Steca Patrizia, Pancani Luca, Greco Andrea, D'Addario Marco, Magrin Maria Elena, Miglioretti Massimo, Sarini Marcello, Scrignaro Marta, Vecchio Luca, Cesana Francesca, Giannattasio Cristina, Fattirolli Francesco, Zanettini Renzo
University of Milan "Bicocca", Italy.
Niguarda Ca' Granda Hospital, Milan and University of Milan "Bicocca", Italy.
Appl Psychol Health Well Being. 2015 Nov;7(3):316-39. doi: 10.1111/aphw.12050. Epub 2015 Jul 28.
Cardiovascular diseases (CVDs) are a major cause of worldwide morbidity and mortality. Nutrition plays an important role in the primary, secondary, and tertiary prevention of CVDs. The present longitudinal study used the Health Action Process Approach (HAPA) to investigate changes in dietary behavior in coronary patients (CPs) affected by acute coronary syndrome and hypertensive patients (HPs) affected by essential arterial hypertension.
CPs (N = 250) and HPs (N = 246) completed a questionnaire during three measurement points (baseline, 6-month follow-up, and 12-month follow-up). Statistical analyses included a repeated measures ANOVA and a multi-sample structural equation model.
HPs showed no changes in dietary behavior, whereas CPs improved their nutrition at 6 months and then maintained the healthier diet. The multi-sample analysis indicated equivalence of the HAPA model for both patient populations.
These findings provide further evidence for the generalisability of the HAPA model, shedding light on dietary behavior among CVD patients and particularly on hypertensive patients which has received little attention. Moreover, the equivalence of the model suggests that the process of change is almost identical for individuals who are at high risk for a coronary event (i.e. HPs) and individuals who have already had the event (i.e. CPs).
心血管疾病（CVDs）是全球发病和死亡的主要原因。营养在心血管疾病的一级、二级和三级预防中起着重要作用。本纵向研究采用健康行动过程方法（HAPA），调查急性冠状动脉综合征患者（CPs）和原发性高血压患者（HPs）的饮食行为变化。
CPs（N = 250）和HPs（N = 246）在三个测量点（基线、6个月随访和12个月随访）完成了一份问卷。统计分析包括重复测量方差分析和多样本结构方程模型。
HPs的饮食行为没有变化，而CPs在6个月时改善了营养状况，然后保持了更健康的饮食。多样本分析表明，HAPA模型在两种患者群体中具有等效性。
这些发现为HAPA模型的通用性提供了进一步的证据，揭示了心血管疾病患者，尤其是高血压患者中很少受到关注的饮食行为。此外，模型的等效性表明，对于有冠状动脉事件高风险的个体（即HPs）和已经发生该事件的个体（即CPs），改变过程几乎是相同的。
