PURPOSE: We examined how attitudes towards eating, self-esteem and body image influence health-related quality of life (HRQOL) in cystic fibrosis (CF) patients.
METHODS: Patients > 13 years who presented for routine healthcare voluntarily completed four surveys: 1) the revised Eating Attitudes Test (EAT), validated for CF patients by Abbott and colleagues, where higher scores reflect worse attitudes towards eating; 2) the Rosenberg Self-Esteem Scale (RSE), where higher scores reflect better self-esteem; 3) the Body Image Scale (BIS), developed for CF patients by Wenninger and colleagues, where higher scores reflect better body image; 4) the Cystic Fibrosis Questionnaire (CFQ), developed by Quittner and colleagues, where higher scores reflect better HRQOL. Also, FEV1%, body mass index (BMI), and pancreatic sufficiency or insufficiency (based on the need for pancreatic enzymes) was recorded. Regression analyses controlling for age, gender and BMI were used to examine the associations between the surveys.
RESULTS: This study included 37 patients with 41% males and a mean age of 26 years. The EAT was negatively associated with the RSE (p=0.015, adjusted R2=0.127), BIS (p=0.001, adjusted R2=0.221) and CFQ (p=0.015, adjusted R2=0.122). The RSE was positively associated with the CFQ (p=0.001, adjusted R2=0.346). The BIS was positively associated with the RSE (p=0.001, adjusted R2=0.529) and CFQ (p=0.001, adjusted R2=0.540). Neither BMI nor pancreatic function was associated with the surveys (p=NS). FEV1% was positively associated with the CFQ (p=0.028, adjusted R2=0.106) but was not associated with the other surveys.
CONCLUSION: More negative attitudes towards eating predict worse self-esteem and body image, while more positive body image predicts better self-esteem. Also, attitudes towards eating, self-esteem and body image are significant predictors of HRQOL with body image being the most important predictor.
CLINICAL IMPLICATIONS: HRQOL is an important clinical outcome measure in CF. Clinicians need to be sensitive to attitudes towards eating, self-esteem and body image in CF patients, because they are important predictors of HRQOL.
DISCLOSURE: Sarika Joshi, No Product/Research Disclosure Information; Grant monies (from sources other than industry) NIH Grant AHRQ HS14009