ผลของโปรแกรมการปรับเปลี่ยนการรับประทานอาหาร ต่อรอบเอวและความดันโลหิตในผู้ป่วยโรคความดันโลหิตสูงที่อ้วนลงพุง

Sunantha  Pokpong; Panan  Pichayapinyo; Sunee  Lagampan; Korapat  Mayurasakorn

Authors

Sunantha Pokpong Faculty of Public Health, Mahidol University
Panan Pichayapinyo Faculty of Public Health, Mahidol University
Sunee Lagampan Faculty of Public Health, Mahidol University
Korapat Mayurasakorn Faculty of Public Health, Mahidol University

Keywords:

abdominal obesity, dietary consumption, hypertension, stage of change

Abstract

Introduction: Hypertension(HT) is a common public health problem in Thailand. Obesity was found as a co-existing incidence among patients with HT. Dietary consumption is recognized as an important factor to control high blood pressure (BP) and reduce waist circumference.

Objectives: The study aimed to investigate an effectiveness of diet change program among hypertensive patients with abdominal obesity to dietary consumption awareness, decisional balance in consumption, perceived self-efficacy of consumption, dietary consumption behavior, BP level, and waist circumference.

Methods: This quasi-experimental study was conducted in the primary care unit, Siriraj hospital from October 2019 to March 2020. The inclusion criteria were: aged 35 years and older, and diagnosed with HT for at least 1 year. Participants visiting the clinic on Monday were assigned into the experimental group (n = 28) and those who visiting on Thursday were assigned into the comparison group (n = 31). The 8-week program applying the Stage of Change theory included health status assessment, educational session of HT and obesity, analysis of eating behavior, goal setting, diet skill practice, and telephone monitoring. The comparison group received routine care from the clinics. Data were collected using questionnaires at baseline and at 6-, and 8-week follow-ups. Data were analyzed using frequency, mean, standard deviation, Chi-square test, Repeated Measure ANOVA, pair t-test, and Independent t-test.

Result: At follow-up, the experimental group had significant greater mean scores of dietary consumption awareness, decisional balance in consumption, perceived self-efficacy, dietary behavior greater, lower systolic BP (p < .001), and lower waist circumference (p < .05) than those at the baseline, but no significant difference in mean of diastolic BP (p > .05). The experimental group had the mean difference scores between the 6^th week and baseline, and those between the 8^th week and baseline of dietary consumption awareness, decisional balance in consumption, perceived self-efficacy, and dietary behavior significant greater than those in the comparison group (p < .001). Also, the experimental group had the mean difference of waist circumference and systolic BP significant greater than those in the comparison group (p < .05). However, the mean difference in diastolic BP between groups was not observed (p > .05).

Conclusion: The diet change program can promote better eating behavior leading to lower systolic BP and lessen waist circumference among patients with HT and abdominal obesity.

Implications: This program can be applied in other community settings. Recommendations for further research include extended study duration, and large sample size to examine the sustainability of behavior and the effectiveness of the program.

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