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Abstract
Purpose
This study examined the effects of a nutrition education program on self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease (CVD).
Method
Sixty-four CVD subjects (37 experimental, 27 control) were recruited from a cardiac center, at a university hospital located in D city, Korea. All subjects attended a first heart camp where pretest measures were performed, and a second heart camp at 6 months for the posttest measures. During the 6 month study period, the experimental group was required to attend five monthly nutrition education sessions, while the control group received only routine outpatient follow-ups. Data were analyzed by X2-test and independent t-test using the SPSSWIN 11.5 program.
REFERENCES
1. Bandura A. In: Self-Efficacy: the exercise of control. New York: W.H. Freeman and Company; 1997.
2. Chait A, Malinow MR, Nevin DN, Morris CD, Eastgard RL, Kris-Etherton P, et al. Increased dietary macronutrients decreased serum homocysteine concentration in patients at high risk of cardiovascular disease. Am J Clin Nutr. 1999; 70:881–887.
3. Chang UJ, Lim KA, Han YB. Effect of nutrition education on weight control program. Korean J Food Nutr. 1999; 12:177–183.
4. Choi JC. In: An Analysis of Effects of Intervention Methods for Community-based Prevention of Cardiovascular Diseases. Kimhae: Inje University; 2005.
5. Cohen J. In: Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum; 1988.
6. Choi BG, Shon RS, Yoon TY, Choi JM, Park SY, Yoo DJ. Association of anthropometric indices with prevalence of hypertension in Korean adults. J Korean Prev Med. 1999; 32:443–451.
7. Edmundson E, Parcel GS, Feldman HA, Elder J, Perry CL, Johnson CC, et al. The effects of the Child and Adolescent Trial for Cardiovascular Health upon psychosocial determinants of diet and physical activity behavior. Prev Med. 1996; 25:442–454.
8. Elliott P, Stamler J, Nichols R, Dyer AR, Stamler R, Kesteloot H, et al. Intersalt revised: further analyses of 24 hours sodium excretion and blood pressure within and across populations. Intersalt Cooperative Research Group. BMJ. 1996; 312:1249–1253.
9. Expert panel on detection, evaluation and treatment of high blood cholesterol in adults (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adults Treatment Panel Ⅲ). JAMA. 2001; 285:2486–2497.
10. Grundy SM, Pasternak R, Greenland P, Smith S Jr, Fuster V. Assessment of cardiovascular risk by use of multiplerisk-factor assessment equations: a statement for healthcare professionals from the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 1999; 34:1348–1359.
11. Gu MO, Yu JS, Kweon IK, Kim HW, Lee EO. A review of research on self-efficacy theory applied to health related behavior. J Korean Acad Nurs. 1994; 24:278–302.
12. Han SH. In: The effect of exercise program with strategies promoting self-efficacy on health status and exercise capacity in patients after the stem cell transplantation. Seoul: Yonsei University; 2000.
13. Janz N, Campion V, Strecher V. The health belief model. In: Glanz K, Rimer B, Lewis F, editors. Health Behavior and Health Education: Theory, Research, and Practice. 3rd ed. San Fransisco, CA: Jossey-Bass; 2002. pp. 45-66.
14. Jensen K, Banwart L, Venhaus R, Popkess-Vawter S, Perkins SB. Advanced rehabilitation nursing care of coronary angioplasty patients using self-efficacy theory. J Adv Nurs. 1993; 18:926–931.
15. Kim MY, Lee SW, Shin ES, Park HS. Diet and eating behavior in obese patients. J Korean Acad Fam Med. 1994; 15:353–362.
16. Kim MS, Kim SY. The three dimensions of eating behavior: development of scale for assessing cognitive restraint of eating, disinhibition, and hunger. J Korean Acad Nurs. 1997; 27:377–388.
17. Kim S, Sohn C, Chung WY. Effects of medical nutrition therapy on food habits and serum lipid levels of hypercholesterolemic patients. J Korean Dietetic Assoc. 2005; 11(1):125–132.
18. Statistics of Causes of Death of Korean. Korea National Statistical Office; 2003.
19. Krauss RM, Eckel RH, Howard B, Appel LJ, Daniels SR, Deckelbaum RJ, et al. AHA dietary guidelines: revision 2000: a statement for health care professionals from the nutrition committee of the American heart association. Circulation. 2000; 102:2284–2299.
20. Lee HJ. In: Effect of Individual Health Education in the Medical Clinic of Public Health Centers on Knowledge, Self-Efficacy, and Self-care behavior in Clients with Hypertension. Seoul: Yonsei University; 2004.
21. Metz JA, Stern JS, Kris-Etherton P, Reusser ME, Morris CD, Hatton DC, et al. A randomized trial of improved weight loss with a prepared meal plan in overweight and obese patients: impact on cardiovascular risk reduction. Arch Intern Med. 2000; 160:2150–2158.
22. Miller CK, Edwards L, Kissling G, Sanville L. Evaluation of a theory-based nutrition intervention for older adults with diabetes mellitus. J Am Dietetic Assoc. 2002; 102:1069–1081.
23. Moon EH. In: Implementation and evaluation of nutrition education program for hypertensive patients among adults aged 50 and over. Seoul: Seoul Women's University; 2004.
24. Oh DJ. In: Characteristics of cardiovascular disease. The Korean Society of Circulation; 2003.
25. Reusser ME, McCarron DA. Reducing hypertensive cardiovascular risk of african americans with diet: focus on the facts. J Nutr. 2006; 136:1099–1102.
26. Shin MJ, Lim HS, Chung NS, Cho SY, Kim SS. Effect of dietary therapy on blood lipid in outpatients with hypercholesterolemia. J Korean Diet Assoc. 2001; 7:313–319.
27. Song R, June KJ, Ro YJ, Kim CG. Effects of motivation-enhancing program on health behaviors, cardiovascular risk factors, and functional status for Institutionalized elderly women. J Korean Acad Nurs. 2001; 31:858–870.
28. Stunkard A, Messick S. The three factor eating questionnaire to measure dietary restrain, disinhibition, and hunger. J Psychosom Res. 1985; 29(1):71–83.
29. Yoon JS, Jeong YH, Park JA, Oh HM. The effect of individualized nutritional education on adults having two or more symptoms of chronic degenerative disease. Korean J Community Nutr. 2002; 7:794–802.
30. Yu SJ, Song MS, Lee YJ. The effects of self-efficacy promotion and education program on self-efficacy, self-care behavior, and blood pressure for elderly hypertensives. J Korean Acad Adult Nurs. 2001; 13(1):108–122.
Table 1.
Homogeneity Test for General and Disease-Related Characteristics between the Experimental and Control Groups (N=64)
| Characteristics |
Frequency (%) |
χ2 | p | ||
|---|---|---|---|---|---|
| Total | Experimental (n=37) | Control (n=27) | |||
| Gender | 3.025 | .082 | |||
| Male | 41 (64.1) | 27 (73.0) | 14 (51.9) | ||
| Female | 23 (35.9) | 10 (27.0) | 13 (48.1) | ||
| Age (yr) | 1.420 | .701 | |||
| < 60 | 5 (7.8) | 4 (10.8) | 1 (3.7) | ||
| 60-64 | 18 (28.1) | 10 (27.1) | 8 (29.6) | ||
| 65-69 | 27 (42.2) | 16 (43.2) | 11 (40.8) | ||
| ≥70 | 14 (21.9) | 7 (18.9) | 7 (25.9) | ||
| Mean (SD) | 66.36 (4.01) | 65.92 (3.69) | 66.96 (4.42) | ||
| Marital status | 2.829 | .093 | |||
| Married | 62 (96.9) | 37 (100.0) | 25 (92.6) | ||
| Widowed | 2 (3.1) | 0 (0) | 2 (7.4) | ||
| Education | 4.093 | .536 | |||
| Elementary school | 17 (26.6) | 8 (21.6) | 9 (33.3) | ||
| Middle school | 7 (10.9) | 4 (10.8) | 3 (11.2) | ||
| High school | 18 (28.1) | 10 (27.1) | 8 (29.6) | ||
| College or more | 22 (34.4) | 15 (40.5) | 7 (25.9) | ||
| Economic status | 1.730 | .188 | |||
| Middle | 48 (75.0) | 30 (81.1) | 18 (66.7) | ||
| Low | 16 (25.0) | 7 (18.9) | 9 (33.3) | ||
| Smoking | 3.768 | .583 | |||
| Current smoker | 3 (4.6) | 1 (2.7) | 2 (7.4) | ||
| Quit | |||||
| ≥5 yr | 15 (23.5) | 10 (27.0) | 5 (18.5) | ||
| <5 yr | 14 (21.9) | 10 (27.0) | 4 (14.8) | ||
| None | 32 (50.0) | 16 (43.3) | 16 (59.3) | ||
| Admission history | 0.152 | .697 | |||
| Yes | 29 (45.3) | 16 (43.2) | 13 (48.1) | ||
| No | 35 (54.7) | 21 (56.8) | 14 (51.9) | ||
| Chronic disease* | |||||
| Arthritis | 16 (25.0) | 10 (27.0) | 6 (20.0) | ||
| Diabetes | 10 (15.6) | 6 (16.2) | 4 (13.3) | ||
| Hypertension | 30 (46.9) | 18 (48.6) | 14 (46.7) | ||
| Vascular disease | 24 (37.5) | 16 (43.2) | 8 (29.6) | ||
| Respiratory disease | 10 (15.6) | 5 (13.5) | 5 (16.7) | ||
| Neuralgia | 10 (15.6) | 6 (16.2) | 4 (13.3) | ||
| Others | 5 (7.8) | 3 (8.1) | 2 (6.7) | ||
| Perceived health status | 2.176 | .537 | |||
| A lot worse | 12 (18.8) | 9 (24.3) | 3 (11.1) | ||
| Somewhat worse | 14 (21.9) | 8 (21.6) | 6 (22.2) | ||
| Similar | 28 (43.8) | 14 (37.8) | 14 (51.9) | ||
| Somewhat better | 10 (15.5) | 6 (16.3) | 4 (14.8) | ||
Table 2.
Homogeneity Test for Self Efficacy, Diet Behavior Pattern and Cardiovascular Risk Factors between the Experimental and Control Groups
Table 3.
Mean Group Comparisons in Self Efficacy, Diet Behavior Pattern and Cardiovascular Risk Factors at the Posttest
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