Kyoungok Ju; Heeyoung So

doi:10.4040/jkan.2008.38.1.64

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Effects of the Nutrition Education Program on Self-efficacy, Diet Behavior Pattern and Cardiovascular Risk Factors for the Patients with Cardiovascular Disease: Kyoungok Ju, Heeyoung So; Journal of Korean Academy of Nursing 2008;38(1):64-73.
DOI: https://doi.org/10.4040/jkan.2008.38.1.64
Published online: February 28, 2008

¹Instructor, Department of Nursing, Chungnam National University

²Professor, Department of Nursing, Chungnam National University, Daejeon, Korea

Address reprint requests to : Ju, Kyoungok Department of Nursing, College of Medicine, Chungnam National University, 640 Daesa-dong, Jung-gu, Daejeon 301-721, Korea Tel: 82-42-580-8321 Fax: 82-42-584-8915 E-mail: jko2080@hanmail.net

• Received: June 1, 2007 • Accepted: September 18, 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

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.
Result
Group comparisons revealed that the experimental group had significantly more improved self-efficacy, frequency of food selection, gustation of salt, systolic blood pressure, and serum total-cholesterol compared to the control group.
Conclusion
A nutrition education program may be effective in improving self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease.
Keywords: Nutrition; Patient Education; Self Efficacy; Diet; Cardiovascular Disease

Table 1.

Homogeneity Test for General and Disease-Related Characteristics between the Experimental and Control Groups (N=64)

Characteristics	Frequency (%)			χ²	p
Characteristics	Total	Experimental (n=37)	Control (n=27)	χ²	p
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)

^*Multiple response.

Table 2.

Homogeneity Test for Self Efficacy, Diet Behavior Pattern and Cardiovascular Risk Factors between the Experimental and Control Groups

Variables		Experimental (n=37)	Control (n=27)	t	p
Variables		Mean (SD)	Mean (SD)	t	p
Self- efficacy		45.62 (9.28)	43.89 (10.02)	-0.713	.739
Diet behavior pattern
	Diet behavior	15.43 (2.63)	15.19 (3.05)	-0.347	.406
	Frequency of food selection	99.92 (5.29)	101.93 (6.25)	1.388	.314
	Gustation of salt (%)	0.32 (0.14)	0.29 (0.12)	-0.716	.190
Cardiovascular risk factors
	Systolic blood pressure (mmHg)	127.86 (17.55)	126.26 (16.21)	-0.373	.707
	Body mass index (kg/m²)	23.96 (2.66)	26.08 (2.56)	3.197	.772
	Body fat rate (%)	24.78 (6.24)	29.63 (5.76)	3.177	.530
	Waist circumference (cm)	84.40 (7.37)	89.36 (7.09)	2.698	.954
	Total-cholesterol (mg/dl)	194.59 (37.91)	178.97 (35.24)	-1.677	.202
	Triglyceride (mg/dl)	113.01 (42.61)	125.85 (43.50)	1.181	.901
	HDL-cholesterol (mg/dl)	49.76 (14.10)	44.44 (11.35)	-1.613	.080
	LDL-cholesterol (mg/dl)	119.54 (32.11)	111.57 (29.28)	-1.018	.327
	Glucose (mg/dl)	100.05 (15.72)	96.37 (13.63)	-0.978	.392

Table 3.

Mean Group Comparisons in Self Efficacy, Diet Behavior Pattern and Cardiovascular Risk Factors at the Posttest

Variables		Posttest scores		Mean difference		t	p
		Experimental (n=37)	Control (n=27)	Experimental (n=37)	Control (n=27)
		Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)
Self- efficacy		46.97 (9.55)	40.22 (9.80)	1.35 (8.37)	-3.67 (8.42)	-2.363	.021
Diet behavior pattern
	Diet behavior	16.32 (2.14)	15.56 (2.03)	0.89 (2.08)	0.37 (2.22)	-0.963	.339
	Frequency of food selection	101.92 (4.95)	99.56 (4.74)	2.00 (5.75)	-2.37 (5.99)	-2.950	.004
	Gustation of salt (%)	0.19 (0.13)	0.28 (0.14)	-0.13 (0.16)	-0.01 (0.15)	2.996	.004
Cardiovascular risk factors
	Systolic blood pressure (mmHg)	125.46 (15.76)	135.19 (15.91)	-2.41 (15.05)	8.93 (11.92)	3.238	.002
	Body mass index (kg/m²)	24.15 (2.58)	26.39 (2.58)	0.19 (0.66)	0.31 (0.73)	0.700	.486
	Body fat rate (%)	26.18 (5.83)	30.67 (5.71)	1.41 (1.68)	1.04 (1.78)	-0.851	.398
	Waist circumference (cm)	84.59 (7.05)	89.70 (7.67)	0.19 (3.06)	0.35 (3.92)	0.179	.858
	Total-cholesterol (mg/dl)	173.14 (30.75)	173.82 (30.64)	-21.46 (41.34)	-4.81 (22.12)	2.075	.042
	Triglyceride (mg/dl)	116.78 (57.72)	131.06 (41.04)	-9.14 (71.89)	11.78 (60.38)	1.228	.224
	HDL-cholesterol (mg/dl)	45.00 (13.07)	42.22 (9.03)	-4.76 (5.59)	-2.22 (5.12)	1.856	.068
	LDL-cholesterol (mg/dl)	106.32 (29.73)	109.74 (39.92)	-13.22 (31.56)	-5.56 (18.48)	1.127	.264
	Glucose (mg/dl)	81.11 (17.27)	83.15 (11.25)	-18.95 (22.04)	-13.22 (14.83)	1.169	.247

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Effects of the Nutrition Education Program on Self-efficacy, Diet Behavior Pattern and Cardiovascular Risk Factors for the Patients with Cardiovascular Disease

Journal of Korean Academy of Nursing. 2008;38(1):64-73. Published online February 28, 2008

DOI: https://doi.org/10.4040/jkan.2008.38.1.64

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Effects of the Nutrition Education Program on Self-efficacy, Diet Behavior Pattern and Cardiovascular Risk Factors for the Patients with Cardiovascular Disease

Characteristics	Frequency (%)			χ²	p
Characteristics	Total	Experimental (n=37)	Control (n=27)	χ²	p
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)

Variables		Experimental (n=37)	Control (n=27)	t	p
Variables		Mean (SD)	Mean (SD)	t	p
Self- efficacy		45.62 (9.28)	43.89 (10.02)	-0.713	.739
Diet behavior pattern
	Diet behavior	15.43 (2.63)	15.19 (3.05)	-0.347	.406
	Frequency of food selection	99.92 (5.29)	101.93 (6.25)	1.388	.314
	Gustation of salt (%)	0.32 (0.14)	0.29 (0.12)	-0.716	.190
Cardiovascular risk factors
	Systolic blood pressure (mmHg)	127.86 (17.55)	126.26 (16.21)	-0.373	.707
	Body mass index (kg/m²)	23.96 (2.66)	26.08 (2.56)	3.197	.772
	Body fat rate (%)	24.78 (6.24)	29.63 (5.76)	3.177	.530
	Waist circumference (cm)	84.40 (7.37)	89.36 (7.09)	2.698	.954
	Total-cholesterol (mg/dl)	194.59 (37.91)	178.97 (35.24)	-1.677	.202
	Triglyceride (mg/dl)	113.01 (42.61)	125.85 (43.50)	1.181	.901
	HDL-cholesterol (mg/dl)	49.76 (14.10)	44.44 (11.35)	-1.613	.080
	LDL-cholesterol (mg/dl)	119.54 (32.11)	111.57 (29.28)	-1.018	.327
	Glucose (mg/dl)	100.05 (15.72)	96.37 (13.63)	-0.978	.392

Variables		Posttest scores		Mean difference		t	p
		Experimental (n=37)	Control (n=27)	Experimental (n=37)	Control (n=27)
		Mean (SD)	Mean (SD)	Mean (SD)	Mean (SD)
Self- efficacy		46.97 (9.55)	40.22 (9.80)	1.35 (8.37)	-3.67 (8.42)	-2.363	.021
Diet behavior pattern
	Diet behavior	16.32 (2.14)	15.56 (2.03)	0.89 (2.08)	0.37 (2.22)	-0.963	.339
	Frequency of food selection	101.92 (4.95)	99.56 (4.74)	2.00 (5.75)	-2.37 (5.99)	-2.950	.004
	Gustation of salt (%)	0.19 (0.13)	0.28 (0.14)	-0.13 (0.16)	-0.01 (0.15)	2.996	.004
Cardiovascular risk factors
	Systolic blood pressure (mmHg)	125.46 (15.76)	135.19 (15.91)	-2.41 (15.05)	8.93 (11.92)	3.238	.002
	Body mass index (kg/m²)	24.15 (2.58)	26.39 (2.58)	0.19 (0.66)	0.31 (0.73)	0.700	.486
	Body fat rate (%)	26.18 (5.83)	30.67 (5.71)	1.41 (1.68)	1.04 (1.78)	-0.851	.398
	Waist circumference (cm)	84.59 (7.05)	89.70 (7.67)	0.19 (3.06)	0.35 (3.92)	0.179	.858
	Total-cholesterol (mg/dl)	173.14 (30.75)	173.82 (30.64)	-21.46 (41.34)	-4.81 (22.12)	2.075	.042
	Triglyceride (mg/dl)	116.78 (57.72)	131.06 (41.04)	-9.14 (71.89)	11.78 (60.38)	1.228	.224
	HDL-cholesterol (mg/dl)	45.00 (13.07)	42.22 (9.03)	-4.76 (5.59)	-2.22 (5.12)	1.856	.068
	LDL-cholesterol (mg/dl)	106.32 (29.73)	109.74 (39.92)	-13.22 (31.56)	-5.56 (18.48)	1.127	.264
	Glucose (mg/dl)	81.11 (17.27)	83.15 (11.25)	-18.95 (22.04)	-13.22 (14.83)	1.169	.247

Table 1. Homogeneity Test for General and Disease-Related Characteristics between the Experimental and Control Groups (N=64)

Multiple response.

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