title: Family education and support interventions in heart failure: a pilot study.
abstract: BACKGROUND
  Self-management of dietary sodium restriction by persons with heart failure (HF) is difficult and usually occurs within the home setting and within a family context.
  
  
  OBJECTIVE
  To compare a patient and family education (EDUC) intervention with a combined education and family partnership intervention (EDUC + FPI) for effects on improving dietary sodium self-management in persons with HF.
  
  
  METHODS
  Patients with HF and a family member (FM) were randomized to EDUC (n = 29 dyads) or EDUC + FPI (n = 32 dyads). Participants with HF were primarily White males with a mean age of 61 years (+/-12). The FMs were primarily women and spouses and had a mean age of 54 years (+/-17). Self-reported dietary sodium (Diet NA) intake and 24-hr urinary sodium (Urine NA) were measured at baseline (BL) and 3 months (3M) after intervention. Data were analyzed with descriptive statistics, generalized least squares regression, paired t test, and chi-square test.
  
  
  RESULTS
  Groups did not differ by age, gender, or clinical variables; however, family functioning (Family APGAR) scores were slightly higher in the EDUC + FPI group at BL. Both groups decreased Diet NA and Urine NA from BL to 3M; the EDUC + FPI group showed greater decrease in Urine NA and had a greater percentage of those who decreased Urine NA by at least 15% (p = .04). Regression analysis to predict Urine NA revealed a significant Group x Time interaction (p = .03) when accounting for time-varying measures of body mass index (p = .001).
  
  
  CONCLUSIONS
  A family-focused intervention may be useful in reducing dietary sodium intake in persons with HF. The Urine NA results support the importance of incorporating family-focused education and support interventions into HF care.
authors.affiliation: Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA 30322, USA. sbdunba@emory.edu
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Dunbar
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Clark
authors.forename: Christi
authors.initials: C
authors.lastname: Deaton
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Smith
authors.forename: Anindya K
authors.initials: AK
authors.lastname: De
authors.forename: Marian C
authors.initials: MC
authors.lastname: O'Brien
mesh_terms: D003863:Depression; D005190:Family; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care; D012944:Social Support; D012982:Sodium, Dietary / Q000008:administration & dosage* / Q000009:adverse effects / Q000652:urine
chemical_list: D012982:Sodium, Dietary