![]() ![]() ![]() Healthy eating and lifestyle recommendations can be provided by many healthcare practitioners involved in IBS management such as general practitioners, nurses, gastroenterologists and dietitians. ![]() Many people will benefit by simple lifestyle modifications. Medication (e.g., antispasmodics, laxatives) can also be used alongside lifestyle modifications to relief symptoms. First line lifestyle and dietary modifications include regular meals, adequate fluids, reduced intake of fat, caffeine and alcohol if associated with symptom generation, consideration of fibre intake, regular exercise and probiotic supplementation. NICE guidelines recommend lifestyle and dietary modifications, medication and psychological support (e.g., cognitive behavioural therapy) for the management of IBS. IBS-related symptoms significantly decrease health-related quality of life, have societal consequences (e.g., isolation, work absence) and impose a profound burden on individuals and the healthcare system. Its’ pathogenesis is not fully elucidated but involves a complex and altered interaction between the gut-brain axis and biological factors. In the UK, it affects at least 12% of the population. The global prevalence of IBS varies between and within countries and has been reported from as low as 1.1% in France and Iran to 36% in Mexico. It is diagnosed using the Rome IV criteria and investigations are carried out (e.g., negative coeliac antibodies, normal faecal calprotectin), to exclude any organic disease with similar symptoms (e.g., coeliac disease, inflammatory bowel disease, cancer). Irritable bowel syndrome (IBS) is a chronic and relapsing functional gastrointestinal disorder characterised by recurrent abdominal pain, bloating, flatulence and changes in bowel habits. ConclusionĪ validated questionnaire to use in practice and research to assess knowledge, attitudes and practices in the dietary management of IBS has been developed. External reliability was >0.6 for each factor and >0.7 for overall items of each domain. Internal reliability was >0.7 for each factor. Significant differences were found in sum scores among dietitians with different levels of IBS experience. Six factors were extracted by PCA with varimax rotation explaining 59.2% of the total variance. Psychometric testing was applied to the refined 90-item questionnaire administered to participating dietitians, resulting in the final 46-item questionnaire. Resultsįace and content validity resulted in the removal of 61 items from the initial 151 items. Internal reliability was assessed by Kuder–Richarson Formula 20 and Cronbach’s alpha coefficient and external reliability by interclass correlation coefficient among participants who completed the instrument at baseline and two weeks later ( n = 28). Construct validity was assessed via principal component analysis (PCA) and the ‘known-groups’ method. ![]() Item reduction analysis was assessed by item difficulty index, discrimination index and point-biserial correlation. Items considered irrelevant were removed and the refined questionnaire was administered to dietitians with different levels of IBS experience ( n = 154) for further psychometric testing. Academic/senior clinical dietitians ( n = 5) provided written feedback and a focus group ( n = 4 gastroenterology dietitians) was undertaken to evaluate content and face validity of the question-items. Subjects/MethodsĪn initial pool of 151 questions was generated addressing three domains (knowledge, attitudes, practices). To develop and validate a questionnaire assessing knowledge, attitudes and practices in the dietary management of IBS. ![]()
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