Factors Influencing Adherence to the DASH Diet in Patients with Hypertension
Article Sidebar
Main Article Content
Abstract
A predictive correlational research design aimed to study the influence of family support, trust in provider, body mass index, duration of treatment, and self-efficacy on adherence to the Dietary Approaches to Stop Hypertension (DASH diet) consumption in patients with hypertension. The samples consisted of 140 patients with essential hypertension, aged 18 years or above, both males and females, being treated with hypertensive medication at least 6 months, normal cognitive function, able to communicate in Thai and able to consume food on their own, who came for follow-up visits at OPD medicine in Somdech Phra Pinklao hospital. The research instruments comprised of personal information questionnaire and health record, family support questionnaire, trust in provider questionnaire, self-efficacy to consume DASH diet and adherence to the DASH diet questionnaire. The questionnaires and assessment tools were content validated and tested for reliability with a Cronbach’s alpha coefficient of 0.95, 0.94, 0.78 and 0.71, respectively. Data were analyzed using descriptive statistics and multiple regression analysis.
The results showed that 50.7 % were male with average age of 62.1 (SD = 11.67); average duration of treatment for high blood pressure 9.62 years (SD = 8.96); BMI > 24.9 equal to 61.4%; 34.3% of the participants were adherent to DASH diet. Trust in provider, and self-efficacy together contributed for 31.3 % (Standard error = 5.909, F = 32.711, p < .01) of the variance explained in adherence to DASH diet. Only self-efficacy could predict adherence to DASH diet in patients with essential hypertension (β = .553, p < .01). Nurses should encourage hypertensive patients to have confidence to consume DASH diet such as providing information about the benefits of DASH diet, healthy food resources and giving examples of role models who consume DASH diet and become successful in controlling blood pressure.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
World Health Organization. Hypertension. [Internet]. [cited 2023 January 19]. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension.
Department of Disease Control. Department of Disease Control advise people to pay attention to their health measure blood pressure regularly prevent hypertension. [Internet]. [cited 2022 December 25]. Available from: https://ddc.moph.go.th/brc/news.php?news=25290&deptcode=brc&news_views. (in Thai).
Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Himmelfarb CD, et al. 2017 ACC/AHA/ AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension 2018;71(6):1269-1324.
World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003.
Padma V. DASH in preventing hypertension. Advances in Biological Research 2014;8(2):94-6.
Schwingshackl L, Chaimani A, Schwedhelm C, Toledo E, Pünsch M, Hoffmann G, et al. Comparative effects of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: a systematic review and network meta-analysis. Crit Rev Food Sci Nutr 2019;59(16):2674-87.
Siervo M, Lara J, Chowdhury S, Ashor A, Oggioni C, Mathers JC. Effects of the dietary approach to stop hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis. Br J Nutr 2015;113(1):1-15.
Thai Hypertension Society. 2015 Thai guidelines on the treatment of hypertension. [Internet]. [cited 2020 June 27]. Available from: http://www.thaiheart.org/images/column_1563846428/Thai%20HT%20Guideline%202019. pdf. (in Thai).
Abbas H, Kurdi M, Watfa M, Karam R. Adherence to treatment and evaluation of disease and therapy knowledge in Lebanese hypertensive patients. Patient Prefer Adherence 2017;11:1949-56.
Shim JS, Heo JE, Kim HC. Factors associated with dietary adherence to the guidelines for prevention and treatment of hypertension among Korean adults with and without hypertension. Clin Hypertens 2020;26:5.
Chacko S, Jeemon P. Role of family support and self-care practices in blood pressure control in individuals with hypertension: results from a cross-sectional study in Kollam district, Kerala. Wellcome Open Res 2020;5:180.
Petprayoon S, Wattanakitkrileart D, Pongthavornkamol K, Peerapatdit T. The influence of perceived severity, health literacy, and family support on self-care behavior of patients with type 2 diabetes mellitus. Journal of Nursing Science Chulalongkorn University 2014;26(1):38-51. (in Thai)
Leon N, Charles S, Agueh VD, Magloire D, Clemence M, Azandjeme C, et al. Determinants of adherence to recommendations of the dietary approach to stop hypertension in adults with hypertension treated in a hospital in Benin. Universal Journal of Public Health 2015;3(5):213-9.
IsangulaK G, Seale H, Nyamhanga TM, Jayasuriya R, Stephenson N. Trust matters: patients’ and providers’ accounts of the role of trust in hypertension care in rural Tanzania. Tanzania Journal of Health Research 2018;20(1):1-15.
Hassan H, Wattanakitkraileart D, Pongthavornkamol K. Factors predicting medication adherence in patients with essential hypertension in Malé, Maldives. Nurs Sci J Thail 2023;41(1):100-13.
Ruangthip T, Wattanakitkrileart D, Charoenkitkarn V, Dumavibhat C. Factors influencing medication adherence in patients with chronic heart failure. Royal Thai Navy Medical Journal 2017;44(3):51-65. (in Thai).
Jones DE, Carson KA, Bleich SN, Cooper LA. Patient trust in physicians and adoption of lifestyle behaviors to control high blood pressure. Patient Educ Couns 2012;89(1):57-62.
Soltani S, Shirani F, Chitsazi MJ, Salehi-Abargouei A. The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials. Obes Rev 2016;17(5):442-54.
Farhadnejad H, Darand M, Teymoori F, Asghari G, Mirmiran P, Azizi F. The association of dietary approach to stop hypertension (DASH) diet with metabolic healthy and metabolic unhealthy obesity phenotypes. Sci Rep 2019;9(1):18690.
Kim H, Andrade FC. Diagnostic status of hypertension on the adherence to the dietary approaches to stop hypertension (DASH) diet. Prev Med Rep 2016;4:525-31.
Hanarong A, Toonsiri C, Rattanagreethakul S. Factors affecting eating behaviors among hypertensive patients. JFONUBUU. 2017;25(3):52-65. (in Thai).
Mahmoodabad SSM, Dashti S, Argouei AS, Fallahzadeh H, Soltani M. Determinants of dietary approaches to stop hypertension (DASH) among prehypertension individuals: an application of protection motivation theory. Medical Sciences 2019;23(96):244-9.
Trongsakul S, Lambert R, Clark A, Wongpakaran N, Cross J. Development of the Thai version of Mini-Cog, a brief cognitive screening test. Geriatr Gerontol Int 2015;15(5):594-600.
Moonsarn S, Sumpowthong K. Effects of dietary behavior modification program guideline of the DASH with self-efficacy theory and social support on reducing the risk of hypertension among pre-hypertensive patients. The Public Health Journal of Burapha University 2016;11(1):87-98. (in Thai).
Buttapim S, Wanitkun N, Sindhu S, Kasemsarn C. Predictive factors of patients’ quality of life three months after post coronary artery bypass graft surgery. Thai Journal of Cardio-Thoracic Nursing 2018;29(2):127-40. (in Thai).
Francisco SC, Araújo LF, Griep RH, Chor D, Molina MDCB, Mil JG, et al. Adherence to the dietary approaches to stop hypertension (DASH) and hypertension risk: results of the longitudinal study of adult health (ELSA-Brasil). Br J Nutr 2020;123(9):1068-77.
Reyes-García A, López-Olmedo N, Basto-Abreu A, Shamah-Levy T, Barrientos-Gutierrez T. Adherence to the DASH diet by hypertension status in Mexican men and women: a cross-sectional study. Prev Med Rep 2022;27:101803.
Siriboonyarit N, Wattanakitkrileart D, Phligbua W. Effects of nutrition education program through line application on dietary behaviors in patients with primary hypertension. Royal Thai Navy Medical Journal 2023;50(2):328-45. (in Thai).
Thai Hypertension Society. 2019 Thai guidelines on the treatment of hypertension. [Internet]. [cited 2020 June 9]. Available from: http://www.thaiheart.org/images/column_1563846428/Thai%20HT%20Guideline%202019. pdf. (in Thai).