Family Education and Support Interventions in Heart Failure: a Pilot Study

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).

Discussion: 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.