Development and validation of the Health Promoting Behaviour for Bloating (HPB-Bloat) scale

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.

A Theory Planned Behaviour of Study on Improving Abdominal Bloating among the Malays Population: A Qualitative Study

“…In addition, eating habits and obesity are among the factors considered to potentially contribute to the increasing number of AB cases worldwide ( 4 , 5 ) due to the linkage with the ‘gut’. Abdullah et al ( 31 ) found that AB is commonly reported to be bothersome and to result in a reduced quality of life due to an impaired health status, mood disturbance, limitation of daily activities and increased need for healthcare. Therefore, the improvement of symptoms or diseases through lifestyle changes may help to increase the wellbeing of people who experience AB.…”

“…Irrespective of gender and underlying medical conditions, AB can cause significant distress to patients. For instance, among AB patients who did not have IBS, the majority reported their symptoms to be moderate to severe and, further stated that they had reduced their daily activities to some degree due to AB ( 31 , 32 ). Moreover, AB has been found to be a significant predictor of the severity of IBS ( 30 ).…”