title: A trial of family partnership and education interventions in heart failure.
abstract: 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).
  
  
  RESULTS
  HF patient and family member (FM) dyads (n = 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 months. FPI and PFE reduced urinary Na at 4 months, and FPI differed from UC at 8 months (P = .016). Dietary Na decreased from BL to 4 months, with both PFE (P = .04) and FPI (P = .018) lower than UC. The proportion of subjects adherent to Na intake (≤2,500 mg/d) was higher at 8 months in PFE and FPI than in UC (χ(2)(2) = 7.076; P = .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 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.
authors: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia; School of Medicine, Emory University, Atlanta, Georgia. Electronic address: sbdunba@emory.edu.
authors: Sandra B
authors: SB
authors: Dunbar
authors: Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, Atlanta, Georgia.
authors: Patricia C
authors: PC
authors: Clark
authors: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia.
authors: Carolyn M
authors: CM
authors: Reilly
authors: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia.
authors: Rebecca A
authors: RA
authors: Gary
authors: School of Medicine, Emory University, Atlanta, Georgia.
authors: Andrew
authors: A
authors: Smith
authors: School of Public Health, Emory University, Atlanta, Georgia.
authors: Frances
authors: F
authors: McCarty
authors: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia.
authors: Melinda
authors: M
authors: Higgins
authors: Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia.
authors: Daurice
authors: D
authors: Grossniklaus
authors: School of Medicine, Emory University, Atlanta, Georgia.
authors: Nadine
authors: N
authors: Kaslow
authors: School of Medicine, Emory University, Atlanta, Georgia.
authors: Jennifer
authors: J
authors: Frediani
authors: College of Nursing, University of Alabama, Birmingham, Alabama.
authors: Carolyn
authors: C
authors: Dashiff
authors: Department of Psychology, University of Rochester, Rochester, New York.
authors: Richard
authors: R
authors: Ryan
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011368:Professional-Family Relations; D057566:Self Report / Q000592:standards; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D017673:Sodium Chloride, Dietary
keywords: Self management; adherence; autonomy support; dietary sodium; medication adherence