利用家庭和社区支持减少农村白蛋白尿患者的膳食盐摄入：美马研究

Dietary salt reduction in rural patients with albuminurea using family and community support: the Mima study.

作者信息

Fujiwara Shinji, Kotani Kazuhiko, Brantley Phillip J, Tsuzaki Kokoro, Matsuoka Yukiyo, Domichi Masayuki, Sano Yoshiko, Kajii Eiji, Sakane Naoki

机构信息

Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Mukuihata-cho, Fushimi-ku, Kyoto 612-8555, Japan.

出版信息

Asia Pac Fam Med. 2010 Feb 25;9(1):6. doi: 10.1186/1447-056X-9-6.

DOI:10.1186/1447-056X-9-6

PMID:20184743

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2843601/

Abstract

BACKGROUND

Residents of rural communities are often more socially connected compared to urban dwellers. Using family and community support to motivate health behavior change may be useful in rural settings. The objective of this study was to pilot a salt reduction (SR) intervention for rural albuminuria patients using support from family and neighborhood residents compared to a usual care condition. The primary outcome was change in urine albumin-creatinine ratio (ACR).

METHODS

All consecutive outpatients with an ACR >= 30 mg/gCr were recruited from the Koyadaira Clinic. Patients self-selected their participation in the intervention group (IG) or the control group (CG) because the rural population expressed concern about not being treated at the same time. In the IG, patients and their families were educated in SR for 30 minutes in their home by experienced dieticians. In addition, patients, families and neighborhood residents were also educated in SR for 2 hours at a public town meeting hall, with educational content encouraging reduction in salt intake through interactive activity. The CG received conventional treatment, and ACR and blood pressure (BP) were measured after 3 months.

RESULTS

Of the 37 subjects recruited (20 male, 16 female, mean age; 72.8 +/- 9.2 years), 36 completed the 3-month follow up and were analyzed. In the IG, ACR decreased significantly from baseline (706 +/- 1,081 to 440 +/- 656; t = 2.28, p = 0.04) and was reduced compared to the CG (213 +/- 323 to 164 +/- 162; F = 3.50, p = 0.07), a treatment effect approaching significance. Systolic BP in the IG (145 +/- 14 to 131 +/- 13 mmHg; t = 3.83, p = 0.002) also decreased significantly compared to the CG (135 +/- 13 to 131 +/- 14; F = 4.40, p = 0.04).

CONCLUSIONS

Simultaneous education of patients, their families and neighborhood residents may be important in rural areas for treatments and interventions requiring health behavior change.

TRIAL REGISTRATION

UMIN000001972.

摘要

背景

与城市居民相比，农村社区居民的社会联系往往更为紧密。利用家庭和社区支持来推动健康行为改变在农村环境中可能会很有效。本研究的目的是针对农村白蛋白尿患者开展一项减盐（SR）干预试验，与常规护理情况相比，该试验利用家庭和邻里居民的支持。主要结局是尿白蛋白 - 肌酐比值（ACR）的变化。

方法

从小谷地诊所招募所有连续的ACR >= 30 mg/gCr的门诊患者。由于农村居民担心不能同时接受治疗，患者自行选择参与干预组（IG）或对照组（CG）。在IG组，经验丰富的营养师在患者家中对患者及其家人进行了30分钟的减盐教育。此外，患者、家人和邻里居民还在公共市政会议厅接受了2小时的减盐教育，教育内容通过互动活动鼓励减少盐摄入量。CG组接受常规治疗，3个月后测量ACR和血压（BP）。

结果

在招募的37名受试者（20名男性，16名女性，平均年龄；72.8 +/- 9.2岁）中，36名完成了3个月的随访并进行了分析。在IG组，ACR从基线显著下降（706 +/- 1,081降至440 +/- 656；t = 2.28，p = 0.04），与CG组相比有所降低（213 +/- 323降至164 +/- 162；F = 3.50，p = 0.07），治疗效果接近显著水平。IG组的收缩压（145 +/- 14至131 +/- 13 mmHg；t = 3.83，p = 0.002）与CG组相比也显著下降（135 +/- 13至131 +/- 14；F = 4.40，p = 0.04）。