Knowledge, attitudes and practice on dietary management among patients with Coronary Heart Disease attending cardiac clinic at Teaching Hospital Batticaloa, Sri Lanka.

Abstract

Coronary heart disease (CHD) is the major contributor for cardiac-associated morbidity and mortality worldwide, as well as in Sri Lanka. Diet plays major role in the secondary prevention of CHD. Nutrition-related knowledge and attitude are necessary for dietary changes towards a healthier dietary pattern. However, many patients with CHD do not have adequate knowledge regarding diet, which facilitates poor outcomes in attitude and practice in Sri Lanka. The objective is to assess knowledge level, attitudes and practice on dietary management among patients with CHD attending cardiac clinic at Teaching hospital Batticaloa, Sri Lanka. A descriptive cross-sectional study was conducted by recruiting 350 patients with CHD attended cardiac clinic at teaching hospital Batticaloa using simple random sampling from October 2022 to December 2023. Validated interviewer-administered questionnaire was used to collect data on socio-demographic and clinical characteristics and information on knowledge, attitude and practice on dietary management. Statistical package for social sciences version 25 (SPSS 25) was used for analysing the data based on the objectives. Majority of the participants were male (69.1%), Tamil (68.9%), married (81.4%), lived in urban area (68.9%), non-vegetarian (97.1%), consumed food from home (88.9%), aged between 60 to 75 years (54.9%), and received information on diet from healthcare professionals (87.1%). Around one-third of the participants had senior secondary education (39.7%), unemployed (34.6%), had monthly family income less than LKR 15, 000 (33.7%) and diagnosed as CHD with the duration of one to five years (38.3%). Regarding clinical characteristics, around half of the participants had ST-elevation myocardial infarction (49.7%) while one-fifth (22.3%) had combination of hypertension, diabetes mellitus and dyslipidemia. Around two-third of the participants had average knowledge (58.9%), negative attitudes (63.1%), and negative practice (64.3%) on dietary management. The findings showed that there was a relationship between level of knowledge on dietary management and residence (p=0.03), educational level (p=0.001), occupation (p=0.02), and family monthly income (p=0.001). Relationship between attitudes towards dietary management and gender (p=0.005), educational level (p=0.005), occupation (p=0.02), family monthly income (p=0.02), comorbidities (p=0.03), and type of diet (p=0.03). Practice on dietary management associated with residence (p=0.03), occupation (p=0.02), and comorbidities (p=0.001) of participants. In conclusion, study participants had average knowledge, negative attitudes and practices toward dietary management. These results highlight the need for targeted interventions to improve knowledge, attitudes, and practices regarding dietary management in this study population.