Document Type : Original Article

Authors

1 Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of health education and promotion, School of health, Isfahan University of Medical Sciences, Isfahan, Iran

3 Instructor, Department of Epidemiology and Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran

4 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

INTRODUCTION: Dietary modification significantly impacts reducing myocardial infarction (MI) mortality and its recurrence. This study aimed to investigate the effect of education on the dietary intake of patients with MI based on the health belief model.
METHOD: This quasi-experimental study was conducted on patients with MI from October 2021 to January 2022. A total of 72 MI cases were randomly divided into intervention and control groups. The intervention group received an educational intervention based on the health belief model for three months in four sessions. The structures of the health belief model were measured using a questionnaire before the intervention and one and three months following it. Dietary intake was measured with a three-day dietary record before and after three months of the intervention.
RESULTS: After the educational intervention, a significant difference was observed between the two groups in terms of the average scores of awareness, perceived susceptibility, perceived severity, perceived benefits, and self-efficacy (P<0.01). However, no significant difference was observed concerning the perceived obstacles. Although there were no significant differences between dietary intake at the baseline, the intake of energy, cholesterol, and energy percent from carbohydrate, total fat, and saturated fatty acids were lower, and fiber intake was higher in the intervention group versus the control group after the intervention (all P<0.05).
CONCLUSION: Given the positive effect of the health belief model in this study, it is suggested to use this model for designing education for MI patients focusing on nutrition.
 

Keywords

1. GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388(10053): 1459-544. https://doi.org/10.1016/s0140-6736(16)31012-1
2. Naghavi M, Shahraz S, Sepanlou SG, Dicker D, Naghavi P, Pourmalek F, et al. Health transition in Iran toward chronic diseases based on results of Global Burden of Disease 2010. Arch Iran Med 2014; 17(5): 321-35.
3. Malakar AK, Choudhury D, Halder B, Paul P, Uddin A, Chakraborty S. A review on coronary artery disease, its risk factors, and therapeutics. J Cell Physiol 2019; 234(10): 16812-23. https://doi.org/10.1002/jcp.28350
4 Anderson JL, Morrow DA. Acute myocardial infarction. N Engl J Med 2017; 376(21): 2053-64. https://doi.org/10.1056/NEJMra1606915
5. Taherinia, Ebrahim Pourian, Laden, Mohsenzadeh, Yazdan. The effect of education on knowledge and activity of patients with myocardial infarction: a health belief model. Alborz Univ Med Sci 2013; 2(1): 33-8. https://doi.org/10.18869/acadpub.aums.2.1.33
6. Goong H, Ryu S, Xu L. A structural model of health behavior modification among patients with cardiovascular disease. Appl Nurs Res 2016; 29: 70-5.https://doi.org/10.1016/j.apnr.2015.06.005
7. Khani Jeihooni A, Jormand H, Saadat N, Hatami M, Abdul Manaf R, Afzali Harsini P. The application of the theory of planned behavior to nutritional behaviors related to cardiovascular disease among the women. BMC Cardiovasc Disord 2021; 21(1): 589.https://doi.org/10.1186/s12872-021-02399-3
8. Ghasemnejad N., Mirmiran P., Asghari G., Azizi F. Is Hdl-C Associated with Nutritional Factors and Anthropometric Indices in Overweight Individuals with Low Hdl-C Level. Iran J Endocrinol Metab 2012; 14(6): 548-55. 
9. Maslakpak MH, Merghati SZ, Didarloo A. Effectiveness of an Educational Intervention (Based on ‎‎BASNEF Model) on lifestyle of patients with heart failure. Payesh (Health Monit) 2017; 16(4): 501-10.
10. Shakiba E, Shahabadi S, Hazavehei MM, Saeidi MR, Marzbani B, Bashiriyan S, et al., Efficacy of transtheoretical model on preventive nutritional behaviors of cardiovascular diseases: A randomized controlled trial. J Mazandaran Univ Med Sci 2018; 28(163): 24-37.
11. Hazavehei SMM, Pirzadeh A, Entezari MH, Hasanzadeh A. The effect of educational program based on BASNEF model on the nutritional behavior of students. Zahedan J Res Med Sci 2010; 13(1): 23-9.
12. Zighaimat F, Ebadi A, Karimi-Zarchi AA, Moradi N, Hajiamini Z, Mehdizadeh S. The effect of education based on health belief model on dietary behavior of Coronary Artery Bypass Graft patients. Iran J Nurs 2010; 23(65): 50-60.
13. Eqbali Ziyarat R, Ghiasvandian S, Zakeri Moghadam M, Kazemnejad A. Effect of Nutrition Counseling on Nutritional Behavior of Patients with Myocardial Infarction. J Ardabil Univ Med Sci 2018; 17(4): 447-55.
14. Ebrahimi Pourian L, Salehi SH, Pourmirza Kalhori R, Abdyazdan GHR, Sharifi A. Assessing the effect of Health Belief Model application on behavior change of the patients with Myocardial Infarction. Iran J Crit Care Nurs 2013; 6(2): 101-8. 
15. Dadkhah Tehrani B, Reza Tavakoli R, Jazayeri SA. The Effect of an Educational Intervention Based on Health Belief Model on Nutritional Behaviors in Type 2 Diabetics. Mil Caring Sci 2018; 5(4): 299-307.https://doi.org/10.29252/mcs.5.4.303
16. Rafiei M, Rostami A, Tavakoli A, Ghiasi M. Principles of nutritional training and counseling for patients in group training sessions based on behavioral change theory. Iran J Med Educ 2010; 10(1): 92-100.
17. Tavassoli E, Reisi M, Javadzade SH, Gharlipour Z, Gilasi HR, Ashrafi Hafez A. The effect of ‎‎education on improvement of intake of fruits and vegetables aiming at preventing cardiovascular diseases. Med J Islam Repub Iran 2015; 29: 183. 
18. Abood DA, Black DR, Feral D. Nutrition education worksite intervention for university staff: application of the health belief model. J Nutr Educ Behav 2003; 35(5): 260-7. https://doi.org/10.1016/S1499-4046(06)60057-2
19. Kalka D, Sobieszczañska M, Kopka L, Marciniak W, Zawadzka Bartczak E, Bak A, et al. Effect of long-term cardiac training on lipids concentration in patients with chronic heart ischemic disease treated with simvastatin. Pol Merkur Lekarski 2007; 22(128): 101-6.
20. Khorsandi M, Fekrizadeh Z, Roozbahani N. Investigation of the effect of education based on the health belief model on the adoption of hypertension-controlling behaviors in the elderly. Clin Interv Aging 2017; 12: 233. https://doi.org/10.2147/CIA.S117142
21. Jalili Z, Maghoul S, Farmanbar R. Assessment of the Effect of Educational InterventionBased on Health Belief Model on Nutritional Behavior of Patients with Myocardial Infarction. J Guilan Univ Med Sci 2018; 27(107): 54-60. 
22. Rafiei M, Boshtam M, Marandi A, Jalali A, Vakili R. The Iranian Food Consumption Program (IFCP), A unique nutritional software in Iran. Iran J Public Health 2002; 31(3-4): 105-7. 
23. Dorostimotlagh A, Tabatabaei M. Food Consumption Table. Iran: Nutrition World Publisher. 2007.
24. Ghaffarpour M, Houshyarrad A, Kianfar H. Food Album. Iran: Natl Nutr Food Technol Res Inst 2006.
25. Mohammadi N, Soltani N, Amini R, Tapak L. The Effect of Education Based on Health Belief Model on Preventive Behaviors Towards Cardiovascular Disease. Sci J Hamadan Nurs Midwifery Fac 2018; 26(4): 227-36. https://doi.org/10.30699/sjhnmf.26.4.237
26. ahmati-Najarkolaei F, Tavafian SS, Gholami Fesharaki M, Jafari MR. Factors predicting nutrition and physical activity behaviors due to cardiovascular disease in ‎tehran university students: application of health belief model. Iran Red Crescent Med J 2015; 17(3): e18879.https://doi.org/10.5812/ircmj.18879
27. Baghianimoghadam MH, Shogafard G, Sanati HR, Baghianimoghadam B, Mazloomy SS, Askarshahi M. Application of the health belief model in promotion of self-care in heart failure patients. Acta Med Iran 2013; 51(1): 52-8. https://doi.org/10.4103/2277-9531.99216
28. Mortazavi Forough Al Sadat, Koshki Akram, Arash Akbari. Investigating the relationship between diet and pregnancy blood pressure.
29. Sasanfar B, Toorang F, Rostami S, Yeganeh MZ, Ghazi ML, Seyyedsalehi MS, et al., The effect of nutrition education for cancer prevention based on health belief model on ‎nutrition knowledge, attitude, and practice of Iranian women. BMC Womens Health 2022; 22(1): 1-9. https://doi.org/10.1186/s12905-022-01802-1
30. Rezaei N, Tahbaz F, Kimiagar M, Alavi Majed H. Investigating the effect of nutrition education on biochemical parameters, nutritional status and awareness, attitude and performance of patients with type 1 diabetes. Iran J Diabetes Metab 2006; 5(3): 244-56.