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The Body of Knowledge on Compliance in Heart Failure Patients: We Are Not There Yet

Nieuwenhuis, Maurice M. W. MSc; van der Wal, Martje H. L. PhD, RN; Jaarsma, Tiny PhD, RN

Journal of Cardiovascular Nursing:
doi: 10.1097/JCN.0b013e3181e27a2d
ARTICLES: Heart Failure
Abstract

Background: Noncompliance with diet and fluid restriction is a problem in patients with heart failure (HF). In recent studies, a relationship between compliance with sodium and fluid restriction and knowledge and beliefs regarding compliance was found. In these studies, however, compliance was primarily measured by interview or questionnaire.

Objectives: To examine the relationship between compliance with sodium and fluid restriction measured with a nutrition diary and knowledge, beliefs, and other relevant variables in HF patients.

Methods: Eighty-four HF patients completed a nutrition diary for 3 days. Patients also completed questionnaires on knowledge, beliefs regarding compliance, and depressive symptoms. Differences in relevant variables between compliant and noncompliant patients were assessed.

Results: Compliance with sodium and fluid restriction was 79% and 72%. Although not statistically significant, a higher percentage of patients were compliant with the less stringent restrictions compared with the more stringent restrictions, and in addition, more noncompliant patients perceived difficulty following the regimen compared with their compliant counterparts. In contrast with other studies, no significant differences in knowledge, beliefs, and relevant demographic and clinical variables were found between compliant and noncompliant patients.

Conclusion: Perceived difficulty and the amount of the prescribed restriction seem to be relevant concepts that play a role in compliance with sodium and fluid restriction in HF and need to be explored in future research.

Author Information

Maurice M. W. Nieuwenhuis, MSc PhD Student, Department of Cardiology, University Medical Centre Groningen, University of Groningen, the Netherlands.

Martje H. L. van der Wal, PhD, RN Senior Researcher, Department of Cardiology, University Medical Centre Groningen, University of Groningen, the Netherlands

Tiny Jaarsma, PhD, RN Professor, Department of Social and Welfare Studies, Faculty of Health Sciences Linköping University, Norrköping, Sweden.

This study was financially supported by the Netherlands Heart Foundation (grant 2000Z003).

Correspondence Maurice M. W. Nieuwenhuis, MSc, Department of Cardiology; University Medical Centre Groningen, University of Groningen. PO Box 30.001, 9700 RB Groningen, the Netherlands (m.m.w.nieuwenhuis@thorax.umcg.nl).

© 2011 Lippincott Williams & Wilkins, Inc.