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.
Highlights
Abdominal bloating (AB) is a common complaint during clinical consultations [1,2], and 1 in 10 Americans report bloating even without heavy meals [2,3]
All were found to have the presence of functional bloating through exploratory factor analysis (EFA)
The mean total score was used to explain the level of severity and quality of life (QoL) instead of each item score, and while total score allowed for an overall picture of severity, but this could be biased since different subscales have different sensitivity to AB, as shown in the subsequent lactose study [41]
Summary
Abdominal bloating (AB) is a common complaint during clinical consultations [1,2], and 1 in 10 Americans report bloating even without heavy meals [2,3]. Bloating affects the general measure of well-being and disease-specific quality of life (QoL) [6]. Bloating can be stand-alone, there are often other accompanying symptoms that increase the severity of the disease [7,8,9,10,11,12]. The ROME IV criteria for functional abdominal bloating/distension stated that it falls under bowel disorders, with the description of recurrent episodes on average at least one day per week and the symptoms predominating over other symptoms (that may co-exist with mild abdominal pain and minor bowel disorder) and that are insufficient to classify with other diagnosis with onset of 6 months and are present during the last 3 months [1]. The management of AB can be complex due to the above reasons [13,14,15,16,17]
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