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由营养师对心力衰竭患者进行教育可提高其对限钠饮食的依从性:一项随机试验。

Education by a dietitian in patients with heart failure results in improved adherence with a sodium-restricted diet: a randomized trial.

作者信息

Arcand Jo Anne L, Brazel Sandra, Joliffe Courtney, Choleva Marlene, Berkoff Frances, Allard Johane P, Newton Gary E

机构信息

Division of Cardiology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Ontario, Canada.

出版信息

Am Heart J. 2005 Oct;150(4):716. doi: 10.1016/j.ahj.2005.02.016.

Abstract

BACKGROUND

Multidisciplinary heart failure (HF) programs reduce hospital readmission and improve clinical outcomes. Although dietitians are often members of such teams, no randomized studies have demonstrated the independent benefit of dietitian-administered dietary counseling for patients with HF. The purpose of this study was to evaluate the effect of dietitian education on adherence to a sodium-restricted diet in ambulatory patients with stable HF.

METHODS

Patients with HF (left ventricular ejection fraction < 35%) were randomized into a dietitian education group (n = 23) or a usual care group (n = 24), then observed for 3 months. Both groups received a 2 g/d dietary sodium prescription. The usual care group received nutrition advice by way of self-help literature, whereas the dietitian education group returned for 2 counseling sessions with a dietitian.

RESULTS

Dietitian education resulted in a significant decrease in sodium intake at 3 months (2.80 +/- 0.30 to 2.14 +/- 0.23 g/d, P < .05). In contrast, there was no change in sodium intake in the usual care group (3.00 +/- 0.31 to 2.74 +/- 0.35 g/d, P = ns).

CONCLUSIONS

Dietitian-administered counseling was more effective than providing literature in reducing dietary sodium intake in patients with stable HF.

摘要

背景

多学科心力衰竭(HF)项目可减少医院再入院率并改善临床结局。尽管营养师通常是此类团队的成员,但尚无随机研究证明营养师提供的饮食咨询对HF患者有独立益处。本研究的目的是评估营养师教育对稳定型HF门诊患者遵守限钠饮食的影响。

方法

将HF患者(左心室射血分数<35%)随机分为营养师教育组(n = 23)或常规护理组(n = 24),然后观察3个月。两组均接受每日2克的饮食钠处方。常规护理组通过自助文献获得营养建议,而营养师教育组则返回与营养师进行2次咨询会议。

结果

营养师教育使3个月时的钠摄入量显著降低(从2.80±0.30降至2.14±0.23克/天,P<.05)。相比之下,常规护理组的钠摄入量没有变化(从3.00±0.31降至2.74±0.35克/天,P =无显著性差异)。

结论

在降低稳定型HF患者的饮食钠摄入量方面,营养师提供的咨询比提供文献更有效。

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