Publication Details

Chan, A., Kinsman, L., Elmer, S. & Khanam, M. (2018). An integrative review: adherence barriers to a low-salt diet in culturally diverse heart failure adults. Australian Journal of Advanced Nursing, 36 (1), 37-47.

Link to publisher version (URL)

Australian Nursing & Midwifery Federation

Additional Publication Information

Reprinted with permission of AJAN


Objective: A sodium restricted diet (SRD) is generally included in chronic heart failure (HF) management. The objective of this review is to explore and synthesise the research findings of the adherence barriers to a SRD in adults from culturally and linguistically diverse (CALD) backgrounds with HF.

Setting: The principle research question addressed in this review is: what are the adherence barriers to a SRD for chronic heart failure management in adults from CALD backgrounds?

Primary argument: Patient education plays an important role in health decision-making but it is only one of the many factors in dietary sodium restriction adherence. In order to promote the adherence behaviours among the adults with HF, nurses should develop a tailored approach to overcome individuals' perceived barriers and circumstances especially adults from CALD backgrounds.

Results: The literature search was undertaken in PubMed, CINAHL and MEDLINE. After eliminating duplicates and applying the selection criteria, eleven titles were included in the review.

Conclusion: This review found three major perceived barriers for adults living with HF to adhere to a SRD from CALD backgrounds: 1) lack of sufficient, appropriate provision of patient education; 2) the levels of interference with social and family life; and 3) the availability and affordability of healthier food alternatives. These barriers are critical to the design of nursing interventions for promoting adherence behaviours. Lack of published research in adults from CALD ethnic minority groups living with HF in Western countries limited the ability to explore all of the barriers identified in this review.