Facilitators and barriers to performing dietary behaviors among chronic community-dwelling stroke survivors: A qualitative secondary analysis

Background: Following a healthy dietary pattern is recommended for secondary stroke prevention, but stroke-related impairments may hinder the performance of dietary behaviors (i.e., accessing, selecting, and preparing food). Objective: The purpose of this study was to characterize facilitators and barriers to performing dietary behaviors in stroke survivors. Methods: We completed a secondary analysis of focus group data using a qualitative descriptive approach and content analysis to examine how 15 chronic (>= 6 months) community-dwelling stroke survivors and 10 care-partners perceived dietary behavior facilitators and barriers. Results: We identified three key themes. First, changes in body functions/structures (e.g., hemiparesis, balance) result in dietary behavior activity limitations (e.g., difficulty grocery shopping, meal preparation). Second, environmental supports (e.g., care-partners, adaptive equipment) and activity modification (e.g., using pre-cut foods, dining out) are used to overcome dietary behavior limitations. Third, negative affect (e.g., dissatisfaction, frustration) and activity limitations lead to participation limitations (e.g., not being able to perform dietary behaviors independently, not being able to socialize when dining out). Conclusions: Dietary behaviors are negatively impacted following stroke, but environmental supports and compensatory strategies may be implemented to overcome activity limitations. More research is needed to develop interventions to facilitate dietary behaviors and participation following stroke. (C) 2022 Elsevier Inc. All rights reserved.