Trends in Psychiatry and Psychotherapy
Trends in Psychiatry and Psychotherapy
Original Article

Cross-cultural psychometric assessment of an appetite questionnaire for patients with cancer

Avaliação psicométrica transcultural de um questionário de apetite para pacientes com câncer

Maria Claudia Bernardes Spexoto; Sergio Vicente Serrano; Vanessa Halliday; João Maroco; Andrew Wilcock; Juliana Alvares Duarte Bonini Campos

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Abstract Objective To evaluate the psychometric properties, along with cross-cultural invariance analysis, of the Cancer Appetite and Symptom Questionnaire (CASQ). Method Data from 555 United Kingdom (UK) cancer patients were used to evaluate the psychometric properties of the CASQ. Construct validity was assessed through factorial and convergent validity. We conducted a confirmatory factor analysis using as indices the chi-square ratio by degrees of freedom (χ2/df), the comparative fit index (CFI), the goodness of fit index (GFI), and the root mean square error of approximation (RMSEA). Convergent validity was estimated by the items’ average variance extracted (AVE). Reliability was estimated by composite reliability and internal consistency. Factorial invariance analysis of the CASQ was evaluated by multigroup analysis (∆χ2) using the UK and Brazilian samples. Results All items showed adequate psychometric sensitivity in the UK sample. One item was removed and four correlations were included between errors with an appropriate fit of the model (χ2/df = 2.674, CFI = 0.966, GFI = 0.964, RMSEA = 0.055). The reliability of the CASQ was adequate and the convergent validity was low. The factorial structure of the CASQ differed across countries, and a lack of measurement invariance for the two countries was observed (λ: ∆χ2 = 64.008, p < 0.001; i: ∆χ2 = 3515.047, p < 0.001; Res: ∆χ2 = 4452.504, p < 0.001). Conclusion The CASQ showed adequate psychometric properties in the UK sample. The ability to estimate loss of appetite and the presence of symptoms was different between UK and Brazilian patients.


Cross-cultural study, cancer, symptom, appetite


Resumo Objetivos Avaliar as propriedades psicométricas, juntamente com a análise de invariância transcultural, do Questionário de Apetite e Sintoma para Pacientes com Câncer (Cancer Appetite and Symptom Questionnaire, CASQ). Métodos Dados de 555 pacientes com câncer do Reino Unido foram utilizados para avaliar as propriedades psicométricas do CASQ. A validade de construto foi estimada por meio das validades fatorial e convergente. Realizou-se análise fatorial confirmatória utilizando como índices a razão de qui-quadrado pelos graus de liberdade (χ2/gl), o comparative fit index (CFI), o goodness of fit index (GFI) e o root mean square error of aproximation (RMSEA). A validade convergente foi estimada pela variância extraída média (VEM). A confiabilidade foi estimada pela confiabilidade composta e consistência interna. A análise de invariância fatorial do CASQ foi avaliada por análise multigrupos (∆χ2) usando as amostras do Reino Unido e do Brasil. Resultados Todos os itens apresentaram adequada sensibilidade psicométrica na amostra do Reino Unido. Um item foi removido e foram incluídas quatro correlações entre erros, o que resultou em ajustamento adequado do modelo à amostra (χ2/df = 2,674, CFI = 0,966, GFI = 0,964, RMSEA = 0,055). A confiabilidade do CASQ foi adequada e a validade convergente foi baixa. A estrutura fatorial do CASQ diferiu entre os países, e uma falta de invariância foi observada para os dois países (λ: ∆χ2 = 64,008, p < 0,001; i: ∆χ2 = 3515,047, p < 0,001; Res: ∆χ2 = 4452,504, p < 0,001). Conclusão O CASQ apresentou adequadas propriedades psicométricas na amostra do Reino Unido. A capacidade de estimar a falta de apetite e a presença de sintomas foi diferente entre pacientes do Reino Unido e do Brasil.


Estudo transcultural, câncer, sintoma, apetite


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