ArticleBMC cardiovascular disorders2026
Factors influencing sodium restriction behavior among patients with chronic heart failure: a cross-sectional study based on the value co-creation theory.
Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundDigital health–supported value co-creation involves patients actively seeking information, communicating with healthcare professionals, and participating in shared decision-making throughout care. Sodium restriction is a cornerstone of chronic heart failure self-management, but adherence in real-world settings is often inadequate. Digital health technologies could strengthen patient–professional value co-creation; however, how value co-creation behaviours relate to sodium-restriction adherence remains unclear, particularly among Chinese patients with chronic heart failure.
objectiveTo investigate the current status of value co-creation behaviors among chronic heart failure patients and analyze factors influencing sodium restriction adherence, thereby providing new perspectives and theoretical directions for sodium restriction management in this population.
methodsChronic heart failure patients who visited a large hospital in Guangxi, China from January to July 2025 were selected as study subjects. Data collection employed a general information questionnaire, Value Co-creation Behavior Measurement Scale, Sodium-Restricted Diet Questionnaire, Social Support Rating Scale, and Self-Rating Anxiety and Depression Scales. Univariate, correlation, and multivariate regression analyses were conducted to assess current value co-creation behaviors and identify factors influencing sodium-restricted dietary adherence.
resultsA total of 229 patients with chronic heart failure were included. Overall sodium restriction adherence was moderate, with 31.44% demonstrating good compliance. The mean value co-creation score was (46.183 ± 5.423). Univariate analysis revealed statistically significant differences between good and poor sodium restriction adherence in age, taste preferences, body mass index, sodium restriction-related cognition and attitudes, social support, and all dimensions of value co-creation behavior (P < 0.05). Multivariate linear regression analysis indicated that older age, preference for salty flavors, and higher body mass index were independently associated with poorer self-reported sodium-restricted dietary adherence. Higher levels of social support and value co-creation behaviors (information seeking, interactive collaboration, and shared decision-making) were independently associated with better self-reported adherence (P < 0.05).
conclusionPatients with chronic heart failure showed moderate levels of value co-creation on all dimensions. Higher levels of value co-creation may be associated with better sodium-restricted dietary behaviors. Future research should develop and evaluate digital health technologies with a sustained focus on patients’ ability to access reliable information and health literacy, thereby promoting patient engagement and shared decision making and reducing the burden of dietary self-management. Follow-up studies should incorporate objective measures such as sodium intake and 24-hour urine sodium testing into the assessment framework.
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