Adherence to health recommendations continues to be a significant and multidimensional problem. Although self-efficacy, health beliefs and social support have been identified as significant predictors of diet adherence among cardiac patients, few studies addressed motivation and problem-solving skills as predictors of diet adherence among cardiac patients. Thus, the purpose of this secondary analysis study was to determine the relationships between perception of adherence to diet regimen, motivation and problem-solving skills in cardiac rehabilitation patients. Additionally, factors that influence the relationships between perception of adherence to diet regimen, motivation and problem-solving skills were explored, specifically, the influence of age, gender, marital status, education, depressed mood and co-morbidity.
The design of this study was descriptive cross-sectional. The Social Problem-Solving conceptual model for health behavior change (Ewart, 1990) guided this study. A sample comprised of 259 patients (161 men and 98 women) who entered a cardiac rehabilitation program and had a cardiac event was used. Consecutive subjects were recruited during the subject’s 8th week in a cardiac rehabilitation program. Data were collected using face-to-face interviews. Standardized instruments were used to measure perception of adherence to diet regimen, motivation, problem-solving skills, depressed mood and co-morbidity.
Findings indicated that motivation and problem-solving skills were significant predictors of perception of adherence to diet regimen even when controlling for the effects of age, gender, marital status, education, depressed mood and co-morbidity. Also, perception of adherence to diet regimen was negatively associated with depressed mood. Age, gender, marital status, education and co-morbidity were not predictors of perception of adherence to diet regimen. Motivation was the greatest significant predictor of perception of adherence to diet regimen (β = .26). Motivation explained 9% of the variance in perception of adherence to diet regimen, 5% of the variance in perception of adherence to diet regimen was accounted for by problem-solving skills. Study findings suggest that the use of interventions to enhance motivation and problem-solving skills among patients with cardiac events are likely to assist patients to improve their diet adherence.