Faculty of Agricultural and Food Sciences, Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon.
Faculty of Health Sciences, Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon.
PLoS One. 2023 Oct 24;18(10):e0287844. doi: 10.1371/journal.pone.0287844. eCollection 2023.
Cardiovascular diseases are increasing at an alarming rate worldwide, reaching epidemic proportions in countries of the Eastern Mediterranean Region, including Lebanon. Despite the growing number of patients suffering from cardiovascular diseases in Lebanon, there is scarce data on whether cardiac patients adhere to therapeutic dietary guidelines, drug prescriptions, and physical activity recommendations and whether such adherence differs according to sociodemographic, lifestyle, or psychosocial characteristics. A cross-sectional study was conducted among 367 Lebanese adult cardiovascular disease patients admitted for hospitalization at various hospital sites in Lebanon. Electronic medical records and a multi-component questionnaire were used to collect information on patients' characteristics. Dietary assessment was performed using a culture-specific validated food frequency questionnaire, and physical activity levels were assessed using the international physical activity questionnaire (IPAQ). Mental well-being was assessed based on the validated five-item well-being index (WHO-5), and drug adherence was evaluated using the Morisky medication adherence scale (MMAS-8). The majority of the patients were males (67.8%), overweight or obese (74%), smokers (62.1%), and unemployed or retired (54.5%). Almost 35% of the patients were lonely, and nearly one fourth were at a high risk of poor mental health. Approximately 43%, 70%, and 52% of the patients were found to have poor adherence to diet, drug, and physical activity recommendations, respectively. A lower sense of mental well-being was a significant predictor of low dietary and drug adherence. Surprisingly, overweight and obesity were associated with higher odds of dietary adherence. Male gender was positively associated with physical activity while loneliness was inversely associated with physical activity. This study showed that adherence to diet, drug, and physical activity recommendations was low in this patient population and identified several non-clinical characteristics that may affect adherence. These findings highlighted the need for considering patients' psychosocial characteristics in the treatment of patients with cardiovascular diseases.
心血管疾病在全球范围内以惊人的速度增加，在包括黎巴嫩在内的东地中海区域国家达到了流行程度。尽管黎巴嫩患有心血管疾病的患者人数不断增加，但关于心脏病患者是否遵守治疗饮食指南、药物处方和体育活动建议，以及这种遵守情况是否因社会人口统计学、生活方式或心理社会特征而异的相关数据却很少。本研究对在黎巴嫩不同医院住院的 367 名黎巴嫩成年心血管疾病患者进行了横断面研究。电子病历和多组分问卷用于收集患者特征信息。饮食评估采用特定文化的验证食物频率问卷进行，身体活动水平采用国际体力活动问卷（IPAQ）进行评估。心理健康状况基于验证的五项目幸福感指数（WHO-5）进行评估，药物依从性使用 Morisky 药物依从性量表（MMAS-8）进行评估。大多数患者为男性（67.8%）、超重或肥胖（74%）、吸烟者（62.1%）和失业或退休人员（54.5%）。将近 35%的患者感到孤独，近四分之一的患者心理健康状况不佳的风险较高。大约 43%、70%和 52%的患者分别被发现饮食、药物和体育活动建议的依从性较差。较低的心理幸福感是低饮食和药物依从性的显著预测因素。令人惊讶的是，超重和肥胖与较高的饮食依从性相关。男性与身体活动呈正相关，而孤独与身体活动呈负相关。本研究表明，该患者人群对饮食、药物和体育活动建议的依从性较低，并确定了一些可能影响依从性的非临床特征。这些发现强调了在治疗心血管疾病患者时需要考虑患者的心理社会特征。
