Dietary Sodium Restriction Questionnaire Research Articles

Psychometric properties of the Iranian version of the thirst distress scale and dietary sodium restriction questionnaire for the elderly with heart failure.

Recognizing thirst distress and sodium intake restriction using valid and reliable tools enable evidence-based care, and improve treatment outcomes for the elderly with heart failure (HF). The present study investigated the psychometric properties of the thirst distress scale (TDS-HF) and dietary sodium restriction questionnaire for Iranian's elderly with HF (DSRQ-HF). This crossectional study was conducted during 2021-2022. Two hundred and forty elderly people referring to the cardiology clinics and offices in the western region of Mazandaran, Iran were selected by the convenient sampling method. First, the two questionnaires were translated. Then, face, content, and construct validity were assessed. Several indices were used to evaluate, including the chi-square/degree-of-freedom ratio (CMIN/DF), parsimonious normed fit index (PNFI), comparative fit index (CFI), parsimonious comparative fit index (PCFI). The value of content validity index of all items of the two questionnaires was higher than 0.62. The fit indices, including PCFI=0.594, PNFI=0.582, CMIN/DF=1.987, and CFI=0.979, confirmed the one-factor construct of TDS. PCFI=0.724, PNFI=0.661, CMIN/DF=1.935, ad CFI=0.905, indicated the confirmation of the three-factor construct of DSRQ. The value of Cronbach's alpha of the two questionnaires were 0.86. The value of Ω of the TDS-HF and DSRQ-HF were 0.858, and 0.860, respectively. The value of θ of the TDS-HF and DSRQ-HF were 0.858, and 0.861, representing the suitability of both constructs. The TDS-HF and DSRQ-HF can be used to measure the psychometric effects of diet therapy and behaviors of the elderly with HF in relation to adherence to diet therapy.

Efficacy of an Educational Intervention for Sodium Restriction in Patients with Hypertension: A Randomized Controlled Trial

There is sound evidence showing the efficacy of non-pharmacological interventions in lowering blood pressure (BP); however, adherence is usually poor. Interventions to induce behavioral changes aim to improve the ability to read labels, choose foods, and eat low-sodium meals, reinforcing adherence to sodium restriction. In this randomized parallel-controlled trial, we assessed the effectiveness of an educational intervention using the Dietary Sodium Restriction Questionnaire (DSRQ) scores. A follow-up period of 6 months was conducted. Participants were randomized into (1) an educational intervention provided by a registered dietitian on individual visits and dietary planning; (2) a control group with the usual care and dietary recommendations. Patients underwent 24-h ambulatory BP monitoring, 12-h fasting blood tests, spot urine collection, and assessment using DSRQ. We randomized 120 participants (67.5% women and 68.3% Caucasians), and 25 participants were lost to follow-up. The 24-h sodium urinary excretion changed in the control (Δ −1610 mg/day; 95% confidence interval [CI] −1800 to −1410) and intervention groups (Δ −1670 mg/day; 95% CI −1800 to −1450) over time. There was no significant difference in the 24-h estimated sodium between groups. In hypertensive patients, DSRQ-based educational intervention is effective for improving the ability to detect and overcome obstacles to a low-sodium restriction diet but is as effective as dietary recommendations for lowering sodium.

Self-care Practices of Patients With Heart Failure Using Wearable Electronic Devices: A Systematic Review.

Heart failure (HF) is the fastest growing cardiovascular condition globally; associated management costs and hospitalizations place an immense burden on healthcare systems. Wearable electronic devices (WEDs) may be useful tools to enhance HF management and mitigate negative health outcomes. We aimed to perform a systematic review to examine the potential of WEDs to support HF self-care in ambulatory patients at home. Five databases were searched for studies published between 2007 and May 2022, including OVID MEDLINE, EMBASE (OVID), APA PsycINFO (OVID), Cochrane Central Register of Controlled Trials (OVID), and CINAHL Plus with Full Text (Ebsco). After 6210 duplicates were removed, 4045 records were screened and 6 were included for review (2 conference abstracts and 4 full-text citations). All studies used WEDs as 1 component of a larger intervention. Outcome measures included quality of life, physical activity, self-efficacy, self-care, functional status, time to readmission, social isolation, and mood. Studies were of moderate to high quality and mixed findings were reported. Enhanced exercise habits and motivational behavior to exercise, as well as decreased adverse symptoms of fatigue and dyspnea, were identified in 2 studies. However, improvements in exercise capacity and increased motivational behavior did not lead to exercise adherence in another 2 studies. The findings from this review suggest that WEDs may be a viable health behavior improvement strategy for patients with HF. However, studies of higher quality, with the primary intervention being a WED, and consistent outcome measures are needed to replicate the positive findings of studies identified in this review.

Linking salt preference to enjoyment of low sodium diet in patients with heart failure

Abstract Background Preference for salty foods is linked to dietary sodium intake. Increased salt preference is a barrier to low sodium diet (LSD) adherence due to perceived poor taste. Although patients with heart failure (HF) are advised to follow a LSD, the adherence remains poor. Understanding the relationship among attitudes, subjective norms (individuals' beliefs about how much they follow the advice of respected others), and perceived control for following a LSD, salt preference, and LSD enjoyment will help in designing interventions to increase adherence in patients with HF. Purpose The purpose of this study was to examine whether attitudes toward following a LSD, subjective norms about LSD, and perceived behavioral control for following a LSD mediated the association between salt preference and enjoyment of a LSD in patients with HF. Methods In this cross-sectional study, outpatients with HF completed the Dietary Sodium Restriction Questionnaire (DSRQ) based on the Theory of Planned Behavior, and rated salt preference and enjoyment of a LSD on a scale from 0 to 10 with 10 indicating the highest salt preference and enjoyment of LSD. Parallel mediation analyses were conducted using the PROCESS macro program in SPSS with 5,000 bootstrap samples controlling for age and gender. Three subscales of the DSRQ (i.e., attitude, subjective norms, and perceived behavioral control) were used as mediators. Results A sample of 117 patients with HF (65% male, mean age = 61.2±14.3, range 27 to 94, 82% white) completed the study. The mean salt preference rating was 5.26 (SD=2.7), and the LSD enjoyment rating was 4.56 (SD=2.5). Salt preference was not directly associated with LSD enjoyment (direct effect = −0.0506, 95% CI: [−0.2394, 0.1381]). There was a significant indirect effect of salt preference on the enjoyment of LSD through perceived behavioral control (indirect effect = −0.1178, 95% CI: [−0.0321, 0.0446]) (Figure 1). Patients with a high salt preference were more likely to have low levels of LSD enjoyment through the mediator of having low levels of perceived behavioral control over following a LSD. Subjective norms and attitudes toward LSD were not significant mediators of the association between salt preference and LSD enjoyment. Conclusion High preference for salty food decreased perceived behavioral control of LSD, which reduced enjoyment of LSD in patients with HF. Salt preference and perceived behavioral control in LSD are behavioral barriers in hedonic shift in LSD enjoyment. The findings suggest that intervention to promote LSD adherence should include strategies to increase perceived behavioral control in eating LSD and decreasing salt preference. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health in the USA

Psychometric Properties of the Turkish Version of the Dietary Sodium Restriction Questionnaire.

Sodium restriction is the primary nonpharmacological treatment in heart failure (HF) to prevent rehospitalization and reduce HF symptom burden. Despite the importance of restricting sodium in the diet, the prevalence of nonadherence to a low-sodium diet has been known to be high. To reduce the high prevalence of nonadherence, we have to know the facilitating and challenging factors. The planned behavior theory shows those factors, including attitudes, social norms, and perceived behavioral control. The Dietary Sodium Restriction Questionnaire (DSRQ) was developed based on the planned behavior theory. However, in Turkey, the psychometric properties of this instrument have not been studied yet. Therefore, the aim of this study was to conduct a psychometric testing of the Turkish version of the DSRQ among patients with HF. Data were collected from 300 patients who were recommended a sodium-restricted diet because of a diagnosis of HF. Validity was tested using content validity index, Kendall W, and exploratory and confirmatory factor analyses. Reliability was tested using item-total and interitem correlations, Cronbach's α coefficient of reliability, independent-sample t test, and test-retest analysis. The exploratory factor analysis revealed that 3 factors accounted for 78.2% of the explained variance. The factor loads ranged between 0.67 and 0.96. The results of the confirmatory factor analysis showed goodness-of-fit indices greater than 0.90, with a root-mean-square error of approximation less than 0.10 and a root-mean-square residual of 0.05. The Cronbach's α coefficient for DSRQ was 0.92 and for each subscale was as follows: attitude and subjective norm, 0.97; perceived external behavior control, 0.89; and perceived internal behavior control, 0.83. The DSRQ is a valid and reliable instrument in assessing the attitudes, beliefs, and perceived behavioral control related to following a low-sodium diet of patients with HF in the Turkish population.

THE DESCRIPTIONS OF SALT CONSUMPTION AMONG FARMERS WITH HYPERTENSION IN PUBLIC HEALTH SERVICES OF PANTI DISTRICT, JEMBER REGENCY

Farmers with hypertension need to restricting their sodium intake to have a better condition. The purpose of this study was describe the restricting sodium intake among farmers with hypertension in Panti District, Jember Regency. A cross-Sectional study design was conducted among 131 hypertensive farmers using consecutive sampling. A self-administered questionnaire was used to identify the socio-demography of farmers. Dietary Sodium Restriction Questionnaire (DSRQ-I) and Sphygmomanometer was used to measured restricting sodium intake and blood pressure among farmers with hypertension, respectively. One sample t test was used to analyze the objective of the study (p >0,05). Among 131 farmers with hypertension were experienced 75,6% of hypertension systolic stage I and 74,8% of hypertension diastolic stage I, respectively. Meanwhile, score of subjective attitudes and norms was 27,29 ± 4,602 among farmers with hypertension. Meanwhile, farmers with hypertension have a bad attitude toward limiting sodium intake. Furthermore, score of control of perceived behavior was 17,12 ± 4,237 among farmers with hypertension. Meanwhile, farmers with hypertension have many obstacles to limiting their sodium intake. Therefore, monitoring of blood pressure and regulating of restricting sodium intake among farmers with hypertension should be maintained regularly per month through Posyandu Non-Communicable Disease (PTM).

Heart Failure Patients’ Knowledge and Barriers of Low Sodium Diet Adherence in Erbil City

Background and objective: A low sodium diet is a cornerstone of non-pharmacologic therapy for heart failure patients. The objective of the study was to assess knowledge and perceived barriers of low sodium diet adherence of heart failure patients in Erbil City.Methods: A descriptive, cross-sectional study design was conducted among a sample of 50 patients diagnosed heart failure in Medical Wards and Cardiac Care Units at both Rizgary and Hawler Teaching Hospitals in Erbil City from Feb 2018 to Oct 2019. Patients who met the inclusion criteria were selected for participation of the study, interviews based on a questionnaire patient’s sociodemographic, clinical characteristics and the Dietary Sodium Restriction Questionnaire (DSRQ). Frequency, percentage, and the chi-square test were used for analyzing data.Results: The results show that majority of heart failure patients were low knowledge (80%) and high perceived barriers (66%) to low sodium diet adherence. There were significant associations between knowledge and barrier with age group (p-value=0.01; p-value=0.04), gender, (p-value=0.00; p=0.05), level of education (p-value=0.00; p-value=0.02) and economic status (p-value= < 0.001; p-value= <0.001).Conclusion: Results of the study show that heart failure patients had low knowledge and perceived more barriers to adherence of low sodium diet.

Attitudes, beliefs and barriers for adherence to the hyposodic diet in patients with heart failure.

To identify attitudes, beliefs and barriers to adherence to the hyposodic diet in patients with heart failure and associated factors. Cross-sectional study with 41 individuals. The Dietary Sodium Restriction Questionnaire was used. Fisher's test was applied for analysis. Attitudes were based on family and professional relationships; in the beliefs, it was highlighted to believe in the diet to improve health. As barriers, insufficient efforts were found to change the diet and taste of low salt foods. It was associated with adherence among the components factors such as: income, perception of cardiac improvement with the diet, family history of renal and heart failure and family adherence to the diet. The identified attitudes and beliefs refer, respectively, to social relationships and trust in the diet to improve health status. The barriers were: insufficient effort to modify the diet and food palatability. Economic, family and clinical factors were associated with hyposodic adherence.

Factors Influencing Low Sodium Intake in People with Non-Dialysis Dependent Chronic Kidney Disease.

To evaluate dietary sodium intake in people with chronic kidney disease (CKD) and identify contributing factors to low sodium intake by applying the Theory of Planned Behaviour (TPB) framework. Non-dialysed people with CKD completed a 24-hour urinary sodium excretion test and Scored Salt Questionnaire (SSQ). A survey including socio-demographic information, Brief Illness Perception Questionnaire, Short Sodium Knowledge Survey and Dietary Sodium Restriction Questionnaire based on TPB measured the factors contributing to dietary adherence. Sixty-three people [age: 71 (IQR: 64-77); 27% female] participated with 80% having high urinary sodium excretion [median: 134 mmol/day (111; 183)] but only 40% reported high sodium intake [SSQ score = 53 (39; 75)]. Overall sodium knowledge was high in 57% of participants although only 33% had seen a dietitian. There was a positive correlation between attitude towards a low-sodium diet and subjective norm (social expectations), r = 0.44, p < 0.01; urinary sodium and the extent of perceived consequences of CKD (r = 0.26, p < 0.05); and the extent to which willpower was perceived as a barrier to adherence to dietary sodium restriction (r = 0.27, p < 0.05). Multiple regression analysis revealed taste of low-salt foods (β = 8.9, p < 0.01) explained 26.4% of variance in dietary sodium intake (R2 = 0.264, F(12, 34), p < 0.01). TPB successfully identified barriers to follow a low-sodium diet in non-dialysed people with CKD. Taste preferences, willpower, meeting social expectations and disease concern were identified as key contributing factors to adherence.

Analysis of dietary sodium intake level and its influencing factors in patients with heart failure

Objective To investigate the dietary sodium intake level of patients with heart failure and analyze its influencing factors, so as to provide reference for formulating dietary intervention strategies for patients with heart failure. Methods From July 2018 to April 2019, 153 patients with heart failure in the First Affiliated Hospital of Nanjing Medical University were selected as the subject by convenient sampling. The General Questionnaire and Dietary Sodium Restriction Questionnaire (DSRQ) were collected, and 24-hour urine sodium determination was used to assess the patient's dietary sodium intake level. Results A total of 155 questionnaires were distributed and 153 questionnaires were returned. The average dietary sodium intake of 153 patients with heart failure was (3 725.39±1 741.84) mg/d. The dietary sodium intake of 24 patients was within the recommended range (2 000-3 000 mg/d) , accounting for 15.7% (24/153) . The total score of the DSRQ was (54.83±9.15) , and the scores of attitude and subjective normative dimension, cognitive dimension and perceptual behavior control were (23.24±3.15) , (11.77±2.08) , and (19.82±6.13) , respectively.Univariate analysis showed different genders, tastes, dental health status, and whether the dietary sodium intake was different for patients prescribed a low-sodium diet, the differences were statistically significant (P<0.05) ; correlation analysis showed that appetite score and sodium intake in patients with heart failure was correlated, the difference was statistically significant (r=0.174, P=0.031) , and the sodium-stable diet behavioral control score was associated with sodium intake in patients with heart failure (r=-0.329, P<0.001) . Multiple linear regression analysis showed that the patient's gender, taste, and patient's perceptual behavioral control of sodium-restricted diet were the main influencing factors of dietary sodium intake in patients with heart failure, explaining 21.5% of the total variation in dietary sodium intake. Conclusions The dietary sodium intake of patients with heart failure is higher than the recommended amount of the guideline, and the current situation is not optimistic. In particular, health care workers should pay attention to individualized dietary guidance and interventions in men with low salty taste and low sodium-stable dietary behavioral scores to reduce heart failure and readmission rates. Key words: Heart failure; Sodium intake; Influencing factors

Adherence to diet and medication and the associated factors among patient with chronic heart failure in a multi-ethnic society

ObjectiveTo investigate diet adherence, medication adherence and self-care behaviour among patients with chronic heart failure (CHF) in a multi-ethnic society and identify the significant factors associated with their diet and medication adherence. MethodsA cross-sectional descriptive correlational study was conducted with a convenience sample of 107 patients with CHF recruited from two cardiology wards of a public tertiary hospital in Singapore. Study variables were measured using the Dietary Sodium Restriction Questionnaire, the Medication Adherence Rating Scale-5 items and the European Heart Failure Self-care Behaviour Scale-12 items. ResultsOur sample reported positive attitudes towards diet adherence, poor self-care behaviour, and good medication adherence. The multiple linear regression results indicated that lower income, Chinese ethnicity, diabetic complications, current smoking, lower New York Heart Association classification I and II, and poorer self-care behaviour predicted poorer diet adherence. In addition, absence of hypertension, having non-myocardial infarction as a cause of CHF, and moderately diminished ejection fraction were identified as significant predictors of poorer medication adherence. ConclusionThe findings from this study have established the need to improve current education and rehabilitation programmes for patients with CHF by addressing those factors significantly influencing their adherence to diet and medication.

Assessing Barriers to Healthy Eating in Hospitalized Older Adults With Heart Failure: Psychometric Properties of Two Questionnaires

Dietary sodium excess and malnutrition have been associated with poor outcomes in heart failure (HF). Few previous studies have examined the barriers to following a low-sodium, nutritionally robust diet in hospitalized patients with HF. As part of a dietary intervention pilot study, 76 inpatients with HF (age 71 ± 8 years, 30% female, 30% black, 36% Hispanic/Latino) completed 2 questionnaires, the Dietary Sodium Restriction Questionnaire (DSRQ) and the Brief Dietary Psychosocial Scale (BDPS), to assess challenges in following a low-sodium, nutritionally complete diet. We assessed the factor structure of the DSRQ and BDPS with confirmatory and exploratory factor analysis (CFA and EFA). CFA did not support the established 3-factor solution for the DSRQ; instead, EFA indicated that a 2-factor solution (subjective norms/attitudes and perceived behavioral control) provided the best fit for the data. EFA supported 4 separate factors for the BDPS, as in its original derivation. Cronbach's alphas supported internal consistency reliability for both scales (DSRQ: 0.85-0.94; BDPS: 0.72-0.95). In a mixed-ethnicity group of hospitalized older patients with HF, the DSRQ and BDPS have reasonable psychometric properties. These questionnaires may help identify barriers to healthy dietary practices and facilitate nutritional interventions in this high-risk population.

Cut-Point for Satisfactory Adherence of the Dietary Sodium Restriction Questionnaire for Patients with Heart Failure.

BackgroundThe low or non-adherence to reduction of sodium intake has been identified as one of the main precipitating factors of heart failure (HF). The Dietary Sodium Restriction Questionnaire (DSRQ) identifies factors that can interfere with adherence to this recommendation. However, there is still no cut-point to define adherence for this questionnaire.ObjectivesTo identify the cut-point for satisfactory adherence to the Brazilian version of the DSRQ, (the Questionário de Restrição de Sódio na Dieta, QRSD).MethodsMulticenter study. Patients with HF in outpatient treatment (compensated) and those treated in emergency departments due to acute HF (decompensated) were included. For the cut-point definition, the DSRQ scores were compared between groups. A ROC curve was constructed for each subscale to determine the best point of sensitivity and specificity regarding adherence. A 5% significance level was adopted.ResultsA total of 206 compensated patients and 225 decompensated were included. Compensated patients exhibited scores that showed higher adhesion in all subscales (all p <0.05). Scores ≥ 40 points of a total of 45 for the subscale of Attitude and Subjective Norm; scores ≤ eight of a total of 20 for Perceived Behavioral Control; and ≤ three of a total of 15 for Dependent Behavior Control were indicative of satisfactory adherence.ConclusionsBased on the evaluation of patients in these two scenarios, it was possible to determine the cut-point for satisfactory adherence to the reduction of sodium in the diet of patients with HF. Countries with similar culture could use this cut-point, as other researchers could also use the results as a reference for further studies.

Psychometric Testing of the Indonesian Version of Dietary Sodium Restriction Questionnaire Among Patients with Hypertension

PurposeThe purpose of this research was to test the validity and reliability of the Indonesian version of the Dietary Sodium Restriction Questionnaire (DSRQ-I) among patients with hypertension. MethodsThe cross-sectional study enrolled hypertensive patients from a cardiac outpatient department in Indonesia using convenience sampling. Eligible patients received a demographic questionnaire and DSRQ-I during a one-month period of data collection. Content and construct analysis examined the validity, whereas internal consistency assessment checked reliability. Participation required 10–15 minutes on average. ResultsOne hundred thirty-five patients participated: mostly females (54.1%) and married (82.9%) with mean age of 58.18 ± 10.44 years. The item of content validity index was .97, and subscale content validity index was .81 for DSRQ-I. The Kaiser–Meyer–Olkin test gave a value of .83, indicating adequate sampling, and the Bartlett's test of sphericity reached significant result (p < .001). The principal component analysis indicated three components, with 64.2% explaining variance, including perceived behavioral control (35.5%), attitude (19.3%), and subjective norm (9.4%). Confirmatory factor analysis produced a parsimonious model on the three-factor outcome by removing a single item. The indices of good fit model was achieved at χ2/df = 2.17, goodness fit index = .85, root mean square error of approximation = .09, standardized root mean square means = .07, and Bentler comparative fit index = .90 (p < .001). Cronbach's alpha coefficients for attitude, subjective norm, and perceived behavioral control were .85, .87, and .85, respectively. All interitem and item-total correlations indicated adequate outcome and acceptable result. Consequently, 15 items were determined reliable measurement and included in the final version of DSRQ-I. ConclusionThe DSRQ-I is a valid and reliable instrument to measure facilitators and barrier of sodium restriction among hypertensive patients in Indonesia.

Knowledge, barriers and attitudes toward dietary sodium in patients with decompensated heart failure

Background and objective: Nonadherence to sodium restriction is one of the main precipitating factors of heart failure (HF) decompensation. The three-subscale Dietary Sodium Restriction Questionnaire (DSRQ) enables evaluation of factors that can interfere with adherence. The objective of this study was to assess knowledge, barriers, and attitudes of patients with decompensated HF toward dietary sodium, by comparing those hospitalized for decompensation due to dietary nonadherence (alone or with medication nonadherence) versus those admitted for decompensation due to other causes.Methods: Cross-sectional study carried out at the emergency departments of two public hospitals in Southern Brazil between 2013 and 2014. The sample included patients admitted for decompensated HF. Patients were divided into two groups: decompensation due to nonadherence to diet (alone or with medication nonadherence) and other causes.Results: A total of 225 patients were included (mean age 66 ± 12 years). Patients exhibited a high degree of knowledge about sodium restriction (up to 50\% achieved 40 of 45 points). The opinions of family and health professionals influenced adherence. The main barriers to adherence concerned palatability and dietary preferences. When compared to patients admitted for other causes, those decompensated due to nonadherence had lower ejection fraction (p = .004) and higher Perceived Behavioral Control subscale scores (p = .009).Conclusions: Patients have a high level of knowledge about sodium restriction. The opinion of significant others affects adherence. Nonadherent patients appeared to be more severely ill and endorsed a greater number of barriers that prevent adequate behavior. Some factors-particularly the taste of foods and patients’ dietary preferences – may justify the high prevalence of nonadherence.

The effectiveness of an educational intervention for sodium restriction in patients with hypertension: study protocol for a randomized controlled trial

BackgroundThe effectiveness of nonpharmacological interventions in blood pressure reduction has been evidenced by several studies. Nevertheless, as adherence to a low-sodium diet is poor, interventions regarding habit changing should be of a motivational nature in order to develop the ability of overcoming obstacles regarding sodium-restriction behavior.The present study aims to describe the protocol and randomization of a clinical trial design in order to evaluate the effectiveness of an educational intervention based on Dietary Sodium Restriction Questionnaire (DSRQ) scores. The effectiveness measures are the DSRQ score variation and reduction in urinary sodium values from baseline to after 2 and 6 months.Methods/designThis parallel, randomized clinical trial will include 120 participants, recruited and randomized as follows: 60 of them to be allocated to a sodium-restriction educational intervention group whose results are based on the DSRQ application; and the other 60 allocated to a control group with usual care. Educational orientation and usual care sessions will be conducted once a month for a period of 6 months. Both spot urine collection – estimating sodium intake – and the DSRQ will be applied at the baseline, in the eighth week and at the end of the follow-up. There will also be blood collection and 24-h ambulatory blood pressure monitoring (ABPM) at the beginning and end of the follow-up. Anthropometric measurements, blood pressure measurement and 24-h food recall will be collected during follow-up.DiscussionThe study “The effectiveness of an educational intervention to sodium restriction in patients with hypertension” is based on the results of the DSRQ application, whose objective is to evaluate aspects related to nonadherence to the recommendation of a low-sodium diet, identifying adherence barriers and facilitators, contributing to the planning of interventions for improving the adoption of a low-sodium diet and, consequently, hypertension control.Trial registration numberClinicalTrials.gov, Identifier: NCT02848690. Registered retrospectively on 27 July 2016.

Long-Term Adherence to Low-Sodium Diet in Patients With Heart Failure.

Although following a low-sodium diet (LSD) for heart failure (HF) has been recommended for decades, little is known about factors related to long-term patient adherence. The purposes of this study were to (a) compare sodium intake and factors affecting adherence in a long-term adherent group and in a non-adherent group and (b) examine predictors of membership in the long-term adherent group. Patients with HF ( N = 74) collected 24-hr urine samples and completed the Dietary Sodium Restriction Questionnaire and the Patient Health Questionnaire-9. Long-term adherence was determined using the Stage of Dietary Behavior Change Scale. The long-term adherent group had lower sodium intake (3,086 mg vs. 4,135 mg, p = .01) and perceived more benefits from LSD than the non-adherent group. Only positive attitudes toward LSD predicted membership in the long-term adherence group (odds ratio [OR] = 1.18, p = .005). Interventions focused on enhancing positive perceptions of the benefits of an LSD may improve long-term dietary adherence in patients with HF.

Validity and reliability of the dietary sodium restriction questionnaire in patients with hypertension.

The study aimed to evaluate the reliability and the validity of the dietary sodium restriction questionnaire (DSRQ) in patients with hypertension receiving outpatient treatment at a tertiary care university hospital in Southern Brazil. This instrument is composed of three subscales: attitude, subjective norm and perceived behavioral control. A total of 104 patients were included. They were 63.3±8.9 years old and 75% were females. Cronbach's alpha coefficient for the subscales of attitude, subjective norm and perceived behavioral control were 0.75, 0.37 and 0.82, respectively. The PCA with the extraction of three factors explained a total of 53.5% of the variance. The data suggest that the 15-item DSRQ is reliable and has internal consistency of its construct to measure the barriers and the attitudes of hypertensive patients related to dietary sodium restriction and may be useful to improve blood pressure control.

Does the Theory of Planned Behavior Predict Dietary Sodium Intake in Patients With Heart Failure?

Sodium intake in heart failure (HF) is a crucial but poorly understood phenomenon. Theoretical models promote understanding and provide a context for rational appraisal of complex situations. The purpose of this study was to determine which factors were associated with sodium intake in HF patients using theory of planned behavior (TPB). In this study, patients' ( N = 244) attitudes, subjective norms, and perceived behavioral control (tenets of the TPB) were assessed using the Dietary Sodium Restriction Questionnaire. Sodium intake was estimated objectively by 24-hr urinary sodium excretion (UNa). The average UNa was 3,811 mg. Subjective norms, gender, and New York Heart Association functional class were associated with sodium intake ( p < .001). Thus, it is important for health care providers to clearly express their approval of following low-sodium diet to their HF patients, and include significant others in interventions to help patients develop/maintain a positive subjective norm to decrease sodium intake and reduce HF exacerbations.

220 - Cut-Point for Satisfactory Adherence of the Dietary Sodium Restriction Questionnaire for Patients With Heart Failure

220 - Cut-Point for Satisfactory Adherence of the Dietary Sodium Restriction Questionnaire for Patients With Heart Failure