M, ranging from 0.74 to 0.93. The Malay language versions of BSQ-M and BLQoL-M are valid and reliable instruments for measuring the severity and QoL of AB for the Asian population with functional bowel disorders.
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Affiliation(s)
- Nurzulaikha Mahd-Ab.lah
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Yee Cheng Kueh
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Garry Kuan
- Exercise and Sport Science, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Life Sciences, Brunel University, London UB8 3PH, UK
| | - Fatan Hamamah Yahaya
- School of Distance Education, Universiti Sains Malaysia, USM, Penang 11800, Pulau Pinang, Malaysia;
| | - Mung Seong Wong
- Medical Department, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (M.S.W.); (N.A.A.S.); (N.H.); (N.M.N.)
| | - Nor Aslina Abd Samat
- Medical Department, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (M.S.W.); (N.A.A.S.); (N.H.); (N.M.N.)
| | - Nurhazwani Hamid
- Medical Department, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (M.S.W.); (N.A.A.S.); (N.H.); (N.M.N.)
| | - Nurhayati Mohamad Nor
- Medical Department, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (M.S.W.); (N.A.A.S.); (N.H.); (N.M.N.)
| | - William E. Whitehead
- Division of Gastroenterology and Hepatology CB 7080, Chapel Hill Department of Medicine, University of North Carolina, 4112 Bioinformatics Bldg, Chapel Hill, NC 27599-7080, USA;
| | - Syed Ismail Thiwan
- Department of Medicine, Eastern Virginia Medical School, Norfolk, VA 23507, USA;
| | - Yeong Yeh Lee
- Medical Department, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (M.S.W.); (N.A.A.S.); (N.H.); (N.M.N.)
- Gut Research Group, Faculty of Medicine, National University of Malaysia, Kuala Lumpur 43600, Selangor, Malaysia
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