Dietary Self-efficacy Research Articles

The Usability and Feasibility of a Dietary Intake Self-Monitoring Application in a Population with Varying Literacy Levels.

Our aim was to study how hemodialysis patients with varying levels of literacy would use a diet and fluid intake monitoring mobile application (DIMA-P) and what would be its impact on their dietary behaviors. We developed a mobile application using user-centered methods and informed by the Integrated Theory of Health Behavior Change (ITHBC). Eight hemodialysis patients were recruited to use the application to record and monitor their diet and fluid intakes for a 6-week study. Overall, the participants had low literacy, numeracy, and technical skills. We collected the data on application usage and administered usability and context-of-use questionnaires to gain insights into the participants' interaction with the application. The participants' portion estimation skills and dietary self-regulation self-efficacy were assessed using various tests. In addition, interdialytic weight gain data were collected to assess the impact of app usage on the participants' health outcomes. The application usage patterns varied, with a general trend towards frequent use (n = 5) correlating with engagement in self-monitoring. The participants gave high comprehensibility, user-friendliness, satisfaction, and usefulness ratings, suggesting that the app was well designed and the target users could easily navigate and interact with the features. While the participants improved in estimating portion sizes, the impact on measuring skills was variable. There was also an improvement in the participants' dietary self-regulation self-efficacy post-study. The interdialytic weight gain trends indicated a slight improvement in fluid and diet management. People with different literacy skills can effectively use icon-based interfaces for portion size estimation and develop personalized usage patterns to self-regulate their fluid and dietary intakes. Moreover, they can experience an enhancement in their dietary self-efficacy skills by using a mobile application aimed at providing nutritional feedback. Furthermore, this research shows that the constructs of the ITHBC are effective in promoting dietary behavior change in a population with varying literacy skills. The target users can benefit from explicitly visualizing the relationship between their health outcomes and the factors influencing those outcomes. These user ambitions could be supported by developing machine learning models. Future research should also focus on enhancing the mechanisms by which technology can further enhance each component of the ITHBC framework.

Health Education Impact on Acute Coronary Syndrome (ACS) Patients' Self-Efficacy & Self-Care

Acute Coronary Syndrome (ACS) is a life-threatening condition. Health education interventions are needed as secondary prevention efforts. This study aimed to analyze the effect of health education on self-efficacy and self-care for ACS patients. This study used a pre-experimental one-group pre-posttest design. The number of samples was 41 respondents taken by purposive sampling technique. Self-efficacy was measured using the General Self-Efficacy (GSE) questionnaire, Cardiac Diet Self-Efficacy (CDSE), and Cardiac Self-Efficacy (CSE). Self-Care Coronary Heart Disease Inventory (S-C CHDI) was used to measure self-care of the patients. Data were analyzed using a dependent t-test. The results showed an increase in the average score of self-efficacy before health education from 129.12 (SD = 16.65) to 142.49 (SD = 13.34) after health education. The self-care score before health education was 51.78 (SD = 11.51), which increased to 59.90 (SD = 10.25) after health education was performed. There was a significant increase in self-efficacy and self-care after health education was conducted, with a p-value = 0.001 <0.05. There was a significant influence of health education intervention on self-efficacy and self-care of patients with ACS. Health education can be programmed as a nursing intervention for ACS patients who are receiving treatment in a hospital.

The Impact of Parental Involvement in the Prevention and Management of Obesity in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Obesity in children is a critical public health issue in developed countries and developing countries. The establishment of health-related behaviors in childhood, significantly influenced by parental involvement, underscores the need for effective intervention measures. This original research is a systematic review and meta-analysis that aimed to investigate the impact of parental involvement on the prevention and management of childhood obesity, focusing on outcomes such as BMI z-score, exercise levels, screen time, dietary self-efficacy, and percentage body fat. Adhering to the PRISMA guidelines, we conducted a systematic review and meta-analysis of 12 randomized controlled trials (RCTs) identified through comprehensive searches of PubMed, Scopus, Web of Science, and the Cochrane Library, including RCTs involving children aged 2-18 years with parental or caregiver participation, reporting on the specified outcomes. Data analysis was performed using RevMan 5.3, employing a random effects model. A total of 5573 participants were included. The meta-analysis revealed a significant reduction in BMI z-score (MD = -0.06, 95% CI: -0.09 to -0.02, p = 0.005, I2 = 58%), a non-significant increase in exercise levels (SMD = 0.26, 95% CI: -0.01 to 0.52, p = 0.05, I2 = 52%), and a significant reduction in screen time (MD = -0.36 h per day, 95% CI: -0.61 to -0.11, p = 0.005, I2 = 0%). Dietary self-efficacy also improved significantly (MD = 0.59, 95% CI: 0.12 to 1.05, p = 0.01, I2 = 0%). However, changes in percentage body fat did not reach statistical significance (MD = -1.19%, 95% CI: -2.8% to 0.41%, p = 0.15, I2 = 0%). Parental involvement in childhood obesity interventions significantly impacts BMI z-score, exercise levels, screen time, and dietary self-efficacy but not percentage body fat. These findings highlight the importance of engaging parents in obesity prevention and management strategies.

Rationale and design of the KP ENRICH trial: A food is medicine intervention in low-income high-risk adults with diabetes within Kaiser Permanente

BackgroundFood insecurity is associated with poor glycemic control and increased risk for diabetes-related complications. The clinical benefit of addressing these challenges through a medically supportive grocery prescription (GRx) program in patients with type 2 diabetes mellitus (T2D) remains unclear. We report the aims and design of a randomized clinical trial to evaluate the effectiveness of a 6-month GRx intervention on hemoglobin A1c (HbA1c) levels among low-income adults with T2D. MethodsThe Kaiser Permanente Evaluating Nutritional Interventions in Food-Insecure High-Risk Adults (KP ENRICH) Study is a pragmatic randomized trial enrolling 1100 participants within Kaiser Permanente Northern California and Southern California, two integrated health care delivery systems serving >9 million members. Medicaid-insured adults with T2D and baseline HbA1c ≥7.5% will be randomized at a 1:1 ratio to either GRx, delivered as $100 per month for select items from among a curated list of healthful food groups in an online grocery ordering and home-delivery platform along with biweekly digital nutrition educational materials, or control, consisting of free membership and deliveries from the online grocery platform but without curated food groups or purchasing dollars. The primary outcome is 6-month change in HbA1c. Secondary outcomes include 12-month change in HbA1c, and 6- and 12-month change in medical resource utilization, food security, nutrition security, dietary habits, diabetes-related quality of life, and dietary self-efficacy. ConclusionsThe results of this large randomized clinical trial of GRx will help inform future policy and health system-based initiatives to improve food and nutrition security, disease management, and health equity among patients with T2D.

Procedural Fairness in Physician-Patient Communication: A Predictor of Health Outcomes in a Cohort of Adults with Overweight or Obesity.

This study aimed to explore whether patients' perception of procedural fairness in physicians' communication was associated with willingness to follow doctor's recommendations, self-efficacy beliefs, dietary behaviors, and body mass index. This was a secondary analysis of baseline data from 489 primary care patients with a BMI ≥ 25kg/m2 (43.6% Black, 40.7% Hispanic/Latino, 55.8% female, mean age = 50years), who enrolled in a weight management study in two New York City healthcare institutions. We conducted ordinary least squares path analyses with bootstrapping to explore direct and indirect associations among procedural fairness, willingness to follow recommendations, self-efficacy, dietary behaviors, and body mass index, while controlling for age and gender. Serial, multiple mediator models indicated that higher procedural fairness was associated with an increased willingness to follow recommendations which, in turn, was associated with healthier dietary behaviors and a lower BMI (indirect effect = - .02, SE = .01; 95% CI [- .04 to - .01]). Additionally, higher procedural fairness was associated with elevated dietary self-efficacy, which was, in turn, was associated with healthier dietary behaviors and lower BMI (indirect effect = - .01, SE = .003; 95% CI [- .02 to - .002]). These findings highlight the importance of incorporating procedural fairness in physician-patient communication concerning weight management in diverse primary care patients.

Caregiver self-efficacy providing nutritional support for pediatric patients undergoing hematopoietic stem cell transplant is associated with psychosocial factors.

Caregiver self-efficacy in providing nutritional support to pediatric hematopoietic stem cell transplantation (HSCT) patients has been little studied despite the increased risk of these children potentially being over- or under-nourished after HSCT, and nutritional status could possibly affect treatment outcomes. The current study aimed to describe caregiver dietary self-efficacy and its associated psychosocial factors and barriers to following dietary recommendations. Caregivers completed questionnaires pre-HSCT and 30 days, 100 days, and one year post-HSCT. A subset provided a 24-h recall of food intake. Results showed generally high caregiver confidence and low difficulty supporting their child nutritionally. However, lower confidence was associated with higher caregiver depression, anxiety, and stress 30 days post-HSCT. Further, higher difficulty at various time points was correlated with lower income, higher depression and anxiety, stress, and miscarried helping (i.e., negative caregiver-child interactions surrounding eating), as well as child overweight status and failure to meet protein intake guidelines. Nutritional criteria for protein, fiber, added sugar, and saturated fat were met by 65%, 0%, 75%, and 75%, respectively. Caregiver attitudes and child behavior were the most frequently reported barriers to healthy eating. Results suggest that directing resources to caregivers struggling emotionally, economically, or transactionally could support pediatric patients undergoing HSCT in maintaining optimal nutritional status.

Promoting dietary self-efficacy through social support: An application to online weight-loss communities

An increase in the number of individuals trying to lose weight has enabled the development of online weight-loss support communities (Weight Watchers, Dukan, etc.). This research aims to study whether and how social support in these communities affects dietary self-efficacy to improve individuals’ food well-being. After an initial qualitative study with 25 community users, we formulated hypotheses and tested them in a quantitative study involving 335 users. The results show that social support contributes to dietary self-efficacy through two sequential mediators: identification with community members and motivation to comply with group norms. Our analyses also show that nutritional knowledge moderates the relationship between motivation to comply and dietary self-efficacy. The results of these two studies enrich the literature on online communities and allow us to suggest managerial recommendations for administrators of these communities and health professionals.

Effects of an Individualized mHealth-Based Intervention on Health Behavior Change and Cardiovascular Risk Among People With Metabolic Syndrome Based on the Behavior Change Wheel: Quasi-Experimental Study.

Metabolic syndrome (MetS) is a common public health challenge. Health-promoting behaviors such as diet and physical activity are central to preventing and controlling MetS. However, the adoption of diet and physical activity behaviors has always been challenging. An individualized mobile health (mHealth)-based intervention using the Behavior Change Wheel is promising in promoting health behavior change and reducing atherosclerotic cardiovascular disease (ASCVD) risk. However, the effects of this intervention are not well understood among people with MetS in mainland China. We aimed to evaluate the effects of the individualized mHealth-based intervention using the Behavior Change Wheel on behavior change and ASCVD risk in people with MetS. We conducted a quasi-experimental, nonrandomized study. Individuals with MetS were recruited from the health promotion center of a tertiary hospital in Zhejiang province, China. The study involved 138 adults with MetS, comprising a control group of 69 participants and an intervention group of 69 participants. All participants received health education regarding diet and physical activity. The intervention group additionally received a 12-week individualized intervention through a WeChat mini program and a telephone follow-up in the sixth week of the intervention. Primary outcomes included diet, physical activity behaviors, and ASCVD risk. Secondary outcomes included diet self-efficacy, physical activity self-efficacy, knowledge of MetS, quality of life, and the quality and efficiency of health management services. The Mann-Whitney U test and Wilcoxon signed rank test were primarily used for data analysis. Data analysis was conducted based on the intention-to-treat principle using SPSS (version 25.0; IBM Corp). Baseline characteristics did not differ between the 2 groups. Compared with the control group, participants in the intervention group showed statistically significant improvements in diet behavior, physical activity behavior, diet self-efficacy, physical activity self-efficacy, knowledge of MetS, physical health, and mental health after a 12-week intervention (P=.04, P=.001, P=.04, P=.04, P=.001, P=.04, P=.04, and P<.05). The intervention group demonstrated a statistically significant improvement in outcomes from pre- to postintervention evaluations (P<.001, P=.03, P<.001, P=.04, P<.001, P<.001, and P<.001). The intervention also led to enhanced health management services and quality. The individualized mHealth-based intervention using the Behavior Change Wheel was effective in promoting diet and physical activity behaviors in patients with MetS. Nurses and other health care professionals may incorporate the intervention into their health promotion programs.

Racial discrimination, self-efficacy, and oral health behaviours in adolescents.

To examine the mediation effect of discrimination on the association of self-efficacy and oral health behaviours among adolescents. A cross sectional study of adolescents aged 12 to 18 years who were recruited from the University outpatient dental clinic were asked to complete a questionnaire consisting of: demographics (12 items), oral health behaviours (7 items), general self-efficacy (10 items) and self-efficacy for self-care (SESS, 15 items). Perceived discrimination was assessed if the adolescent had ever been treated unfairly based on their race. Perceived discrimination was assessed if the adolescent had ever been treated unfairly based on their race. Using pathway analyses, the relationship between oral health behaviours, self-efficacy, and discrimination was explored. Mediation and hierarchal logistic regression analyses were conducted. Of 252 participants, mean (SD) age was 14 (1.8) years old. 60% were female, 81% were born in Canada, 56% identified themselves as White, and 20% perceived discrimination. Mean score of all task-specific self-efficacies were significantly different within respective oral health behaviour categories (P-value <0.001). Of demographics, age and ethnicity (White) were significantly associated with discrimination (OR = 1.25: 95% CI; 1.06-1.48 and OR = 0.29: 95% CI; 0.15-0.55, respectively). Perceived discrimination was positively associated with higher sugar consumption and mediate the association between diet self-efficacy and adolescent's dietary behaviour. Significant mediation effect of perceived discrimination on the association of diet specific self-efficacy and diet oral health behaviour was observed. Oral health behaviours were self-reported which may have influenced the results.

Effects of a smartphone app-based diet and physical activity program for men living with HIV who have dyslipidemia: A pilot randomized controlled trial.

People living with HIV are at a high risk for cardiovascular disease owing to antiretroviral therapy use and chronic inflammation. There is limited evidence on the evaluation of serum lipid levels through lifestyle modification. This study aims to evaluate the effect of a smartphone application-based diet and exercise improvement program on men living with HIV and dyslipidemia. This was a randomized controlled trial recruiting Japanese men living with HIV who have dyslipidemia: intervention group (n = 19) and control group (n = 19). The intervention group received a third individual guidance session during the 6-month intervention and was encouraged to record their diet on a smartphone application. An intention-to-treat analysis of the results was conducted. The intervention group showed significantly reduced change in low-density lipoprotein levels compared to the control group (-4.00 ± 20.2 mg/dL vs. 10.11 ± 21.1 mg/dL) (p = .042) from baseline to 6 months post-intervention. No significant differences were found in other serum lipid levels. Abdominal circumference decreased significantly in the intervention group (p = .048) from baseline to 6 months post-intervention. Total energy, protein, carbohydrate, fat, and salt intake, dietary and physical activity behavior change stages and social support, dietary self-efficacy, and loneliness significantly improved in the intervention group (p < .05) from baseline to 6 months post-intervention. A diet and physical activity improvement program using a smartphone application based on Japanese-specific health guidance may reduce low-density lipoprotein cholesterol levels in this population. Further sample expansion and examination of long-term effects are needed.

Self-Efficacy and Readiness to Change Among Women with Recent Gestational Diabetes Engaging in a Web-Based Lifestyle Intervention: The Balance After Baby Intervention Trial

Few evidence-based programs exist to help women with a history of gestational diabetes reduce their risk of developing type 2 diabetes. In secondary analyses from a randomized clinical trial of a web-based lifestyle intervention program for postpartum women with recent gestational diabetes, we studied changes in self-efficacy for diet and physical activity and readiness to change health behaviors. Women were randomized at ∼6 weeks postpartum and completed questionnaires at 6 weeks and 6, 12, 18, and 24 months. Our study included 181 women (mean age 32.4 ± 5.2 years; 48% White, 19% Asian, 14% Black or African American, 17% other/mixed race; 34% Hispanic). In a linear mixed effects model, women in the intervention had significantly greater improvement in overall self-efficacy scores for physical activity compared with the control group at 24 months (difference in change scores between groups .35, 95% CI: .03 to .67, P = .03). The intervention group also demonstrated significantly greater improvement in self-efficacy scores for both physical activity subdomains, specifically “sticking to it” at 24 months and “making time” at 12 months. Participants in the intervention did not experience a significant difference in change in self-efficacy for diet or readiness to change compared with those in the control arm.

Body Self-Perception, Dietary Self-Efficacy, and Body Mass Index in Young Adults: A Cross-Sectional Survey

Body self-perception and dietary self-efficacy may represent an important factor in the prevention of excess body weight. This study evaluated body self-perception, dietary self-efficacy, and body mass index (BMI) in the Peruvian population. A cross-sectional online survey was administered to 190 men and 210 women. Each participant was shown 9 Stunkard anatomical silhouettes corresponding to BMI values. The results obtained were classified as underweight, normal weight, overweight, and obese. The Dieting Self-Efficacy Scale (DIET-SE) was also applied. Chi-square statistic, Kruskal-Wallis, Student t-test, and ANOVA were used to explore differences in means and proportions. Age was significantly higher in those who underestimated their weight and who were dissatisfied with their body (p = 0.000). BMI was higher in men, most were dissatisfied with their body (p<0.05), and were more likely to underestimate their weight compared to women (p = 0.000). Those participants who were dissatisfied with their body and who underestimated their weight were more likely to have an elevated BMI compared to those who were satisfied and who did not underestimate their weight. All participants had low dietary self-efficacy (LDSE), with a little higher proportion in men compared to women (62.6% vs 61.4%). The majority (45.9%) reported little confidence to resist high-calorie food temptations. More than half of the participants reported body dissatisfaction and LDSE, this was more frequent in men compared to women. It is necessary to develop and implement preventive measures to improve self-perception of the body, taking into account factors such as gender, age, and eating habits.

Improving the nutrition quotient and dietary self-efficacy through personalized goal setting and smartphone-based nutrition counseling among adults in their 20s and 30s

Improving the nutrition quotient and dietary self-efficacy through personalized goal setting and smartphone-based nutrition counseling among adults in their 20s and 30s

The Relationship of Psychological Well-being with a Cardiac Diet Self Efficacy in Acute Coronary Syndrome Patients

Acute Coronary Syndrome (ACS) is a cardiovascular disease that causes significant deaths in most countries. No study assessed the directly how this psychological well-being is related to Cardiac Diet Self-Efficacy (CDSE). This study aimed to identify the relationship between psychological well-being and cardiac diet self-efficacy in ACS patients after treatment. This cross-sectional study involved 150 patients at two hospitals in Jambi Province that treated heart disease, especially ACS. We used Cardiac Diet Self-Efficacy (CDSE) Scale and Psychological Well-Being questionnaire. The associations between psychological well-being a cardiac diet self-efficacy were confirmed by the Pearson Correlation test using SPSS 26.0. The correlation test showed a p-value of 0.018, indicating a relationship between psychological well-being and cardiac diet self-efficacy. Furthermore, the value of r obtained at 0.41 shows a reasonably strong relationship between psychological well-being and cardiac diet self-efficacy. Therefore, it is necessary to prepare for improving psychological well-being in ACS patients both from the discharge planning stage and post-hospital intervention so that ACS patients can have good cardiac diet self-efficacy after treatment.

Concise Scale of Eating Attitudes

The article presents the procedure for the construction of the Concise Scale of Eating Attitudes, which is intended for the study of attitudes towards nutrition in the social sciences. This novel tool is the result of research work on diagnosing eating attitudes, the source of which is an individual’s world view. The six-component structure of the scale was verified using confirmatory factor analysis (RMSEA = 0.059; CMIN/DF = 1.629; CFI = 0.929). Internal reliability of sub-scales was tested by calculating Cronbach’s Alpha coefficients: Factor 1 (anorectic attitude) - α = 0.779; Factor 2 (religious attitude) - α = 0.844; Factor 3 (vegetarian attitude) - α = 0.890; Factor 4 (hedonistic attitude) - α = 0.654; Factor 5 (orthorectic attitude) - α = 0.655; Factor 6 (experimental attitude) - α = 0.842. The result is a concise scale made up of six factors built using a total of 16 items. Criterion relevance was established on the basis of correlation with other tools measuring similar structures, including the Three-Factor Eating Questionnaire (Polish adaptation of TFEQ-13), the Eating Behaviour Questionnaire (KZZJ), the Eating Preoccupation Scale (SZJ), and the Diet Self-Efficacy Scale (Polish adaptation of DIET-SE). Satisfactory psychometric properties were obtained based on a study involving 184 adults aged 18-35 years.

Nutrition Quotient and Dietary Self-efficacy according to the Transtheoretical Model in Adolescent Athletes

PURPOSE: This study aimed to explore the direction of nutrition management and education for adolescent athletes based on the transtheoretical model (TTM).METHODS: This cross-sectional study was conducted on 205 male adolescent athletes using questionnaires in Seoul and Gyeonggi provinces. Differences in nutritional indices, dietary behaviors, and dietary self-efficacies were compared according to the stage of dietary behavior change, and significance was verified using analysis of variance and chi-square tests.RESULTS: According to the stage of change in dietary behavior, a significant difference was observed in the grade and score of the nutrition quotient (NQ), and the nutritional status and quality of meals were extremely poor in the precontemplation and contemplation groups. Dietary self-efficacy differed significantly according to the stage of change in dietary behavior. Compared to the pre-contemplation and contemplation stage groups, the action and maintenance stage groups had a higher willingness to practice desirable dietary behaviors and overcome barriers.CONCLUSIONS: In this study, we demonstrated that individualized nutritional intervention based on TTM was an effective strategy for healthy dietary behavior and had a positive impact on adolescent athletes’ sports performance. Furthermore, nutrition education should include content that enhances students’ dietary self-efficacy.

Dietary self-efficacy and social support interactions in junior athletes' acquisition of life skills.

ObjectiveAccording to the stages of change, this study identified the association between dietary control self-efficacy and social support for healthy diets as factors influencing life skills acquisition in dietary habits among adolescents in Japan.Research designThis cross-sectional study was conducted between April and May 2018 among eight high school baseball teams in Japan.MethodParticipants included 180 Japanese high school baseball players. Survey items evaluated life skills (dependent variables), self-efficacy's influence on dietary control, social support (explanatory variables), and stages of change. Hierarchical multiple regression analysis was used to reveal the associations.ResultsIn the pre-action stage, although there was no significant association between the interaction of self-efficacy and social support on total life skills (β = 0.11, p = 0.158), a significant association was observed in the action/maintenance stage (β = 0.32, p < 0.05). The interaction between self-efficacy and social support showed a significant association with goal setting in the pre-action stage (β = 0.19, p < 0.05) and with communicating in the action/maintenance stage (β = 0.34, p < 0.05).ConclusionThe acquisition of life skills amidst dietary situations can be facilitated by providing social support that considers self-efficacy in relation to dietary control, according to the stages of change.

Associations between perceived self-efficacy and oral health behaviours in adolescents.

Self-efficacy is a strong health predictor as it affects patients' certainty about their ability to perform recommended behaviours to improve their health. The aim of this study was to examine the associations between perceived self-efficacy and oral health behaviours among adolescents. A convenience sample of adolescents aged 12 to 18 years old was recruited from the University of Alberta dental clinic. Demographics, oral health behaviours, self-rated oral health and task-specific and general self-efficacy were assessed using a questionnaire with three sections. For the comparisons of outcomes across different categories, Student t-test, multivariate regression and chi-squared tests were used. A total of 252 adolescents with average (SD) age of 14 (1.7) years participated in the study; 60% were girls; 81% were born in Canada; 56% were White; and 61% had dental coverage. Demographic characteristics had no significant correlation with general self-efficacy. However, correlation coefficients indicated that younger adolescents had higher dietary self-efficacy (negative correlation), girls had higher toothbrushing and dental visit self-efficacy, and those with dental coverage had higher dental visit self-efficacy. A significant association was found between toothbrushing, dietary habits and dental visits self-efficacy (subscales of task-specific self-efficacy) and their respective outcomes (frequency of toothbrushing, sugar intake and regular dentist visits). General self-efficacy was significantly associated with frequency of toothbrushing and participant's self-rated oral health. Higher task-specific and general self-efficacy correlated with better oral health behaviours among adolescents. Therefore, behavioural interventions should be designed to enhance self-efficacy among adolescents in order to improve their oral health outcomes.

The Relationship Between Nutrition Literacy and Diet Self-Efficacy in Individuals who Have Cardiovascular Disease or Cardiovascular Risk Factors Receiving Dietary Therapy

Purpose: We aimed to determine the nutrition literacy and diet self-efficacy levels of individuals who have a cardiovascular disease or risk factors and receive dietary therapy, and to determine the effect of nutrition literacy on diet self-efficacy.&#x0D; Methods: “Nutrition Literacy Assessment Tool in Adults” and “Self-Efficacy Scale in the Regulation Nutritional Habits in Heart Patients” were used among 150 participants between November 2019 and February 2020. Participants' age, sex, place of residence, educational levels, current cardiovascular diseases and risk factors, previous cardiovascular operations, other accompanying chronic diseases, and previous dietary treatment were questioned; height, body weight, and waist circumference were measured.&#x0D; Results: A significant difference was found between the educational levels of the participants, their place of residence, and their nutrition literacy levels (p

Psychometric Properties and Effects on Health Outcomes of the Patient Assessment of Chronic Illness Care (PACIC) in Korean Hemodialysis Patients.

Background: The satisfaction of patients receiving integrated care with End-Stage Renal Disease (ESRD) is widely advocated and patients with ESRD have special health needs, but few studies have investigated whether integrated care was associated with health outcomes. Our aims were to evaluate the psychometric properties of the Korean-translated patient assessment of chronic illness care (PACIC) in patients with ESRD, and to evaluate whether PACIC evaluated by patients was associated with health outcomes. Methods: ESRD patients on hemodialysis (n = 172) at 2 dialysis centers. Data quality, internal consistency and correlation between items and scales were assessed. To test the external validity, the association between PACIC and the health behaviour and outcomes of hemodialysis patients was analyzed. Results: The mean score of the PACIC items was 3.0. The item-scale correlation (0.67–0.85) and test-retest correlation (0.72–0.82) regarding scales for internal consistency showed excellent consistency. Total PACIC score was significantly associated with dietary self-efficacy (β = 0.22) and serum potassium (Exp(B) = 1.65). Higher overall PACIC score was significantly associated with higher physical health status (β = 3.52). Conclusions: The Korean-translated PACIC questionnaire is a tool with reliability and validity. Comprehensive treatment strategies for ESRD patients may improve their health behaviors and outcomes.