Family Functioning Impacts Effectiveness of Education Interventions to Reduce Dietary Sodium

Study Questions:

Can you reduce sodium intake in patients with heart failure (HF) if, in addition to patient education on self-care needs and dietary counseling, you educate the patients’ families about how to give support, communication skills, empathy, and autonomy support?


Secondary analysis was conducted from a three-group randomized control trial of usual care, patient family education, and family partnership interventions. Usual care education came from educational pamphlets. Patient family education came from pamphlets and 1- and 2-hour education sessions on self-care and dietary counseling. Family partnership interventions used patient family education and also included two additional 2-hour group sessions on how to give support, communication, empathy, and autonomy support.


Participants with poorly functioning families had significant improvement in levels of sodium intake compared with baseline when intense family-focused intervention was included in patient education programs at 4 months (p = 0.024) and 8 months (p = 0.018) when compared with the usual care group. The most significant improvement was in women (p = 0.01) and those with depression (p = 0.05).


In poorly functioning families, patient education concerning HF should include not only self-care and recognition of symptoms but also how to improve family communication.


Social support has been shown to improve outcomes in patients with HF. It is important to recognize that lower functioning families will need additional instruction on how to improve family communication.

Clinical Topics: Heart Failure and Cardiomyopathies, Prevention, Acute Heart Failure

Keywords: Communication, Counseling, Empathy, Family Relations, Heart Failure, Pamphlets, Secondary Prevention, Self Care, Social Support, Sodium, Dietary

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