Development and reliability of an instrument to measure psychosocial determinants of salt consumption among hypertensive patients

Abstract

Cornélio ME, Gallani MCBJ, Godin G, Rodrigues RCM, Mendes RDR, Nadruz W Junior. Development and reliability of an instrument to measure psychosocial determinants of salt consumption among hypertensive patients. Rev Latino-am Enfermagem 2009 setembro-outubro; 17 (5) C h a n g e s i n f o o d p a t t e r n s , w i t h l e s s vegetable consumption, increased use of meet and, recently, industrialized products (1) , have resulted i n s a l t i n t a k e a b o v e r e c o m m e n d e d l i m i t s i n different population groups (2)(3) . A recent study (3) found daily salt consumption between 13 and 17g in hypertensive patients, with 40 to 55% of this consumption deriving from addition to foods during or after their preparation, while consumption of high-salt foods was also frequent. This intake greatly exceeds the recommended limit of 6g of salt/day for normotensive people or 4g of salt/day for hypertensive persons (4) .Excessive salt consumption, in turn, has been associated with severity of arterial hypertension and ventricular hypertrophy (5) , resulting in international recommendations for the use of reduced-salt diets as an important non-pharmacological intervention in hypertension prevention and treatment (6) .Hypertensive patients are familiar with recommendations about the need to restrict salt consumption in their diet. Many report following lowsalt diets, as appointed in earlier research (7)(8) . The actual measurement of this behavior, however, indicates continued high consumption in that population, which confirms that food pattern changes are not easy to achieve and maintain. There is growing evidence that education programs have the highest chance of success if they are aimed at factors that operate on the motivation to act (9) .In social psychology, there are conceptual models that serve as a base to understand and to p r e d i c t h e a l t h b e h a v i o r s . I n g e n e r a l , s t r o n g variations are found between subjects who adhere or not to certain behaviors, particularly in terms o f c o g n i t i v e f a c t o r s , d e s c r i b e d a s t h e m o s t important determinants of the motivation to actand, consequently, of behavior (10) . Among theories aimed at understanding and predicting health behaviors, the Theory of Planned Behavior (11) -TPB has been widely used, including for food-related behaviors (12)(13) . According to TPB, the proximal METHOD Instrument developmentThe instrument was designed after an extensive literature review of research that used sociocognitive theories to study food behaviors and specific studies on factors interfering in salt consumption. TPB was used as the theoretical framework, in addition to other variables related to food behavior (self-efficacy, habit and environment) or specifically to salt consumption (food preferences, hedonic determinants and diet quality assessment).Direct measurements of the involved constructs were carried out (11) . Definition of psychosocial variablesBehavior was initially defined as: consider a low-salt diet as: consumption ...

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Characterization of salt consumption among hypertensives according to socio-demographic and clinical factors

“…The instruments used for the socio-demographic and clinical characterization and for the measurements of the behaviors of salt consumption had previously been validated (15) .…”

“…The higher the score, the less the healthy behavior was undertaken, and, therefore, the greater the salt intake (15) . was transformed into grams of salt, considering that 1g of salt = 400mg of sodium.…”

“…With a view to the planning and implementation of educational strategies for reducing salt intake among hypertensives, a previous study (12,15) had investigated the psychosocial determinants related to the consumption of sodium in these individuals. Three behaviors related to salt consumption were evaluated: the addition of, at the most, 4g of salt in the preparation of meals (Behavior I);…”

Knowledge, attitude and behavior toward dietary salt: The nescience among hypertensive patients in Indonesia

“…1,3 It is known the low salt intake is challenging and difficult to follow. 1,4 As a result, the excessive salt and sodium consumption is often unpreventable. Overconsumption of salt will directly affect blood pressure and is associated with increasing risk of fatal cardiovascular events.…”