Clinical InvestigationA Trial of Family Partnership and Education Interventions in Heart Failure
Section snippets
Design
A 3-group randomized design with data collected at baseline (BL), and after 4 and 8 months was used. HF patients and 1 FM were randomized as dyads. The 3 randomization groups were: 1) UC, 2) PFE, and 3) FPI. The intervention was provided 1–2 months after BL measures were obtained. The time frame from BL to 4 months was considered to be the initiation phase of behavior change, and the time frame from 4 to 8 months was considered to be the maintenance phase of behavior change. We expected to see
Sample Characteristics
The recruitment procedures resulted in 170 consented dyads, and the CONSORT chart (Fig. 1) reflects randomization/attrition from groups. There was an overall attrition rate of 31% between consent and BL data collection because of 2 deaths and 51 withdrawals or loss to follow-up due to the HF patients' progressive illness, FM illness or dropout, loss of interest in the study, travel, or other activities that interfered with ability to participate. Thus, 117 dyads completed the BL data
Discussion
Based on the objective 24-hour urinary Na measures, the theory-based FPI intervention reduced dietary Na intake compared with UC at 8 months. The FPI, in addition to the education and feedback, was effective in fostering the initiation and maintenance of lifestyle changes needed to reduce dietary Na. The data reflect a sustained effect of lowering dietary Na intake in the FPI group even though we expected to see little change between 4 and 8 months (maintenance). Telephone booster sessions that
Acknowledgement
The authors acknowledge Judy Robinson, RN, MSN, Kendaly Meadows, RN, MA, Bridget Fielder, RN, MSN, Christina Quinn, RN, PhD, and Caroline Coburn, RN, DNP, for their outstanding contributions to this project.
Disclosures
None.
References (66)
- et al.
Medication adherence among community-dwelling patients with heart failure
Mayo Clin Proc
(2011) - et al.
Relationship between psychosocial variables and compliance in patients with heart failure
Heart Lung
(2001) - et al.
A high-sodium diet is associated with acute decompensated heart failure in ambulatory heart failure patients: a prospective follow-up study
Am J Clin Nutr
(2011) - et al.
Patient teaching to promote behavioral change
Nurs Outlook
(2000) - et al.
Dyads affected by chronic heart failure: a randomized study evaluating effects of education and psychosocial support to patients with heart failure and their partners
J Card Fail
(2012) - et al.
Family caregiving for patients with heart failure: types of care provided and gender differences
J Card Fail
(2010) - et al.
Self-care behaviors among patients with heart failure
Heart Lung
(2002) - et al.
Daily self-monitoring of body weight, step count, fruit/vegetable intake, and water consumption: a feasible and effective long-term weight loss maintenance approach
J Acad Nutr Diet
(2012) - et al.
A new method of classifying prognostic comorbidity in longitudinal studies: development and validation
J Chron Dis
(1987) - et al.
Relation of loop diuretic dose to mortality in advanced heart failure
Am J Cardiol
(2006)
Treatment adherence in chronic disease
J Clin Epidemiol
Effect of a medication-taking behavior feedback theory-based intervention on outcomes in patients with heart failure
J Card Fail
Testing the psychometric properties of the Medication Adherence Scale in patients with heart failure
Heart Lung
Gender differences in adherence to the sodium-restricted diet in patients with heart failure
J Card Fail
Defining an evidence-based cutpoint for medication adherence in heart failure
Am Heart J
Evaluation of 2 methods for sodium intake assessment in cardiac patients with and without heart failure: the confounding effect of loop diuretics
Am J Clin Nutr
A group-based multi-professional education programme for family members of patients with chronic heart failure: effects on knowledge and patients' health care utilization
Patient Educ Couns
Factors related to nonadherence to low sodium diet recommendations in heart failure patients
Eur J Cardiovasc Nurs
Medication and dietary compliance beliefs in heart failure
West J Nurs Res
Factors influencing medication adherence in patients with heart failure
Heart Lung
Temporal trends in adherence to cardiovascular medications in elderly patients after hospitalization for heart failure
Clin Pharmacol Ther
Midsummer Eve in Sweden: a natural fluid challenge in patients with heart failure
Eur J Heart Fail
Factors associated with exacerbation of heart failure include treatment adherence and health literacy skills
Clin Pharmacol Ther
Characterization of the precipitants of hospitalization for heart failure decompensation
Am J Crit Care
Patient and informal caregivers' knowledge of heart failure: necessary but insufficient for effective self-care
Eur J Heart Fail
Increasing self-management skills in heart failure patients: a pilot study
Congest Heart Fail
Educational attainment has a limited impact on disease management outcomes in heart failure
Dis Manag
Family influences on self-management among functionally independent adults with diabetes or heart failure: do family members hinder as much as they help?
Chronic Illn
Family caregiving and congestive heart failure. Review and analysis
Eur J Heart Fail
Factors associated with caregiver burden in heart failure family caregivers
West J Nurs Res
Family influences on heart failure self-care and outcomes
J Cardiovasc Nurs
Social support and self care in heart failure
J Cardiovasc Nurs
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Funding: “A Family Partnership Intervention for Heart Failure” (RO1 R08800), National Institute of Nursing Research, National Institutes of Health (NIH), July 1, 2004–November 30, 2009; Public Health Service (PHS) grants M01 RR0039 from the General Clinical Research Center program and UL1 RR025008 from the Clinical and Translational Science Award program, National Center for Research Resources, NIH; and Nitromed.
See page 840 for disclosure information.