Development and validation of the FR-QoL-29-Dutch (Flemish) Questionnaire and assessment of clinical factors associated with food-related quality of life in a Belgian inflammatory bowel disease population: a cross-sectional study.

Abstract

Objective: Food-related quality of life (FR-QoL) is the psychosocial impact of food, nutrition, eating and drinking on QoL and can be profoundly affected by inflammatory bowel disease (IBD). We aimed to translate and validate the FR-QoL-29 Questionnaire in a Belgian IBD population and investigate associations with relevant clinical variables.

Methods: The English FR-QoL-29 was translated to Dutch using the forward-backward method. Consecutive patients with IBD attending the outpatient clinic in a university hospital in Belgium completed the FR-QoL-29 Dutch (Flemish), alongside questionnaires assessing disease severity and IBD-related disability. Clinical and biochemical data were collected. Exploratory factor analysis (EFA) with promax rotation assessed the underlying factor structure. Reliability measures (internal consistency, test-retest reliability) were evaluated. Pearson and Spearman correlations assessed relationships between FR-QoL-29 Score and continuous demographic and clinical variables, while categorical parameters were analysed using independent t-tests and one-way analysis of variance with Tukey post hoc tests.

Results: 301 patients were included, with 31 (10.3%) completing the retest. EFA revealed a one-factor structure explaining 55% of the variance. The FR-QoL-29-Dutch (Flemish) showed excellent internal consistency (Cronbach's α=0.97) and very good test-retest reliability (intraclass correlation=0.94). Lower FR-QoL-29 Score was associated with higher serum albumin levels, younger age, disease activity and IBD-related disability. FR-QoL-29 Score was lower in females, those with Crohn's disease (CD), CD patients with a stricturing phenotype and those previously receiving IBD-related surgery.

Conclusion: The FR-QoL-29-Dutch (Flemish) is valid and reliable and correlates with disease activity and IBD-related disability. Patients with CD, stricturing disease and who previously underwent IBD-related surgery have a significantly lower FR-QoL and should be targeted for support.