ABSTRACT
There is sound evidence showing the efficacy of non-pharmacological interventions in lowering blood pressure (BP); however, adherence is usually poor. Interventions to induce behavioral changes aim to improve the ability to read labels, choose foods, and eat low-sodium meals, reinforcing adherence to sodium restriction. In this randomized parallel-controlled trial, we assessed the effectiveness of an educational intervention using the Dietary Sodium Restriction Questionnaire (DSRQ) scores. A follow-up period of 6 months was conducted. Participants were randomized into (1) an educational intervention provided by a registered dietitian on individual visits and dietary planning; (2) a control group with the usual care and dietary recommendations. Patients underwent 24-h ambulatory BP monitoring, 12-h fasting blood tests, spot urine collection, and assessment using DSRQ. We randomized 120 participants (67.5% women and 68.3% Caucasians), and 25 participants were lost to follow-up. The 24-h sodium urinary excretion changed in the control (Δ -1610 mg/day; 95% confidence interval [CI] -1800 to -1410) and intervention groups (Δ -1670 mg/day; 95% CI -1800 to -1450) over time. There was no significant difference in the 24-h estimated sodium between groups. In hypertensive patients, DSRQ-based educational intervention is effective for improving the ability to detect and overcome obstacles to a low-sodium restriction diet but is as effective as dietary recommendations for lowering sodium.
Subject(s)
Hypertension , Sodium, Dietary , Humans , Female , Male , Sodium , Hypertension/therapy , Diet, Sodium-Restricted , Sodium Chloride, Dietary , MealsABSTRACT
Objective:To test the reliability and validity of the Chinese version of Dietary Sodium Restriction Questionnaire in patients with chronic kidney disease.Methods:From July 2020 to February 2021, a total of 120 patients with chronic kidney disease admitted to the Zhongda Hospital Affiliated to Southeast University were assessed with the Chinese version of Dietary Sodium Restriction Questionnaire, and its reliability and validity were analyzed.Results:Exploratory factor analysis showed that KMO value was 0.783, three common factors were extracted, namely attitude and subjective norms, perceptual behavior control and cognition, which could explain 58.83% of the total variation. Cronbach α coefficient of internal consistency was 0.777, and Cronbach α coefficient of three common factors were 0.849, 0.824 and 0.752 respectively. Six experts scored the questionnaire, the CVI of each item were 0.83-1.00, and the average CVI was 0.968. The correlation coefficient between each item and the total score were 0.322-0.648 ( P<0.01). Conclusions:The Chinese version of Dietary Sodium Restriction Questionnaire has good reliability and validity in the study of sodium restriction diet compliance of patients with chronic kidney disease, and can be used as a tool to evaluate the cognition, attitude and behavior of patients with chronic kidney disease.
ABSTRACT
BACKGROUND: The effectiveness of nonpharmacological interventions in blood pressure reduction has been evidenced by several studies. Nevertheless, as adherence to a low-sodium diet is poor, interventions regarding habit changing should be of a motivational nature in order to develop the ability of overcoming obstacles regarding sodium-restriction behavior. The present study aims to describe the protocol and randomization of a clinical trial design in order to evaluate the effectiveness of an educational intervention based on Dietary Sodium Restriction Questionnaire (DSRQ) scores. The effectiveness measures are the DSRQ score variation and reduction in urinary sodium values from baseline to after 2 and 6 months. METHODS/DESIGN: This parallel, randomized clinical trial will include 120 participants, recruited and randomized as follows: 60 of them to be allocated to a sodium-restriction educational intervention group whose results are based on the DSRQ application; and the other 60 allocated to a control group with usual care. Educational orientation and usual care sessions will be conducted once a month for a period of 6 months. Both spot urine collection - estimating sodium intake - and the DSRQ will be applied at the baseline, in the eighth week and at the end of the follow-up. There will also be blood collection and 24-h ambulatory blood pressure monitoring (ABPM) at the beginning and end of the follow-up. Anthropometric measurements, blood pressure measurement and 24-h food recall will be collected during follow-up. DISCUSSION: The study "The effectiveness of an educational intervention to sodium restriction in patients with hypertension" is based on the results of the DSRQ application, whose objective is to evaluate aspects related to nonadherence to the recommendation of a low-sodium diet, identifying adherence barriers and facilitators, contributing to the planning of interventions for improving the adoption of a low-sodium diet and, consequently, hypertension control. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, Identifier: NCT02848690 . Registered retrospectively on 27 July 2016.
