Development of Koreans Gut Quotient Measurement Scales

Yoon Jin Choi; Jae Ho Cho; Dong Ho Lee; Dong Jin Song; Young Jae Kwon; Sung Min Baek; Yang Jin Kim; Min Ho Jang; Dong Han Lee; Ha Young Park; Min Cheol Kim; Ji An Yang

doi:10.4166/kjg.2019.73.6.341

Journal List > Korean J Gastroenterol > v.73(6) > 1128273

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Choi, Cho, Lee, Song, Kwon, Baek, Kim, Jang, Lee, Park, Kim, and Yang: Development of Koreans Gut Quotient Measurement Scales

Original Article

The Korean Journal of Gastroenterology 2019; 73(6): 341-349.

Published online: 27 June 2019

DOI: https://doi.org/10.4166/kjg.2019.73.6.341

Development of Koreans Gut Quotient Measurement Scales

Yoon Jin Choi^*, Jae Ho Cho^1,^*, Dong Ho Lee¹

, Dong Jin Song¹, Young Jae Kwon¹, Sung Min Baek¹, Yang Jin Kim¹, Min Ho Jang¹, Dong Han Lee², Ha Young Park², Min Cheol Kim², Ji An Yang³

Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.

¹Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

²Ildong Pharmaceutical Co., Ltd., Seoul, Korea.

³Sejong Cyber University Graduate School of Business, Seoul, Korea.

Correspondence to: Dong Ho Lee, Department of Internal Medicine, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. Tel: +82-31-787-7008, Fax: +82-31-787-4051, dhljohn@yahoo.co.kr

Equal contributor:

*The first two authors contributed equally to this work as co-first authors of this paper.

Received 27 January 2019 Revised 1 May 2019 Accepted 8 May 2019

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

The aim of this study was to develop ‘Koreans Gut Quotient Measurement Scales (GQ)’, in which Koreans respond to questionnaires about the subjective feelings and symptoms of their intestinal health status.

Methods

Among 66 items pooled from previous studies and 4 items that were added following a focus group interview, 15 items were chosen using the Delphi survey. The content validity was evaluated using the content validity ratio. Data collected from 1,120 people from the general public in Korea were analyzed to verify the reliability and validity of GQ.

Results

The finalized GQ consisted of 17 items (including two exploratory measurement items) that were classified into three independent factors based on exploratory factor analysis (EFA): ‘perceived intestine discomfort’, ‘bowel movement discomfort’, and ‘bowel movement control discomfort’. The discriminant and convergent validity of GQ were identified using EFA, reliability test, and confirmatory factor analysis. In addition, the criterion-related validity of GQ was identified using correlation and multiple regression analysis.

Conclusions

The GQ, which is a simplified intestinal health index developed based on an easy questionnaire for the public to understand, can be used as a tool for the public to evaluate their own intestinal health and determine when to visit clinics.

Keywords: Koreans Gut Quotient Measurement Scales, Scale development, Scale validity

Figures and Tables

Fig. 1

Process for developing ‘Koreans Gut Quotient Measurement Scales’.

Fig. 2

Formula for the 100 point conversion method of the quotient factor.

Fig. 3

Formula for ‘Koreans Gut Quotient Calculating’.

Table 1

Baseline Characteristics of the Study Subjects

Table 2

Exploratory Factor Analysis Results

^aExploratory factor analysis: Kaiser-Meyer-Olkkin (KMO) measure of sampling adequacy=0.899, Bartlett's test of sphericity χ²=6,222.479 (p<0.001, df=105), cumulative %=56.508%.

Table 3

Confirmatory Factor Analysis Results

AVE, average variance extracted; CCR, composite reliability.

^aConfirmatory factor analysis: χ²=559.533 (df=87), goodness of fit index (GFI)=0.935, adjusted goodness of fit index (AGFI)=0.910, root mean square residual (RMR)=0.026, normed fit index (NFI)=0.911, comparative fit index (CFI)=0.923, Tucke-Lewis index (TLI)=0.907, incremental fit index (IFI)=0.923, root mean square error of approximation (RMSEA)=0.070; ^bp<0.001.

Table 4

Internal Consistency Analysis Results

^aCorrelation is significant at the 0.001 level (2-tailed).

Table 5

Multiple Regression Analysis Results of Koreans Gut Quotient Measurement Scales Factors and Bowel Movement Frequency

^ap<0.001.

Table 6

Multiple Regression Analysis Results of Perceived Intestine Discomfort, Bowel Movement Discomfort, Bowel Movement Control Discomfort Factor and Overall Intestinal Symptoms

^ap<0.05; ^bp<0.01; ^cp<0.001.

Table 7

Multiple Regression Analysis Results of ‘Koreans Gut Quotient Measurement Scales’ Factors and Overall Intestinal Symptoms

^ap<0.05; ^bp<0.001.

Notes

^{Financial support} None.

^{Conflict of interest} None.

References

1. Guideline of functionality evaluation for health functional food - ‘help to maintain healthy bowel function’. Cheongju: National Institute of Food and Drug Safety Evaluation;2015.

2. Bourlioux P, Koletzko B, Guarner F, Braesco V. The intestine and its microflora are partners for the protection of the host: report on the Danone symposium “the intelligent intestine,” held in Paris, June 14, 2002. Am J Clin Nutr. 2003; 78:675–683.

3. Song KH, Jung HK, Min BH, et al. Development and validation of the Korean Rome III questionnaire for diagnosis of functional gastrointestinal disorders. J Neurogastroenterol Motil. 2013; 19:509–515.

4. Drossman DA. ROME IV functional gastrointestinal disorders: disorders of gut-brain interaction. 4th edition. Raleigh: Rome Foundation, Inc.;2017.

5. Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther. 1997; 11:395–402.

6. Boyce P, Gilchrist J, Talley NJ, Rose D. Cognitive-behaviour therapy as a treatment for irritable bowel syndrome: a pilot study. Aust N Z J Psychiatry. 2000; 34:300–309.

7. Patrick DL, Drossman DA, Frederick IO, DiCesare J, Puder KL. Quality of life in persons with irritable bowel syndrome: development and validation of a new measure. Dig Dis Sci. 1998; 43:400–411.

8. Groll D, Vanner SJ, Depew WT, et al. The IBS-36: a new quality of life measure for irritable bowel syndrome. Am J Gastroenterol. 2002; 97:962–971.

9. 80% of human immune cells are distributed intestinal, increase beneficial intestinal bacteria to prevent disease. [Internet]. Seoul: ChosunMedia Healthchosun;2015. 12. 08. cited 2019 Jan 31. Available from: http://health.chosun.com/site/data/html_dir/2015/12/07/2015120702710.html.

10. Churchill GA Jr. A paradigm for developing better measures of marketing constructs. J Mark Res. 1979; 16:64–73.

11. DeVellis RF. Applied social research methods series, Vol. 26. Scale development: theory and applications. Thousand Oaks: Sage Publications Inc.;1991.

12. Lawshe CH. A quantitative approach to content validity. Pers Psychol. 1975; 28:563–575.

13. Veldhuyzen van Zanten SJ, Chiba N, Armstrong D, et al. Validation of a 7-point global overall symptom scale to measure the severity of dyspepsia symptoms in clinical trials. Aliment Pharmacol Ther. 2006; 23:521–529.

14. Hensley RL. A review of operations management studies using scale development techniques. J Oper Manage. 1999; 17:343–358.

15. Woo JP. The concept and understanding of structural equation modeling with AMOS 4.0–20.0. Seoul: Hannarae Publishing Co.;2012.

16. Connell AM, Hilton C, Irvine G, Lennard-Jones JE, Misiewicz JJ. Variation of bowel habit in two population samples. Br Med J. 1965; 2:1095–1099.

17. Drossman DA, Sandler RS, McKee DC, Lovitz AJ. Bowel patterns among subjects not seeking health care. Use of a questionnaire to identify a population with bowel dysfunction. Gastroenterology. 1982; 83:529–534.

18. Heaton KW, Radvan J, Cripps H, Mountford RA, Braddon FE, Hughes AO. Defecation frequency and timing, and stool form in the general population: a prospective study. Gut. 1992; 33:818–824.

19. Talley NJ, Weaver AL, Zinsmeister AR, Melton LJ 3rd. Onset and disappearance of gastrointestinal symptoms and functional gastrointestinal disorders. Am J Epidemiol. 1992; 136:165–177.

20. Harari D, Gurwitz JH, Avorn J, Bohn R, Minaker KL. Bowel habit in relation to age and gender. findings from the national health interview survey and clinical implications. Arch Intern Med. 1996; 156:315–320.

21. Jeon SG, Sohn CI, Kim JE, et al. Bowel habits in routine check-up subjects. Korean J Med. 1999; 57:36–41.

22. Jun DW, Park HY, Lee OY, et al. A Population-based study on bowel habits in a Korean community: prevalence of functional constipation and self-reported constipation. Dig Dis Sci. 2006; 51:1471–1477.

SUPPLEMENTARY MATERIALS

Supplementary Table 1

Expert Delphi Survey Results for the Initial Items

Supplementary Table 2

Finalized Gut Quotient Consisting of 17 Items (Include two Exploratory Measurement Items)

Supplementary Table 3

Gut Quotient Results for the 1,120 Korean Samples

Supplementary Fig. 1

Input-output model for ‘Koreans Gut Quotient Calculating’.

TOOLS

ORCID iDs: Dong Ho Lee
https://orcid.org/0000-0002-6376-410X
Similar articles