A Trial of Family Partnership and Education Interventions in Heart Failure

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• 作者：S ; ra B. Dunbar ; Patricia C. Clark ; Carolyn M. Reilly ; Rebecca A. Gary ; Andrew Smith ; Frances McCarty ; Melinda Higgins ; Daurice Grossniklaus ; Nadine Kaslow ; Jennifer Frediani ; Carolyn Dashiff ; Richard Ryan
• 关键词：Self management ; adherence ; dietary sodium ; medication adherence ; autonomy support
• 刊名：Journal of Cardiac Failure
• 出版年：December, 2013
• 年：2013
• 卷：19
• 期：12
• 页码：829-841
• 全文大小：690 K

文摘

Background

Lowering dietary sodium and adhering to medication regimens are difficult for persons with heart failure (HF). Because these behaviors often occur within the family context, this study evaluated the effects of family education and partnership interventions on dietary sodium (Na) intake and medication adherence (MA).

Methods and Results

HF patient and family member (FM) dyads (n聽= 117) were randomized to: usual care (UC), patient-FM education (PFE), or family partnership intervention (FPI). Dietary Na (3-day food record), urinary Na (24-hour urine), and MA (Medication Events Monitoring System) were measured at baseline (BL) before randomization, and at 4 and 8聽months. FPI and PFE reduced urinary Na at 4聽months, and FPI differed from UC at 8聽months (P聽=聽.016). Dietary Na decreased from BL to 4聽months, with both PFE (P聽=聽.04) and FPI (P聽=聽.018) lower than UC. The proportion of subjects adherent to Na intake (鈮?,500聽mg/d) was higher at 8聽months in PFE and FPI than in UC (蠂²₍₂₎聽=聽7.076; P聽=聽.029). MA did not differ among groups across time. Both FPI and PFE groups increased HF knowledge immediately after intervention.

Conclusions

Dietary Na intake, but not MA, was improved by PFE and FPI compared with UC. The UC聽group was less likely to be adherent with dietary Na. Greater efforts to study and incorporate family-focused education and support interventions into HF care are warranted.