Research MethodologyPsychometric Evaluation of Two Appetite Questionnaires in Patients With Heart Failure
Section snippets
Sample and Procedure
Data were obtained from a consecutive sample of patients diagnosed with reduced ejection fraction (HFrEF) who had a New York Heart Association (NYHA) functional classification of II–IV, were ≥18 years old, and were familiar with the Swedish language. Patients with renal failure on dialysis and patients with advanced cancer were excluded. A total of 316 patients were invited to participate in the study, of whom 186 accepted (59%). A comparison of nonparticipants and participants revealed no
Demographic and Clinical Characteristics
The majority of the 186 included patients were men (70%). The overall average age was 70 years (median 72, interquartile range [IQR] 65–78, range 31–89). Most patients cohabited with someone else (67%) and had HF symptoms (NYHA II 61%). The median body mass index was 28 kg/m2 (IQR 25–32). Ninety-four percent were being treated with beta-blocker, 60% with angiotensin-converring enzyme inhibitor, and 41% with angiotensin receptor blocker.
Data Quality and Item-Total Correlations
There were no missing responses for any of the items. All
Discussion
This is the 1st study to evaluate the psychometric properties of self-rating scales for measuring appetite in patients with HF. In this sample, we found that the CNAQ and SNAQ had sound psychometric properties regarding construct validity, known-group validity, and internal consistency. Appetite is an important variable to assess because it is related to undernutrition and survival. Having a valid appetite questionnaire is important for evaluating both changes of appetite over time and effects
Study Limitations
One study limitation is that a majority of the sample had mild HF symptoms, which might affect the generalizability to patients with severe HF symptoms. Nonetheless, the findings support that CNAQ and SNAQ are sensitive to symptom severity and probably can be used regardless of HF symptoms. The number of nonparticipants was relatively high and they were significantly older compared with the participants. However, no sex differences were detected and the sample included a wide age span.
Conclusion
Early detection of poor appetite in HF may prevent undernutrition. Both CNAQ and SNAQ are short instruments with sound psychometric properties. They can therefore be relevant tools for routine assessments of appetite in both HF care as well as in research. Even though SNAQ is shorter than CNAQ, we recommend that, where possible, the entire CNAQ scale be used owing to its greater reliability.
Disclosures
None.
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2023, Western Journal of Nursing ResearchAssessment and Management of Appetite Loss in Older Adults: An ICFSR Task Force Report
2023, Journal of Frailty and AgingAnorexia of Ageing: Pathway to Frailty and Sarcopenia
2022, Journal of Nutrition, Health and Aging
Funding: Center for Clinical Research, Sörmland County Council, Sweden, Swedish Heart and Lung Foundation, King Gustaf V and Queen Victoria's Freemason Foundation, and Medical Research Council of Southeast Sweden. Dr Sawatzky holds a Canada Research Chair (Tier 2) funded by the Canadian Institutes of Health Research.
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