It has previously been demonstrated that patients with heart failure (HF) in an urban
public hospital had significant gaps in knowledge regarding dietary sodium restriction.
The objective of this study was to determine what risk factors were associated with
such gaps in knowledge and to determine if these gaps in knowledge would increase
the risk for HF readmission. A standardized test of sodium knowledge (scored 0 to
10) was administered prospectively to 97 hospitalized patients with HF <48 hours before
discharge. The incidence of 90-day hospital readmission for HF was compared between
subjects with low dietary sodium knowledge (score 0 to 3) and the remainder of the
cohort (score 4 to 10) in univariate and multivariate analyses. Another 48 patients
with HF were prospectively recruited, and the dietary sodium knowledge test and a
survey of psychosocial and other parameters, including the Test of Functional Health
Literacy in Adults, a validated measure of health literacy, were administered. The
90-day readmission rate for HF was 3 times higher in those with low sodium knowledge
than in the remainder of the cohort (28% vs 9%, p = 0.02). This association persisted
in multivariate models adjusting for potential confounders. Low health literacy, but
not other psychosocial parameters, was associated with low dietary sodium knowledge.
In conclusion, low dietary sodium knowledge was an independent risk factor for 90-day
HF hospital readmission in the urban setting. Deficiency in dietary sodium knowledge
is one pathway through which low health literacy leads to adverse outcomes in patients
with HF.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Potential contributing factors to noncompliance with dietary sodium restriction in patients with heart failure.Am Heart J. 2002; 143: 29-33
- High-sodium food choices by southern, urban African Americans with heart failure.J Card Fail. 2006; 12: 144-148
- Therapy of heart failure in African Americans: lessons from an urban public hospital.Congest Heart Fail. 2004; 10: 40-43
- The test of functional health literacy in adults: a new instrument for measuring patients' literacy skills.J Gen Intern Med. 1995; 10: 537-541
Research Triangle Institute. 2006 National Survey on Drug Use and Health, 2005. Available at: http://oas.samhsa.gov/nsduh/methods.cfm#2k6. Accessed August 8, 2008.
- The Dallas Heart Study: a population-based probability sample for the multidisciplinary study of ethnic differences in cardiovascular health.Am J Cardiol. 2004; 93: 1473-1480
- Beta-blocker therapy in patients with heart failure in the urban setting: moving beyond clinical trials.Am Heart J. 2004; 148: 958-963
- Factors related to nonadherence to low sodium diet recommendations in heart failure patients.Eur J Cardiovasc Nursing. 2005; 4: 331-336
- Health literacy: report of the Council on Scientific Affairs.JAMA. 1999; 281: 552-557
- The Health Literacy of America's Adults: Results from the 2003 National Assessment of Adult Literacy (NCES 2006-483).United States Department of Education, Washington, District of Columbia2006
- The prevalence of limited health literacy.J Gen Intern Med. 2005; 20: 175-184
- Functional health literacy and the risk of hospital admission among Medicare managed care enrollees.Am J Public Health. 2002; 92: 1278-1283
- Health literacy and mortality among elderly persons.Arch Intern Med. 2007; 167: 1503-1509
- Association of health literacy with diabetes outcomes.JAMA. 2002; 288: 475-482
Article info
Publication history
Published online: August 29, 2008
Accepted:
June 30,
2008
Received in revised form:
June 30,
2008
Received:
February 28,
2008
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
