Iranian Journal of Medical Sciences

Document Type : Original Article(s)

Authors

1 Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

2 Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

3 Department of Medicine, Islamic Azad University, Tonekabon Branch, Tonekabon, Mazandaran, Iran

4 Department of Nursing, Tarbiat Modares University, Tehran, Iran

5 Department of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

6 Department of Nursing, School of Nursing and Midwifery, Shahr-e-Kord University of Medical Sciences Shahr-e-kord, Iran

Abstract

Background: Adult eating behavior questionnaire (AEBQ) is an age upward extension tool that measures appetite traits in individuals. This instrument was developed by Hunot in 2016. The present study aimed to determine the psychometric properties of the Persian version of AEBQ in adults with epilepsy.
Methods: The current research is a cross-sectional study conducted in 2019 in Iran. 700 adults with epilepsy completed the 35-item AEBQ. Qualitative face validity, qualitative content and structure validity (exploratory factor analysis [EFA], N=400, and confirmatory factor analysis [CFA], N=300) appetitive traits were evaluated. Reliability was also measured using Cronbach’s alpha, Construct reliability (CR), and Intra-Class Correlation (ICC). The SPSS 26-AMOS24 software was employed to analyze the data with a significance level of 0.05.
Results: The EFA and CFA results comprised eight factors,
namely enjoyment of food, emotional over-eating, food responsiveness, hunger, satiety responsiveness, emotional under-eating, food fussiness, and eating slowly. Indices of root mean square error of approximation=0.068, parsimonious normed fit index=0.644, parsimonious comparative fit index=0.671, adjusted goodness of fit index=0.618, goodness of fit index=0.911, and Chi square degree-of-freedom ratio (normalized Chi square CMIN/DF=2.842) confirmed the fitness of the final model. Convergent and divergent validity was acceptable for all the factors. The results revealed that the internal stability>0.8 and CR>0.7 of the eight extracted AEBQ structures are confirmed. The ICC was 0.899 (95% CI: 0.878-0.917; p <0.001). The results also showed that AEBQ has acceptable convergent and divergent validity.
Conclusion: The eight-factor structure of AEBQ can measure eating behavior traits and is of good validity and reliability for assessing the eating behavior of Iranian adults with epilepsy.

Keywords

  1. Yannakoulia M, Mamalaki E, Anastasiou CA, Mourtzi N, Lambrinoudaki I, Scarmeas N. Eating habits and behaviors of older people: Where are we now and where should we go? Maturitas. 2018;114:14-21. doi: 10.1016/j.maturitas.2018.05.001. PubMed PMID: 29907241.
  2. Jezewska-Zychowicz M, Gebski J, Kobylinska M. Food Involvement, Eating Restrictions and Dietary Patterns in Polish Adults: Expected Effects of Their Relationships (LifeStyle Study). Nutrients. 2020;12. doi: 10.3390/nu12041200. PubMed PMID: 32344767; PubMed Central PMCID: PMCPMC7230548.
  3. Djalalinia S, Saeedi Moghaddam S, Sheidaei A, Rezaei N, Naghibi Iravani SS, Modirian M, et al. Patterns of Obesity and Overweight in the Iranian Population: Findings of STEPs 2016. Front Endocrinol (Lausanne). 2020;11:42. doi: 10.3389/fendo.2020.00042. PubMed PMID: 32174887; PubMed Central PMCID: PMCPMC7055062.
  4. Sayehmiri K, Tavan H, Sayehmiri F, Mohammadi I, K VC. Prevalence of epilepsy in iran: a meta-analysis and systematic review. Iran J Child Neurol. 2014;8:9-17. PubMed PMID: 25657765; PubMed Central PMCID: PMCPMC4307363.
  5. Hunter RM, Reilly C, Atkinson P, Das KB, Gillberg C, Chin RF, et al. The health, education, and social care costs of school-aged children with active epilepsy: A population-based study. Epilepsia. 2015;56:1056-64. doi: 10.1111/epi.13015. PubMed PMID: 26040629.
  6. Cui W, Zack MM, Kobau R, Helmers SL. Health behaviors among people with epilepsy--results from the 2010 National Health Interview Survey. Epilepsy Behav. 2015;44:121-6. doi: 10.1016/j.yebeh.2015.01.011. PubMed PMID: 25678033; PubMed Central PMCID: PMCPMC4580240.
  7. Silveira DC, Klein P, Ransil BJ, Liu Z, Hori A, Holmes GL, et al. Lateral asymmetry in activation of hypothalamic neurons with unilateral amygdaloid seizures. Epilepsia. 2000;41:34-41. doi: 10.1111/j.1528-1157.2000.tb01502.x. PubMed PMID: 10643921.
  8. Mollaoglu M, Durna Z, Bolayir E. Validity and Reliability of the Quality of Life in Epilepsy Inventory (QOLIE-31) for Turkey. Noro Psikiyatr Ars. 2015;52:289-95. doi: 10.5152/npa.2015.8727. PubMed PMID: 28360726; PubMed Central PMCID: PMCPMC5353064.
  9. Aydin K, Kartal A, Keles Alp E. High rates of malnutrition and epilepsy: two common comorbidities in children with cerebral palsy. Turk J Med Sci. 2019;49:33-7. doi: 10.3906/sag-1803-79. PubMed PMID: 30761843; PubMed Central PMCID: PMCPMC7350856.
  10. Kremmyda O, Forbrig R, Heinrich J, Winkler T, Straube A. Subcortical lesions due to cobalamin deficiency: an unusual MRI lesion pattern. Nutr Neurosci. 2021;24:564-8. doi: 10.1080/1028415X.2019.1657659. PubMed PMID: 31454297.
  11. Kariuki SM, Chengo E, Ibinda F, Odhiambo R, Etyang A, Ngugi AK, et al. Burden, causes, and outcomes of people with epilepsy admitted to a rural hospital in Kenya. Epilepsia. 2015;56:577-84. doi: 10.1111/epi.12935. PubMed PMID: 25689574; PubMed Central PMCID: PMCPMC4813756.
  12. Mbelesso P, Luna J, Yangatimbi E, Mboukou C, Preux PM. Sociocultural representations of epilepsy in the Central African Republic: A door-to-door survey. Seizure. 2019;67:23-6. doi: 10.1016/j.seizure.2019.02.018. PubMed PMID: 30856458.
  13. Armeno M, Verini A, Del Pino M, Araujo MB, Mestre G, Reyes G, et al. A Prospective Study on Changes in Nutritional Status and Growth Following Two Years of Ketogenic Diet (KD) Therapy in Children with Refractory Epilepsy. Nutrients. 2019;11. doi: 10.3390/nu11071596. PubMed PMID: 31337135; PubMed Central PMCID: PMCPMC6682914.
  14. Bertoli S, Cardinali S, Veggiotti P, Trentani C, Testolin G, Tagliabue A. Evaluation of nutritional status in children with refractory epilepsy. Nutr J. 2006;5:14. doi: 10.1186/1475-2891-5-14. PubMed PMID: 16640779; PubMed Central PMCID: PMCPMC1550412.
  15. Hinkle JL, Cheever KH. Brunner and Suddarth’s textbook of medical-surgical nursing. Bangalore: Wolters Kluwer India Pvt Ltd; 2018.
  16. Mahmoodi M, Moloodi R, Ghaderi A, Babai Z, Saleh Z, Alasti H, et al. The Persian Version of Eating Disorder Examination Questionnaire and Clinical Impairment Assessment: Norms and Psychometric Properties for Undergraduate Women. Iran J Psychiatry. 2016;11:67-74. PubMed PMID: 27437002; PubMed Central PMCID: PMCPMC4947222.
  17. Ahmadi S, Moloodi R, Zarbaksh MR, Ghaderi A. Psychometric properties of the Eating Attitude Test-26 for female Iranian students. Eat Weight Disord. 2014;19:183-9. doi: 10.1007/s40519-014-0106-7. PubMed PMID: 24563207.
  18. Mostafavi SA, Akhondzadeh S, Mohammadi MR, Eshraghian MR, Hosseini S, Chamari M, et al. The Reliability and Validity of the Persian Version of Three-Factor Eating Questionnaire-R18 (TFEQ-R18) in Overweight and Obese Females. Iran J Psychiatry. 2017;12:100-8. PubMed PMID: 28659982; PubMed Central PMCID: PMCPMC5483235.
  19. Abbaspoor Z, Javadifar N, Miryan M, Abedi P. Psychometric properties of the Iranian version of mindful eating questionnaire in women who seeking weight reduction. J Eat Disord. 2018;6:33. doi: 10.1186/s40337-018-0220-4. PubMed PMID: 30410760; PubMed Central PMCID: PMCPMC6214170.
  20. Nouhi S, Janbozorgi M, Agah Haris M, Najimi A. Standardization of children’s eating behavior questionnaire (CEBQ). Quarterly Journal of Health Psychology. 2020;9:41-56. doi: 10.30473/HPJ.2020.42927.4189.
  21. Dehghan P, Asghari-Jafarabadi M, Salekzamani S. Validity, Reliability and Feasibility of the Eating Behavior Pattern Questionnaire (EBPQ) among Iranian Female Students. Health Promot Perspect. 2015;5:128-37. doi: 10.15171/hpp.2015.015. PubMed PMID: 26290828; PubMed Central PMCID: PMCPMC4539050.
  22. Hunot C, Fildes A, Croker H, Llewellyn CH, Wardle J, Beeken RJ. Appetitive traits and relationships with BMI in adults: Development of the Adult Eating Behaviour Questionnaire. Appetite. 2016;105:356-63. doi: 10.1016/j.appet.2016.05.024. PubMed PMID: 27215837; PubMed Central PMCID: PMCPMC4990060.
  23. Zickgraf HF, Rigby A. The Adult Eating Behaviour Questionnaire in a bariatric surgery-seeking sample: Factor structure, convergent validity, and associations with BMI. Eur Eat Disord Rev. 2019;27:97-104. doi: 10.1002/erv.2628. PubMed PMID: 30039633; PubMed Central PMCID: PMCPMC7052954.
  24. Shahhosseni M, Afshari A, Noury Ghasemabadi R. Determining psychometric properties of Drive for Muscularity Attitudes Questionnaire (DMAQ) among Iranian athletes. Journal of Fundamentals of Mental Health. 2017;20:50-62. doi:10.22038/JFMH.2017.10043.
  25. Mallan KM, Fildes A, de la Piedad Garcia X, Drzezdzon J, Sampson M, Llewellyn C. Appetitive traits associated with higher and lower body mass index: evaluating the validity of the adult eating behaviour questionnaire in an Australian sample. Int J Behav Nutr Phys Act. 2017;14:130. doi: 10.1186/s12966-017-0587-7. PubMed PMID: 28938904; PubMed Central PMCID: PMCPMC5610469.
  26. Munro BH. Statistical methods for health care research. Vol 1. Philadelphia: Lippincott Williams and Wilkins; 2005.
  27. McCoach DB, Gable RK, Madura JP. Instrument development in the affective domain. New York: Springer; 2013.
  28. Fok D. Development and testing of a Low Vision Product Selection Instrument (LV-PSI): A mixed-methods approach. Electronic Thesis and Dissertation Repository. 2011.
  29. Meyers LS, Gamst G, Guarino AJ. Applied multivariate research: Design and interpretation. California: Sage publications; 2016.
  30. Fornell C, Larcker DF. Structural equation models with unobservable variables and measurement error: Algebra and statistics. Los Angeles: Sage Publications; 1981.
  31. Javali SB, Gudaganavar NV, Raj SM. Effect of varying sample size in estimation of coefficients of internal consistency. WebmedCentral Biostatistics 2011;2(2):WMC001649. doi: 10.9754/journal.wmc.2011.001649.
  32. Perry JL, Nicholls AR, Clough PJ, Crust L. Assessing model fit: Caveats and recommendations for confirmatory factor analysis and exploratory structural equation modeling. Measurement in physical education and exercise science. 2015;19:12-21. doi: 10.1080/1091367X.2014.952370.
  33. Sarstedt M, Ringle CM, Hair JF. Partial least squares structural equation modeling. Handbook of market research. 2017;26:1-40. doi: 10.1007/978-3-319-05542-8_15-1.
  34. Mayers A. Introduction to statistics and SPSS in psychology. New York : Pearson Higher Ed; 2013.
  35. Thorlacius L, Garg A, Riis PT, Nielsen SM, Bettoli V, Ingram JR, et al. Inter-rater agreement and reliability of outcome measurement instruments and staging systems used in hidradenitis suppurativa. Br J Dermatol. 2019;181:483-91. doi: 10.1111/bjd.17716. PubMed PMID: 30724351.
  36. Beckett C, Eriksson L, Johansson E, Wikström C. Multivariate data analysis (MVDA). In: Schlindwein WS, editors. Pharmaceutical Quality by Design. Chapter 8. 2018. p. 201-25. doi.org/10.1002/9781118895238.ch8.