ABC | Volume 112, Nº2, February 2019

Original Article d’Almeida et al Cut-point for Dietary Sodium Restriction Questionnaire Arq Bras Cardiol. 2019; 112(2):165-170 Table 1 – Characteristics of the participants Characteristics Compensated (n = 206) Decompensated (n = 225) p Sociodemographic Age (years)* 60 ± 12 66 ± 12 < 0.001 Male (%) † 65.0 53.8 0.023 Ethnicity (%) † < 0.001 White 85.4 57.8 Black 9.7 16.4 Mixed-race 4.9 25.8 Years of study (%) † 0.083 Until 8 years 75.7 83.0 9 to 11 years 19.9 12.1 12 years or more 4.4 4.9 Marital status (%) † < 0.001 Lives with a companion 69.4 49.3 Lives alone 30.6 50.7 Clinical LVEF (%)* 31.3 ± 9.1 42.0 ± 15.7 < 0.001 Functional class NYHA (%) † < 0.001 I 42.0 1.4 II 34.2 20.7 III 23.3 63.1 IV 0.5 14.9 Etiology (%) † 0.002 Ischemic 33.0 43.2 Hypertensive 18.0 10.9 Others 49.0 45.9 Medications prior to admission (%) † Beta-blockers 85.4 69.2 < 0.001 Anti-hypertensives 96.6 87.5 0.001 Diuretics 82.5 83.9 0.795 LVEF: left ventricular ejection fraction; NYHA: New York Heart Association. *Continuous variables described as mean ± standard deviation, unpaired Student’s t test; † categorical variables expressed as %, chi-square test. the relationship between knowledge, attitudes, and barriers to adherence of a low-sodium diet in patients with HF, and also found similar sociodemographic characteristics, with mean age of 65 years and 32% of participants living alone. In fact, advanced age is among the main factors that contribute to high rehospitalization rates due to decompensation of HF patients. 18 In addition to advanced age, many patients with HF have cognitive deficits, including memory loss. 19 Regarding ethnicity, a recent study demonstrated an association between non‑white race and non-adherence in patients withHF after hospital discharge. 20 The fact of living alone can interfere with adherence, since this behavior is largely influenced by the opinion of people whom patients consider important, including spouses and family members. 12 Lack of family support can make the patient feel alone. The inclusion of family members in the treatment of HF – mainly in relation to adherence to non-pharmacological measures – seems to be a crucial point and has been used as a strategy for self-care. 21,22 The multifactorial causation and subjectivity related to adherence could explain the difficulty encountered by health professionals to measure patients’ commitment to a particular behavior. In this context, instruments that can provide more reliable information on patient outcomes in terms of knowledge, barriers and attitudes, with cut-points for adequate and poor adherence could help to identify factors that potentially influence this outcome. 23 According to the researchers responsible for developing the QRSD, the instrument was built with the goal of being a self‑administered tool. 8 However, considering cultural 167