Self-efficacy as a predictor of compliance to a cardiac diet regimen

Abstract

Twenty two cardiac inpatients of St. Joseph's Hospital in Tucson, Arizona, were studied to assess the relationship between an individual's perception of self-efficacy (SE) in following a low fat diet and actual amount of kilocalories (kcals) consumed as fat. Subjects were eligible if they were between the ages of 21 and 80, admitted to the Coronary Intensive Care Unit with the diagnosis of angina or myocardial infarction, without additional chronic diseases and the ability to read, write, and speak English. One patient refused participation. Following educational intervention by a Registered Dietitian, a SE questionnaire was administered. Participants were asked to rate statements regarding intentions towards diet using a 5-point Likert Scale. The participants were then followed up by telephone at 6 and 12 weeks post-intervention and interviewed to obtain a 24-hour dietary recall and food frequency assessment. Three patients were not able to be contacted for follow-up. The Spearman Rank Correlation Coefficient (p<.05) was employed to determine if a relationship existed between perceived SE and actual amount of kcals consumed as fat. Although no relationship between the defined variables was confirmed, all of the subjects except for two consumed an amount of fat equal to or less than 30% of estimated kcals to maintain ideal body weight. This suggests that all of the subjects were compliant with the diet prescribed. In addition, all subjects except for one in the present study scored above 40 on the SE questionnaire, indicating that 95% of the participants felt that he/she “could probably do” all of the tasks indicated to lower fat intake. Inherent drawbacks with this study included a relatively small sample size (N=19), and subjective reports of dietary intake. Telephone follow-up was found to be of value, albeit time consuming, affording an opportunity for informal evaluation of the subject's comprehension of the diet prescription and useful feedback on educational methods. The contact also provided the subjects a change to ask questions and to receive reinforcement for progress to date.