Understanding dietary decision‐making in patients attending a secondary prevention clinic following myocardial infarction

Aims and objectives. This study aimed to explore the issues that influence the dietary choices made by patients attending a secondary prevention clinic following a myocardial infarction. Background. Secondary prevention clinics play an important role in promoting dietary advice, yet evidence suggests that many individuals are neither implementing nor maintaining the lifestyle changes recommended. Research largely focuses on compliance to lifestyle changes in general, and only a small number of quantitative studies address the issues surrounding adherence to dietary advice. Design. Phenomenology was selected as the most appropriate approach for this qualitative study, enabling patients’ lived experiences of dietary decision‐making to be explored. Method. A purposive sample of nine participants was selected from a cardiac secondary prevention clinic. Semi‐structured interviews were taped, transcribed and analysed using an interpretative approach. Results. Data analysis produced six central themes contributing to patients’ decision‐making. Fear, determination and self‐control were enabling factors and poor recall of information, a need for additional support and a lack of will power were disabling factors. Findings suggest that patient motivation and ability to make sustainable dietary change can decline as disabling factors reduce determination and self‐control, and initial fear of their heart condition subsides. Conclusion. In this study, patients’ motivation regarding dietary decision‐making changed over time and was strongly influenced by a fear of future heart problems. Relevance to clinical practice. Health care professionals need to understand the temporal nature of decision‐making postmyocardial infarction and adopt a wide repertoire of responsive strategies that support patients to follow a healthy diet in the longer term.