Nutrition and Health Post-graduation program, Department of Nutrition, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Nursing Graduation Course, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Nutrition. 2024 Aug;124:112451. doi: 10.1016/j.nut.2024.112451. Epub 2024 Apr 3.
Nutritional recommendations, a core component of cardiovascular rehabilitation, play a vital role in managing cardiovascular diseases. However, adherence to these recommendations is complex, particularly in low-resource settings. This study explored the barriers and facilitators influencing adherence to nutritional recommendations among participants in a low-resource cardiovascular rehabilitation program in Brazil.
A mixed-methods approach was employed. Sociodemographic data, the Mediterranean diet score, scale for assessing nutrition, and open-ended questions on adherence were collected. Those who completed the questionnaires (phase 1) were invited to participate in one focus group session (phase 2). The participants were characterized according to the responses provided in phase 1 (Mediterranean diet score and scale for assessing nutrition) in low adherence or high adherence to dietary practice. Descriptive statistics and thematic content analysis within the context of the theory of planned behavior were employed.
Seventy-four participants completed phase 1, with 41.9% classified into low adherence and 27.0% in high adherence; of those, 17 participated in phase 2. Focus group findings revealed 9 themes/29 subthemes. Barriers included food prices, income, knowledge, routine, food access, family patterns, disease, work, anxiety, eating habits, and food planning. Facilitators included affordable food, health considerations, taste preferences, knowledge, family/professional support, government assistance, personal willpower, income stability, easy food access, media influence, and a quiet eating place.
The study findings underscore the need for targeted interventions, including individualized meal planning, community engagement, and enhanced access to healthcare professionals, to optimize dietary adherence and improve cardiovascular outcomes.
营养建议是心血管康复的核心组成部分，对管理心血管疾病起着至关重要的作用。然而，在资源匮乏的环境中，这些建议的遵循较为复杂。本研究旨在探讨影响巴西低资源心血管康复项目参与者遵循营养建议的障碍和促进因素。
采用混合方法。收集社会人口统计学数据、地中海饮食评分、营养评估量表和关于遵循情况的开放性问题。那些完成问卷的人（第 1 阶段）被邀请参加一个焦点小组会议（第 2 阶段）。参与者根据第 1 阶段（地中海饮食评分和营养评估量表）的回答特征分为低遵循或高遵循饮食实践。采用描述性统计和有计划行为理论的主题内容分析。
74 名参与者完成了第 1 阶段，其中 41.9%被归类为低遵循，27.0%为高遵循；其中 17 名参与者参加了第 2 阶段。焦点小组的发现揭示了 9 个主题/29 个子主题。障碍包括食品价格、收入、知识、日常生活、食物获取、家庭模式、疾病、工作、焦虑、饮食习惯和食物规划。促进因素包括负担得起的食物、健康考虑、口味偏好、知识、家庭/专业支持、政府援助、个人意志力、收入稳定、方便获取食物、媒体影响和安静的用餐地点。
研究结果强调需要采取有针对性的干预措施，包括个性化膳食计划、社区参与以及增强获得医疗保健专业人员的机会，以优化饮食遵循并改善心血管结局。
