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Randomized Controlled Trial
. 2016 Jul-Aug;45(4):311-8.
doi: 10.1016/j.hrtlng.2016.04.001. Epub 2016 May 9.

Family partnership and education interventions to reduce dietary sodium by patients with heart failure differ by family functioning

Sandra B Dunbar  1 , Patricia C Clark  2 , Kelly D Stamp  3 , Carolyn M Reilly  1 , Rebecca A Gary  1 , Melinda Higgins  1 , Nadine Kaslow  4
Affiliations
Randomized Controlled Trial

Family partnership and education interventions to reduce dietary sodium by patients with heart failure differ by family functioning

Sandra B Dunbar et al. Heart Lung. 2016 Jul-Aug.

Abstract

Objectives: Determine if family functioning influences response to family-focused interventions aimed at reducing dietary sodium by heart failure (HF) patients.

Background: Lowering dietary sodium by HF patients often occurs within the home and family context.

Methods: Secondary analysis of 117 dyads randomized to patient and family education (PFE), family partnership intervention (FPI) or usual care (UC). Dietary sodium measures were obtained from 3-day food record and 24-h urine samples.

Results: In the poor family functioning groups, FPI and PFE had lower mean urine sodium than UC (p < .05) at 4 months, and FPI remained lower than UC at 8 months (p < .05). For good family functioning groups, FPI and PFE had lower mean sodium levels by 3-day food record at 4 and 8 months compared to the UC group.

Conclusion: Optimizing family-focused interventions into HF clinical care maybe indicated.

Keywords: Adherence; Dietary sodium; Family functioning; Heart failure; Self-care.

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Conflict of interest statement

Disclosures: There are no disclosures or conflicts of interests.

Figures

Figure 1
Figure 1. 24-Hour Urinary Sodium (mg/day) Over Time By Group Stratified by Good and Poor Family Functioning (GFF)
24-Hour Urinary Sodium (mg/day) Over Time By Group Stratified by good and poor Family Functioning (GFF) Markers indicate means adjusted for covariates (gender, BDI and furosemide equivalents). Error Bars indicate 95% confidence intervals. For Poor GFF, there were significant overall group differences (p=.012). Sidak adjusted post hoc tests yielded significant group differences between UC and FPI at 4m (p=.024) and 8m (p=.018). Covariates were significant for the Poor FF strata: gender (p=.001) (women had lower sodium levels), BDI-II (p=.006) (subjects with higher depression had higher sodium levels) and furosemide equivalents (p=.010) (subjects with higher furosemide equivalents had higher sodium levels).
Figure 2
Figure 2. Three Day Food Record Dietary Sodium (mg/day) Over Time By Group Stratified by FAD-GFF
Three Day Food Record (3-DFR) Dietary Sodium Stratified by Good and Poor GFF (patient perspective). Markers indicate means adjusted for covariates (gender and BDI-II). Error Bars indicate 95% confidence intervals. For Good GFF, there were significant overall time differences (p=.024). Sidak adjusted post hoc tests yielded significant time differences between baseline and 4 months for the PFE group (p=.052) and FPI group (p=.028). The only significant covariate for the Good GFF strata was gender (p=.017) (women had lower sodium levels).
Figure 3
Figure 3. Percentage of Participants Adherent to ≤2500 mg/day Sodium Over Time By Group Stratified by FAD-GFF
Using Generalized Multilevel Models (binary response logit-link function) for the percentage of subjects meeting the recommended <=2500 mg/day sodium levels (percentages adjusted for covariates: gender, BDI and furosemide equivalents). For Good GFF PFE showed significant change from baseline to 8m (p=.024) and for Poor GFF at 8m the FPI group was significantly higher than UC (p=.011). For Poor GFF strata: gender (p=.010) and depression BDI (p=.052) were significant covariates.
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References

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