Adherence to dietary plan and associated factors among patients undergoing mechanical valve replacement at Jakaya Kikwete Cardiac Institute

Abstract

ABSTRACT Background: Dietary plan adherence to patient with mechanical valve replacement remains an integral part of the proper functioning of the new valves and the maintenance of patient’s hemodynamics in general. Several factors including patient-level factors, disease factors, and sociodemographic factors are linked with patient’s adherence to the dietary plan. Complications associated with non-compliance to the dietary recommendations post heart-valves replacement can be severe and life threatening. Objectives: This study aimed to determine the level and factors associated with adherence to dietary plan among patients who underwent mechanical valve replacement at Jakaya Kikwete Cardiac Institute Dar es Salaam, Tanzania. Methodology: Cross-sectional study design with quantitative approach was used in this study. The study involved 334 patients with heart-valves replacement in the surgical ward and outpatient clinic at JKCI. Patients were selected by using systematic random sampling technique. Every study participant was interviewed by using interviewer-administered questionnaire to obtain data. Measures such as mean, standard deviation, proportions and regression analysis were used to analyze the data. Results: About 120 (35.9%) of the respondent were middle-aged (24–44 years old). Two third of the respondents were female 194(58.1%) and 145(43.4%) had primary school education. Furthermore,198 (59.3%) of the respondents were married and the mean weight of the respondents were 66 kg. The majority of the respondents had high adherence to the recommended dietary plan 267 (79.9%) and high awareness of vitamin K rich food and fruits 256 (77.5%). The presence of chronic illness and the unavailability of suitable dietary needs for patients with mechanical valves around the hospital were main challenges facing respondents in following dietary plan as prescribed, 149(50.3%) and 148(50.0%) respectively. Marital status and having insurance were the predictors of the level of adherence to the dietary plan with 95%CI: 1.414-4.213, P=0.001 and 95%CI:4.54-15.79, P=0.001 respectively. Additionally, Knowledge on vitamin K rich food and fruits and who they received the counselling from had association with adherence to the dietary plan, 95%CI 0.005-0.030, P=0.001 and 95%CI 0.001-0.017, P=0.001 respectively. Conclusions and recommendations: Study found that patients’ adherence to the recommended dietary plan was high. Marital status, having health insurance, knowledge on vitamin K rich food and fruits and health care provider who counsel the patients were significantly associated with level of adherence. Institutional policy advocacy is essential to help availability of suitable diet for in-patients, and multidisciplinary approach in planning individualized dietary plan is needed. Further research, particularly longitudinal studies, can provide deeper insights in monitoring changes in dietary adherence over a period of time and better understanding of causative factors.