A qualitative study of cardiac rehabilitation patients' perspectives on making dietary changes

Background: Making healthier food choices is recognised as being important in the secondary prevention of coronary heart disease (CHD) and the provision of information about making dietary changes should be included in cardiac rehabilitation (CR), a secondary prevention strategy. Studies indicate that patients do not always make the recommended dietary changes, although research on CR patients' perspectives on dietary change appears to be limited. The present study aimed to explore CR patients' perspectives on making and maintaining dietary changes. Methods: Following ethical approval, in-depth, audiotaped, qualitative interviews were conducted with 15 post-myocardial infarction CR patients (11 men and four women) who had completed a hospital-based CR programme. Participants comprised White British individuals aged 42-65 years, from a variety of socioeconomic backgrounds. Interview topics included perspectives on CHD and lifestyle changes, including diet. Follow-up interviews with 10 patients, conducted approximately 9 months later, explored whether their perspectives had changed. Results: Patients tended to only make and maintain dietary changes if they perceived their diet to be a cause of their CHD. The only dietary changes patients reported involved 'cutting things out' of their diet; patients did not make dietary changes if they considered that they did not need to 'cut things out'. Conclusions: These findings suggest that, despite receiving information about eating a balanced diet, CR patients may perceive dietary change in terms of whether or not they need to 'cut things out' of their diet. Greater emphasis may be needed in dietary information on increasing the proportion of healthy foods consumed and choosing healthier alternatives.