Parker Katrina, Mitchell Sarah, O'Brien Paul, Brennan Leah
Centre for Obesity Research and Education (CORE), Level 6, The Alfred Centre, Monash University, 99 Commercial Rd, Melbourne, Victoria 3004, Australia; School of Psychological Sciences, Level 4, Building 17, Monash University Clayton Campus, Clayton, Victoria 3168, Australia.
School of Psychological Sciences, Level 4, Building 17, Monash University Clayton Campus, Clayton, Victoria 3168, Australia.
Eat Behav. 2015 Dec;19:39-48. doi: 10.1016/j.eatbeh.2015.05.007. Epub 2015 Jun 6.
Bariatric surgery is considered the most effective weight loss intervention for obese persons. However, accurate assessment is essential to identify disordered eating that may impair achievement of optimal post-surgical outcomes. Measures of disordered eating are yet to be thoroughly psychometrically evaluated in bariatric surgery patients, therefore their utility is unknown.
Participants were 108 adults who completed psychological measures approximately 12 months after bariatric surgery. The fit of the original scale structures was tested using Confirmatory Factor Analysis (CFA) and alternative factor solutions were generated using Exploratory Factor Analysis (EFA). Reliability (internal consistency) and construct validity (convergent and divergent) were also assessed.
Eating Disorder Examination Questionnaire (EDE-Q), Questionnaire of Eating and Weight Patterns Revised (QEWP-R), Three Factor Eating Questionnaire (TFEQ) and Clinical Impairment Assessment (CIA).
CFA revealed none of the original disordered eating measures met adequate fit statistics. EFA produced revised scales with improved reliability (original scales α=0.47-0.94; revised scales α=0.76-0.98) and correlational analyses with measures of psychological wellbeing and impairment demonstrated adequate convergent validity. Reported prevalence of disordered eating behaviours differed between the EDE-Q and QEWP-R.
Psychometric evaluation did not support the use of the commonly used disordered eating measures in bariatric patients in their original form. The revised version of the EDE-Q replicates findings from recent research in bariatric surgery candidates. The alternate structures of the CIA and TFEQ suggest differences in the manifestation of disordered eating following surgery. Results suggest that revised measures are required to overcome the limitations of existing measures.
减肥手术被认为是肥胖者最有效的减肥干预措施。然而，准确评估对于识别可能损害手术最佳效果的饮食失调至关重要。饮食失调的测量方法尚未在减肥手术患者中进行全面的心理测量评估，因此其效用尚不清楚。
参与者为108名成年人，他们在减肥手术后约12个月完成了心理测量。使用验证性因素分析（CFA）测试原始量表结构的拟合度，并使用探索性因素分析（EFA）生成替代因素解决方案。还评估了信度（内部一致性）和结构效度（收敛性和发散性）。
饮食失调检查问卷（EDE-Q）、修订后的饮食与体重模式问卷（QEWP-R）、三因素饮食问卷（TFEQ）和临床损害评估（CIA）。
CFA显示，没有一项原始的饮食失调测量方法达到足够的拟合统计量。EFA产生了修订后的量表，其信度有所提高（原始量表α=0.47-0.94；修订后量表α=0.76-0.98），并且与心理健康和损害测量的相关分析表明具有足够的收敛效度。EDE-Q和QEWP-R报告的饮食失调行为患病率有所不同。
心理测量评估不支持在减肥患者中使用原始形式的常用饮食失调测量方法。EDE-Q的修订版重复了最近对减肥手术候选人研究的结果。CIA和TFEQ的替代结构表明手术后饮食失调表现的差异。结果表明需要修订测量方法以克服现有测量方法的局限性。
