Authors (including presenting author) :
EKH Luk(1), ZWY Choy(1), AK Cheung(1), Q Ding(2), MWS Tang(2)
Affiliation :
1.Dietetics Department, Shatin Hospital; 2. Department of Medicine & Geriatrics, Shatin Hospital
Keyword 1: :
Congestive Heart Failure
Keyword 2: :
Sodium intake
Keyword 3: :
Knowledge and Behaviors
Keyword 4: :
Multi-disciplinary Approach
Introduction :
Around 25% of the patients with congestive heart failure (CHF) had unplanned readmissions within 4 weeks in public hospitals in Hong Kong. Knowledge deficit in dietary sodium intake was known to be a risk factor for hospital readmissions in patients with heart failure. It is proposed that improvement in knowledge levels of dietary salt (sodium chloride) intake is positively related to engagement in salt reduction behaviors, which in turn will improve clinical outcomes such as hospital readmissions.
Objectives :
This study investigated the associations between knowledge & behaviors of dietary sodium intake and readmissions of patients with CHF in a multi-disciplinary rehabilitation program.
Methodology :
Twenty-six patients with CHF, who had a mean age of 82, were recruited from inpatient and geriatric day hospital settings to a multi-disciplinary rehabilitation program in Shatin Hospital from January 2023 to June 2024 by convenience sampling. A validated, self-reported questionnaire regarding dietary salt knowledge and salt consumption behaviors was used with the original author’s consent. Low sodium diet education was delivered to the patients by dietitians after first-time completion of the questionnaire. The same questionnaire was completed again in the follow-up sessions. A score of lower or equal to 20 out of 43 was used as cut-off for knowledge deficit in dietary salt intake and less engagement in salt reduction behaviors, according to the average score of Hong Kong citizens. The hospital readmission rates due to CHF or fluid overload within 4 weeks were compared between the higher and the lower score groups. Wilcoxon Signed-Rank test was used to compare the pre and post scores after diet education.
Result & Outcome :
The hospital readmission rate for the 26 patients with CHF was 19% (5 out of 26 patients). 11 patients had higher scores while 15 patients had lower scores in the questionnaire. For the patients who had higher scores, the hospital readmission rate was 9% (1 out of 11 patients). For patients who had lower scores, the hospital readmission rate was 27% (4 out of 15 patients). The hospital readmission rate for the higher score group was three times lower compared to the lower score group. Out of the total 26 patients, 9 of the patients had completed the self-reported questionnaire before and after diet education. The post diet education score was significantly higher than the pre diet education score (Mdn 13 vs 21, Z=2.5, p=< 0.01, r =0.9).
