Secondary Logo

Institutional members access full text with Ovid®

Share this article on:

Depressive Symptoms Moderate the Association Between Appetite and Health Status in Patients With Heart Failure

Andreae, Christina, RN; Strömberg, Anna, PhD, RN; Chung, Misook, L., PhD, RN; Hjelm, Carina, PhD, RN; Årestedt, Kristofer, PhD, RN

The Journal of Cardiovascular Nursing: March/April 2018 - Volume 33 - Issue 2 - p E15–E20
doi: 10.1097/JCN.0000000000000428
Feature Article/Online Only

Background: Decreased appetite and depressive symptoms are clinical problems in patients with heart failure. Both may result in impaired health status.

Objective: The aims of this study were to investigate the association between appetite and health status in patients with heart failure and to explore whether depressive symptoms moderate this association.

Methods: In this cross-sectional study, patients with heart failure (n = 186; mean age, 71 years), New York Heart Association class II to IV, participated. Data on appetite (Council of Nutrition Appetite Questionnaire), depressive symptoms (Patient Health Questionnaire-9), and health status (EQ-5D 3-level scale [EQ-5D-3L] descriptive system, EQ-5D-3L index, and EQ Visual Analog Scale) were collected by self-rating questionnaires. Pearson correlation was used to investigate the association between appetite and health status. Multiple regression was performed to examine whether depressive symptoms moderate the association between appetite and health status.

Results: There was a significant association between appetite and health status for EQ-5D-3L descriptive system, mobility (P < .001), pain/discomfort (P < .001), and anxiety/depression (P < .001). This association was also shown in EQ-5D-3L index (P < .001) and EQ Visual Analog Scale (P < .001). Simple slope analysis showed that the association between appetite and health status was only significant for patients without depressive symptoms (B = 0.32, t = 4.66, P < .001).

Conclusions: Higher level of appetite was associated with better health status. In moderation analysis, the association was presented for patients without depressive symptoms. Decreased appetite is an important sign of poor health status. To improve health status, health professionals should have greater attention on appetite, as well on signs of depressive symptoms.

Christina Andreae, RN PhD Student, Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, Sweden, and Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.

Anna Strömberg, PhD, RN Professor, Division of Nursing Science, Department of Medical and Health Sciences, and Department of Cardiology, Linköping University, Sweden, and Program in Nursing Science, University of California Irvine.

Misook L. Chung, PhD, RN Professor, College of Nursing, University of Kentucky, Lexington.

Carina Hjelm, PhD, RN Lecturer, Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, Sweden.

Kristofer Årestedt, PhD, RN Professor, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden; Department of Research, Kalmar County Hospital, Kalmar Sweden; Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, Sweden.

This study was funded by the Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden; the Swedish Heart and Lung Foundation; King Gustaf V and Queen Victoria’s Freemason Foundation; and the Medical Research Council of Southeast Sweden.

The authors have no conflicts of interest to disclose.

Correspondence Christina Andreae, RN, Department of Medicine, Mälarsjukhuset, 63188 Eskilstuna, Sweden (christina.andreae@dll.se).

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved