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P587. Assessing how IBD patients see themselves? Validation and first use of a targeted body image instrument

E. McDermott1, G. Mullen2, D. Keegan1, K. Byrne1, G. Doherty1, G. Cullen1, K. Malone3, H. Mulcahy1, 1St Vincent's University Hospital, Centre for Colorectal Disease, Dublin, Ireland, 2University College Dublin, Department of Clinical Psychology, Dublin, Ireland, 3St Vincent's University Hospital, Department of Psychiatry, Dublin, Ireland

Background

Body image refers to a person's sense of their own physical appearance. This can be influenced both positively and negatively by a number of factors including disease states and treatments. IBD carries a distinct psychosocial as well as a physical burden, but body image and dysfunction has never been formally studied in IBD patients, nor is there a validated body image questionnaire available for such patients.

Aim: To develop and validate a body image questionnaire for IBD patients and quantitatively and qualitatively assess it in an IBD population.

Methods

241 ambulatory IBD patients (median age 36 years; 130 male) completed a questionnaire that included validated psychosocial instruments in addition to a combined quantitative and qualitative modified body image disturbance questionnaire (BIDQ). Qualitative analysis was performed using the grounded theory methodology.

Results

Internal consistency of the BIDQ was demonstrated with a Cronbach alpha of 0.88. The mean BIDQ score was 2.3 (range 1–5). Construct validity was established by a correlation coefficient of 0.66 (p < 0.001) with other body image measures (Hopwood body image scale). Convergent validity was demonstrated with a correlation coefficient of between 0.45 and 0.61 (p < 0.001) with validated measures of psychosocial dysfunction. In addition, BIDQ was independently associated with poor quality of life using validated disease specific and general quality of life instruments. Qualitative analysis identified specific body image problems including steroid side effects, abdominal disfigurement, toilet usage and multiple physical symptoms. Psychosocial consequences included low self-esteem, anxiety, work and social disability and the need for significant work and life adjustments.

Conclusion

The modified BIDQ is a valid and consistent measure of body image in IBD patients and quantifies impairment as a combination of dissatisfaction, distress, dysfunction and poor quality of life.