Psychometric Evaluation Of Appetite Questionnaires In Elderly Polish Patients With Heart Failure

Figures & data

Table 1 Original And Polish Version Of The CNAQ And The SNAQ

Item	Original English Version Council On Nutrition Appetite Questionnaire [8]	Translated Polish Version Kwestionariusz Apetytu Rady ds. Żywienia
A**	My appetite is: 1) Very poor; 2) Poor; 3) Average; 4) Good; 5) Very good.	Poziom mojego apetytu określił(a)bym jako: 1) Bardzo słaby; 2) Słaby; 3) Przeciętny; 4) Dobry; 5) Bardzo dobry.
B**	When I eat: 1) I feel full after eating only a few mouthfuls; 2) I feel full after eating about a third of a meal; 3) I feel full after eating over half a meal; 4) I feel full after eating most of a meal; 5) I hardly ever feel full.	Kiedy jem, czuje się najedzony/a: 1) Już po kilku łyżkach/kęsach; 2) Po zjedzeniu ok. Jednej trzeciej posiłku; 3) Po zjedzeniu ponad połowy posiłku; 4) Po zjedzeniu większej części posiłku; 5) Prawie nigdy.
C	I feel hungry 1) Rarely; 2) Occasionally 3) Some of the time; 4) Most of the time; 5) All of the time.	Odczuwam głód: 1) Nigdy; 2) Rzadko; 3) Czasami; 4) Przez większość czasu; 5) Cały czas;
D**	Food tastes: 1) Very bad; 2) Bad; 3) Average; 4) Good; 5) Very good.	Jedzenie smakuje: 1) Bardzo źle; 2) Źle; 3) Przeciętnie; 4) Dobrze; 5) Bardzo dobrze.
E	Compared to when I was younger, food tastes: 1) Much worse; 2) Worse; 3) Just as good; 4) Better; 5) Much better.	W porównaniu z okresem, gdy miałem/am 50 lat, jedzenie smakuje: 1) Dużo gorzej; 2) Gorzej; 3) Tak samo; 4) Lepiej; 5) Dużo lepiej;
F**	Normally I eat: 1) Less than one meal a day; 2) One meal a day; 3) Two meals a day; 4) Three meals a day; 5) More than three meals a day.	Zazwyczaj zjadam: 1) Mniej niż jeden stały posiłek dzienne; 2) Jeden posiłek dziennie; 3) Dwa posiłki dziennie; 4) Trzy posiłki dziennie; 5) Więcej niż trzy posiłki dziennie (włączając przekąski);
G	I feel sick or nauseated when I eat: 1) Most times; 2) Often; 3) Sometimes; 4) Rarely; 5) Never.	Kiedy jem jest mi niedobrze lub odczuwam mdłości: 1) Prawie zawsze; 2) Często; 3) Czasami; 4) Rzadko; 5) Nigdy;
H	Most of the tome my mood is: 1) Very sad; 2) Sad; 3) Neither sad nor happy; 4) Happy; 5) Very happy.	Mój nastrój określił(a)bym zazwyczaj jako: 1) Bardzo zły; 2) Zły; 3) Ani dobry, ani zły; 4) Dobry; 5) Bardzo dobry;
Scoring	*The results are calculated by adding the numbers assigned to the patient’s response. A total of less than 28 should be a cause a concern.	*Wynik obliczamy poprzez zsumowanie cyfr powiązanych z odpowiedziami pacjenta. Wynik niższy niż 28 stanowi powód do niepokoju.

Notes: *Answers scored based on the following numerical scale: a=1; b=2; c=3; d=4; e=5. **Questions of the SNAQ.

Abbreviations: CNAQ, The Council on Nutrition Appetite Questionnaire; SNAQ, The Simplified Nutritional Appetite Questionnaire.

Table 2 Sociodemographic And Clinical Characteristics Of The Study Participants (n=103)

Parameter		n	%
Sex	Women	54	52
	Men	49	48
Age	65–70 years	36	35
	71–76 years	18	17
	77–82 years	17	17
	83–88 years	21	20
	>88 years	11	11
Marital status	Single	64	62
	In relationship	39	38
Education	None or primary	9	9
	Vocational	33	32
	Secondary	35	34
	Higher	26	25
NYHA class	II	33	32
	III	46	45
	IV	24	23
LVEF (%)	< 40	38	37
	40–49	43	42
	≥50	22	21
BMI (kg/m^2)	<22.9	34	33
	23–30.9	50	49
	>31	19	18
Medications*	Diuretics	81	79
	ACE inhibitors/ARB	75	73
	β- adrenolytics	82	80
	Digoxin	13	13
MNA	Malnourished	52	50
	At risk of malnutrition	45	44
	Normal nutritional status	6	6

Note: *Percentage does not add up to 100% because it was a multiple-choice question.

Abbreviations: NYHA, New York Heart Association; LVEF, left ventricular ejection fraction; BMI, body mass index; ACE, angiotensin-converting enzyme; ARB, angiotensin II receptor blockers.

Table 3 Score Distribution And Homogeneity For CNAQ And SNAQ

Item	Score Distribution (%)					Item-Total Correlation*
	I	II	III	IV	V	CNAQ	SNAQ
1.	18.4	29.1	34	10.7	7.8	0.83	0.88
2.	9.7	33	32	22.3	2.9	0.79	0.85
3.	11.7	40.8	40.8	6.8	0	0.65	–
4.	12.6	30.1	42.7	10.7	3.9	0.84	0.80
5.	29.1	27.2	39.8	1.9	1.9	0.69	–
6.	0	8.7	47.6	33	10.7	0.71	0.78
7.	11.7	35	26.2	15.5	11.7	0.83	–
8.	2.9	16.5	39.8	37.9	2.9	0.47	–

Notes: *Recommended level of rho was > 0.3. 1. My appetite is … 2. When I eat … 3. I feel hungry … 4. Food tastes … 5. Compared to when I was younger, food tastes … 6. Normally, I eat … 7. I feel sick or nauseated when I eat … 8. Most of the time my mood is …

Abbreviations: CNAQ, The Council on Nutrition Appetite Questionnaire; SNAQ, The Simplified Nutritional Appetite Questionnaire.

Table 4 Goodness-Of-Fit Indices For (CNAQ) And (SNAQ) (n=103)

Model	χ^2 Goodness Of Fit			RMSEA			CFI	TLI	SRMR
	χ^2	df	P Value	RMSEA	90% CI	P Value
CNAQ - I	65.04	20	0.00	0.15	0.11–0.19	0.00	0.89	0.85	0.06
CNAQ - II	18.06	14	0.20	0.05	0.00–0.12	0.43	0.99	0.98	0.04
SNAQ	1.93	2	0.38	0.00	0.00–0.19	0.47	1	1	0.02

Abbreviations: CNAQ, The Council on Nutrition Appetite Questionnaire; SNAQ, The Simplified Nutritional Appetite Questionnaire; RMSEA, Root Mean Square Error of Approximation; χ², Chi-squared; df, degrees of freedom; CI, confidence interval; CFI, Comparative Fit Index; TLI, Tucker-Lewis Index; SRMR, Standardized Root Mean Square Residual.

Table 5 Factor Loadings And Residual Variances For The Confirmatory Factor Analysis Models Of The CNAQ And SNAQ (n=103)

Item	CNAQ - Model I	CNAQ - Model II	SNAQ
1.	0.96 (0.36)	0.96 (0.37)	1.04 (0.22)
2.	0.74 (0.45)	0.81 (0.37)	0.74 (0.45)
3.	0.45 (0.41)	0.43 (0.43)	-
4.	0.81 (0.27)	0.79 (0.31)	0.73 (0.4)
5.	0.59 (0.55)	0.62 (0.52)	-
6.	0.55 (0.34)	0.55 (0.33)	0.55 (0.33)
7.	0.96 (0.48)	0.93 (0.53)	-
8.	0.36 (0.6)	0.38 (0.58)	-

Notes: 1. My appetite is … 2. When I eat … 3. I feel hungry … 4. Food tastes … 5. Compared to when I was younger, food tastes … 6. Normally, I eat … 7. I feel sick or nauseated when I eat … 8. Most of the time my mood is …

Abbreviations: CNAQ, The Council on Nutrition Appetite Questionnaire; SNAQ, The Simplified Nutritional Appetite Questionnaire.