Inadequate Dietary Education and Poor Adherence to a High Protein, Low Sodium Diet in Cirrhosis: Mixed Methods Approach.

Autor: Brown C; Dell Medical School, University of Texas at Austin, 1601 Trinity St., Building B, Austin, TX, 78712, USA. cristal.brown@austin.utexas.edu.; Ascension Medical Group, 1601 Trinity St., Building B, Austin, TX, 78712, USA. cristal.brown@austin.utexas.edu.; University of Texas Health Austin, 1601 Trinity St Building A, Austin, TX, 78712, USA. cristal.brown@austin.utexas.edu.; University of Texas at Austin, Health Discovery Building 1601 Trinity St Z0900, Austin, TX, 78712, USA. cristal.brown@austin.utexas.edu., Hernandez R; Dell Medical School, University of Texas at Austin, 1601 Trinity St., Building B, Austin, TX, 78712, USA., Ford T; Dell Medical School, University of Texas at Austin, 1601 Trinity St., Building B, Austin, TX, 78712, USA., Aksan N; Dell Medical School, University of Texas at Austin, 1601 Trinity St., Building B, Austin, TX, 78712, USA., DiVincenzo C; Dell Medical School, University of Texas at Austin, 1601 Trinity St., Building B, Austin, TX, 78712, USA.; Ascension Medical Group, 1601 Trinity St., Building B, Austin, TX, 78712, USA.; University of Texas Health Austin, 1601 Trinity St Building A, Austin, TX, 78712, USA., Muir AJ; Division of Gastroenterology, Department of Medicine, Duke University School of Medicine, 300 W Morgan St., Durham, NC, 27701, USA.
Jazyk: angličtina
Zdroj: Digestive diseases and sciences [Dig Dis Sci] 2024 Sep; Vol. 69 (9), pp. 3226-3235. Date of Electronic Publication: 2024 Jun 28.
DOI: 10.1007/s10620-024-08526-2
Abstrakt: Background: Malnutrition in cirrhosis is associated with poor outcomes, leading to guidelines for a high protein, low sodium diet; however, there is no guidance regarding the implementation of diet education in clinical practice.
Methods: A mixed methods study enrolled 21 patients with cirrhosis and their caregivers. Semi-structured interviews on barriers and facilitators of dietary education and adherence were conducted. Demographic and clinical data were obtained, along with quantitative measures of dietary adherence, including 24-h food recall and spot urine sodium. Combined deductive and inductive coding was used to identify qualitative themes, along with a quantitative assessment of interviews. Quantitative data was reported using descriptive statistics with frequencies, mean and confidence intervals.
Results: Participants were mostly male (16/21) with a mean age 57.8 years (SE 2.8) and MELD-Na 9 (SE 1.2). 4 themes emerged: 1. More than 50% of participants and caregivers endorsed no or inadequate diet education 2. They reported mostly negative experiences with dietary adherence with largest impact on social life 3. Facilitators of adherence included the presence of household support and fear of complications of cirrhosis 4. Overwhelmingly desired non-generic handouts and information. Dietary adherence was poor with only one participant meeting protein and sodium requirements based on food recall. Four participants who adhered to < 2000 mg sodium had inadequate daily caloric intake.
Conclusions: Dietary education is inadequate, and adherence to dietary recommendations is poor in patients with cirrhosis. Future studies should use these barriers and facilitators for intervention development.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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