Psychometric Evaluation of Two Appetite Questionnaires in Patients With Heart Failure

• The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ) have sound psychometric properties in patients with heart failure (HF).
• CNAQ and SNAQ are unidimensional measures of appetite that are sensitive to HF severity.
• CNAQ and SNAQ are associated with symptoms of depression supporting construct validity.

BackgroundDecreased appetite in heart failure (HF) may lead to undernutrition which could negatively influence prognosis. Appetite is a complex clinical issue that is often best measured with the use of self-report instruments. However, there is a lack of self-rated appetite instruments. The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ) are validated instruments developed primarily for elderly people. Yet, the psychometric properties have not been evaluated in HF populations. The aim of the present study was to evaluate the psychometric properties of CNAQ and SNAQ in patients with HF.Methods and ResultsA total of 186 outpatients with reduced ejection fraction and New York Heart Association (NYHA) functional classifications II–IV were included (median age 72 y; 70% men). Data were collected with the use of a questionnaire that included the CNAQ and SNAQ. The psychometric evaluation included data quality, factor structure, construct validity, known-group validity, and internal consistency. Unidimensionality was supported by means of parallel analysis and confirmatory factor analyses (CFAs). The CFA results indicated sufficient model fit. Both construct validity and known-group validity were supported. Internal consistency reliability was acceptable, with ordinal coefficient alpha estimates of 0.82 for CNAQ and 0.77 for SNAQ.ConclusionsCNAQ and SNAQ demonstrated sound psychometric properties and can be used to measure appetite in patients with HF.