Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, The Netherlands.
Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, The Netherlands.
PLoS One. 2020 Jan 31;15(1):e0228465. doi: 10.1371/journal.pone.0228465. eCollection 2020.
This study aims to identify determinants of dietary behaviour in wheelchair users with spinal cord injury or lower limb amputation, from the perspectives of both wheelchair users and rehabilitation professionals. The findings should contribute to the field of health promotion programs for wheelchair users.
Five focus groups were held with wheelchair users (n = 25), and two with rehabilitation professionals (n = 11). A thematic approach was used for data analysis in which the determinants were categorized using an integrated International Classification of Functioning, Disability and Health and Attitude, Social influence and self-Efficacy model.
Reported personal factors influencing dietary behaviour in wheelchair users were knowledge, boredom, fatigue, stage of life, habits, appetite, self-control, multiple lifestyle problems, intrinsic motivation, goal setting, monitoring, risk perception, positive experiences, suffering, action planning, health condition, function impairments, attitude and self-efficacy. Reported environmental factors influencing dietary behaviour in wheelchair users were unadjusted kitchens, monitoring difficulties, eating out, costs, unfavourable food supply, nutrition education/counselling, access to simple healthy recipes, eating together, cooking for others, and awareness and support of family and friends.
Important modifiable determinants of dietary behaviour in wheelchair users that might be influenced in lifestyle interventions are knowledge, fatigue, habits, self-control, intrinsic motivation, risk perception, attitude and self-efficacy. It is recommended to involve relatives, since they appear to significantly influence dietary behaviour.
本研究旨在从轮椅使用者和康复专业人员的角度确定脊髓损伤或下肢截肢的轮椅使用者饮食行为的决定因素。研究结果应有助于为轮椅使用者的健康促进计划领域做出贡献。
对 25 名轮椅使用者（n=25）进行了 5 次焦点小组讨论，对 11 名康复专业人员（n=11）进行了 2 次焦点小组讨论。采用主题分析方法对数据进行分析，使用综合的国际功能、残疾和健康分类以及态度、社会影响和自我效能模型对决定因素进行分类。
报告的影响轮椅使用者饮食行为的个人因素包括知识、无聊、疲劳、生活阶段、习惯、食欲、自我控制、多种生活方式问题、内在动机、目标设定、监测、风险感知、积极体验、痛苦、行动计划、健康状况、功能障碍、态度和自我效能。报告的影响轮椅使用者饮食行为的环境因素包括未调整的厨房、监测困难、外出就餐、成本、不利的食物供应、营养教育/咨询、获得简单健康食谱、一起吃饭、为他人做饭、以及家人和朋友的意识和支持。
可能在生活方式干预中影响轮椅使用者饮食行为的重要可改变决定因素是知识、疲劳、习惯、自我控制、内在动机、风险感知、态度和自我效能。建议让亲属参与进来，因为他们似乎会显著影响饮食行为。
