Delahanty Linda M, Hayden Doug, Ammerman Alice, Nathan David M
Massachusetts General Hospital, Diabetes Center, Boston 02114, USA.
Ann Behav Med. 2002 Fall;24(4):269-78. doi: 10.1207/S15324796ABM2404_03.
Following a heart-healthy diet to lower cholesterol levels is often assumed to be difficult, to be burdensome, and to have a negative impact on quality of life (QOL). The purpose of this study was to evaluate the impact of medical nutrition therapy (MNT) versus usual care (UC) for hypercholesterolemia on patient satisfaction and QOL. Ninety ambulatory care patients (60 men and 30 women), age 28 to 66, were randomly assigned to receive either MNT from dietitians using a National Cholesterol Education Program-based protocol or UC from their physicians. Patients who received MNT reported no difference in QOL related to the taste or enjoyment of food compared with UC patients. However, the MNT group reported initial improvements in QOL related to the convenience and cost of following a low-fat diet when compared with the UC group. The MNT group also reported significant and lasting improvements in perceived QOL related to self-care compared with the UC group. MNT patients were more satisfied with the interaction at visits, knowledge and ability to manage their cholesterol, eating habits, appearance, time spent exercising, and life in general. Moreover, MNT patients did not report any negative impact related to following a low-fat diet in regard to feeling restricted by diet; interference with lifestyle activities; or difficulty planning, purchasing, or preparing meals or eating away from home. Contrary to popular belief there is no apparent reduction but rather an improvement in some measures of QOL and patient satisfaction with MNT for hypercholesterolemia.
遵循有益心脏健康的饮食以降低胆固醇水平通常被认为是困难的、负担沉重的，并且会对生活质量（QOL）产生负面影响。本研究的目的是评估针对高胆固醇血症的医学营养治疗（MNT）与常规护理（UC）对患者满意度和生活质量的影响。90名年龄在28至66岁之间的门诊患者（60名男性和30名女性）被随机分配，分别接受营养师依据基于国家胆固醇教育计划的方案提供的MNT或医生提供的UC。与接受UC的患者相比，接受MNT的患者报告称在与食物味道或享受相关的生活质量方面没有差异。然而，与UC组相比，MNT组报告称在与遵循低脂饮食的便利性和成本相关的生活质量方面有初步改善。与UC组相比，MNT组还报告称在与自我护理相关的感知生活质量方面有显著且持久的改善。MNT患者对就诊时的互动、管理胆固醇的知识和能力、饮食习惯、外表、锻炼时间以及总体生活更为满意。此外，MNT患者没有报告任何与遵循低脂饮食相关的负面影响，如感觉受饮食限制；干扰生活方式活动；或在计划、购买、准备膳食或外出就餐方面存在困难。与普遍看法相反，对于高胆固醇血症的MNT，生活质量的某些指标并没有明显下降，反而有所改善，患者满意度也有所提高。
