Cut-Point for Satisfactory Adherence of the Dietary Sodium Restriction Questionnaire for Patients with Heart Failure

Abstract

BackgroundThe low or non-adherence to reduction of sodium intake has been identified as one of the main precipitating factors of heart failure (HF). The Dietary Sodium Restriction Questionnaire (DSRQ) identifies factors that can interfere with adherence to this recommendation. However, there is still no cut-point to define adherence for this questionnaire.ObjectivesTo identify the cut-point for satisfactory adherence to the Brazilian version of the DSRQ, (the Questionário de Restrição de Sódio na Dieta, QRSD).MethodsMulticenter study. Patients with HF in outpatient treatment (compensated) and those treated in emergency departments due to acute HF (decompensated) were included. For the cut-point definition, the DSRQ scores were compared between groups. A ROC curve was constructed for each subscale to determine the best point of sensitivity and specificity regarding adherence. A 5% significance level was adopted.ResultsA total of 206 compensated patients and 225 decompensated were included. Compensated patients exhibited scores that showed higher adhesion in all subscales (all p <0.05). Scores ≥ 40 points of a total of 45 for the subscale of Attitude and Subjective Norm; scores ≤ eight of a total of 20 for Perceived Behavioral Control; and ≤ three of a total of 15 for Dependent Behavior Control were indicative of satisfactory adherence.ConclusionsBased on the evaluation of patients in these two scenarios, it was possible to determine the cut-point for satisfactory adherence to the reduction of sodium in the diet of patients with HF. Countries with similar culture could use this cut-point, as other researchers could also use the results as a reference for further studies.

Attitudes, beliefs and barriers for adherence to the hyposodic diet in patients with heart failure

“…To this date, this is one of the few studies that used the Brazilian version of the DSRQ in order to identify attitudes, beliefs and barriers to adhering to a hyposodic diet among individuals with HF, since its translation and validation in the Brazilian population (6,10,12) . This research was also able to evaluate the factors associated with adherence to the components of attitude and subjective norm, perceived behavioral control and dependent behavior, considering the recent cutoff points validation for adherence to a hyposodic diet in Brazilian patients with HF (15) .…”

“…For the analysis of the second and third subscales, scores 1 and 2 corresponded to the category "Not at all", scores 3 to "partially (little)" and scores 4 and 5 were assigned to the category "A lot". The cutoff points used for satisfactory adherence are ≥ 40 points for the Attitude and Subjective Norm subscale; ≤ 8 for Perceived Behavioral Control; and ≤ 3 for Dependent Behavior (15) .…”